Doctor's Diary: Dr. Bill Frist's Notes and Thoughts From Africa

Dr. Bill Frist, the former U.S. Senate majority leader, is an accomplished heart and lung transplant surgeon who trained at Stanford University and was among those who pioneered heart transplants. A Tennessean, Dr. Frist opened the first transplant center in the South at Vanderbilt University. In 1994 he left medicine and was elected to the U.S. Senate. He promised to serve only two terms, so at the end of last year, after 12 years, Dr. Frist retired.

During the four years that he was majority leader, Dr. Frist continued his practice of going to Africa on medical missions, and he began to see that the power of healing can go a long way to improving America's reputation in the world and, more importantly, providing peace and stability in the region.

Dr. Frist is back in Africa, traveling with his wife, Karyn, and Franklin Graham, the president of Samaritan's Purse, and is blogging for His first blog entry follows.

Feb. 3: Preparing for the Trip

The alarm went off at 3 a.m., and Karyn and I got up to finish packing. I've learned from experience — we don't need to take much. I had been up until about 2 trying to get Karyn's new iPod downloaded with all of the boys' music and audiobooks.

Seventeen hours on the airplane to get there and another 40 hours flying in bush planes over the next month will leave plenty of time to be listening to the downloads. Though I'm not sure Karyn will enjoy the downloads of the boys' rap music. It took me a while, because I made the mistake of ordering the first season of "24" and didn't realize that just the download would take several hours.

Click here to view photos of Dr. Frist during his mission to Africa.

We left home at 3:50 and got a call along the way from Franklin Graham, who just wanted to make sure we would show up on time at the right place — for a 5 a.m. departure.

After a quick de-icing of the plane we were off for a refueling stop in Canada and then on to Berlin, then Luxor and finally Kampala, Uganda.

Reflections Ahead of a Long Journey

This trip will be a bit different than others in several regards. First and most importantly, I will be with Karyn.

Although she has been to Africa on a number of occasions and has visited eight countries there, this is the first time that she has gone on a trip solely aimed at humanitarian purposes — from watching me do surgery at mission hospitals, to interacting with the women who suffer so greatly in Darfur, to visiting the displacement camps where 10-year-olds who have been trained to kill are being rehabilitated.

In the past each year, I have taken my sons, one at a time, but this is a first for Karyn.

Also with us is Dick Furman, a close friend who along with Franklin founded World Medical Mission 25 years ago. Dick had done his general and thoracic surgical residency with my brother Bobby in Kentucky. That is how we met.

Franklin Graham runs Samaritan's Purse, which is the international relief organization that does so much good in so many ways around the world, a division of which is World Medical Mission. World Medical Mission places about 400 doctors in 26 countries on short mission trips each year.

Franklin and I have been good friends over the years, our parents and families having known each other, and have traveled to Sudan together on medical mission trips in the past.

Click here to visit the Samaritan's Purse Web site.

We have found that the serendipitous presentation of events as our journey unfolds often leads to the most exciting opportunities to do good (like the time a chance meeting in 1999 in the lobby of Hotel Serena in Nairobi with the ill governor of Nuba Mountains led to us going a few days later to Nuba, thereby accelerating the opening up of that region to future international relief).

What to expect? We will see poverty, devastation, suffering, disease, sorrow, hopelessness. But we will see also volunteers, compassion in action, an optimistic people, dreams and hopes. We will see good-intentioned programs that are badly missing the mark, and we will see entrepreneurial programs that open up all sorts of possibilities.

I'm going to do my best to be open to new ideas, to be keenly observant, to discern how we can bring peace and health to the peoples and countries we visit.

A couple of things I am really excited about. Three years ago I created a foundation called World of Hope. Through the generosity of others, we raised several million dollars in a short period of time and contributed a half a million dollars to The AIDS Support Organization (TASO), a respected non-profit organization in Uganda whose purpose is to fight HIV.

Why had I chosen TASO? What was that money used for? I was on a medical trip five years ago and passed through Kampala. I stopped by TASO and saw first-hand how effective their programs were. That visit had opened my eyes to their program and their success. I visited, I touched and I felt.

So when I decided to start the WOH foundation, I knew they should be one of the early beneficiaries. I will see if the money I gave them (the source of which was hundreds of people in the United States) has made a difference.

Anticipating Progress

I can't wait to visit the child soldier camps in Lira, Uganda, to compare them to similar camps I visited in southern Sudan six years ago. I remember how amazed I was in Sudan that the kids, who had suffered through so much (their parents murdered, their indoctrination to kill) were so well-behaved and so futuristic in their discussions. I remember the commitment of the teachers, the optimism that colored the camp.

I'm looking forward to seeing the status of the HIV efforts in Uganda, Kenya, Sudan and Rwanda, both those generated locally and those supported by the U.S. and the Global Fund, which I helped start while in the Senate.

Are we making headway? Should we be doing something differently?

It seems like yesterday that President Bush surprised everyone at the State of the Union address four years ago when he committed $15 billion to the global effort to fight AIDS — the largest commitment against a disease by any government in history. Are we making the progress we'd like? What should we be doing differently?

I'm excited about seeing the beginning of rebuilding the churches destroyed by the radical Islamists throughout southern Sudan, a project led by Franklin Graham and Samaritan's Purse.

The church is the most respected and powerful institution in Sudan and throughout Africa. It is where people place their trust. Rebuilding churches is rebuilding trust.

The rebuilding process will allow people from all over the world to participate, to give of themselves, in being a part of something much greater than themselves. I envision churches from the states partnering with the churches being rebuilt, with hundreds of mission trips in the future bringing Americans (and people from around the word) to establish relationships with the people of Sudan, on the ground, one on one, forging relationships that they could never otherwise have.

Monday, Feb. 5: Waging War on HIV

A country about the size of Oregon, Uganda sits in east central Africa. I've been in and out of Uganda over the years on medical trips, and several years ago I took a large delegation of U.S. senators there to review the tremendous work that President Yoweri Kaguta Museveni has done in fighting HIV.

Years ago, he was the first African leader to come out and say he would do everything in his power as president to fight HIV, which was ravaging the continent. That was vitally significant because, being a national leader, he helped decrease the stigma that had so dominated any mention or reference to HIV.

That a leader talked so directly about this disease and recommended testing and treatment was revolutionary. It opened up the possibility of reversing the course of this deadly disease, which was ripping the heart and soul out of the people of Africa.

And, indeed, Uganda became the model for addressing this virus. On Monday I look forward to visiting TASO, a leading NGO (non-governmental organization) that has been instrumental in fighting AIDS in Uganda, and on Tuesday I look forward to visiting with President Museveni.

Children in the Line of Fire; 1.6 Million Displaced by Conflicts

Uganda continues to be subject to armed fighting among hostile ethnic groups, armed gangs, militias and various government forces. Some 1.6 million people have been displaced by two decades of civil wars between the Lord's Resistance Army (LRA) and the Government of Uganda.

The LRA has abducted more than 25,000 children since 1986. Things have improved over the past year in terms of violent activity by the LRA. I just hope that it is permanent.

Karyn and I will spend the day with Samaritan's Purse, which manages six internally displaced (IDP) camps with approximately 12,000 IDPs living in and around the camps in northern Uganda, around the district of Lira. In Lira (population 750,000), until very recently there were 350,000 in 38 camps.

The Lord's Resistance Army is a rebel paramilitary group formed in 1987 operating primarily in northern Uganda. The group is engaged in armed rebellion against the Ugandan government in what is one of Africa's longest-running conflicts.

In 1994 the LRA began to target civilians and that year saw the first mass abduction of children and youth. As most of the LRA combatants are abducted children, a military solution is widely perceived as a massacre of children.

The abducted young rebels are both the victims and perpetrators of brutal acts. The camps are crowded and unsanitary. The population continues to be attacked within the camps.

Up to 12,000 people have been killed in the violence, with many more dead from disease and malnutrition as a result of the conflict. Nearly 2 million civilians have been forced to flee their homes, living in internally displaced (IDP) camps.

The U.N. estimates that around 25,000 have been kidnapped by the LRA since 1987. A 2006 survey estimates the figure to be 66,000. Each night, children between the ages of 3 and 17, referred to as "Night Commuters," walk up to 12 miles from IDP camps to larger towns in search of safety.

While the LRA appears to consist of less than 2,000 combatants, the government has been unable to end the insurgency. Progress has been made in recent months, however, and there has been no fighting in the Lira region in about a year.

History of Insurgency; Peace Talks Begin

A little history: The Lords Resistance Army first moved across the Lira District in mid-2002 and escalated its attacks in the second half of 2003. Numerous attacks on villages and IDP camps resulted in major displacement of the rural population in 2004.

In a massacre at Barlonyo Camp in late February 2003, 16 miles north of Lira town, over 200 people were killed. In mid-July 2006 peace talks between the LRA and the Ugandan government began.

The talks are ongoing and, although the outcome is unpredictable, there has been relative peace in Northern Uganda since July. The district originally hosted 340,000 displaced people in 24 rural camps scattered throughout the area with camps ranging from 2,000 to 30,000 people.

As security continues to improve, people have started returning to their homes, and it is hoped that all of the camps will be disbanded by the end of 2007. Samaritan's Purse activities have started shifting from relief to rehabilitation.

Today, we drove from Kampala, Uganda, to Entebbe airport and boarded a refurbished DC-3 for the one-hour flight north to Lira. Flying the DC-3 allows us to land in very short dirt fields — useful for the type of places in the bush we visit. We landed on the dirt field in the bush, welcomed joyfully by many of the native people.

Returning to Normal; Stories of the Sick

Our first stop was Aler, a trading center in the bush, which a year ago was an active and crowded IDP camp populated by several thousand but which more recently is returning to normal life with the decrease in violence by the Lord's Resistance Army.

Here, with Franklin Graham, head of Samaritan's Purse, and Dr. Dick Furman, Karyn and I visited the HIV program of Samaritan's Purse. The Lira HIV/AIDS Education program was initiated in October 2004 to provide people in rural internally displaced camps with accurate information about the prevention and treatment of AIDS.

It receives funding from the President's Emergency Plan for AIDS Relief (PEPFAR). Samaritan's Purse has established a presence in 12 rural camps and 14 municipal camps.

We met with about 30 HIV-infected individuals who had come to express their gratitude for the counseling and fellowship and treatment they received over the past two years. We heard the individual testimonies. All are receiving antibiotics and a few are receiving antiretroviral medications.

We met with Grace, a 40-year-old woman whose husband had died of AIDS three years before she discovered she was HIV positive. He had infected her, and before treatment she was disabled and diagnosed with tuberculosis.

She presented with a huge left flank mass and later had multiple abscesses drained from her right thigh. Her mother, with tears in her eyes, came forward to express her appreciation for the compassion Samaritan's Purse's staff, who had overseen her care at the local health facility and given her the moral support to pick herself up and return to a tolerable quality of life.

She smiled, expressed her joy at seeing us, and asked us to thank the many people who have reached out and touched her life. We met with the 30 or so HIV positive individuals who had come from the surrounding area to meet with us — all with a story of how they contracted and how they were living with HIV.

The Samaritan's Purse program there has trained and mobilized church and community leaders to increase awareness of HIV AIDS, reduce the stigma and decrease the impact on vulnerable families.

Feeding the Masses

We drove nine miles up the dirt road to Agweng, an active IDP camp of about 7,000, to participate in a large food distribution going on today. Over 30,000 people had come that day from the surrounding region to receive food to last them for the next three months.

In 2006 Samaritan's Purse had distributed over 27,000 metric tons of food and helped resettle about 250,000 internally displaced persons. The food helps sustain populations displaced and affected from conflict. The program has helped the IDP population meet the food gap created by the conflict in the region over the past three years.

It was incredible to see the thousands of people lined up peacefully and orderly to receive their allotment of corn, beans or peas, oil, rationed to them at a 50 percent daily nutritional level.

Many had come from miles. All walking. No cars. Scattered bicycles. You can imagine the innovation and creativity we witnessed as women (mainly) and children struggled to carry the large white bags back to their homes.

We helped unload the 15 semi-trailers that had brought a total of 600 metric tons consisting of 100-pound bags of grain and supplies. I've seen a lot of food distribution centers in various parts of the world, but nothing of this magnitude — again, all so orderly! And way out in the bush.

A huge field was covered with rows and rows of piles of eight to 10 of the white 100-pound sacks labeled "UN World Food Program," with 4- or 5-gallon oil cans labeled "USA Corn Oil" on top of each.

It is fascinating to see the coordination among the various NGOs from around the world that come together to participate in this endeavor. Today our focus was on Samaritan's Purse, which handled the massive ground distribution, from truck unloading to delivery to the individual. It was like a symphony in many ways as the individuals went from line to line to receive their allotment.

Return to Entebbe

Back to the DC-3 with the flight back to Entebbe.

Karyn and I then spent a special few hours at TASO in Kampala. Two years ago, World of Hope (thank you to those of you who have participated) donated half a million dollars to the inspiring TASO, which since 1987 has successfully been addressing HIV in communities throughout Uganda.

We toured the clinic, which today treats 8,000 "clients" with anti-retroviral medications — all paid for by the generosity of the American taxpayer through the PEPFAR program. How proud we were as the staff and the clients again and again thanked the American people for their generosity.

We were pleased to learn how the $500,000 we had donated to this organization had been spent — to purchase land for their new headquarters ("House of Hope"), completion of a facility in Mbarara, and support of the drama groups that are instrumental in educating the Ugandan people about prevention of AIDS and restoration of hope.

TASO has cared for over 150,000 clients since its reception. Through agencies like TASO and the generosity of so many, including American citizens, the incidence of HIV in Uganda has been cut in half and it has become a prototype for countries around the world.

Well, Karyn and I are ready to go to bed! It's been a great day in east Africa!!!

Click here to view photos of Dr. Frist during his mission to Africa.