The Laughing Doctor

By Bryan Walsh / Hong Kong

Sok Thim laughs when you ask about the day in 1975 when the Khmer Rouge came to his village in Cambodia and put an end to his medical education and his freedom. He laughs about the nearly four years he endured in a forced-labor camp, the decade he spent working with tuberculosis patients in refugee camps along the Thailand-Cambodia border. He laughs about the 20-hr. days he put in getting the NGO he co-founded, the Cambodian Health Committee (CHC), off the ground--the only work that was harder than Khmer Rouge re-education. The one thing Sok Thim, 48, takes absolutely seriously is the right of every patient--no matter how poor, no matter how desperate-- to receive treatment for TB.

With his partner, Dr. Anne Goldfeld, a Harvard biomedical researcher, and American Brian Heidel, Sok formed the CHC on a shoestring in 1994, two years after he was repatriated to Cambodia from the refugee camps. From the start, their target was TB. The disease takes an estimated 2 million lives a year globally, and Cambodia has one of the highest rates in the world, 508 cases per 100,000 people. The tragedy of TB is that it can be cured with a six-to-eight-month series of daily antibiotics, but interrupted treatment can lead to the rise of multi-drug-resistant TB that is far more difficult and expensive to cure. So serious were fears about the spread of resistant TB that when Sok first began working in the camps during the 1980s, the strategy for treating refugees with TB was simple--don't. Refugees were not considered good bets to complete their course of medication.

CHC took a radically different tack. Patients received free medication if they signed a contract pledging that they would finish their treatment; friends and family served as co-guarantors. Those in the program received nutritional supplements through the World Food Program. "Our whole approach from the beginning is that no one wants to be sick, no one wants their kid or wife to die," says Goldfeld, who visits the program several times a year from her base at Harvard. "If you give someone the education of how to be well, they'll do it." The World Health Organization was doubtful at first, but Sok and Goldfeld were right. CHC achieved a cure rate of 90% to 95%. By the end of 2004, some 5,000 of their patients had recovered.

At the heart of CHC's success has been Sok and Goldfeld's synergistic partnership. "Thim without Anne is just another local NGO leader struggling to start an organization," says Joel Charny, a former member of the CHC board. "Anne without Thim is a Harvard researcher without the connections to get things done." Today CHC is adapting its TB program for Cambodia's growing HIV problem and launching ambitious clinical trials, led by Goldfeld, that will study how to treat patients simultaneously suffering from both diseases. This is CHC at its best--harnessing grassroots programs to find answers to vital medical questions, which can then be used to help the very patients for whom CHC was originally founded.

For Sok, the motivation goes back to his time as a refugee. "I learned a lot in the camps," he says. "I learned about dignity, and I learned to see the value of a person." His own value is inestimable. This summer, 30 years after the Khmer Rouge interrupted his education, Sok Thim finally got his medical degree. He'd laugh if you did so, but you can call him Dr. Sok.