Women's Rights and Health Outcomes

Lately there has been a lot of discussion about women's empowerment in Globemed at Brown. It is interesting to think about how gender roles and women's empowerment directly and indirectly relates to health outcomes. For example, there has been research done in Lesotho, Africa that describes how many AIDS orphans lack caretakers since that is typically a "women's" role, and therefore men are hesitant to take responsibility for care. Issues such as this one really emphasize the fact that gender discrimination and social norms can be devastatingly restrictive in many aspects of daily life. How can these norms be changed or altered in order to better health outcomes? Are health initiatives more or less effective in areas with strong traditional gender roles? I think it is crucial to look at articles and issues written about women rights and the oppression of women and try to put these events in the context of health. How can this societal judgment harm or extinguish the lives of those who give life?

An interesting article to try to read through this lens is one titled "Why Do They Hate Us" by Mona Eltahawy. 

- Megan M.

Public Health Concerns in the Aftermath of Haiyan

Last week, the Philippines were ravaged by what may be the most severe typhoon in history, Haiyan. The reported death toll has risen to almost 4,000 people, and many more have been injured, displaced from their homes, or otherwise affected. 

According to this Popular Science article by Brooke Borel, the immediate public health concern is dealing with the trauma inflicted by the storm itself, including preventing or treating infection in injuries sustained. To address this, mobile hospitals are being set up around the country to treat patients on the ground as well as address their daily health issues. 

Perhaps more difficult to contend with is the public health dangers associated with the loss of infrastructure. With no clean water or reliable sanitation, Filipinos will be extremely vulnerable to diarrheal diseases, like cholera, and vector-borne diseases, like malaria. Preventing the spread of these diseases will be challenging because they they cannot be defeated with medicine alone. To stay healthy, Filipinos will need safe drinking water, sanitation systems, and new housing, even in the most remote areas.

What other public health measures do you think should be taken after natural disasters like Haiyan?

Anna

How should we approach aid?

International aid is a contentious issue. Between the efforts of NGOs and the at times heavy handed influence of developed nations, the realm of aid and relief work is usually a jumbled mess. Progress tends to be iffy, metrics for tracking development skewed, and consistency in methodology and follow-through shoddy at best.

This TED Talk is one of my favorites. My senior year Economics teacher presented it to the class during our development studies and used it as a launching point for the Sachs vs. Easterly debate in development economics (give this a Google search if you have never heard of these guys). Ernesto Sirolli provides a compelling thesis for the reasons behind the failure of much of the developed world's aid work in LDCs. He suggests that rather than coming onto the scene with a predisposed idea of what might be the most effective aspect of life to target, the true potential for success in development comes in true cooperation with those in need. A welcoming ear seems to outdo deep pockets when we look toward true progress.

http://www.ted.com/talks/ernesto_sirolli_want_to_help_someone_shut_up_and_listen.html

Cheers,
Mike

The Increasing Presence of Mental Health in Global Health

Over the past fifteen year, the field of global mental health has emerged. International organizations, such as the World Health Organization, have created departments specifically for mental health. Prominent health focused NGOs (e.g. Partners in Health and Doctors Without Borders) have expanded their programs to address mental health and now employ numerous mental health workers. There are research centers at universities and hospitals dedicated solely to global mental health. Our partner, U-Tena, has actually put mental health on their agenda for this year. This significant push towards understanding and improving mental health has revealed the significant and prevalence and burden of mental illnesses around the world. The WHO estimates that mental illness account for 15% of the global burden of disease and that approximately 4 to 5 million people have a mental illness. See this recent article on the prevalence and burden of depression for example of what this research looks like: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001547. The poor treatment and human rights abuses of individuals with mental illnesses has also come to light. The famous medical anthropologist, Arthur Kleinmen, wrote that conditions and treatment of individuals with mental illnesses are “a failure of humanity” (his 2009 article on this topic: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)61510-5/fulltext). The field of global mental health, however, does certainly have its critics and there are legitimate concerns about the over use of psychotropic medications and imposition of western models of mental illness. This article titled “The Americanization of Mental Illness has more information on this topic: http://www.nytimes.com/2010/01/10/magazine/10psyche-t.html?pagewanted=all. While debates rage on about the proper ways to address the issue of mental illness globally, it is now clear that there is no health without mental health and that this is an issue anyone interested in global health must confront.

For more information on the field of global mental health check out these videos and articles:

Vikram Patel’s TED Talk “Mental health for all by involving all”: http://www.ted.com/talks/vikram_patel_mental_health_for_all_by_involving_all.html

“Grand challenges in global mental health”: http://www.nature.com/nature/journal/v475/n7354/full/475027a.html

“The Unseen: Mental Illness’s Global Toll”: http://www.cartercenter.org/documents/2407.pdf

- Daniel C.

HCV--silent killer

http://online.wsj.com/news/articles/SB10001424052702304200804579163523170170660

HCV (Hepatitis C Virus), often called the "silent killer," is a virus that causes Hepatitis C which affects the liver, and may lead to various liver diseases including cirrhosis.  HCV is often neglected because it does not have one of the highest rates of infection and mortality rate recorded in the United States.  However, considering that the risk groups, such as IDUs (injection drug users), are not included in national surveys, much higher rate of the disease is highly likely.
Especially, baby boomers are under risk, due to high experiment drug uses in the 1960s and 70s and low surveillance of blood supply used in transfusions.

Push for HCV testing for all baby boomers at doctor's visit may help to catch the "silent killer," and treat it before it leads to liver failure.

-Hwajin

Hilltop 2013

Hi everyone! This past weekend I attended Hilltop at Columbia, which is a global health conference for students in GlobeMed.  I would love to share with you all some of the things I took away from the conference, and how this might help us function as a chapter.  I would also like to touch upon some of the main points of the lecturers and how they pertained to the theme of the conference.  The theme this year was "Politics, Culture and Business: Expanding the Conversation on Global Health."

The main takeaway I got from the combination of lecturers and group forums was that the global health discussion is moving in a different direction.  The use of the private market to make global health projects possible is something that we are seeing more and more.  The first speaker was Mark Arnoldy, the executive director of Nyaya Health.  Nyaya is an non-profit that works in Nepal to provide healthcare for those who cannot access it.  It does so by using the basic infrastructure already there and building upon it.  For example, it works to improve small clinics that are closer to people in rural areas than the major hospital.  Another interesting event was a panel of people who work in global health, but also in the business world.  The connection of for-profit organizations and non-profit global health organizations was discussed.  The notion that businesses can be making a profit while a non-profit also helps to promote health equity is just now being discussed.

The really great element to the conference was meeting people from GlobeMed chapters from around the Northeast as well as a few people from Wisconsin.  My fellow hosted student was actually from the University of Michigan.  We had plenty of discussion about our own chapters and how they differed/compared.  Overall, I was very impressed by other chapters as described by their representatives.  They had some really great ideas for how to raise money, how to unite our chapter, and how to make our name known on campus.  I am going to list some of the ideas I jotted down here so that we can all take a look and see if any would be appropriate for Brown:

-5k (people from many chapters have done this but it may be a bit much for PVD)
-bar crawl (mentioned by a Tufts student)
-Color wars (basically throw paint at each other)
-Gala for GlobeMed
-Karaoke night
-Hosting a party at a club downtown

These are just a few of the ideas I got from the conference! It was a great experience and I think if you get the chance to attend at least one national conference during your time in GlobeMed you should take it! I think that it gave me and Betty a chance to bond and I ended up making a friend all the way from Michigan.  If nothing else, it was a networking opportunity. If anyone has any questions about my experience feel free to talk to me!


GlobeMed Love,

Leah Rivard

Improving health and standard of living

1) http://www.ted.com/talks/ernest_madu_on_world_class_health_care.html

2) http://www.ted.com/talks/andrew_mwenda_takes_a_new_look_at_africa.html

3) http://www.ted.com/playlists/67/the_quest_to_end_poverty.html

I found these TED talks to be interesting, because they relate to the topics we have been talking at our weekly meetings. 

In the first video Ernest Madu uses the Heart Institute of the Caribbean in Jamaica, as an example of what can be done in Nigeria to improve the treatment of cardiovascular diseases. He points out that efficient treatment is possible and does not have to be expensive. 

In the second Andre Mwenda suggests that the international world not just view Africa as a charity case, but should help the continent become self-efficient. The continent needs opportunity and has potential. Africans need wealth, in order to treat the causes that create disparity. 

In the third video Jacqueline Novogratz explains Jane's escape from poverty. Jane lived in a slum outside of Nairobi, but was able to provide for her family and move into low-cost housing. This third link also has 7 other videos, which all relate to the quest of ending poverty. 

Got Community?

This past Sunday, our Community Builders organized a small group of staff to decorate a box that will be used to collect winter clothing donations for the needy. Brown students will get to see our handiwork outside the doors of campus's main dining hall and donate their unwanted clothing to a good cause.

Camille and Megan adorn the clothing donation box with drawings of winter
clothes and other winter-themed items like snowflakes and snowmen :)

So far this semester, Community Building has done a wonderful job planning events to get staff to know each other. Several weeks ago, the Community Builders prepared a scavenger hunt that pitted the staff (divided into 3 teams) against each other in heated competition to hunt for campus's primary landmarks (and others that were not so well-known or obvious!). In two weeks, the Community Builders will hold a movie screening and potluck meal so staff can gather and socialize one more time before the Thanksgiving break.

GlobeMed at Brown is just as much about creating community among staff as it is educating staff about global health issues and fundraising for our partner, U-Tena –– so thank you Community Builders for all the fantastic work you're doing!

Marisa M.

Cancer is Only For Rich People, Right?

For a class this semester at Brown, one of the assigned texts included Julie Livingston’s Improvising Medicine. One of the discussions in the book revolved around cancer in Botswana that discusses how the world outside of Africa does not usually correlate the specific disease of cancer with Africa. Most people believe that Botswana has not yet undergone the epidemiological transition we see in wealthier states, and that infectious disease, rather than chronic disease, is overwhelmingly the single most important cause of morbidity and mortality. Livingston’s ethnography elucidates, however, how not only does cancer exist in Botswana but it takes on an entirely different form. As opposed to the pre-screening and testing that characterizes cancer in the United States, in Botswana, because hospitals are considered the last possible option for most people, cancer arrives at the hospital as irreversible and the patients essentially cadaveric. The reason I bring this up is because Livingston helped remind me to back away from assumptions regarding global health. I feel like it can be easy at times, especially because we as GlobeMed at Brown often focus on AIDS and HIV, to forget that health problems that people around the world actually suffer from are not always what we assume and expect them to be. At the same time, we also have to be wary of assuming that certain diseases and conditions have universally common lived-experiences and etiologies. The book as a whole was an eye-opening and interesting read for anyone interested!

Shyam