In Malawi, Khami Chokani serves as medical director of Zomba Central Hospital, seeing up to 100 patients a day. This fall, Shashu Zegeye, a public health nurse, sociologist, and mother of four, took the training she received at the school back to Ethiopia.

by Pam Auchmutey ighteen mahogany trees stand proudly outside Zomba Central Hospital in the southern African nation of Malawi. In all likelihood, some of the trees were saplings when Scottish missionaries founded the hospital in 1895. The original mud brick structure, with room enough for eight beds, has grown in stages to become a 311-bed facility, where five doctors and one dentist care daily for an average of 650 inpatients. Many patients spill over into the mahogany grove , a welcome respite from the confines of the tuberculosis ward. During rounds, medical director Khami Chokani sees up to 100 patients, many with HIV, TB, and malaria. "It's quite a job," the 37-year-old doctor says cheerfully. "I used to see my patients on top of the beds, under the beds, between the beds. Patients also use the veranda. When it's raining, that's a problem." Some 2,000 miles away, Shashu Araya Zegeye has a different task. She travels to villages in the arid stretches of northern Ethiopia, training women in maternal and child health on behalf of Tigray Development Association, which provides rural developm ent programs for people in that part of the country. Before joining the association, Zegeye worked with a children's center in the southeast, where the remoteness of some areas posed a hazard for a woman travelling alone. But Zegeye is accustomed to hards hip. Her husband disappeared without a trace during Ethiopia's civil war, which ended in 1991. "My colleagues used to tell me, 'Don't go there, it's risky,'" says the 44-year-old public health nurse, sociologist, and mother of four. "But I like going to the villages. I like working in the community. We work very hard." Though their backgrounds differ, Zegeye and Chokani crossed paths last year at the Rollins School of Public Health. Their lives converged with eight other colleagues from Botswana, China, Jamaica, Tanzania, Trinidad/Tobago, and Yemen. All are recent pa rticipants in the Hubert H. Humphrey Fellowship Program, initiated by President Jimmy Carter in 1978 to honor the late senator and vice president for his commitment to public service. Selected by the J. William Fulbright Scholarship Board, the Humphrey fe llows are mid-career professionals from developing countries and selected Central and Eastern European nations. To date, more than 2,500 people from different public service fields have studied in the United States through the program. "They're chosen because of their ability and their potential to become the top people in their fields," says Philip S. Brachman, the professor of international health who coordinates Emory's Humphrey Program. "They can step back, restoke the fires, mee t people, and learn about new ideas and technologies."

The 1997-1998 Humphrey fellows included: (standing, l to r) Habaudi Njiro Hobona, Robert Kendal Lee, Aboabakar Ahmed Ba-amer, Yu Xie, Ali Suleiman Amour, Jiatong Zhuo, Ogone Mogano, and Khami Chokani. Seated are Sheila Campbell-Forrester (l) and Shashu Araya Zegeye.

rachman has led the program here since 1993, and Emory will retain the competitive program at least for another five years. Strong academic resources and proximity to the Centers for Disease Control and Prev ention (CDC), the American Cancer Society, county and state health departments, and organizations such as CARE, the American Red Cross, and The Carter Center enhance the fellows' experiences at Emory. For most fellows, this visit marks their first to the United States. Some must attend language school before arriving on campus. "My English isn't so good," laughs Zegeye, who saw Niagara Falls while studying English in upstate New York. Once the fellows are at Emory, Brachman and his staff assist them with graduate housing, bank accounts, Social Security numbers - the necessities. To ease the adjustment, staff and fellows retreat to the North Georgia mountains for fellowship, food, an d a hot game of volleyball before starting coursework. "They have a great deal of difficulty selecting their classes - everything looks so good," Brachman says. "We tell them, 'You can't take 25 credit hours (compared with a normal load of 8 to 12 credits). You won't be able to travel and do the things you need to do.'" With class schedules set, fellows begin their professional development - meeting colleagues at the CDC and other health agencies and attending workshops locally and across the United States. They also help educate others by hosting brown bag lunches fo r students and speaking to civic, school, and church groups in Atlanta. By year's end, fellows have absorbed new ideas about epidemiology and public health policy, learned improved computer and research skills, expanded their network of colleagues, and traveled around the United States. The experience is both rewarding and overwhelming, according to those who have completed it.

Philip Brachman directs the competitive Hubert H. Humphrey Fellowship program at Emory.

ost of us have come from developing countries, and the US health care system is new for many of us. I don't understand it," Zegeye confesses. Back home, she hopes to continue training community workers who will counsel women on prenatal care and keeping children healthy after birth. She will have a strong ally. "Education is power," she says. "By using the information I've learned, I can now say, 'This is a problem for youngsters. This is a problem for new mothers. Research shows evidence of this.' The first thing I will say when I go home is, 'I need a computer in my office so I can show people what I've learned and what we can do.'" For Chokani, Emory's Humphrey program has enlarged his view of health policy and the network of people who can advise him on national health insurance and other issues. In 1964, when he was 3, politics forced his family to flee Malawi. He studied and w orked outside the country before returning in 1994. Today, he serves as medical superintendent for the Ministry of Health and Population in a nation with one of the highest birth rates in the world. "I wanted a chance to learn how institutions such as Emory, the CDC, and the World Bank function on their own ground and to see what is new in the world. I thought I could better prepare myself to be part of the team as we go through health reform in M alawi," says Chokani, who will remain at the school another year with his wife and young daughter to complete an MPH. Consequently, he has met the eight 1998-99 Humphrey fellows along with Emory's first Edmund S. Muskie fellows. These new students represent Azerbaijan, Belarus, Georgia, Moldova, and the Ukraine. They are part of a program established by Congress in 19 91 to encourage economic and democratic growth in the newly independent and Baltic states of the former Soviet Union. The program is named for the late Maine senator who served as President Carter's secretary of state. Muskie fellows tend to be younger than their Humphrey colleagues, with an average age of 25. They study for two years to earn master's degrees in public health and other fields. Because they are enrolled in a degree program, Muskie fellows don't travel as often as Humphreys, but their training period is longer. "The Humphrey and Muskie programs are valuable personally to the fellows and to foreign policy as a way of strengthening the world," Brachman says. "I'd like to think the fellows have the same motivation - to become educated so they can go back and hel p their countries." Pam Auchmutey is publications manager at The Carter Center.