1999.05.30: May 30, 1999: Headlines: COS - Benin: COS - Iran: Medicine: Biostatistics: Leishmaniasis : Personal Web Page: The centuries-old scourge of leishmaniasis brought Benin RPCV Larry Moulton to Iran, a land where generations of his family ministered to the sick

Peace Corps Online: Directory: Iran: Peace Corps Iran : The Peace Corps in Iran: 1999.05.30: May 30, 1999: Headlines: COS - Benin: COS - Iran: Medicine: Biostatistics: Leishmaniasis : Personal Web Page: The centuries-old scourge of leishmaniasis brought Benin RPCV Larry Moulton to Iran, a land where generations of his family ministered to the sick

By Admin1 (admin) (adsl-70-240-139-98.dsl.okcyok.swbell.net - 70.240.139.98) on Monday, September 11, 2006 - 2:49 pm: Edit Post

The centuries-old scourge of leishmaniasis brought Benin RPCV Larry Moulton to Iran, a land where generations of his family ministered to the sick

The centuries-old scourge of leishmaniasis brought Benin RPCV Larry Moulton to Iran, a land where generations of his family ministered to the sick

Moulton, a droll, 42-year-old biostatistician, learned of the Iranian project at a 1996 seminar at the Johns Hopkins School of Hygiene and Public Health. The vaccine trials offered him a unique opportunity to work in a country virtually closed to Americans for 20 years. But the real draw was the chance to realize his boyhood dream to visit the places where his Presbyterian grandfather, great-grandfather and great-great-grandfather ministered to the Muslim and Christian villagers of northern Iran. Moulton was writing another chapter in the family history in Iran. He walked amid the graves and saw those of several Cochrans, their names scripted in English and Syriac. He spotted the grave of his great-grandmother, his sister's namesake, Katharine Hale Cochran, the Vassar College girl from Minnesota whom his great-grandfather wed and took to Persia. She died in 1895.

The centuries-old scourge of leishmaniasis brought Benin RPCV Larry Moulton to Iran, a land where generations of his family ministered to the sick

Scientist realizes roots as healer in visit to Iran
Hopkins biostatistician helps doctors in search of leishmaniasis vaccine By Ann LoLordo
Sun Foreign Staff

TEHRAN, Iran -- A centuries-old scourge brought Larry Moulton to this land where generations of his family ministered to the sick.

Flying across an ocean and two continents, the Johns Hopkins public health specialist traveled to this 200-year-old capital and villages beyond to help an Iranian research team find a vaccine for a deadly, disfiguring parasitic disease.

For Moulton, this is not the land vilified by his government. It is a land recollected in childhood stories, the Persian rugs in his parent's homes, the Iranian miniatures on the walls, the whirling dervish begging bowl he played with as a boy.

This was the land of his mother Mary's birth, the place where his maternal great-grandfather, Dr. Joseph P. Cochran, founded a hospital and medical school in the late 19th century.

Moulton's great-grandfather Cochran, and his father before him, the Rev. Joseph G. Cochran, both died of typhoid fever in Iran. Moulton, a former Peace Corps worker in West Africa, always wanted to visit the family graves in northeastern Iran.

"Chance of a lifetime," the bearded and bespectacled scientist says of his opportunity to work here.

"In science,

there is no border, no religion, no politics. Just science," added Dr. Ali Khamesipour, Moulton's Iranian host.

Moulton initially knew little about the disease the Iranian doctors were battling. Ranked as one of the world's most confounding public health concerns, leishmaniasis afflicts about 12 million people in 88 countries.

International health experts suspect as many as 350 million people in Africa, South America, the Indian subcontinent, parts of Asia and the Mediterranean coast of southern Europe may be at risk of contracting the disease.

In its most virulent form, leishmaniasis kills. The strain, known as "kalazar" or visceral leishmaniasis, killed more than 50,000 people during an epidemic in southern Sudan between 1991 and 1993.

Moulton, a droll, 42-year-old biostatistician, learned of the Iranian project at a 1996 seminar at the Johns Hopkins School of Hygiene and Public Health. The vaccine trials offered him a unique opportunity to work in a country virtually closed to Americans for 20 years.

But the real draw was the chance to realize his boyhood dream to visit the places where his Presbyterian grandfather, great-grandfather and great-great-grandfather ministered to the Muslim and Christian villagers of northern Iran.

In Iran, the doctor overseeing the vaccine trials was Ali Khamesipour. The disease has taken the American-trained, Iranian microbiologist from his medical laboratory in Tehran to rural health clinics and schools across the country -- to places like Dastgard in a dusty agricultural region of central Iran where two forms of the disease are endemic, and spreading fast.

At the girls school there, a wide-eyed third-grader in white Muslim headdress and gray smock offered her small hand to Khamesipour.

He spotted the leishmaniasis sore immediately, a lesion seen in this country as long ago as the ninth century. Khamesipour asked Marziah Barati whether anyone in her family had the sores.

Two brothers and a sister, she replied.

Named for a 19th-century British army surgeon who discovered the disease-causing parasite, leishmaniasis is transmitted by the bites of a mosquito-like sand fly or a gerbil-like rodent.

Small bumps appear under the skin. They bloom into lesions that can become ulcerous and painful. In its acute and yet most benign form, the lesions heal within several months. But some patients live with the sores for years, some with several dozen.

If the lesions heal, they often leave a horrible scar that, in this traditional society, can affect a family's ability to marry off its daughters.

The scars are so prevalent that Taghi Shafioff, the school's male nurse, says that "in the past, they used to believe that anybody who doesn't have the scar of leishmaniasis is a bastard."

Shafioff has seven scars. The school's custodian turned her left cheek to reveal a spider web-like scar. The vice principal lifted up the hem of her coat-like manteau to show a scarred leg.

In a class of 35 fifth-graders, 13 said they have had "salak," the Farsi word for the disease.

`My face would be ruined'

Vahideh Maimar fears she will wake one day to find a sore on her face. "My face would be ruined," the 11-year-old said. "I would be ugly."

Khamesipour and his team of Iranian researchers are at the forefront of efforts to test a vaccine against leishmaniasis.

"There is not a single effective vaccine against any human parasitic infection," said David Sacks, an immunologist at the National Institutes of Health in Bethesda and a volunteer consultant to the Iranian trials. "`There's not one against malaria or sleeping sickness. Even a vaccine against leishmaniasis that worked marginally would be somewhat of a first."

Over more than four years, Khamesipour and his public health team have injected about 6,100 children with a placebo or a dead form of the parasite that causes the disease in the course of blind trials. The dead parasites are injected with a live vaccine called BCG that is used to immunize people against tuberculosis in many parts of the world. It is thought that the BCG will make the immune response against the dead parasites more powerful.

The trick to find just the right dose to stimulate an immune response against leishmaniasis. Such a vaccine would protect people from future infection or decrease the severity of the disease once contracted.

Now, the disease is commonly treated with an antibiotic-like injection. But the cost -- from $12 to $181 -- puts treatment out of reach for most victims who live in poverty. And, if a person's immune system is suppressed, treatment is ineffective.

In the past, attempts to rid Iran of the carriers failed. A spraying campaign against the velvet-winged flies also failed. So did efforts to poison the furry gerbils.

"That makes the vaccine the most important way to protect the people against the disease," said Khamesipour. "If it protects 50 percent of the people, we are saving thousands of lives every year in Sudan, India, Ethiopia."

Although Iran actually harbors the least deadly form of the disease, the World Health Organization chose it as a site of three vaccine trials because of the country's experience with the disease, its system of health clinics and its well-trained physicians. Trials are also under way in Sudan, Venezuela, Colombia and Ecuador.

In 1993, while he was a post-doctoral fellow at the University of California in Irvine, Khamesipour was invited by a former teacher to head up the Iranian vaccine trial. Khamesipour, who agreed to lead the WHO-sponsored project, says: "I wanted to do something for my country."

In Baltimore, Dr. Lawrence H. Moulton got a similar request three years ago. The Iranians needed help organizing and monitoring their data. Moulton had evaluated measles and influenza vaccine trials in the past.

"I saw some real potential for collaboration," he said.

"They have been trying out pretty basic vaccines in these trials. First one shot, then two shots, now three shots," said Moulton. "I was especially impressed by this group in Iran, by how much they have been able to put together on a shoestring."

While Moulton describes his role as that of "a bit player," Khamesipour is consumed by the project.

Before dawn one morning, Khamesipour set out for Zavoreh, a town in central Iran where half of the 8,000 residents are infected with leishmaniasis. A vaccine trial is under way and monitoring is essential.

But follow-up of about 200 patients in the 2,120-person trial was lax. The Shahid Nasahi Clinic lost track of many of the patients when their employer, an oil company, relocated. Khamesipour explained to the clinic director that his staff had to find them. "We need to account for as many as possible to maintain the integrity of the trial."

As Khamesipour met with the health care workers, Abu Tali Rafii shuffled into the clinic. The 39-year-old teacher could barely walk because of the large, pus-filled ulcer on his swollen foot. "Five months, it's been this way," Rafii told Khamesipour.

After examining several patients, Khamesipour climbed into his buff-colored Toyota and drove to the neighboring town of Ardestan. Three trial subjects had not shown up that morning for their checkup. Khamesipour arrived to find two men waiting for him. Khamesipour examined their vaccine sites, measured and photographed them.

Then, Saik Allah Sedagh walked in. Khamesipour smiled.

"He has not come to see me for two months," the doctor said as the 50-year-old driver rolled up his shirt sleeve and displayed his vaccine scar. "Ah, he's very good. He's healed. If the lesion starts and heals, we are 100 percent sure they are protected."

So far, the Iranian trials have shown that the vaccine regime is safe. But they have yet to determine the right dose to protect the world against the disease.

"After four years," Khamesipour said, "we know that a single injection doesn't work. It's not something you can speculate through science. You have to go through the trial."

But the trials are paying off.

On his most recent trip to Iran, Moulton, the Hopkins consultant, joined Khamesipour and representatives from the WHO, the London School of Hygiene and Tropical Medicine and Iran's Center for Research and Training in Skin Diseases and Leprosy at a meeting in Tehran.

The experts met to determine if the Iranian vaccine team was any closer to its goal. Their review found the project to be on track. In a year, the trial results would be known.

Another mission

After finishing his consulting work in Tehran, Moulton had enough time to complete another mission -- to visit the family grave site.

He flew to Orumiyeh, the northeastern Iranian town where his ancestors had lived and worked. Moulton was met by a local medical historian who is writing a book about his great-grandfather Cochran.

They toured the site of the hospital and medical school founded by his Yale-educated great-grandfather in 1882. The trees apparently planted by his great-grandfather at the entrance of the medical school now stand 100 feet tall.

From there, they drove up Mount Sier to the walled, Presbyterian mission graveyard. A Kurdish shepherd stood among grazing flocks. Snow-capped mountains soared into a cloudless blue sky.

Moulton was writing another chapter in the family history in Iran. He walked amid the graves and saw those of several Cochrans, their names scripted in English and Syriac. He spotted the grave of his great-grandmother, his sister's namesake, Katharine Hale Cochran, the Vassar College girl from Minnesota whom his great-grandfather wed and took to Persia. She died in 1895.

"Tears were welling up in my eyes," Moulton recalled.

At his great-grandfather's grave, Moulton stopped. The 1000-pound tombstone had fallen over.

"While we were there, three Kurdish men came by," Moulton said. "One of them went off and got a long metal bar. We all pushed and leveraged it and got the thing up again."

Now, Moulton could read his great-grandfather's name, Joseph P. Cochran (1855-1905) and the biblical epitaph, "He came not to be ministered unto, but to minister."

Originally published on May 30 1999





When this story was posted in September 2006, this was on the front page of PCOL:


Contact PCOLBulletin BoardRegisterSearch PCOLWhat's New?

Peace Corps Online The Independent News Forum serving Returned Peace Corps Volunteers
Meet Ron Tschetter - Our Next Director Date: September 6 2006 No: 978 Meet Ron Tschetter - Our Next Director
Read our story about Ron Tschetter's confirmation hearing before the Senate Foreign Relations Committee that was carried on C-Span. It was very different from the Vasquez hearings in 2001, very cut and dried with low attendance by the public. Among the highlights, Tschetter intends to make recruitment of baby boomers a priority, there are 20 countries under consideration for future programs, Senator Dodd intends to re-introduce his third goal Peace Corps legislation this session, Tschetter is a great admirer of Senator Coleman's quest for accountability, Dodd thinks management at PC may not put volunteers first, Dodd wants Tschetter to look into problems in medical selection, and Tschetter is not a blogger and knows little about the internet or guidelines for volunteer blogs. Read our recap of the hearings as well as Senator Coleman's statement and Tschetter's statement.

Top Stories and Breaking News PCOL Magazine Peace Corps Library RPCV Directory Sign Up

The Peace Corps Library Date: July 11 2006 No: 923 The Peace Corps Library
The Peace Corps Library is now available online with over 40,000 index entries in 500 categories. Looking for a Returned Volunteer? Check our RPCV Directory or leave a message on our Bulletin Board. New: Sign up to receive our free Monthly Magazine by email, research the History of the Peace Corps, or sign up for a daily news summary of Peace Corps stories. FAQ: Visit our FAQ for more information about PCOL.

Chris Shays Shifts to Favor an Iraq Timetable Date: September 2 2006 No: 971 Chris Shays Shifts to Favor an Iraq Timetable
In a policy shift, RPCV Congressman Chris Shays, long a staunch advocate of the Bush administration's position in Iraq, is now proposing a timetable for a withdrawal of American troops. How Mr. Shays came to this change of heart is, he says, a matter of a newfound substantive belief that Iraqis need to be prodded into taking greater control of their own destiny under the country’s newly formed government. As Chairman of the House Government Reform subcommittee on national security, he plans to draft a timetable for a phased withdrawal and then push for its adoption. A conscientious objector during the Vietnam War who said that if drafted he would not serve, Chris Shays has made 14 trips to Iraq and was the first Congressman to enter the country after the war - against the wishes of the Department of Defense.

Peace Corps' Screening and Medical Clearance Date: August 19 2006 No: 964 Peace Corps' Screening and Medical Clearance
The purpose of Peace Corps' screening and medical clearance process is to ensure safe accommodation for applicants and minimize undue risk exposure for volunteers to allow PCVS to complete their service without compromising their entry health status. To further these goals, PCOL has obtained a copy of the Peace Corps Screening Guidelines Manual through the Freedom of Information Act (FOIA) and has posted it in the "Peace Corps Library." Applicants and Medical Professionals (especially those who have already served as volunteers) are urged to review the guidelines and leave their comments and suggestions. Then read the story of one RPCV's journey through medical screening and his suggestions for changes to the process.

Gates charity races to spend billions Date: August 12 2006 No: 954 Gates charity races to spend billions
Warren E. Buffett’s gift of $31 billion to the Bill and Melinda Gates Foundation means that for tax reasons, starting in 2009, the foundation must distribute $3 billion annually, or a little more than twice what it distributed last year.

PCOL Comment: The Foundation says that "preventing the spread of HIV is the most durable long-term solution to the AIDS epidemic, and a top priority for the foundation." Peace Corps Volunteers and Returned Volunteers have been doing just that in AIDS Education for the past 15 years. Why not consider a $100M annual contribution to the Peace Corps to put 2,500 additional volunteers in the field to expand AIDS education worldwide?

RPCV Ron Tschetter to head Peace Corps Date: July 29 2006 No: 937 RPCV Ron Tschetter to head Peace Corps
President Bush has nominated Ron Tschetter to serve as Director of the Peace Corps. Tschetter, 64, is the president of an investment firm based in Montana. He volunteered with his wife to work as family planning advisers in India and is a former Chairman of the National Peace Corps Association.

PCOL Comment: Congratulations to the Bush administration for an inspired choice for Peace Corps Director. Ron Tschetter is not only an RPCV but was Chairman of the NPCA. Best wishes to Mr. Tschetter on his future tenure as Director of the Peace Corps.

Latest: How Ron Tschetter was selected as Peace Corps Director.

The Peace Corps is "fashionable" again Date: July 31 2006 No: 947 The Peace Corps is "fashionable" again
The LA Times says that "the Peace Corps is booming again and "It's hard to know exactly what's behind the resurgence." PCOL Comment: Since the founding of the Peace Corps 45 years ago, Americans have answered Kennedy's call: "Ask not what your country can do for you--ask what you can do for your country. My fellow citizens of the world: ask not what America will do for you, but what together we can do for the freedom of man." Over 182,000 have served. Another 200,000 have applied and been unable to serve because of lack of Congressional funding. The Peace Corps has never gone out of fashion. It's Congress that hasn't been keeping pace.

Support the US-Peruvian Trade Pact Date: July 20 2006 No: 930 Support the US-Peruvian Trade Pact
Peruvian President Alejandro Toledo, the Peace Corps President, has been lobbying both Democratic and Republican legislators to support the US-Peruvian trade pact before July 28, when his term ends and a US congressional recess begins. If President Bush fails to get approval before Congress goes on recess, it will be a case study proving that the United States does not reward its friends. Please call your representatives.

Changing the Face of Hunger Date: June 28 2006 No: 915 Changing the Face of Hunger
In his new book, Former Congressman Tony Hall (RPCV Thailand) says humanitarian aid is the most potent weapon the United States can deploy against terrorism. An evangelical Christian, he is a big believer in faith-based organizations in the fight against hunger. Members of Congress have recently recommended that Hall be appointed special envoy to Sudan to focus on ending the genocide in Darfur.

PC will not return to East Timor in 2006 Date: June 8 2006 No: 913 PC will not return to East Timor in 2006
Volunteers serving in East Timor have safely left the country as a result of the recent civil unrest and government instability. Latest: The Peace Corps has informed us that at this time, the Peace Corps has no plans to re-enter the country in 2006. The Peace Corps recently sent a letter offering eligible volunteers the opportunity to reinstate their service in another country.

Chris Dodd considers run for the White House Date: June 3 2006 No: 903 Chris Dodd considers run for the White House
Senator Chris Dodd plans to spend the next six to eight months raising money and reaching out to Democrats around the country to gauge his viability as a candidate. Just how far Dodd can go depends largely on his ability to reach Democrats looking for an alternative to Hillary Clinton. PCOL Comment: Dodd served as a Volunteer in the Dominican Republic and has been one of the strongest supporters of the Peace Corps in Congress.

First Amendment Watch Date: May 4 2006 No: 883 First Amendment Watch
Maine Web Report hit with Federal Lawsuit
Website wins trademark suit against Jerry Falwell

Peace Corps stonewalls on FOIA request Date: April 12 2006 No: 869 Peace Corps stonewalls on FOIA request
The Ashland Daily Tidings reports that Peace Corps has blocked their request for information on the Volkart case. "After the Tidings requested information pertaining to why Volkart was denied the position — on March 2 — the newspaper received a letter from the Peace Corps FOIA officer stating the requested information was protected under an exemption of the act." The Dayton Daily News had similar problems with FOIA requests for their award winning series on Volunteer Safety and Security.

PCOL readership increases 100% Date: April 3 2006 No: 853 PCOL readership increases 100%
Monthly readership on "Peace Corps Online" has increased in the past twelve months to 350,000 visitors - over eleven thousand every day - a 100% increase since this time last year. Thanks again, RPCVs and Friends of the Peace Corps, for making PCOL your source of information for the Peace Corps community. And thanks for supporting the Peace Corps Library and History of the Peace Corps. Stay tuned, the best is yet to come.

History of the Peace Corps Date: March 18 2006 No: 834 History of the Peace Corps
PCOL is proud to announce that Phase One of the "History of the Peace Corps" is now available online. This installment includes over 5,000 pages of primary source documents from the archives of the Peace Corps including every issue of "Peace Corps News," "Peace Corps Times," "Peace Corps Volunteer," "Action Update," and every annual report of the Peace Corps to Congress since 1961. "Ask Not" is an ongoing project. Read how you can help.

RPCV admits to abuse while in Peace Corps Date: February 3 2006 No: 780 RPCV admits to abuse while in Peace Corps
Timothy Ronald Obert has pleaded guilty to sexually abusing a minor in Costa Rica while serving there as a Peace Corps volunteer. "The Peace Corps has a zero tolerance policy for misconduct that violates the law or standards of conduct established by the Peace Corps," said Peace Corps Director Gaddi H. Vasquez. Could inadequate screening have been partly to blame? Mr. Obert's resume, which he had submitted to the Peace Corps in support of his application to become a Peace Corps Volunteer, showed that he had repeatedly sought and obtained positions working with underprivileged children. Read what RPCVs have to say about this case.

Military Option sparks concerns Date: January 3 2006 No: 773 Military Option sparks concerns
The U.S. military, struggling to fill its voluntary ranks, is allowing recruits to meet part of their reserve military obligations after active duty by serving in the Peace Corps. Read why there is opposition to the program among RPCVs. Director Vasquez says the agency has a long history of accepting qualified applicants who are in inactive military status. John Coyne says "Not only no, but hell no!" and RPCV Chris Matthews leads the debate on "Hardball." Avi Spiegel says Peace Corps is not the place for soldiers while Coleman McCarthy says to Welcome Soldiers to the Peace Corps. Read our poll results. Latest: Congress passed a bill on December 22 including language to remove Peace Corps from the National Call to Service (NCS) military recruitment program

Why blurring the lines puts PCVs in danger Date: October 22 2005 No: 738 Why blurring the lines puts PCVs in danger
When the National Call to Service legislation was amended to include Peace Corps in December of 2002, this country had not yet invaded Iraq and was not in prolonged military engagement in the Middle East, as it is now. Read the story of how one volunteer spent three years in captivity from 1976 to 1980 as the hostage of a insurrection group in Colombia in Joanne Marie Roll's op-ed on why this legislation may put soldier/PCVs in the same kind of danger. Latest: Read the ongoing dialog on the subject.


Read the stories and leave your comments.






Some postings on Peace Corps Online are provided to the individual members of this group without permission of the copyright owner for the non-profit purposes of criticism, comment, education, scholarship, and research under the "Fair Use" provisions of U.S. Government copyright laws and they may not be distributed further without permission of the copyright owner. Peace Corps Online does not vouch for the accuracy of the content of the postings, which is the sole responsibility of the copyright holder.

Story Source: Personal Web Page

This story has been posted in the following forums: : Headlines; COS - Benin; COS - Iran; Medicine; Biostatistics; Leishmaniasis

PCOL34404
07


Add a Message


This is a public posting area. Enter your username and password if you have an account. Otherwise, enter your full name as your username and leave the password blank. Your e-mail address is optional.
Username:  
Password:
E-mail: