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Our latest Iran Chat is with Dr.\\xa0James Miller, Managing Director of the Oxford International Development Group, a health research and project management consulting company in Oxford, Mississippi. \\xa0

Dr. Miller began working in the area of health diplomacy in 2004 while seeking ways\\xa0to improve health outcomes and access to medical care for people in the impoverished rural Mississippi Delta region.\\xa0 For this, he turned\\xa0to Iran\\u2019s primary health care model, which is known for its\\xa0system of health houses staffed by citizen health workers who provide health education and preventative health services to their local communities.\\xa0 Recognized by the World Health Organization for its success in improving\\xa0medical outcomes for rural communities in Iran, \\xa0Dr. James Miller began working with the architects of this system to develop and adapt the Iranian model in ways that could address the health disparity challenges in the impoverished Delta regions.\\xa0 \\xa0

Our conversation with Dr. Miller involves an examination of this interesting project to bring Iran\'s health care\\xa0model to the rural Mississippi Delta region; it also covers\\xa0a range of related topical issues\\u2013 including the ways that humanitarian programs can improve dialogue and understanding between the US and Iran, and a broader discussion of health care, which continues to be a hot button issue in the US.\\xa0\\xa0

Some highlights from our conversation:

The Background of Iran\\u2019s Preventative Health Care System:\\xa0

\\u201cIn 1978 all WHO members unanimously agreed in the Alma-Ata Declaration \\u2013 a seminal document in public and global health initiatives that access to basic health services was a fundamental human right. The declaration also highlighted the importance of primary care and many countries, including Iran, revised their health care system around the primary health care focus\\u2026 After Alma-Ata, key health care experts in Iran including the late Dr. Shadpour, who was one of the original architects of the primary health care model in Iran, determined the most effective way forward for Iran was through the implementation of a comprehensive and integrated primary health care system with the health house serving as the main service entry point, and the results speak for themselves\\u2026. The infant mortality rate in Iran fell over 70%, with similar results in maternal mortality. Health care access in rural areas compared to those in urban areas all but eliminated health disparities, and infectious diseases were all but eliminated in rural areas."

Why Mississippi Looked to Iran for Help:

"The rural counties in the Delta are some of the most impoverished in the US and the living conditions in those counties have health indicators and economic conditions similar to those in developing countries. It\\u2019s shocking.\\xa0 Overall Mississippi is the poorest state in the US and today it has 22% of its population living below the poverty line. Subsets of that [are faring even worse]: the African American poverty rate is over 34%, Native Americans over 28% and Latinos at 27.5%.\\xa0 Mississippi is also the unhealthiest state, and it ranks last in national surveys by respected foundations and institutions\\u2026 [Furthermore] there has been no change, no discernible improvement with time.\\xa0Health problems twenty years ago are still the same as we have now.\\xa0 Of special concern\\u2026 and this is what got us so interested in the Iranian model: infant mortality rates in a number of Delta counties are similar to that of Algeria, Libya, and Vietnam\\u2026"

"[Therefore we looked to see if] there were some places around the world that might be similar in lack of resources, using a cost effective and adaptable model that we could deploy in those counties throughout the Delta region, and deal especially with the issue that there are few doctors available to serve this particular segment of the population.\\xa0 The World Bank and World Health Organization, and in researching\\xa0and reviewing the results,\\xa0all pointed to the Iranian system as being most effective."

Health Diplomacy: Meetings Between American and Iranian Doctors

"Doctors see things [from a perspective of] science and empirical analysis.\\xa0 They want to hear new things about treatments.\\xa0 From what I observed, when Iranian and American doctors\\xa0got together, it was like friends getting together for a great time, talking about their work and their families and personal issues.\\xa0 You couldn\\u2019t tell them apart!\\xa0 \\xa0My observation was they can get along famously.\\xa0 There is no problem between physicians and scientists:\\xa0 science is nonpolitical no one country owns science or medicine\\u2026 it belongs to us all and that is something in the upper most in physicians\\u2019 and scientists\\u2019 minds; it\\u2019s universal."

Making the Case to Politicians for Engagement:

"Back in December I started a letter writing campaign to my congressmen and senators to say, \'Here\\u2019s [my experience from my work engaging with Iran] and please take this into consideration when you\\u2019re viewing the Iranians and formulating Iranian policy.\\xa0 If you cut this positive channel of communication off, then we\\xa0(Americans) are the losers in this, and it\\u2019s going to just lead to more tension.\'\\xa0 In fact, this kind of public diplomacy is the kind of communication\\xa0we need to be emphasizing\\u2026 The State Department isn\\u2019t involved so much anymore in trying to build Iranian relations, so we the people have to do it, and we need to communicate it with our elected representatives."

"Our representatives have to consider what we know, what we have seen, what we hope.\\xa0 That\\u2019s the nature of a democracy and I\\u2019m trying to do my part, and I hope others who may listen to this podcast may be willing to do their part in helping us avoid conflict."