February 6, 2004

The Durant Fellowship: Walking in the footsteps of a great humanitarian

They are large shoes to fill. When beloved MGH physician, Thomas S. Durant, MD, died in November 2001 from cancer, he left behind a rich, humanitarian history of helping impoverished people in the most deprived parts of the world. Durant, who served the MGH as assistant director, spent most of his career traveling to bleak places such as Cambodia, Albania, Bosnia, Rwanda, Somalia, Croatia and Afghanistan, bringing supplies, medicine, medical expertise and, most important of all, hope to those who had lost all hope of survival.

His legacy now lives on with the Thomas S. Durant, MD, Fellowship in Refugee Medicine. Its first recipient, Kristian R. Olson, MD, of MGH Internal Medicine, recently spent 10 months walking in the footsteps Durant left behind.

At left and below, Olson with Thailand refugees

The Durant Fellowship provides funding for an MGH clinician to assist in the prevention and treatment of disease among refugees throughout the world. "Kris was the unanimous choice for the first Durant Fellow," says Larry Ronan, MD, director of the Durant Fellowship. "He completely fulfilled our high expectations as a dedicated, enthusiastic MGH representative in refugee medicine."

Olson, who returned from the Thailand-Burma border in November, was fortunate to have met Durant. Olson had developed an interest in international health care when he was completing a combined residency in Pediatrics and Internal Medicine at the MGH. "Because of my interest, I was put in touch with Dr. Durant," says Olson. "He gave me great advice and would talk about some of his adventures. I remember how surprised I was when he said to me, 'I'm jealous of you. If I had the chance, I would do this all over again.' He was a great mentor."

When the fellowship was established after Durant's death, Olson applied. Once he was selected, he traveled to London to study tropical diseases for three months at the London School of Hygiene and Tropical Medicine. He then went to Thailand to take care of refugees for the American Refugee Committee — the same organization Durant had represented.

As a clinical coordinator, Olson was put in charge of medical care for a 4,000-person refugee camp that had gone without a doctor since the previous physician had left four weeks earlier. Because the United Nations would not let civilians stay in the refugee camps for security reasons, Olson had to drive an hour and a half each day on treacherous roads from a Thai village — through three military checkpoints — to get to the camp. The refugees lived in bamboo huts with no electricity or running water. Raised on stilts, the field hospital had a basic lab to run medical tests, a small inpatient area for severely ill patients and an outpatient clinic. Olson provided care along with refugees who had some medical training — nine medics and a handful of midwives.

He found that the medics were very eager to learn more about traditional Western medicine. "Teaching them was a humbling experience for me," he says. "They were so eager to learn. When we were doing rounds, they would write notes on their arms and later transfer the notes to their journals. They had everything memorized the next day. The experience made me a better teacher."

The medics spoke English, but most in the camp spoke Karen, a local dialect. After two months, Olson was transferred to work in two other camps with populations of 12,000 and 17,000 residents, providing medical care and performing an assessment of HIV in the camps.

During his time there, Olson corresponded with Durant's widow, Fredericka, and upon his return to the United States, she commented how much Olson's letter reminded her of some of her late husband's sentiments about this kind of work.

"It was a great experience. I would love to go back," Olson says. "I like to think of it as a fellowship in perspective. After studying medicine at a cutting-edge Western facility and then being transplanted to a deprived place with so few resources, it gave me a different perspective on my practice. It was medical care stripped down to its essentials."