Husband and Wife Team Committed to Global Health

Husband and wife team Koji Nakashima MD, a BWH hospitalist and Erin George, RN, MSN, CNM, a member of the BWH Nurse Midwifery Service, have a storied history of working in Haiti in partnership with Partners In Health (PIH). “We firmly believe that we need to level that playing field for people,” says Nakashima, specifically in the areas of access to food, clean water, and housing.

Nakashima was raised in southern California where his family instilled the value of service to others. “Many people believe that there is this true American dream that if you work hard you can get wherever you want,” says Nakashima. “But there are other people like myself who think that everyone does not start off on the same level playing field.”

This philosophy inspired Nakashima to engage with Paul Farmer, MD, MPH, chair of BWH’s Division of Global Health Equity and become part of the PIH family. Nakashima completed his training in the Global Health Equity residency program, which offers a combined approach of service at BWH and PIH in Haiti. He discussed the importance of not just building health systems, but thinking more broadly about global health equity and addressing the social determinants of health.

Nakashima described the importance of women in the Haitian community and the value of employment in addressing complex issues such as HIV prevention. He shared how offering women jobs addresses HIV prevention by making women less vulnerable and allowing them to gain power in their communities.  As global health experts, both Nakashim and George discussed the important issues related to the inextricable link of women’s and children’s health and human rights.

George, who is a native Bostonian, learned about Haiti and its rich culture through a childhood spent with friends of Haitian descent. She always knew she would give back to the community, but didn’t realize that she would one day be part of PIH in Haiti. George became passionate about pursuing a career in nursing and completed a second baccalaureate degree at the MGH Institute of Health Professions, including a culminating clinical practicum in Haiti with a Haitian nurse preceptor, Naomi Marcelin, RN, who is an expert in pediatric nursing and with whom she maintains an ongoing professional relationship.

Subsequently, George pursued a Master of Science in Nursing degree with a focus on nurse midwifery at the Yale School of Nursing. Because of her talent and expertise, George was selected for a prestigious Yale Law School Gruber Fellowship to continue her work in Haiti with PIH. Upon completion of this fellowship, George became a member of the BWH Center for Women and Newborns Nurse Midwifery Service, where she practices in both the inpatient and ambulatory settings.

George developed a manuscript in collaboration with Marcelin and Dr. Patrice Nicholas from the BWH Center for Nursing Excellence called “Orphans and At-Risk Children in Haiti: Vulnerabilities and Human Rights Issues Post-Earthquake.” Published in the journal Advances in Nursing Science, the manuscript addresses the complex issues faced by children in Haiti.

Because of poverty, children may be relinquished by their families to other families that may be viewed as less affected by poverty—all in the hope that the children’s lives will improve. However, these children may be required to serve the household, missing crucial opportunities for education and full engagement with society. The United Nations has addressed this problem as a contemporary form of slavery.

The husband and wife team also shared their wisdom on avoiding cynicism—which can be fatal to improving the lives of the world’s people. Nakashima cautioned, “Do not fall into cynicism; be part of the solution, not the problem.”

George also addressed the importance of including our local community as part of the broader global health picture, since many local community members struggle with some of the same complex issues that are evident in global locations. From her perspective, “There is need everywhere and it is important to plug in whenever you can.”