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Early in my career, when I was an intern, having just finished medical school, I attended the Medical Association of Georgia’s annual meeting. One of the issues being debated was whether sexually transmitted diseases needed to be taught in medical school. I stood up in a room of maybe fifteen people and said I thought there was a need. The resolution passed and the Georgia delegation sent me to the American Medical Association convention to speak to the same issue – and the resolution again passed. Within six months every medical school in this country was encouraged to include sexually transmitted diseases as part of their core curriculum.  I learned that one person can make a difference, whether it’s in medical policy, in medical practice, or in reproductive health.


I learned that one person can make a difference, whether it’s in medical policy, in medical practice, or in reproductive health.

We know that lack of access to reproductive and sexual health is a leading cause of morbidity and mortality in the world. In the United States, it is one of the key strategic priorities that we’re pursuing at the Department of Health and Human Services through our National Prevention Strategy. As we know in the international arena, these issues may differ in magnitude, but they are very similar around the world, from the small town in Alabama where I started out as a doctor to villages in Africa. We need better access to prenatal visits. We need to increase the number of skilled healthcare workers, increase the number of cervical cancer screenings, and increase access to STD and AIDS screening throughout  the world.

When I began to practice medicine, the National Health Service Corps sent me to Bayou La Batre, Alabama, a small fishing village of 2500 people along the Alabama Gulf Coast. It’s a pretty place, but it’s a poor place. I found a community of working poor, too poor to afford medical care, but too rich to qualify for Medicaid. I quickly learned that my patients had problems my prescription pad alone could not cure.

I realized that in addition to providing my patients with information about basic health care such as diabetes, hypertension, and reproductive health, I needed to bring in programs to help some of them learn to read, find jobs, and to help keep our bayou clean. This work continues as surgeon general as we recognize the social determinants of health in all our initiatives.

I learned from my grandmother that you can always make a difference in someone’s life. Our homestead is along a highway, and during the Depression of the 1930s, my grandmother would set out lemonade and sandwiches for the poor and hungry who would be passing by. The hobos, as some regulars were called, knew there would always be something there to eat and a cool drink. I learned it is important to be a part of your community and help others, whether you know them or not.

Often I think of my mother’s older sister, whom I never got to meet. As the story goes, she was sixteen years old when she became pregnant, unknown to her family. She apparently got sick, because her baby had died, although no one knew this.

My aunt got sicker and sicker until she became septic and she, too, died. It was preventable. I often imagine the "what ifs"– what if she had access to family planning, a home pregnancy test for example, what if she had necessary prenatal care, what if she had a simple ultrasound, or just the information to know what to expect.
 
Sometimes challenges can seem insurmountable. But it is often women – like my grandmother, my mother, and aunt – who inspire me and keep me going.

The day that President Obama held a press conference in the Rose Garden to announce my nomination as surgeon general, my immediate family was not there with me. My mother had died of lung cancer because she started smoking as a teenager. My father died from complications of a stroke, due to high-blood pressure, and my brother,  my only sibling,  died of HIV. All of these were preventable diseases, and I don’t want anyone else to suffer the loss of a loved one from a condition that could have been prevented.

Prevention is the foundation of my work as surgeon general, especially in terms of women and reproductive health – from sexually transmitted diseases to smoking, to eliminating chronic diseases.

I am honored to chair the National Prevention Council, consisting of seventeen federal agencies. Our vision is to change our health care system from a system based on sickness and disease to one based on wellness and prevention. To make prevention and wellness a part of our everyday lives and everything we do.