Letter from our Founder

International Cardiovascular Health Alliance



Letter from our Founder

In 2006, shortly after finishing my internal medicine residency, I worked as a volunteer physician in a fishing village in Southern Ghana. This was my first experience working in Sub Saharan Africa, and I was struck by the number of patients who walked into my exam room with severe difficulty breathing from untreated congestive heart failure, paralyzed limbs from undiagnosed strokes, searing headaches from uncontrolled hypertension, and festering leg wounds from untreated diabetes. I didn't realize it at the time, but what I was seeing was the epidemic of non-communicable diseases that was devastating a community that was already impoverished and ridden with infectious diseases such as malaria, TB, and HIV.

When I came back to the United States, I resolved to find an organization that was fighting this hidden epidemic of global chronic disease, but I couldn't find one. This was how the International Cardiovascular Health Alliance (ICHA) was born. In 2008, I joined with Nikka Rapkin, a deeply idealistic attorney committed to fighting the effects of global poverty, and we started ICHA.

For the next few years, we worked in Ghana to teach community health workers how to prevent cardiovascular disease by treating hypertension, diabetes, poor diet, and physical inactivity. We started a secondary schools program to teach high school students what they could do to prevent cardiovascular disease. Among our successes in Ghana were that we were able to mobilize the community, hear stories, expose and cultivate passion among the community for preventing this epidemic.

We learned many lessons from this work, but perhaps the biggest lesson that ICHA’s work taught us was that changes in thinking and behavior come slowly, incrementally, imperceptibly, until one day everything is different. When we left Ghana, we left behind health workers who knew how to treat hypertension through diet changes and medications. We left behind teenagers who could teach their families to eat healthier diets and recognize simple signs of heart disease. And, most importantly, we left behind innumerable people with passion and the drive to keep fighting this epidemic. The biggest lesson that I personally learned was that as foreigners our role is not to impose our priorities but rather to partner with communities, to inspire and ignite them to prevent cardiovascular disease in their communities, and to support and connect them with the resources that they need.

This is how Project Ignite, ICHA's newest program in rural Southern India, started in 2012. ICHA joined an incredibly committed group of doctors and nurses working at an Indian NGO, the Tribal Health Initiative, to successfully to provide excellent health care to a neglected tribal population in a remote part of Tamil Nadu. Clinicians at the Tribal Health Initiative had noticed an abundance of hypertension in the patient population, and had enlisted UCSF and ICHA's help to stem the tide of this rising epidemic.

Together, THI and ICHA, with the support of the incredible research resources of UCSF, have created a system to diagnose and manage high blood pressure in the population of 10,000 individuals in the Sittilingi Valley. We have trained community health workers to diagnose hypertension in the villages, send new hypertensive patients to the central clinic for management, and treat stable hypertensive patients in the community. We have taught the community health workers how to counsel their hypertensive peers about diet modification and exercise, and how to dispense simple medications. ICHA has helped ignite a movement for hypertension control among the THI community.

Currently, Project Ignite is on the second phase of its operation, helping THI create an information system to monitor hypertensive patients effectively. We're providing the community health workers with electronic tablets with which they can record BP values, and a computer system so that the blood pressure of a patient who is seen by a health worker in a village today can be seen by a physician at the clinic tomorrow. We're helping THI streamline hypertension care while also creating a rigorous system for evaluating and monitoring the program so we can tweak the program as we go along depending on the need.

After six years, I am proud of what ICHA has been able to accomplish in Ghana and India. And I’m excited and hopeful as ICHA finds new ways to impact vulnerable populations throughout the world.

Sujatha Sankaran, MD
Medical Director and Co-Founder, ICHA