Pharmacist created Rx for Rwanda’s future

By Judith Doolin Spikes

“I didn’t grow up on an ashram no one in our family ever did anything like this.”

Joel Zive, a 1979 graduate of Ardsley High School and still a resident of the school district, is referring to his volunteer work in Rwanda and to Prescription for Hope, Inc., his recently formed not-for-profit organization that offers pharmacy consulting services to developing countries.

Today (Feb.17), he leaves for his third visit to Rwanda since January 2005, this one a 12-day stay to complete a pharmacy in the capital, Kigali, which will serve as a prototype for the service Prescription for Hope will offer elsewhere: “design, development, supervision of construction, and training of pharmacy staff to obtain sustainability of pharmacy operations,” in the words of the organization’s brochure.

A third-generation pharmacist/owner (Zive Pharmacy in the Bronx), Zive became involved in changing the world almost by accident less than two years ago.

“Filling prescription for and counseling HIV-AIDS patients since 1994, I’d become curious to learn more about HIV,” he explained one night last week in his Hartsdale home. “As part of marketing our pharmacy, I visit clinics and community-based organizations in the Bronx, and at one I mentioned that I’d always wanted to go to an international AIDS conference. A case manager suggested I write an abstract on adherence [to doctor’s orders] and submit it for presentation at the July 2004 conference in Bangkok.”

As a result, Zive attended the conference and, while awaiting his flight home at the Bangkok airport, fell into conversation with one Kathryn Anastos- without knowing then that she was a specialist in the treatment of women with AIDS and an associate professor at Albert Einstein College of Medicine in the Bronx.

Fast forward to November of that year. While attending a meeting a Jacobi Medical Center, Zive heard a doctor speak about having just returned from Kigail, Rwanda, where a clinic for HIV-positive women and their children was being set up – by Dr. Kathryn Anastos.

Zive learned that his chance acquaintance is the principal investigator for the Bronx Women’s Interagency Study and the Rwanda Women’s Study and Assessment (RWISA) and executive co-director of Women’s Equity in Access to Care & Treatment (WE-ACTx).

‘Let me know if you need me’

On impulse, Zive asked for Anastos’ telephone number and left a message on her answering machine: “Let me know if you need me.”

Anastos returned Zive’s call the next day, an on January 5, 2005, the two met in the cafeteria of Lincoln Hospital in the Bronx. “She asked me if I could be on a plane for Rwanda on January 21, to design a pharmacy in Kigali and train staff in modern pharmacy practices. I said yes. I got all my shots and malaria meds that same day.”

And two weeks later he was off, with crates of donated equipment, tow second-hand laptop computers, and a laser printer.

“It was the most amazing two weeks of my life,” Zive says. “It was magical. I expected to see poverty and remnants of war. I also saw a country on the mend, with an indomitable spirit, making a comeback.

“The European Union has donated a lot of infrastructure, and the Chinese have a larger presence there. There were a lot of nice restaurants, and soccer games were beamed into hotels – including the Hotel Des Mille Collines,” featured in the 2004 film “Hotel Rwanda.” Zive lived in a modern ranch – style house with other Western health and human – rights workers.

“I felt very comfortable there, more comfortable than in South Africa, which is supposed to be more modern. Security companies supply private armed guards, but I walked 2 miles alone in the dark from the house to a hotel to use the Internet and was never threatened.

“They went through a horrific period,” he says of the tribal war between the Tutsis and the Hutus. The incidence of HIV-AIDS in women and children is due in large part, he notes, to the atrocities of the 1994 genocide in which 800,000 perished and thousands of rape victims were infected with HIV. “The official doctrine is that there is no difference between them [the tribes] now. It is a country on the mend.”

Zive was overwhelmed with admiration for his Rwandan translators. “They spoke three languages. Here in the U.S., they would be entrepreneurs or manager of Fortune 500 companies.”

The landlocked nation, slightly smaller than Maryland, was and still is at the current 8.5 million the most populous country in Africa. Some 250,000 Rwandans, both men and women, are HIV – positive.

Pharmacy tailored to HIV study

WE-ACTx began work in Rwanda in 2004 with a treatment clinic and pharmacy in the capital city. In order to conduct a research study as well as treatment, Anastos needed to have the pharmacy organized specifically for the research. That was her charge to Zive.

“She’s looking at the effects on HIV-positive people who have not [previously] been treated with any drug, to see how they do on a drug,” Zive explains. “Major international agencies are bringing AIDS drugs into the country. The drugs are very cheap, or donated by manufacturers – I believe generic manufacturers from India supply the drugs.”

After a 19 – hour, 7,200 – mile flight, Zive found himself in Kigali and began to discover abilities in architecture and information technology he didn’t know he had, drawing floor plans and designing cabinets and setting up a computer system to track the research results. “When I got the drug labels to print out, it was one of the highlights of my life.”

He returned to the clinic for 72 hours in June 2005 (on his way home from a course in “anti retrovirus supply chain management” in south Africa). But it was the first trip, Zive says, that “really changed my life. After I came back, I was talking to a drug rep about it, and she said, “You should start a nonprofit.” Again, he took an idea and ran with it.

Zive, who earned a doctorate in pharmacy from St. John’s University in 2003, serves as executive director of Prescription for Hope. He credits Congresswoman Nita Lowey with facilitating the organization’s acquisition of 501c-3 (federal tax – exempt) status. Anastos is a member of the board of directors, as in Ardsley resident Solomon Torres, CFO of Columbia University College of Physicians and Surgeons Department of Surgery, and Rochelle Cohen, the popular former principal of Concord Road School – among others.

The organization has donated a generator to the WE – ACTx pharmacy in Kigali, Zive says, and “due to the generosity of some drugs companies, I just sent 900 pounds of [computer] supplies to Africa.”

The WE – ACTx pharmacy, Zive adds, “is a prototype that could profoundly change the lives of thousands of people. We want to go to various funders and say ‘this is what we can do in these conditions.’”

Upon returning from his first trip to Rwanda, spilling over with enthusiasm – “I was like your first teenage love: it’s great, then it’s over – people reacted in one of four ways, Zive says:

“You’re crazy”; I wish I had the guts to do what you did”; “Where do I sign up?” and “I wish my kids appreciated what they have.”

The last response is “the most telling,” Zive believes. “Kids don’t always listen to you, but they’re always watching you. In a way, I’m setting a good example for my kids.”

That would be Jacob, 11, who arrived home just as the interview was ending, and Rachel, 9, who had sat on her father’s lap through most of it, displaying photos on a computer screen and prompting, “Tell about this! Tell about that!”