Bethany Hubbard

1. NU-AID establishes new site in Oaxaca

   December 7, 2011 by Bethany Hubbard
   

   The Oaxaca team at a weekly lecture on global health issues wearing their new brigade-vests for the upcoming fieldwork. (Muthiah Vaduganathan - bottom row, first from left, Mania Kupershtok - bottom row, first from right)

   For more than 10 years, the Northwestern University Alliance for International Development (NU-AID) has been sending medical students to Latin America to provide care for underserved populations. This past summer, for the first time, 10 students traveled to Oaxaca, Mexico to establish a new project site.

   “Prior to this trip we were going twice a year to Nicaragua,” said NU-AID board member and second year medical student Pedro Engel Gonzalez.

   Gonzalez, who helped plan the Oaxaca trip, said the site was chosen after they were given the challenge of finding a location where students could not only stay longer, but also work within the country’s medical system.

   “We decided that the Oaxaca trip provided a similar opportunity to what we were doing in Nicaragua – working with an underserved population and tropical medicine,” he said, adding that the Oaxaca trip lasted a month, significantly longer than the week-long Nicaragua trips.

   NU-AID partnered with Child Family Health International, a U.S. non-governmental organization, started many years ago by a Stanford student who wanted to provide more opportunities for medical students to work in global health in a sustainable way.

   Muthiah Vaduganathan, a fourth year medical student, was a member of the 10-person team that traveled to Oaxaca

   

   Public health "platica" (or lecture) attendees holding up their mosquito nets donated by the medical students.

   this past summer.

   “I was looking for a good opportunity to see real kinds of international health issues and have a global health experience,” he said. “We were able to see many clinical situations that we wouldn’t get to see in the United States.”

   The first two weeks students worked in several different clinics with local physicians. Vaduganathan said Dengue fever, a virus transmitted by mosquitos, and Chagas disease, also spread by insects, were a few of the illnesses students saw at the Oaxaca clinic.

   The second two weeks were devoted to public health issues. Vaduganathan’s team addressed the high maternal mortality rates. They spoke with midwives and 40 local women about contraceptives.

   “This is the first time they were being exposed to health workers from abroad,” he said. “We were able to integrate our talks into their existing system.”

   Mania Kupershtok, a second year medical student who was another member of the Oaxaca team, went on a previous NU-AID trip to Nicaragua. She said the Oaxaca trip was another great service-oriented opportunity.

   “They have a really strong public health foundation,” she said, citing Oaxaca’s Opportunidades program, which the NU-AID team worked in tandem with. “I was surprised at how well they are currently doing. In the poorest areas everyone was still very educated about diabetes, hypertension – even down to how it works in your body.”

   Though there is always room for more education, Vaduganathan said the people of Oaxaca are doing well with what they have.

   “Although resources and money really limit a lot of the overall care, I think with the resources they have, the Mexican health care system was actually very efficient in terms of how they utilized those resources,” he said. “Their care for every day issues was excellent.”

   Gonzalez said NU-AID plans to return to Oaxaca next summer, and though he won’t be able to join the trip then, he hopes to participate in his fourth year.

   “How to reach out to underserved populations globally is a hard topic right now,” he said. “Hopefully we’re going to be sending a trip every year.”

   Learn more about NU-AID: http://groups.northwestern.edu/nuaid/

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   Category: Child Health, Community Health, Global Health Initiative, Global Initiatives, Infectious Diseases | Tags: Mexico, NU-AID, Oaxaca | Comments (0)

2. Initiative addresses maternity care concerns in Tanzania

   October 31, 2011 by Bethany Hubbard
   

   Dr. Crystal Patil with traditional birth attendants in Tanzania, where she has been studying maternity care at the Haydom Lutheran Hospital. Photo courtesy of Dr. Crystal Patil.

   Imagine being pregnant, without a car and more than six miles away from the nearest hospital. This is the reality for many women living in rural north-central Tanzania. As a result, giving birth can be dangerous and even fatal. But, global public health agendas, like the Safe Motherhood Initiative and 2015 Millennium Development Goals, have been inspiring change.

   In 2008, the Haydom Lutheran Hospital, in the Mbulu district of the Manyara region of Tanzania, began offering free ambulance and maternity services in an effort to reduce maternal mortality rates.

   Biocultural anthropologist Dr. Crystal Patil, who is an assistant professor of Anthropology and African American Studies at UIC, has been studying the effects of the policy changes at the Haydom hospital. She presented her research to students in Northwestern University’s Program of African Studies, as part of the program’s “Public Health in Africa Series.”

   “Some social and economic barriers were removed by this policy,” Patil said. “But, the changes in the policy may have had an impact on the quality of care.”

   The Haydom policy change has been effective with 4,558 hospital births reported in 2008, up from 3,343 the previous year. In addition, 94 percent of those who live less than two kilometers from Haydom gave birth in the hospital.

   However, there are many factors still keeping women at home when they give birth, and several challenges preventing the new system from

   

   Ambulance driver dropping off a laboring woman to the maternity ward at Haydom. Photo courtesy of Dr. Crystal Patil.

   running smoothly.

   Patil and her team conducted interviews and surveys, and held village meetings. They spoke with mothers, hospital workers and traditional birth attendants.

   Women said gossip, perceived discrimination, social support, transportation and sudden labor are some of the many factors that influence where they choose to give birth. Often the reason was simply, “Huwezi kupanga,” which means, “You just can’t plan.”

   But, even if planning is possible, once a woman reaches the hospital, she may not receive a nurse’s care because Haydom is severely understaffed.

   “So if the woman comes in and she looks OK, they have her labor by herself and deliver by herself,” Patil said. The nurses feel they can’t perform their jobs properly because it’s physically impossible.

   Because of this, nurses can’t accompany ambulance drivers, who already face poor road conditions and difficulty locating homes.

   “The ambulance drivers aren’t trained to provide healthcare services,” Patil said. “They’re mechanics, so they’re not comfortable going to pick up a laboring woman.”

   Though the policy changes have given women more support, there is still a long way to go. Patil said women want to be treated well even if the care they are receiving is free. But, with so few options, it is hard to make a case.

   “People don’t have choices,” Patil said. “You have to go to the closest one, so choosing a hospital based on quality of care is impossible.”

   Jessica Pouchet, a first-year graduate student in anthropology, came to Patil’s talk because she will be doing her fieldwork in Tanzania, studying the connections between language and environment.

   “One element that resonated with me was how the distance from the hospital affects women’s decisions on where to give birth,” she said.

   Even as distance becomes less of an issue, such policy changes need to be matched with changes in staffing, said Patil, who heads to Malawi on Friday to work on a group antenatal care project. Until then, women’s hospital birth experiences may be compromised if such quality of care issues are not addressed.

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   Category: Child Health, Community Health, Global Health Initiative, Global Initiatives, Infectious Diseases | Tags: Mexico, NU-AID, Oaxaca | Comments (0)