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Podcast Transcript: Dr. Roger Glass

Dr. Glass speaking in front of the exhibition at the opening

Elizabeth Cohen: Good morning and welcome. My name is Elizabeth Cohen and I am a medical correspondent with CNN Television and I am proud and honored to be the MC of this event today. I've read so much about the work that people in the audience have done and people whose stories are told in the exhibit and I am in awe of the incredible work that all of you have done. And when I was in public health school, more years ago than I care to remember, some of you young ones may have been little children when I was there, we heard stories about people who had done incredible work all over the world to promote public health, and now to be in this room with so many of you is truly an honor.

Elizabeth Cohen: And now I would like to introduce Dr. Roger Glass. Dr. Glass is the director of the Fogarty International Center at the National Institutes of Health. This group has been a leader in promoting and funding international public health research. Dr. Glass.

Dr. Roger Glass: Thank you, Elizabeth. I have a teenage son who's 17, and when I told him I was going to talk to a group of high school students today he said, "Dad, what are you going to tell them?" And after this movie I don't know really where to begin.

Dr. Roger Glass: I really started my career in medicine not knowing exactly what I wanted to do but knowing I wanted to make a difference. And after my training I ended up going to Bangladesh, one of the poorest countries of the world to see what I could do to prevent cholera which is the most fatal and rapidly fatal of all diarrheal diseases. You know, have any of you had diarrhea? (Laughter) You have, OK; I see one or two hands back there. Well, in fact, this is one of the most common diseases in the world. Every kid gets it. Every adult gets about an episode a year and Cholera's the worst. And Cholera, you can lose a liter or a quart of water an hour and this can continue for 12 hours, and in 12 hours if you lost ten percent of your body weight, you die.

Dr. Roger Glass: And so I was out to see what we could do to make a vaccine or prevent death from Cholera in Bangladesh which is the home of Cholera. And in the course of three and a half years, and I went out as naïve as all of you are not knowing, never having seen a case, not knowing what it was, I really learned a lot. I mean I went into people's houses who had children with severe diarrheal disease, and where children died, and it's the number one cause of death of children in Bangladesh. And you know you think about the US at the turn of the century, our life expectancy was about 40 years. Now you certainly know a lot of people who are older than 40 years and if you think back at the turn of the century many of them would not be alive today. Now as we go into the 21st century, our life expectancy in the United States is 75 years. So we've conquered a lot of those childhood diseases like diarrhea and we're thinking about other diseases.

Dr. Roger Glass: Well, there I was in Bangladesh, kids dying from diarrheal diseases, and the question was what could we do about it, how could we prevent this. And you'll see in this exhibit tomorrow some very basic research done by Americans working in Bangladesh with Bangladeshi scientists to address this rapid flow of diarrheal illness. I mean, it's the least sexy of all diseases, but it's the one that kills. And what these scientists found was that as rapidly as you have diarrheal diseases, you can rehydrate yourself by taking a fluid solution of salt and water, a simple solution, and they went out and they did a clinical trial, and it was a very dangerous trial, because if the oral treatment did not work a patient might die. And so the investigators had ethical clearance, they were very careful to watch patients 24 hours a day. And in the course of the summer they were able to demonstrate that instead of giving intravenous fluids to patients to resuscitate them, fluids that are expensive and hard to reach in far off communities, they could give these same patients this simple solution of fluid of electrolytes of salt and water and bring them back to life.

Dr. Roger Glass: And so, I could not believe this would actually work and as I was in Bangladesh in the field, I went to a clinic in the middle of a cholera epidemic, where there were about a couple of dozen patients with severe dehydrating disease and there were two kids, eighteen years of age, who had minimal experience, minimal education but knew how to rehydrate patients. And in the course of a couple of hours, these two eighteen-year-olds resuscitated a couple dozen patients. And I scratched my head and I said, in my medical career I've never resuscitated a couple dozen patients in a day and brought them back to life. I said these two little kids here, these eighteen-year-old who knew how to give oral rehydration therapy, and intravenous, made a difference. And I was incredibly proud of these kids because it was something that I, they were doing better in their little careers as physician assistants as I had done in my own career as a well-trained doctor. So I realized that kids have an opportunity to make a difference and it's an amazing opportunity.

Dr. Roger Glass: The second idea that I learned, that I took home from this experience was that knowledge is really the key to success. And it was through a combination of science, of understanding, that you could actually rehydrate someone who was terribly dehydrated that you could, you could save them. And since that I've had that experience I realized that cholera was not the only diarrhea disease in Bangladesh, I took off to do work on rotavirus, another very common, the most common cause of severe disease in children. And over the last 25 years, we've worked to identify the burden of this disease. It's about half of all the children hospitalized for diarrhea have rotavirus now. We've gone on to develop vaccines and we've seen these vaccines last year incorporated into routine immunization of children. What this means for you is that while you kids in the audience all had rotavirus as children, that your children will not have the most severe diarrheal disease today. And some of the experience and the knowledge we learned, we learned from working in Bangladesh and seeing what we could do for cholera and now what we can do for rotavirus. Furthermore, and you'll see in the exhibit, every American mother, when she has a child with a diarrheal illness gives that child oral rehydration therapy. Where did that therapy come from? Well it came from those studies of those severely ill patients in Bangladesh. A treatment that was developed for Cholera but now is used a million, millions of times a year in the United States to take care of you and your little brothers and sisters.

Dr. Roger Glass: So we've learned a lot from global health and I think we have a lot more to learn. Well, I don't want to say more, 'cuz you'll see the exhibit, but I want, I just want to leave you with a few ideas. One is that each of you can make a difference. And the second is that knowledge and the understanding that you build up in your education will really brace you for the rest of your life. And third is that serendipity, the unexpected often happens. You know, when I look back, I've been working on diarrheal diseases for 25, 30 years, if you had told me 30 years ago that I would work on diarrheal diseases, and I say this to my son and he says, "Oh Dad, go on" or "Don't talk about this," I never would have, I never would have started out. But having gotten into it further and further and realized that we could actually prevent over a million deaths a year from severe diarrheal illnesses with oral therapy, which is used today, a million deaths a year, can you imagine that? And we could prevent a half a million deaths a year from rotavirus with a vaccine, that I'm actually excited now to see vaccines for this new diarrheal disease go out into the world and stop what turns out to be one of the most common causes of mortality and death in small children.

Dr. Roger Glass: So with that, with that little experience I've come back to be director of Fogarty. And at Fogarty we're one of the institutes of NIH that works and trains for training and research in global health. And that experience to me says that the most important thing we can do at Fogarty is what I call early childhood education. Do you know what early childhood education is? It's really getting people early in their careers, people just like you, to go out into the world and find problems that you think you'd like to solve. And then give you the experience to go out and address these and show that you have the confidence to make a difference. Later in this program you're going to see people, people your own age who have done just this. And I'm just an old guy, who started this 30 years ago and have aged in the process. So, my son would say, "Now, Dad, sit down now, you've given the message." And I'm going to sit down, but I think those are the messages I'd like to leave for you. You're all here today you'll see the exhibit but don't shy away from stepping to the plate and trying to do something wonderful. The health field provides incredible opportunities to grow throughout your life, to get involved in science, to learn as you go and to feel incredibly proud that what you do can actually have a major impact on the health of others and the happiness of others. Thanks very much.


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