DANIEL Enquobahrie wanted to make a difference. Yet, having grown up in Ethiopia, where he later attended medical school in his country's capital, Addis Ababa, he knew that combating even common infectious diseases such as tuberculosis and malaria was problematic.

"There was a lack of medications,"? Enquobahrie says. "There were diseases related to the unavailability of clean water. Diseases related to malnutrition, inappropriate pregnancy care. All of these were compounded by the fact that resources were inadequate, as Ethiopia was a developing country."

Despite the less-than-ideal conditions for a health professional, Enquobahrie was happy with his rural practice. In fact, he'd probably still be there today if his girlfriend (and now wife) hadn't moved across the world to Seattle, where his life, too, would take a fortuitous turn at the University of Washington (UW).

The university since the mid-1960s has been a powerhouse in medical research, a nucleus for satellite research organizations and spin-off companies. It has developed into a major technology hub, where, in its Turing Center, engineering professor Oren Etzioni is trying to teach machines to translate languages. Its oceanography department is embarking on a multimillion-dollar underwater project, headed by professor John Delaney, that will allow scientists to monitor seismic and volcanic activity on the floor of the Pacific Ocean. And the university happens to be one of the most successful among public and private institutions at fund raising and endowment procurement. If it was resources Enquobahrie wanted, the university had plenty.

Enquobahrie graduated with a master's degree in public health this year and is currently pursuing his doctorate in epidemiology. His timing was ideal, as the university last year announced it was creating a Department of Global Health, a joint venture of the university's schools of medicine and public health and community medicine. The department will be the first in the nation. It will concentrate on building interprofessional educational programs, collaborative research, professional service in public health policy and practice, and medical care to establish sustainable improvements in global health.

The department will further identify and evaluate health problems and health inequities in underserved populations and will develop and implement innovative interventions that may reduce the proliferation of disease. There will be a research arm of the department that will work on infectious diseases, injury control, nutrition, the delivery of health care systems, and reproductive, maternal and child health. It will also build on existing research programs such as the origin and prevention of malaria, tuberculosis and hepatitis C.

ORGANIC GROWTH
The department was seeded by a $30 million grant from the Bill and Melinda Gates Foundation. UW officials estimate that the department could attract as much as $100 million in grants and contracts once it is fully operational.

The new department represents a consolidation of numerous, organically developed global health initiatives that have sprung up in and around the university. Many of them will likely operate under the global health department, which, while getting approval from the school's board of regents, is still under construction and is looking for a chairman.

"Seattle has become a worldwide center of global health somewhat quietly,"? says UW Medical School Dean Paul G. Ramsey. "Many of our faculty and students have research teaching and service-health-related programs in Africa, South America, Asia and other areas around the world. Fogarty International AIDS Research and Training program has been operating here since the early '80s."?

One of the pre-existing programs slated to be brought into the new department is the Multidisciplinary International Research Training [MIRT] program, which Enquobahrie took part in. MIRT sends students around the world to perform health-related, population-based research and training in developing countries. Last year, Enquobahrie spent a month in Tbilisi in the Republic of Georgia, where he conducted research on emergency cardiology patients to evaluate factors associated with risk and severity of coronary heart disease.

For years, UW has brought students such as Enquobahrie to the forefront of global health through international partnerships. But the creation of the department has helped integrate efforts "in a truly interdisciplinary fashion,"? says Daren Wade, who operates the Global Health Resource Center, one of the pre-existing programs that fall under the new department.

ENCOURAGING INVOLVEMENT
The new department may also encourage student involvement. Take, for example, UW student Molly Robertson, who is pursuing a master's degree in public health. Although she is only one class away from graduating, she is putting her education on hold and heading to Mozambique for two years to work with Health Alliance International (HAI) and its effort to thwart HIV/AIDS.

"AIDS is a big problem in Mozambique. As much as 12 percent of the population is infected. In some urban areas, it's up to 40 percent," she says. "I will be doing community outreach, telling community members about the HAI's clinical services and giving them support to take their medication."

The department may also be a catalyst to spur businesses into preventive action. Anne Marie Kimball, UW professor of epidemiology, says that SARS, HIV/AIDS and the avian flu have alerted companies to health considerations when doing business overseas. "Some of us are intensively interested in public/private partnerships as a means of assuring health care delivery, so companies with particular business interests may want to partner on humanitarian concerns in their countries of interest," adds Kimball, who is also the author of Risky Trade: Infectious Diseases in an Era of Global Trade.

Wade adds, "There is potential not only to spark new ideas, collaborations, projects and international relationships, but also to attract new people and organizations to the UW, the Seattle area and Washington state to work with us."?

For his part, Enquobahrie said the new department will help him pursue his academic career in research and teaching. Perhaps someday he may even go back to Ethiopia to work on public health issues. "Growing up in a developing country, the magnitude of health issues was brought to my attention at an early age. After seeing problems associated with poor health care and the human suffering caused by disease, the vision of making a difference motivated me to study medicine,"? he says.

"From trying to understand the determinants and outcomes of at-home labor and delivery in rural Ethiopia to identifying genetic factors in cardiovascular diseases, I have come to appreciate the complexity of global health problems and the challenge of studying them. The way public health in general and epidemiology in particular [have] evolved to confront this challenge is truly remarkable."