Our Stories

The Health Care that Doesn't Trickle Down

Tye Sundlee '08 is heading for the unknown this year, courtesy of a Fulbright grant. He'll be living in an unfamiliar country speaking an unfamiliar language analyzing an unfamiliar health care system, and he's looking forward to it.

Sundlee's Fulbright experience began with boot camp, a language immersion program in Vermont where he pledged to speak only Russian for nine weeks. No text messages, calls or letters in English -- no exceptions. Sundlee, who has spoken English, Japanese, Spanish and Danish, says, "It was probably the most frustrating thing I've ever done."

From there he'll head to Ukraine, where he'll apply his economics degree toward the study of resource allocation in the country's struggle against HIV/AIDS. Ukraine was a natural choice: The country has the highest HIV caseload in Europe.

Sundlee will work with the International HIV/AIDS Alliance looking at a classic problem for non-government organizations (NGOs): how to administer large sums of money without having them whittled away all the way down the supply chain, until there's nothing left for the intended recipients.

In 2006 the World Bank suspended its tuberculosis and HIV/AIDS program in Ukraine because only 2 percent of the initial $60 million had resulted in services for the high-risk groups it was intended to serve: expectant mothers, street children, drug users, sex workers and prisoners.

"There's always a question of where you apply your efforts, where you send donations for the greatest amount of good with the least amount of overhead or outright corruption," Sundlee says. "I'll be collecting sensitive information, so cultural awareness will be job one."

Sundlee will use a technique that has maximized results in many countries, one based on evaluating past allocations in order to make effective decisions about future allocations. He'll identify goods and services that were actually delivered, quantify the benefits and overhead of each program, and identify programs that deliver services most efficiently. Before his departure next year he'll give his findings to the International HIV/AIDS Alliance to help them in their decision-making.

Hard data can't come soon enough. HIV/AIDS is increasing exponentially in Ukraine's young people, due in part to high unemployment. "This is a ticking time bomb for their economy," Sundlee says. "The virus is crippling individuals and depleting the current and future workforce. It also lowers government revenues while requiring higher expenditures.

"This experience will give me an opportunity to learn firsthand how health care policy is made," says Sundlee. He'll live in the capital city of Kyiv, an old city whose historic churches abut modern apartment buildings.

"After graduate school I want to work with NGOs around the world, helping with strategic health care decisions. I really like international life," says Sundlee, who has lived in Japan, Denmark and New Zealand. "It's invigorating to live in another country. And with not-for-profit organizations, you can target a social goal and not be driven by the bottom line. That freedom allows you to focus on the main objective, whether it's alleviating malaria or HIV/AIDS."

As a foreigner speaking a new language asking delicate questions about a delicate subject, Sundlee says the experience will be humbling. "I'll be flying by the seat of my pants," he says with a smile. "There's a very thin line between being brave and foolhardy. I hope I'm on one side and not the other."

For information about the Fulbright and other scholarships, contact Monique Bourque in the Student Academic Grants and Awards Office on the second floor of the University Center.



07-15-2008