Entrant: Maureen Reinsel
Nominee: John Varallo, MD, MPH, Senior Technical Advisor
Obstetricians and gynecologists choose to dedicate themselves to women’s health, but that alone does not qualify them as a Women’s Health Hero. A hero humbly exceeds the average expectations to create true and lasting positive change. Dr. John Varallo, through his selfless and untiring contributions to women’s health in the United States, Guyana, Tanzania, Uganda, Belize, Guatemala, and Australia, is a Women’s Health Hero.
While I know him through his work on cervical cancer prevention and treatment in Guyana, it is far from his only contribution to women’s health globally. Dr. Varallo works with the most vulnerable women, and inspires others to join him through education and collaboration.
Dr. Varallo has contributed to improved prevention and treatment of cervical cancer, particularly among HIV positive women. Cervical cancer, caused by the sexually transmitted Human Papilloma Virus (HPV), is a preventable disease that kills an estimated 253,500 women worldwide annually (National Cervical Cancer Coalition, www.nccc-online.org). The burden of disease is particularly onerous among HIV positive women, who have a more difficult time clearing the virus from their system and in whom the cancer moves significantly more quickly.
Dr. Varallo’s efforts have led to a considerable expansion in coverage of cervical cancer prevention, detection, and treatment. In Guyana alone, he has trained 23 physicians, advance practice nurses, and registered nurses in one year to detect and treat pre-cancerous lesions. His work in Guyana has led to the Ministry of Health instituting a national cervical cancer prevention and treatment program, and he was the principle author of the country’s cervical cancer prevention and treatment policy and guidelines.
Providers trained by Dr. Varallo have screened more than 5,000 women in one year, providing approximately 800 women with preventative treatment. In addition to his work in Guyana, Dr. Varallo has trained health care providers in cervical cancer prevention and treatment in five other countries, including the United States.
Dr. Varallo provides hospitals, clinics, and providers with support on reducing maternal and infant mortality, improving family planning services, and integrating women’s health into HIV/AIDS care and treatment. In all of this work, he has dedicated himself to improvement of health care for society’s most vulnerable. In the United States, he works primarily with American Indian communities, having provided clinical services and leadership with the Indian Health Services in Montana, Arizona, and Alaska. He provides pro-bono clinical services for asylum seekers with Physicians for Human Rights. Not satisfied with sitting in an office to see patients, Dr. Varallo goes to meet women where they are.
He has led or participated in mobile clinics in Australia, Guatemala, Belize, Guyana, Uganda, and the United States (Australia, most notably), going into remote communities to see and treat women who rarely have the chance to receive health care services at all. Not only does Dr. Varallo treat these women; he also treats them well. In my experience and that of my colleagues, his visits to Guyana that include clinical days mean long lines of women, including health care workers, who demand to be seen by “Dr. John” because they appreciate his respectful and open bedside manner, which is in stark contrast to the condescending treatment they so often receive from other providers.
Dr. Varallo is a leader and educator; he does not provide these services alone, but rather builds the skills and commitment of other providers to join him in preventing the needless deaths of women wherever he is working. This might be the most critical element of his heroism: catalyzing the actions of others. He taught for three years at the Medical University of South Carolina, but then began to take his pedagogical skills global. He has provided Continuing Medical Education for health care professionals in Guyana, Belize, and the United States (Alaska) in topics as varied as:
- Gestational hypertension and hypertensive crises in pregnancy
- Pre-eclampsia and Eclampsia
- Prevention of mother-to-child transmission of HIV
- Postpartum hemorrhage
- Diabetes in pregnancy
- Cesarean section
- Family planning and modern contraception
- Cervical cancer
- Abnormal uterine bleeding
- Uterine fibroids
- Management of unexpected labor and delivery
- Collaborative prenatal care
As someone who dreams of one day being a women’s health nurse and who works in the field of international public health, I am surrounded by people who spend their days endeavoring to improve health care globally. Nonetheless, Dr. Varallo stands out as someone with a unique level of commitment. He has inspired in me a real passion for preventing cervical cancer, and has earned my admiration through the genuine kindness and the respect that he demonstrates to everyone he works with, from clients to community health workers, from student nurses to the Minister of Health.
Dr. Varallo is my Women’s Health Hero.