ONE HEROIC ENDEAVOR

PVAMU researcher of HIV/AIDS uncovers how a lack of transportation prevents health care in rural areas

Comic book superheroes like Luke Cage and Spiderman are admired for going where most cannot or will not to right a wrong or to help those in distress. The world needs such people, both in fiction and in real life.

Dr. Mark Tschaepe does not present himself as a hero — certainly not like the collection of larger-than-life comic book figures and posters that adorn his office — but the potential results of his work could lead to life-saving results for HIV/AIDS victims who reside in rural areas.

Dr. Mark Tschaepe

HIV/AIDS and how it affects its victims and society as a whole has been a constant focus of researchers since the early 1980s. Back then, doctors had yet to accurately diagnose the disease and struggled simply to identify the cause of several life-threatening cases involving severe immune deficiency.

Since that time, effective treatment methods such as protease inhibitors have been discovered and made available to contain the disease’s impact. But medical breakthroughs do no good if those afflicted lack the transportation to reach the health care facilities offering treatment.

Dr. Mark Tschaepe does not present himself as a hero — certainly not like the collection of larger-than-life comic book figures and posters that adorn his office — but the potential results of his work could lead to life-saving results for HIV/AIDS victims who reside in rural areas.

That’s the challenge in the spotlight of Tschaepe’s research. As an assistant professor in Prairie View A&M University’s College of Arts and Sciences with a background in public health and neuroscience, Tschaepe has been doing HIV/ AIDS research for about four years, enabled by the RR-6 Regional Research Project in Human Sciences, which is funded through the Evans Allen Research Program of the U.S. Department of Agriculture, Social Systems and Allied Research Unit. What he’s found is a serious lack of treatment accessibility for patients in rural areas like Waller County. Tschaepe’s research began with a focus on various science and methodology aspects of HIV/AIDS research and evolved into an ethical study. At the time, Tschaepe was researching how doctors at the University of California at Los Angeles Medical Center learned in the early 1980s that HIV/AIDS was a disease that no doctor had ever diagnosed.

The renowned Houston-based physician Wayne Shandera wrote the first report about AIDS in 1981 while at UCLA Medical. While conducting his own research, Tschaepe realized Shandera was working at Baylor College of Medicine in Houston. Tschaepe contacted and interviewed Shandera, and gradually became inspired about focusing on accessibility to HIV/AIDS treatment as well as HIV/AIDS education.

“It became something very personal for me,” Tschaepe says. “I figured, ‘I’m in a professional position where I can actually give back to the community,’ so I got involved with AIDS Foundation Houston and became a board director there, which I still am.”

Working at PVAMU in a largely rural area like Waller County has proven to be an ideal location for the research goals Tschaepe is pursuing. “There is what is known in the CDC (Centers for Disease Control and Prevention) as the ‘Southern strategy,’ which involves targeting rural areas to try to solve this issue of the rates of HIV increasing,” Tschaepe says. “We see (HIV) rates decreasing in many urban areas of the North, however in the South, both in urban and rural areas, we see them rising.”

Tschaepe’s research soon revealed how Waller County residents badly needed access to basic health care in general — not just for major ailments like HIV/AIDS.

“What the research opened was this entire medical desert,” he says. “This lack of health care within the county. My next step is to look at how this is affecting minority populations. This includes children and the elderly because those

are two populations that are not only overlooked with regard to HIV, especially in the rural South, but overlooked with regard to health care in general,” says Tschaepe.

And when a community survey on health care was conducted in 2010 by Texas A&M University, adequate transportation stood out as the No. 1 problem, Tschaepe says.

Currently, Tschaepe is preparing a survey for Waller County to more closely track health care accessibility issues. “If we have transportation, we don’t often think about it,” he says. “When we look at minority populations, as well as the elderly and children, are we considering whether these groups are able to access health care?”

Tschaepe has already noted that the average traveling distance to reach health care takes half an hour for many people. “There are very few primary physicians in Waller County,” Tschaepe notes. “Also, Waller County has no one who specializes in issues involving therapy with regard to African-Americans or Latinos and no one specializing in issues of sexuality or gender.

“For people within the transgender population in Waller County (for example), no one is facilitating their needs at all,” he says. “There is no one group more important than another. I’m interested in uncovering what the needs might be for groups that are being ignored.”

In Waller County, the disparity between the number of potential health care patients and available primary care physicians is 17,700 to 1. Compare that to Brazos County, for example, where the disparity is 982 people for every one physician. In Harris County, it’s about 1,500 people per physician.

Tschaepe recalls that he and a former graduate assistant who helped him gather research learned that some staff members at the Waller County Department of Health and Human Services assumed PVAMU actually had a direct role in providing health care services. Securing statistical health information within the county can take time, he says. “There’s a lot of delegation and outsourcing,” he adds. “Waller County gets outsourced to Brazos, Brenham, and Cypress, but that does not cover the immediate needs of people within the county who lack the transportation to travel out of Waller for necessary health care treatment.”

Tschaepe will soon examine comparisons between Waller County and surrounding counties. After that, Tschaepe would like to propose methods on improving accessibility to departments of health and human services in rural areas across the Southern United States.

“Extending the work beyond Texas is the ultimate plan to facilitate more inclusive work that uncovers needs within other rural communities that may be facing similar issues (regarding accessibility),” Tschaepe says.

There’s a great deal of opportunity for PVAMU and the community-at-large to work together in resolving various challenges, he says. “Through this kind of needs assessment, we might be able to form stronger community-based partnerships between the university and Waller County that actually can provide some of the services that could fold into curricula re-development and student learning.” o

assessment needs

“What the research opened was this entire medical desert. This lack of health care within the county. My next step is to look at how this is affecting minority populations. This includes children and the elderly because those are two populations that are not only overlooked with regard to HIV, especially in the rural South, but overlooked with regard to health care in general,” RESEARCH EXCELLENCE AT THE VIEW – Dr. Tschaepe 21