Rajesh Ramesh Panjabi ’02
When Raj Panjabi ’02 (’07 MD) led a group of board members from his nonprofit Last Mile Health to some of the villages served by the health care delivery system, the American-based team got a sense of what “last mile” really means.
After flying to Monrovia, the group traveled by Jeep 12 hours over unpaved roads, a journey that took them only 100 miles. Back in the Jeep the next day, they continued through the rainforest around potholes deep enough to swallow a truck, and forded shallow rivers that rose over the hood of the Jeep. Cellphone coverage had ended miles before. Surely this was the last mile. But the next day, the group hopped on motor scooters, sometimes pushing them across small rivers and, when they were lucky, over bridges formed from fallen logs.
“Raj thinks nothing of going to these places where no one else has gone except the people who live there,” said Brendan Cullen, a Last Mile board member and managing director of Draper Richards Kaplan Foundation, a major funder of Last Mile. “He shows up in one of those villages and says, ‘How can we help?’ His courage is off the charts.”
Raj took the scenic route through medical school. His advisers at the School of Medicine let him take six years to complete the four-year curriculum, making time for a two-year side trip to Liberia, his birth country, to do an independent study on childhood pneumonia that led to his helping the government begin to rebuild the health care system that was dismantled during civil strife. Raj returned to Chapel Hill with a business plan for delivering primary care to villagers in areas of the rainforest so remote that waking up with a fever could be a portent of death.
The model for Raj’s business, had it been up and running in all West African countries before the Ebola epidemic struck, might have saved hundreds of lives by treating patients in their home villages and containing the spread. But Raj doesn’t linger on what could have been.
“Despair isn’t going to solve an epidemic,” he said. “Leaders with solutions are.”
Raj was only 9 when warlord Charles Taylor came into power. Raj’s family was privileged — his father was a merchant — and they made it onto a plane that carried them away from harm. Most of those left behind were killed. That disparity instilled in him a mission to return to Liberia someday to work on behalf of those who didn’t have his advantages.
As an undergraduate, Raj was a member of Golden Fleece and Order of the Grail and was president of the Campus Y as a senior. He also was a Burch Fellow, which took him to Bethel, Alaska, the summer before his senior year where he studied Alaska’s model of delivering health care to its 600,000 residents living across hundreds of thousands of miles of tundra. The network relied on village residents trained as community health care workers to provide basic primary care.
Those lessons came to bear when Raj returned to Liberia in 2005 and began working on the country’s national health policy. He saw the gaps in health care delivery in Liberia, where a mother would have to carry her feverish child by foot and canoe sometimes for a two-day journey to a clinic for treatment. He focused on creating a workforce to save lives in the world’s most remote villages.
As soon as he graduated from medical school in 2007, Raj and his wife, Amisha Raja ’02, whom he had met as a freshman at UNC, used the money they received as wedding gifts to start Last Mile Health. From the onset, Raj made sure Last Mile would build capacity that would be sustainable when he wasn’t there. He partnered with Liberia’s Ministry of Health to train a villager in each remote community to diagnose and treat the top 10 killers. The Ministry of Health helped ensure access to medicines and other treatment supplies the village workers needed.
Last Mile Health has reached 42 villages so far and has a goal of reaching 300 more in the coming three years. Raj, as CEO, has forged public/private partnerships, enlisting the support of cellphone companies, for instance, and winning grants from private foundations, such as the Draper Richards Kaplan Foundation. He remains on staff at Brigham & Women’s Hospital in Boston and on the faculty of Harvard’s Division of Global Health Equity. Amisha has stepped back from Last Mile to care for their two sons. The family moved to the Triangle recently to enjoy the support of family nearby as Raj travels frequently, including a trip back to Liberia over the summer as the Ebola epidemic spread.
Of all his accomplishments, Raj said he is most proud of being a dad. “It’s one of the most challenging things I’ve done, and it reminds me of what real responsibility is and why the work of Last Mile really matters.”
His ambitious scholarship at UNC, his faculty mentors — the late Dr. Alan Cross, George Lensing, Virginia Carson ’71, Judith Blau and Dr. Georgette Dent among them — and his acceptance into medical school made it possible for him to have the impact he has today.
“We would not have had the boldness to take on Last Mile had it not been for the experience and opportunities UNC offered me,” he said.