An interview with Hilbrand Haak, consultant in health and development.

 

Anneke Middeldorp

 

Bangladesh, Brazil, Yemen, Ghana, India, Zambia. I meet Hilbrand Haak in his office on the second floor of his house in Leiden, the Netherlands. The bookshelves are packed with files with names of the most exotic countries, travel books and dictionaries. From this place Hilbrand sends dozens of emails per day to collaborators all over the world. In the next room his Indonesian wife is making phone calls.

 

Hilbrand and his wife work as consultants in public health and have their own company called Consultants for Health and Development (CHD). Since establishing CHD in the mid- 990s their business now has a wide spectrum of worldwide activitie. Their involved in planning, monitoring and the evaluation of healthcare programs in developing countries. Hilbrand: ‘a lot of people think that public health is soft. Its associated with social medicine, and therefore they think it is not the 'real medicine'. But as Hilbrand explains it, it may actually be more interesting than clinical medicine, as it is about whole populations instead of only individual patients. When Hilbrand studied Medicine in Groningen in the early eighties, he expected himself to go into the clinical health care - like most of the students nowadays would probably still do. But, already during his study, Hilbrand was an active traveller and active in solidarity committees for Latin America. In the final year of his study he went abroad, to do research in Brazil. After graduation he started working as a medical assistant in a small hospital in Geleen. He also did a training course for health care in the tropics during three months at theRoyal Tropical Institute.

 

'CHD has much work in making medicines available for developing countries, and there are not that many people working in this area.' It is for example very important to know if patients take their medicines properly, which is not as self-evident as it seems. CHD makes clinicians aware of this aspect of medicine. Another important thing is how to invest your money best when it comes to buying medicines. CHD advises countries which medicines to select for the national health care systems, and for national health insurance. Hilbrand knows where to buy high quality medication for a low price. For example in the case of Malaria: 'Three quarters of the drugs that can be bought at the world market are of poor quality. You have to know the market, and what is the best and affordable choice.'

 

After his training at the Royal Tropical Institute Hilbrand wanted to work as a clinician in Latin America. At that time however few organisations sent people to Latin America, and only the Dutch government assigned people to work in international agencies, such as Unicef and the World Health Organisation (WHO). These so-called 'Associate Professional Officer' positions were not in the field of clinical care, but in public health. That is how Hilbrand went to Peru to work for two years in PAHO/WHO. He worked there in the control of diarrhoeal diseases. 'A lot of children die of diarrhoea, because of dehydration. When febrile, or having diarrhoeal diseases, children can get dehydrated in a few hours. Rehydration is necessary, but this was not very well known in developing countries at that time. Doctors generally like to give dehydrated children expensive intravenous fluids that often are dangerous.' Later, Hilbrand worked in control of diarrhoeal diseases for countries around the world from the WHO Headquarters in Geneva. After spending 2 years in Switzerland he decided to get a Masters degree in public health and went to Harvard. 'It was of course expensive; and afterwards I was stone-broke. But you only live once,' according to Hilbrand.

 

After his master's study Hilbrand followed his heart and went to Indonesia. He had met a nice girl there a couple of years before and wanted to see her more often. It was in Yogyakarta where he started to work as a consultant. In 1995 he married and with his new wife he went to the Netherlands.

 

Together they founded CHD, a business they are now running for over ten years. 'Selecting the proper drugs is just the beginning.' Drugs also have to be distributed and stored properly. Anti-AIDS medicines for example, are very expensive and should be stored below 15ºC. Which may of course be a bit more difficult in tropical areas. Hilbrand also advises countries on this aspect. Hilbrand has a broad spectrum of activities in developing countries. He jokingly calls himself â€˜plumber in public health': 'you can call me, I will do the job, and send you the bill…'. However, with more demands for his services, he has become aware of the need to prioritise. 'I have started to become more critical over the years in which jobs I vaccept.' However, Hilbrand readily admits that if an assignment seems fun, he'll do it whatever it takes. He still finds time to do voluntary work. According to Hilbrand, 'you can't expect the world only to give to you. I try to give something back by doing volunteer work. And I can do this, because I am boss of my own company.' After all, a nice job so it seems. Hilbrand travels around the world. And in all the countries he visits, he builds systems, to help the population of such a country. And this all, with its basis in his own house, together with his family.

 

www.chd-consultants.nl