Rotary International Advance Global Health with Low-Cost, High-Impact Solutions
Author(s): Scott Douglas Jacobsen
Publication (Outlet/Website): A Further Inquiry
Publication Date (yyyy/mm/dd): 2025/06/26
Part 3 of 3
Pat Merryweather-Arges, Executive Director of Project Patient Care and longtime Rotarian, shares insights from her decades of humanitarian work across over 30 countries. Merryweather‑Arges explains that under‑resourced hospitals gain quickest impact from three essentials: staff training in evidence‑based protocols, reliable WASH (water, sanitation, hygiene), and vaccinations, especially against pneumonia and polio. Clean water alone slashes infection‑related deaths ten‑fold. She cites Rotary’s four‑decade polio‑eradication campaign—launched in 1985, expanded from a Philippine pilot, now down to ten cases in Pakistan and Afghanistan—as its largest, proving disciplined partnerships, Gates Foundation matching, and field technology can ultimately push diseases to zero.
Scott Douglas Jacobsen: When you’re doing your assessments, as a professional and expert, how do you determine what’s appropriate and most urgently needed in a hospital with limited infrastructure? And more broadly, what do under-resourced hospitals, particularly in rural or low-income areas, most often need to achieve high impact with minimal cost?
Pat Merryweather-Arges: Two things come to mind immediately.
First is training and education. Many births, surgeries, and procedures occur in these settings—often without proper protocols. Just ensuring that staff are trained in best practices can dramatically improve outcomes.
Second is clean water. It sounds basic, but infections are rampant, and clean water is fundamental to preventing complications and maintaining hygiene. Without it, even basic care becomes risky.
The situation becomes extremely dangerous without clean water, and the number of infection-related deaths is significantly higher. I have the data written down somewhere—people die of infections even in the U.S., but the rate is about 10 times higher in countries lacking water and sanitation infrastructure.
I remember visiting a hospital in India—well-intentioned but overwhelmed. In one corner, bloody linens were piled up. They had one delivery room, which consisted of a chair with an opening for childbirth. The exam table where women lie down during delivery had gloves on it.
We were there because they had a very high maternal and infant mortality rate.
I asked the physician about the gloves. He said, “Well, I clean them after I deliver.” But that is a huge source of infection. Surgical gloves are porous, and you cannot reuse them. So we had to explain to him why single-use gloves are essential and how critical it is to have clean water available.
Truck deliveries can bring water in—it is not impossible. But the combination of water, sanitation, and hygiene (WASH) saves lives. Once babies are born, immunizations are critical as well.
Depending on the region, of course, polio is a concern, but so is pneumonia, which is a leading cause of death for children under five. Many of them do not receive pneumococcal vaccines, which could prevent that.
So I would say the three most essential things are:
- Vaccines,
- WASH (Water, Sanitation, Hygiene), and
- Proper medical protocols.
You cannot perform surgery and then expect a wound to heal in an unclean environment. Dirt and bacteria will almost certainly lead to complications.
Jacobsen: What is the biggest, longest-running project Rotary International has ever taken on—either solo or in collaboration? Something where the effort spanned years, and ultimately succeeded?
Merryweather-Arges: That would be polio eradication. Rotary took that on as a global mission in 1985. At that time, there were approximately 150,000 children paralyzed every year due to polio.
Rotary ran a pilot program in the Philippines, and it was successful—the country was eventually declared polio-free. From there, Rotary decided to expand the initiative globally. So yes, they have been working on it for over 40 years. That was the beginning of the global push. It has been a long road, but the commitment has never wavered.
This year, there have been only ten wild poliovirus cases worldwide. But it is still a challenge. It has a ripple effect when countries begin cutting back on funding, especially in key areas. For example, USAID provided significant financing for polio vaccines, the workers, and the cold storage necessary to keep the vaccines viable.
That support has been cut, and we are working hard to fill the gap. Other countries have stepped in, but there remains a huge gap that we are still addressing.
The goal is simple: get to zero cases. And we are close, very close.
When I was in India, it was the first time I witnessed the scale of polio’s impact on people’s lives. People had been paralyzed by polio. I saw them at train stations, trying to earn any money they could. Many were using modified skateboards to move around, pushing themselves along with their hands.
It was heartbreaking—but also deeply motivating. We are at the eradication threshold, and it is not just Rotary leading the charge.
We helped launch the Global Polio Eradication Initiative (GPEI), which includes the World Health Organization, CDC, UNICEF, and critically, the Gates Foundation.
The Gates Foundation has been a game-changer. They match Rotary donations two to one and have also brought advanced technology. When you are down to just a handful of cases, you need to pinpoint exactly where they are and ensure everyone in the area is immunized.
The Gates Foundation introduced mobile technology, like iPads, for healthcare workers to use in the field. That technology has vastly improved tracking, reporting, and coordination.
So yes, this is Rotary’s long-term project, but it has had far-reaching effects. We have learned so much. We now run health fair campaigns in many parts of Africa and beyond—all because we know that vaccination and fundamental healthcare matter.
Jacobsen: I do not think we are going to top that.
Merryweather-Arges: [laughs] It is something. If the malaria vaccine proves effective, that will be huge—malaria kills so many people each year. Tuberculosis is another one, and they are working on a vaccine for the latest strain.
This work has been challenging, especially early on, because it was uncharted territory. Rotary had never taken on something of this scale before. But now, we are down to just Pakistan and Afghanistan, where the last wild polio cases remain. Thank you so much.
Jacobsen: Thank you. Have a great weekend!
Merryweather-Arges: You too. Bye!
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