When Theodore MacKinney, MD '85, MPH, arrived in rural Nepal for the first time in 1993, the small village he would call home for six years experienced an average of one death per day. The statistics were easily tracked, as deaths were broadcast as the bodies were carried through the village on the way to the cremation site.
When he left, after building a 20-bed mission hospital where previously there was no health care outside of natural healers and medicine shops, that rate had dropped to fewer than one death per month. Built along an ancient trade route, Living River Health Services serves an area with half a million people and no other doctors. Since 2000, the hospital has been nationalized and run by local people, thanks to Dr. MacKinney's leadership.
Dr. MacKinney has spent the better part of his professional life living among the poor in Nepal with his wife, Rachel. His three children, now 16, 18 and 20, consider it home at least as much as the U.S. While not glamorous, this path has been rewarding and certainly significant to the many people he has helped.
"This was a career choice, or a life calling to find and serve people who are the most needy. It is also a spiritual calling for us. When I think about the difference we've made in people's lives, I think, 'that was really fun,'" said Dr. MacKinney, who periodically had returned for stints in the U.S. He has been stateside since 2005, serving as Assistant Professor of Medicine at the Medical College of Wisconsin. He received a 2007 Humanitarian Award from the Alumni Association for his incredible dedication to the health of the Nepalese people.
Nepal is one of the poorest countries in the world, and Dr. MacKinney lived and cared for people in one of the poorest areas of Nepal. His family lived in a modified village house of stone and mud. Upon his initial arrival, he literally practiced medicine under a tree with the help of one nurse. Eventually, they adapted a home into a temporary clinic and started seeing 100 patients a day with a larger staff of U.S. expatriates and Nepalese.
Dr. MacKinney and his family faced the same survival struggles as the people he served. They were ill quite often – typhoid, dysentery, tuberculosis exposure – before their immune systems adapted. Additionally, a Maoist guerilla war that still rages today began the same year he arrived, and the conflict's epicenter was in the same district as the mission hospital.
His goal was to provide as much care as he could to as many people as he could, Dr. MacKinney said, and this often required learning some skills, such as surgery, on the spot. For one woman, he repaired an open dislocation of the knee and then created a splint from PVC pipe left over from the hospital's construction. For a man who entered the hospital paralyzed from cobra venom, Dr. MacKinney consulted a book, administered anti-venom, and six hours later, the man walked out. The villagers had never seen anyone survive that before.
"One of the joys we had was seeing cases that the villagers thought were hopeless," he said. "That guy probably had five minutes to live. We did it with common sense, a little bit of equipment and a little bit of medicine."
In addition to building the hospital, Dr. MacKinney was field director for two rural Nepal hospitals and oversaw their nationalization between 2000 and 2004. From Kathmandu, he oversaw 12 mission hospitals and helped develop clinical and educational models for all of Nepal.
Education / Training
- Residency in Internal Medicine - Johns Hopkins Bayview Medical Center - Baltimore, MD (1985-1988)
- MPH - Johns Hopkins University School of Medicine - Baltimore, MD (1988)
- Doctor of Medicine - Medical College of Wisconsin - Milwaukee (1985)