His journey began, as many do, with a train ride. Thirty years ago, Lee Todd Miller, MD, was a UCLA assistant professor traveling from Philadelphia to New York. After threading his way through the crowded aisles of every car, he eyed the last three vacant seats in the caboose. “I chose a fortuitous seat next to an elderly gentleman from Shanghai,” Dr. Miller recalls. “He was a pediatrician teaching students, just like me.
Dr. Lee Miller, associate dean for student affairs at the David Geffen School of Medicine at UCLA, in a pediatric clinic in a village in Mozambique, Africa.
Photo: Rob Stark
The ride passed quickly as the older physician recounted stories about his work in global health. When the two exchanged business cards at the end of the ride, Dr. Miller was astonished to learn that he had been chatting for two hours with Hu Ching-Li, MD, assistant director general of the World Health Organization (WHO).
That chance encounter led Dr. Miller to take a sabbatical from UCLA four years later to join the WHO, where he worked on a medical education project at the agency’s headquarters in Switzerland. Traveling frequently from Geneva to lead medical school workshops in countries like Egypt, Ethiopia, Myanmar and Zambia, Dr. Miller was working to provide the foundation for his later career consulting in Afghanistan, Ecuador, Mozambique, Peru and South Africa.
In his 32-year career as a pediatrician and global health advocate, Dr. Miller has quietly made it his mission to address health care disparities in developing countries, while inspiring the next generation of young physicians to follow his example. Today, he is associate dean for student affairs at the David Geffen School of Medicine at UCLA.
The sabbatical he took, in 1994, coincided with the end of the civil war in Rwanda that August, when millions of ethnic Hutus fled their homeland to escape genocide by Tutsi extremists. Traveling by foot and acutely weakened by shock, fatigue, hunger and thirst, the survivors sought sanctuary in a refugee camp in Zaire, now the Democratic Republic of the Congo. When Dr. Miller arrived at the camp, he confronted unspeakable scenes of human suffering.
Because the region’s volcanic ground prevented the digging of latrines and graves, human waste and corpses slid into Lake Kivu, contaminating the refugees’ only drinking water. Dysentery and cholera swept through the camp. Cases of meningitis broke out, forcing doctors to perform spinal taps on people lying in the dirty grass. All told, starvation, dehydration and disease killed 2,000 children and adults each day in the camp.
“We would wake up early, grab coffee and a muffin and then a truck would drive us to the refugee camps,” Dr. Miller says. “Every morning, we rolled children’s bodies over to check if they were still alive. Frantic mothers surrounded us, begging for water for their own children, yet we only had enough to give to the sickest children. The experience remains indelibly and painfully imprinted upon my mind.”
As a physician there, Dr. Miller struggled to distance himself in order to help his patients. “You have to keep emotional blinders on,” he says. “You can’t process what you’re seeing at the time.
Over the duration of his stay, the number of people dying in the camps dropped from 2,000 to 500 per day — still an unfathomable loss of life. Shaken by the horrors he had witnessed, Dr. Miller was unable to discuss his experience for several years. Upon his return to UCLA, he poured his energy into two new outlets. He co-founded the medical school’s global health program, where he still serves as its director of overseas educational programs for senior medical students. And in partnership with UCLA Mattel Children’s Hospital and the Department of Pediatrics, he launched Partners for Pediatric Progress, a non-profit project dedicated to improving children’s health care. Its mission is to strengthen the ability of low-income communities to deliver health care by training local physicians to teach the next generation of health care leaders.
“Our students and residents come back changed,” Dr. Miller says. He describes the story of one such trainee. Ryan Coller, MD (RES ’10, FEL ’12), MPH ’12, was the first UCLA trainee to work in the children’s hospital in Mozambique, one of the poorest countries in the world. One day, the third-year resident noticed a 2-year-old boy who had stopped breathing. He resuscitated the toddler, performed chest compressions and prepared to slide a tube into his throat to prepare him for artificial ventilation. When the battery died on the laryngoscope, he replaced it with a battery from the Walkman in his backpack.
Finally, he asked the medical team to bring a ventilator. “There are none available,” he was told. “You have to let the child go.” The young student decided the best gift he could give the boy was to not let him die alone. He gently rocked him until the child died in his arms. Two years later, Dr. Coller joined the pediatrics faculty at UCLA Mattel Children’s Hospital, and he accompanied Dr. Miller on another medical mission in Peru. Today, he is division chief for pediatric hospital medicine at the University of Wisconsin School of Medicine and Public Health-Madison.
“Global health work offers us a priceless perspective,” Dr. Miller says. “It reminds us how fortunate we are to live in a resource-rich country, and what an incredible privilege it is to be a physician.”
He offers a final word of encouragement: “Keep reaching out until you find your own fortuitous seat on the train.”
Elaine Schmidt is a senior public information officer for UCLA Health.
For information about Partners for Pediatric Progress, go to: p3project.org
