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sk Dr. Martha Collins, MPH'72, what keeps her connected to Tanzania more than 30 years after her first visit, and her answer is simple: "there's always something to do. someone who needs treating. someone who needs help."

Finding something to do has never been a problem for Collins, whose career in public health has ranged from missionary to regional leprosy officer to pediatrician to psychiatrist. In each of these roles--and her newest as founder of a non-profit agency focusing on children's physical and psychological health--one thing remains constant: her commitment to the children of Tanzania.

Having first visited Tanzania with the Medical Missionaries of Mary in 1967, Collins discovered her love for the east African country with a strong sense of community and need for medical services. "Although I'd often find myself the only white person in many groups, I've never felt more a part of the community," says Collins. "Whatever talents you have, you absolutely can put them to use. It's a place where you can stretch on behalf of others. I was drawn to the children."

Collins's work in Tanzania has included both direct interaction with patients--treating children with diarrhea and other common diseases as medical officer in charge of Dareda Hospital--as well as teaching public health to others. She collaborated with the Ministry of Health of Tanzania to train regional and local aides in the treatment of malaria, leprosy, tuberculosis, and diarrhea at the village level. While lecturing at the medical school at the University of Dar es Salaam, Collins discovered one area where much work remained to be done: pediatric psychiatry.

"When I was in medical school, psychiatry didn't make much sense to me. It was a lot of terms," Collins recalls. But within the context of her pediatric practice in Tanzania, the need for treating epilepsy, autism, and other of these conditions made perfect sense. Collins had firsthand knowledge of children who had been severely injured and burned as a result of epileptic seizures. As she explains it, the primitive living conditions found in Tanzania prove especially dangerous for children with these conditions. Children suffering seizures frequently injure themselves by falling on hard stone floors. The visual stimulation of open fires used for cooking may actually bring on seizures, with tragic results.

With those images fresh in her mind, Collins made the trip back to Boston to begin a clinical fellowship in child and adolescent psychiatry at Children's Hospital. Upon returning to Tanzania, she found the need to do battle not only with the medical needs of her patients, but with cultural stigmas and misunderstanding surrounding their conditions. "Epilepsy is considered a curse on your father or a curse from the devil," says Collins. "It can be very isolating and unjust for the people who have to suffer with it." At school, classmates would be unwilling to play with children with epilepsy and were particularly afraid if they witnessed a seizure. Autism and other illnesses, while not so stigmatized, were not well understood.

The unmet medical and educational needs of children with neuropsychiatric conditions led Collins to form a pair of organizations for parents of children with epilepsy and autism. "Parents are the ones who treat, who advocate, and find resources for their children," notes Collins. "That's why working with parents was both so relevant and so rewarding." In a country where even the least expensive medications to control these conditions are too expensive for most families, the problems faced by parents are as tangible as locating affordable medicine and as complex as educating the community about illness.

The organizations Collins founded in Tanzania are doing both. The Parents Organization for Children with Epilepsy Tanzania (POCET) is a parent-run organization that helps acquire affordable medication and sell it to members at cost. It also provides support for the parents and caregivers of children with epilepsy, and reaches out to primary school students to teach them about the real causes and treatment of the disorder. The National Association of Parents of Children with Autism Tanzania is a similar parent-run group that focuses on developing educational services for autistic children. One such program, a special classroom at the Msimbizi Mseto Primary School, serves as a focal point for Collins's newest project, OMPACO--the Organization for Medical and Psychological Assistance for Children Overseas.

Having yet again returned to the Boston area from Tanzania a few years ago, Collins, together with several colleagues, began making plans for a non-profit organization that would replicate the models used in Tanzania to serve the medical and psychological needs of children in all parts of the world. "We’re really looking to facilitate and coordinate programs in the spirit of the ones in Tanzania," she asserts. This effort may include setting up programs to buy affordable medical supplies and medicine, or connecting overseas programs with pediatricians, speech therapists, and other professionals who can support their work.

Although OMPACO is still just getting on its feet (Collins points to its mission statement and new bank account as examples of how it is progressing), the group has already had its first successes. Following a research visit by Collins and her colleagues Dr. Susan Folstein and Ray Mankoski to the Autism Unit at the Dar es Salaam Primary School, the research team shared stories of their experience and photographs of the students and the classroom with other members of the OMPACO board. OMPACO Secretary Deborah Arin “got very fired up” by the photos and began a project to locate computers and special language learning programs for children with autism. In addition to acquiring and shipping the computers and programs (a very expensive process), the organization also located educational toys and was even able to provide financial support to train a teacher in using the new hardware and software.

Her career has seen her take many trips back and forth between Tanzania and Boston, where she is currently an instructor in psychiatry at Tufts University School of Medicine and a child, adolescent and adult psychiatrist at Tufts-New England Medical Center. One of Collins's favorite times in the U.S. was her stint at the Harvard School of Public Health. "I loved my time there. I'd been in the bush for five years, so it took a few months for me to retain things," she laughs. Not surprisingly, Collins's most lasting connections from School are the ones she made with other doctors who shared her experience in developing countries--both as practitioners and as natives. "I considered myself one of the foreign doctors. I had actually come from Tanzania to learn public health so I could return to Tanzania. It was very interesting to exchange stories and ideas." Collins shares her knowledge with the next generation of HSPH students, formerly as a member of the School's Alumni Council and currently as a mentor to two students with whom she meets to discuss their experiences. As someone who always knows when there's work to be done, Collins laughs when admitting that she owes the students another get-together. There's little doubt that she'll make it happen.

Michael Floreak

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