|Davidson H. Hamer, MD, FACP, FIDSA, FASTMH
Zambia Center for Applied Health Research & Development
Upon graduation from the University of Vermont College of Medicine, Dr. Hamer did a residency at the Washington Hospital Center in Washington, DC. Recalls Hamer, “Doing my residency in Washington, DC; in a large urban hospital from 1987 to 1990 during a surging epidemic of HIV in the MSM, IDU, and heterosexual communities stimulated a long term personal interest in HIV. This was a psychologically tough time when many patients came in with multiple opportunistic infections, profoundly low CD4 counts, and the outcome of their illness was often death.” As Hamer’s career continued, he did an Infectious Diseases fellowship at Tufts-New England Medical Center. He has provided care in drug and alcohol rehabilitation centers, rehabilitation hospitals, travel clinics, and nursing homes. Hamer is board certified in Internal Medicine and Infectious Diseases, and has Certificates in Travel Health (ISTM) and ClinTropMed (ASTMH). Hamer had an unique opportunity to work in Dhaka, Bangladesh after his first year in medical school where he spent a few days at a pediatric nutrition-infection clinic. “Seeing children blinded from vitamin A deficiency, wasted from severe malnutrition, and infected with measles and other vaccine-preventable diseases triggered a lifelong interest in the interaction between nutrition and infection,” says Hamer.
For over three years now, Hamer has been on leave from patient care while working as the Director of Research and Evaluation at the Zambia Center for Applied Health Research and Development in Lusaka, Zambia. While his research activities are focused on maternal, newborn, and child health, HIV has a major influence on outcomes there given the scope of the epidemic in Zambia. In teaching rounds at the provincial hospital in Lusaka, there are many young patients, aged 20 to 40, with HIV, often complicated by tuberculosis or other opportunistic infections. Says Hamer of his work in Zambia, “Seeing research results translated into national or global policy is very rewarding especially when these lead to population-level benefits. Working in sub-Saharan Africa and Asia, one of the greatest obstacles that I encounter is the health system. Quality of care, communication between different levels of the health system, inadequate transport for referrals, disgruntled, over-worked health workers, shortages of supplies, and stockouts of medications combine to make the delivery of high quality care a major challenge.”
Hamer feels it is important to really know his patients; their personal life style, usual schedule, work and home situations, in order to understand potential barriers and facilitators to adherence to their ART regimens. “I also review their most recent medication-taking at each clinic visit to make sure that they are on track and try to identify new problems such as increased drug or alcohol abuse, or depression that might be interfering with their adherence,” says Hamer. His clinic uses a team approach so that a physician, nurse, and often a psychiatrist and a pharmacist all work with individual patients to help them to cope with the health care system, side effects of their medications, and adherence. “While this approach may not be unique, if implemented effectively, it can provide major benefits to our patients.” Hamer’s hope is to be able to make substantial contributions through evidence-based interventions to improve the health of mothers and children in sub-Saharan Africa.
Looking to the future, Hamer’s envisions the field of HIV care to utilize personalized approaches to the initiation of ART, faster, more efficient tests for genetic susceptibility to adverse effects of medications, and rapid tests for antiretroviral resistance. Outside of his professional life, Hamer enjoys tennis, skiing, traveling, cooking, oenology, and learning about different cultures. As for why he is an AAHIVM Member, Hamer says, “I joined AAHIVM due to my longstanding interest in HIV care and to work within a society that helps strengthen the quality of delivery of HIV care while concurrently advocating for providers who practice within this specialized field.”