SEGMENT 3: Dr. Michael DeBaun talks about his community outreach projects, including his work at a Nashville community health center and the Sickle Cell Sabbath program.


Dr. Gary H. Gibbons, director, NHLBI:  I know that in addition to your contributions scientifically and clinically and in this educational realm, that you also integrate and see that as part of an extension to the broader community that is affected by – is where your patients are derived from. Could you speak to that interface of engaging people not only within the clinic walls but where they live and the involvement you have in communities and the areas that surround your practice? 

Dr. Michael DeBaun, Vanderbilt University:  I’m thrilled to have the opportunity to pursue this medical home model of sickle cell disease at Vanderbilt. I dare say it’s an experiment. I’m not sure what the end result will be, but we are having tremendous fun pursuing this vision. What we’ve done is essentially moved the specialty care team out of the boundaries of Vanderbilt School of Medicine and we have embedded ourselves into a community health center located in the heart of the black neighborhood in Nashville. The interaction is unbelievable. 

I will just give you one small story to give you a sense of the advantage of the specialists working in a community health center alongside an internist and a pediatrician. I have a 3-year-old with sickle cell disease and her mother was unable to assume responsibility so the grandfather and grandmother are now her legal custodians. They are working poor. We have extended our hours to the last appointment occurring at 6:00 so they always see this young lady, this 3-year-old girl who is on hydroxyurea, we always see her every two months in the evening around 5:30. A completely dedicated family. 

As I was sitting there evaluating the child it became clear to me that the grandfather did not look healthy. He was at least 50 pounds overweight. His wife also was not healthy-appearing. And I asked them when was the last time they had seen a physician. They looked at me and said, “It has been a while.” I said, “Well, how long is that?” They said over 10 years. And so the impact of this child’s grandparents having an acute illness would have had a tremendous impact on this child’s quality of life. Because of the set up of the community health center, I was able to do something that we used to do growing up, just yell out the door. That is what I did. Everybody got a big kick out of it. I said, “Dr. Holley, I have a new family for you.” Then I walked around the corner and knocked on Dr. Holley’s door and asked him to come on out and meet the family. He spent about five minutes in the room with all of us. That’s what I think it’s about, right? The boundaries and the barriers in our current academic center doesn’t truly allow that to occur. And yet, the need is even greater now than it has ever been for our families. 

So we enjoy the opportunity to take care of our families. We have evening clinic hours one day a week and we have clinic on Saturdays for our working families. That’s one aspect of the community involvement. 

We have a program that has taken off in Nashville, but we started in St. Louis, that we refer to as Sickle Cell Sabbath. This was directed specifically to improve the knowledge about the importance of blood donation in the African American community. When we first started off in 1999, there were less than 3,000 units that were designated as units coming from African Americans. By the time I left, we had been up to as many as 17,000 units donated from individuals who identified themselves as African Americans – per year. The impact has been unbelievable because we get the opportunity to be at the pulpit for five or 10 minutes to explain the importance of knowing one’s sickle cell trait status. Many African Americans aren’t aware that they are a carrier of the sickle cell trait or c-trait or thalassemia trait. We have blood drives usually on a Sunday and there was a window of time where we were able to actually perform sickle cell trait testing. 

We took that model that was funded by NIH and multiple publications and came here to Nashville and was able to team up with Meharry Medical College. In the first year, we had six churches we were working with, and this past year, we have 12 churches that we are working with, to do exactly what I just said, which is provide sickle cell trait testing at the site, have an educational session for the congregation and then partner with the American Red Cross in the Nashville area and have blood donation. 

The blood donation doesn’t go specifically for children with sickle cell disease or adults, it’s the act of giving and understanding the importance of blood donation for all of us who may eventually need blood. 

Dr. Gibbons:  Excellent. That’s great work.