Tag Archives: Dr. Bill Roper

Kigali and Gisenyi

Will with people we met on the road

Will with people we met along the roadside

Today was a very good day.

We did several things to get settled ? changed money, got cheap cell phones, got our passes for the mountain gorilla tour (which we will do in a couple of days).

Then we went to the Kigali Genocide Memorial. It tells the incredible story of the 1994 genocide in very effective and moving terms. It is really impossible to do it justice in a short blog posting, but this country has been through horrific trauma, and is now making amazing progress in reconciliation and development.

Then we drove almost three hours to Gisenyi, which is on the shores of Lake Kivu, a huge, beautiful lake. There are a number of resort hotels there, and we went to a very nice one, and had a late lunch. It was magnificent — we sat overlooking the lake as we ate.

We are now in Musanze, where we will spend the next two nights. The town used to be called Ruhengeri.

Our day starts tomorrow with the early English service at the Anglican Cathedral, and then we will spend the rest of the day relaxing. The guesthouse has a pool and the weather here is great.

Then we set out early on Monday to see the gorillas.

Arrived in Rwanda

On the way here via Brussels, we got to spend an unplanned extra day in Belgium. Our plane flight was cancelled, and we had to wait a day for it to go.

Everyone was very kind to us ? they put us up in a hotel at the Brussels Airport, and served us great food.

We got to visit with several of our fellow pilgrims to Rwanda ? a couple from Little Rock on their way to visit their daughter who is working for an non-profit group in Rwanda, three college students who are going there to do volunteer work with another group for several weeks, a lady going home to Congo (she lives a five hour bus ride from Kigali, Rwanda), and an AIDS researcher who works in Rwanda. It turns out we know lots of people in common.

We arrived after dark this evening ? so have not yet seen much, but it is clearly hilly. After all, Rwanda is known as the Land of a Thousand Hills.
Tomorrow we visit the main genocide memorial and then leave the capital city to visit some of the outlying areas.

En route to Rwanda

Greetings from Brussels ? our son, Will, and I are on our way to Rwanda for a long-planned visit.

This will be the fourth of our international visits together, in which we combine our interest in global health with an effort to learn more about the world ? especially those parts which are far away from Chapel Hill.

Will Roper in the Brussels Airport

Will Roper in the Brussels Airport

In 2007, Will and I went to South Africa, Malawi and Zambia. We focused especially on the UNC Institute for Global Health and Infectious Disease work that has long been done in Malawi. We learned a lot, and Will got to work in an AIDS orphanage.

In 2008, he and I went to China, where we again met with UNC collaborators, particularly in the China CDC. And we got to take in some of the Beijing Olympics!

In 2009, Will and I went to Peru, with Drs. Luis Diaz and Doug Morgan, and we saw first-hand the work that they and colleagues are doing to advance our understanding of health and disease. This has direct relevance to our efforts in Latino Health in North Carolina. And we got to see Machu Picchu too!

This year it's Rwanda ? a small country in east central Africa ? with a troubled past, but an exciting present and future. The 1994 genocide in Rwanda is a major part of the history of the country, and we will be visiting genocide memorials and learning of the horror of what happened 16 years ago.

But we will also be learning of the widespread reconciliation work that seems to be bearing much fruit, and the rapid development of the country and its economy.

UNC does not yet have global health work in Rwanda, but I will be visiting with leaders in the Ministry of Health, and in the hospitals and medical school. I look forward to learning much about what others are doing in Rwanda, and to thinking about the further opportunities.

In addition, our church in Chapel Hill has a partnership with the Anglican Church in Rwanda, and our sister parish is St. Paul's Cathedral in Butare, Rwanda. I will be visiting with church leaders there and elsewhere in Rwanda.

All in all, we have much to learn and experience. It promises to be a great trip!

Much more to come.

Health Reform ? hurray

This week will long be remembered as a momentous time in American health policy and politics.

President Obama signed the landmark health reform legislation and the Senate seems poised to complete the complicated process with passage of a reconciliation bill making a number of changes in the earlier law.

I have long worked for far-reaching overhaul of how we finance and deliver health care in America, and I celebrate this major accomplishment.

We are all hearing several narratives from different quarters ? that predictably conflict:

After decades of trying ? by Democrats and Republicans, far-reaching health reform has passed into law.

This is a major victory for a more compassionate and communitarian society.

President Obama and his party can be proud of their leadership on achieving this.
This legislation gives the federal government a significantly greater role in directing the American health care system.

Republicans will campaign against a government takeover of health care, and they could see major electoral gains this fall and in 2012.

Will it work?

Can we afford it?

Each of us will choose which of those and other narratives to emphasize.

I am very glad it passed, even with its flaws and other consequences that we don't yet know about.

On the whole ? we badly have needed to cover the uninsured ? and this legislation, when implemented, will do that in a big way. The fact that not everyone will be covered is surely true ? but this is a major step in the right direction.

As the head of a major public safety net institution, I am very concerned about the proposed cuts in Medicare. I have to believe, and I do, that these will not occur ? to anything like the extent promised ? because of the predictable push-back of seniors and health providers.

So what that means is this will add hugely to the federal budget deficit ? not a happy prospect, to be sure.

I continue to believe that our nation must press ahead with additional health system reform, that delivers quality care at much lower costs. We can do that ? but it will stretch us like nothing we have ever done before. Just like this process has challenged our political system.

Here at UNC we are dedicated to reform, and we are determined to be a leader ? creating a new model for organizing and delivering care.

So … Health reform has passed … With much more to come! I believe we will be arguing about all of this for months ? indeed for years to come.

Stay tuned!

Edward M. Kennedy a Personal Reflection

Today the news is filled with stories about the passing of Senator Edward Kennedy of Massachusetts from an incurable brain tumor. kennedy

During his almost fifty years in the Congress, Senator Kennedy has been a dominant leader in so many areas of our national life health and health care, education, civil rights, and on and on.

Twenty years ago, in the summer of 1989, as a mid-level member of President George H. W. Bush's White House staff, I was tapped to be the Administration's negotiator with the Congress for what came to be known as the Americans with Disabilities Act.

My chief counterpart in those negotiations was a person on Senator Kennedy's staff and across that summer I had many, many long meetings up on Capitol Hill. Some of those sessions included our bosses and there I was privileged to meet and get to know Senator Kennedy a bit.

I grew to admire him a great deal for his earnest commitment and tireless energy and focus. He was, and we were, ultimately successful, and the ADA is now the law of the land.

Of all the activities I have been involved with, across a number of government jobs, I am proudest of my work on the ADA.

Today I recall proudly and fondly my time twenty years ago and how I intersected briefly and in a small way with Senator Edward Kennedy.

He will be greatly missed.

National Health Reform the main event

The decibel level of the Washington health reform debate is going up rapidly.

President Obama has put health reform at the top of his domestic agenda, right next to saving and strengthening the economy.

The challenge is how to deal with the main problem faced by most Americans the staggering cost of health care, while at the same time dealing with covering the uninsured and our quality / safety concern.

Two ideas that have often been raised — but just as often said to be out of bounds are front and center in the debate now.

They are (1) setting a limit on the amount of health care benefits that can be received tax-free, and (2) mandating that everyone have health insurance (and subsidizing the cost of health insurance for those who cannot afford it).

The tax cap (or taxing excessive health benefits, if you want to call it that) will force people toward more cost-effective health insurance plans, and will raise tax revenue that can pay for the subsidies for those who need them.

Mandating that everyone have health insurance (with subsidies for those who cannot pay themselves) is the surest way to make certain that everyone (or almost everyone) has coverage.

I have long been in favor of both of these ideas and they seem to be supported by growing numbers in Congress.

The next few weeks / months will be filled with rhetoric and passion. Let's get on with it.