Leadership Q&A

The Rev. Peter Le Jacq, M.D., with an
AIDS support club sponsored by the
Catholic Church in Mwanya, Tanzania.

Peter Le Jacq is not your average physician. One of only about 100 Roman Catholic priests worldwide who are medical doctors, the Rev. Le Jacq, M.D., has spent a dozen years as a health care worker and medical missionary in one of the world's poorest countries. In 1987, Rev. Le Jacq realized a lifelong dream when he completed a special 12-year program that combines theological training at the Maryknoll Seminary with medical training at Cornell University. After short stints in Cambodia, Guatemala, and Ireland, Rev. Le Jacq headed to Tanzania in 1987. There he spent much of the following 12 years at the Bugando Medical Centre as one of 10 doctors for a population of 7 million. In the early 1990s, Rev. Le Jacq also served as Pope John Paul II's personal consultant on AIDS in East Africa. The AAMC Reporter talked to Rev. Le Jacq about his work in Africa and what medical schools and teaching hospitals can do to address the AIDS and health crises there.

Q: Far fewer than 1 percent of the half- million Roman Catholic priests in the world are medical doctors. What made you pursue this rarely taken dual-career path?

A: As a child, I wrote my eighth-grade religion paper about why I want to be a missionary, priest, and doctor in Africa. My reasons remain valid today. They were to bring joy to myself and others in this life, while preparing to be with God after I die.

Q: Why Tanzania? Did the realities meet your expectations?

A: With nearly as many countries in Africa as there are states in the United States, I had many choices. I chose Tanzania because it was the second poorest country in the world at the time of my assignment, and the poorest country in which Maryknoll, the Catholic Foreign Mission Society of America, served. I wanted the challenge of poverty in my spiritual life, and I wanted to make a conscious effort for the poor. Secondarily, Tanzania's Ministry of Health accepted the American medical license, and the national language of Swahili was relatively easy to learn. The realities of poverty, drought, famine, and disease surpassed my worst expectations, almost to the degree to which the spiritual strength of the people overwhelmed and inspired me. What surprised me the most in the dozen years I lived in Tanzania is the unconditional love and trust I enjoyed with the people with whom I served.

Q: We often hear statistics about the AIDS epidemic in Africa. What are some of your personal experiences?

A: Unfortunately in my experience, the statistics are accurate. But just as unfortunately, the faces that make up those statistics are rarely seen. I have the advantage of knowing the statistics by name…Bhoke, Mwita, Chacha…. While I know that biologically heterosexual intercourse with an infected individual is the most frequent means of contracting AIDS in Tanzania, I am equally convinced that poverty acts as the main enabler of the disease in the "highly indebted poor countries" - as the World Bank/ International Monetary Fund describes many developing nations. Sex workers in Tanzania are not uncommon. Nurses, teachers, and farmers turn to sex in exchange for food when they see no other way to care for their children. But the most common story I have been told by infected women is one of faithfulness to an unfaithful husband who may have been acting out sexually as a coping mechanism for his untreated depression during the decades of drought that have failed to produce enough food for Tanzania's people. The most inspiring story is of a mother who lay on her soon-to-be deathbed, the same one in which her late husband infected her, as her three daughters cared for her. She spoke positively about the husband who had been unfaithful and infected her. When I asked her why she spoke so well of the man, she replied that she was simply doing for him what God does for each of us - forgive before we ask to be forgiven. She also confided that she wanted her daughters to be free to love their husbands, so she knew they needed to be able to love their father. That woman was not educated beyond primary school, but she taught me.

Q: Are academic medical centers doing enough to help with the health crisis in Africa?

A: None of us is doing enough to help with the AIDS and health crises in Africa - or elsewhere. There are few, if any, questions on M.D. licensing exams related to the socioeconomic or anthropologic factors in pandemics. There is little profit to be made with a patent for a medication that treats a disease endemic among the people of developing countries, e.g., malaria. Academic medical centers in the U.S. generally train doctors for roles in curative medicine within this country and rarely address diseases present primarily outside the nation. A global approach to health and disease is lagging behind our current global approach to economics.

Q: What more can medical schools and teaching hospitals do to make a difference, and what will happen if we don't act?

A: We need to be more realistic about the effects of disease anywhere on people everywhere. It is essential to continue training physicians to diagnose and treat individual patients who suffer from our most common illnesses in the U.S. But if we limit ourselves to only an elective for tropical disease, anthropology, sociology, or economics, we are telling the next generation of medical doctors it is not important to know about the most common diseases on Earth, such as malaria, or the factors that occasion their continuing existence at a time when we have the technology to prevent and treat most, if not all, tropical disease. Clearly, if a disease exists anywhere on Earth, it could eventually reach the shores of the U.S. It may be that AIDS and West Nile Encephalitis are just the first of many diseases that originate outside our borders but quickly become part of the required curricula at U.S. medical schools. All people would be well served if we trained medical doctors for the planet, not just for the country.

Q: What are you doing now, and will you go back to Africa?

A: I am currently serving at the Catholic Foreign Missionary Society of America in an administrative role that includes vocation recruiting,fundraising, and teaching. I am also serving as a part-time chaplain and adjunct assistant professor at the United States Military Academy at West Point, and I am participating in Cornell University's Humanities and Medicine Program. In 2002, I will participate in the founding of the first Catholic medical school in East Africa.