Patricia Hastings

1. Northwestern students advocate access to treatment on World AIDS Day

   December 6, 2011 by Patricia Hastings

   December 1 marks World AIDS Day — a day to show support for survivors, remember those who have died and unite in the fight against HIV.

   Feinberg School of Medicine students hosted a series of events on this day to promote the global AIDS discussion.

   I’ll admit, at first I was skeptical. I wondered, how could medical students at a prestigious university in the States’ third large city possibly understand the plight of the estimated 33.3 million people living with HIV?

   Turns out, they know a thing or two.

   “We’ve been taught that it’s a chronic disease that’s totally treatable,” said Chelsea Carlson, 2nd year Feinberg medical student. In reality, she added, only 20 percent of people have access to treatment worldwide.

   More than 75 percent of the 1.2 million people diagnosed with HIV in the U.S. are linked to care within four months, according to an estimate released Tuesday by the Centers for Disease Control and Prevention.

   “People ask ‘why is there a difference?’” Carlson said.

   Like any disease, AIDS is a social issue. It not only threatens public health, but also a country’s development by undercutting economic and educational growth. Third world countries struggle with the AIDS epidemic and continue to struggle because it’s a systemic problem.

   To learn more, I slipped into Carlson’s afternoon screening of the film Pills Profits Protest: Chronicle of the Global AIDS Movement, a documentary about AIDS treatment activism. She chose the film for its holistic approach. The film touches on issues of global health, research, drug development and access to health care.

   

   Students from Northwestern University's Feinberg School of Medicine hosted a film screening of "Pills Profits Protest: Chronicle of the Global AIDS Movement," a documentary about the AIDS activism, on World AIDS Day.

   Countries in the Outcast Films documentary show how they’re incrementally making AIDS treatments accessible for every patient who needs them, whether or not patients can afford them. Brazil, for one, manufactures its own AIDS drugs to cut costs and make them more available. The film says it’s not a perfect system, but it’s a step.

   So, what’s the big picture? The film asks: Can the world afford universal HIV treatment? (Or, afford not to treat these people?) This question pits marginalized individuals against formidable opponents: governments, corporations and the multinational drug industry.

   Oh, and did I mention greed? Power struggles have created animosity and anger among opposing groups. As agendas and demands stack on top of one another, the AIDS movement can seem like a messy, overwhelming mountain to scale.

   Pills and Profits, however, also shows how people are making incremental changes to better the lives of those living with HIV.

   “Starting small is still a start,” said Phoebe Arbogast, 2nd year Feinberg medical student.

   The AIDS movement has come a long way. Up until the mid-1990s, a patient couldn’t imagine living a long life after contracting AIDS. Feinberg students are well aware of AIDS status as a major medical problem that still has a long way to go.

   They know that within the country’s poorer states there are waitlists for AIDS medicine. They know that public image can be ruined for all the players in the global AIDS debate. They know that social stigmas attached to people suffering from AIDS need to end. And they know that young people just like them die from this disease every single day.

   “Someone in this room could have it and you wouldn’t know,” Carlson said.

   After the film, I hung out at the Global Health Happy Hour, where students continued talking about the film and the day’s events. What they seemed to recognize most is the cost of inaction. People who get treatment and live have the chance to be productive. They can teach others about AIDS, bring treatment demands to policy makers and mobilize people to fight for the rights of the poor.

   Students agreed that the split between treatment and prevention is a false debate because they are complementary. Both help push the AIDS movement forward.

   The day ended on a hopeful note, much like the film, with a winter concert put on by medical student musicians. Despite the gravity of the AIDS epidemic, singers belted out holiday tunes with lots of energy and laughter.

   As singing group DOCappela serenaded the crowd with Jingle Bell Rock, I couldn’t quite identify the feeling I was having. Was I impressed? Surprised? Proud? Whatever the feeling I’m glad to see young people sincerely care. I’m afraid we can easily become disenfranchised with the disease since treatment options have become available in our lifetime.

   I may not see the end of AIDS in my lifetime, but at least I’ve met people who are dedicated to giving the end of AIDS a heck of a shot.

   Related posts:

   1. NU students unite for global health
   2. Global Health students work to perfect technologies that aid in kangaroo mother care
   3. One drop at a time: Northwestern students tackle water sanitation in a far-flung Indian desert
   4. NU students help shape the future of Evanston public health
   5. ‘Contagion’ echoes the reality of public health outbreaks

   Category: Chicago, Community Health, Global Health Initiative, Global Initiatives, Healthcare Industry, HIV/Aids, Policy, Public Health | Comments (0)

2. Northwestern student researches domestic violence in India

   October 28, 2011 by Patricia Hastings
   

   Maya Ragavan is a Northwestern University medical student researching intimate partner violence in India

   In India domestic violence kills more people than terror attacks, according to a survey by the United Nations. Emotional, physical, sexual and financial abuse runs the gamut of intensity in India, says Feinberg medical student Maya Ragavan.

   The most common form, she says, is yelling while the more sensational include throwing acid at a woman.

   “People will pour carotene on a woman and light her on fire,” she says.

   Ragavan is volunteering for Actionable Research and Training in Health in Udaipur, an English-speaking city in Western Ragastan. She’s interviewing women to learn how they define abuse and how it manifests in Indian society.

   India’s interdependent culture relies heavily on the family unit. People also live in joint families, so abuse can occur among family members — not just between husband and wife.

   “Traditionally, it creates a hierarchy,” Ragavan says. “India is very patriarchal as well.”

   According to the United Nations, 35% of women face violence in India, which ranks as the fourth most dangerous place for women to live. Common reasons for intimate partner violence include dissatisfaction with dowry, arguing with your partner, refusing sex, leaving the home without telling your partner, not cooking the right way, not caring for in-laws and even infertility.

   India’s Protection of Women from Domestic Violence Act of 2005, however, recognizes intimate partner violence as a crime.  The law provides rights, protections and services for victims of domestic violence.

   Instances of cruelty recognized by the courts include:

   • Denying a woman food
   • Not allowing her to see her family
   • Locking her out of the house
   • Denying her access to her children
   • Keeping the woman at home and not allowing her to socialize
   • Abusing her children in front of her
   • Threatening to divorce her unless a dowry is given

   “The local government, which is called the panchayat, is really key in enforcing laws,” Ragavan said. “Depending on where you are in this country, the panchayat will have a different attitude towards domestic violence.”

   Ragavan wants to know what actions women would take if they were in these abuse situations and what resources are available to them. Ragavan aims to create an attitudes survey and use the data to improve domestic violence programming. She’ll stack up what she learns about attitudes in India with the Western perspective on domestic violence.

   What would these women do in hypothetical situations involving physical or emotional abuse? What about abuse from a mother-in-law?

   The answer to these questions will contribute to ongoing research in the struggles Indian women a face. Seema Sinah’s article in the Indian Times, “It’s tough being a woman,” looks at the dangers and how India compares to other countries.

   Related posts:

   1. Northwestern student researches plastic surgery needs in Kenya
   2. Global Engagement Summer Institute Presents Development Projects from India, Bolivia, and Nicaragua
   3. Marching for “World Toilet Day” in Rajasthan, India
   4. Blood, bones, organs, bodies: Scott Carney discusses “The Red Market”
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   Category: General, Human Rights, India, Policy, Women's Health | Tags: actionable research and training in health, domestic violence, domestic violence act, domestic violence india, dowry theft, emotional abuse, emotional abuse india, india domestic violence act 2005, Indian Times, intimate partner violence, physical abuse, physical abuse india, sexual abuse, sexual abuse india | Comments (0)

3. ‘Contagion’ echoes the reality of public health outbreaks

   October 24, 2011 by Patricia Hastings
   

   Panelists discuss public health outbreaks on-campus and worldwide during a discussion at Northwestern University.

   Anyone who sees the Hollywood thriller “Contagion” may be a little on edge. In the film an unknown pathogen moves from Hong Kong to Chicago before globetrotting in a ruthless killing spree. The medical community struggles to contain it and find a cure as the world panics, falling into chaos.

   Could an epidemic like “Contagion” really happen?

   “Not only could it happen it already has,” said Maryn McKenna, a journalist and author specializing in infectious disease and public health.

   The author of Superbug, a book about drug-resistant staph, led a discussion at Northwestern University about “Contagion” and how the government handles health outbreaks.

   She said the film parallels the spread of the Nipah virus that swept Malaysia in 1999, which spread from bats to pigs to humans. Handshaking, kissing and dice-rolling all play a role in spreading the virus documented in the film. As the Centers for Disease Control and Prevention try to get a handle on the health panic, a blogger pushes a holistic cure.

   “All of this, remarkably, is a realistic scenario,” McKenna said.

   H5N1 bird flu was predicted to be like the disease in “Contagion.” Bird flu has a mortality rate that can reach 90 to 100 percent, often within 48 hours, according to the Centers for Disease Control and Prevention.

   The autism and MMR vaccine scare caused many parents to hold off on vaccinating their kids and opt for a more holistic approach to medicine. This shift in practice led to an outbreak of measles.

   Or how about the SARS outbreak of 2003? SARS infected thousands of people around the world before the World Health Organization could contain it.

   The film paralleled many of these moments in infectious disease history. Screenwriters even threw in a couple public health jokes: They made the Minnesota Department of Health look like idiots even though they’re one of the country’s top health departments.

   To create “Contagion”, actors went to the CDC to learn about public health outbreaks. Actual scientists also vetted the science in the film.

   “The only thing that’s wrong is it’s really too positive,” McKenna said. “We’re not in as good of shape as the government says we are.”

   “Contagion” happens over a period of a few months, when in reality it takes at least nine months to get a vaccine. McKenna said the government needs additional people and technology to move forward in preventing public health outbreaks. Most flu vaccines still use 50-year-old technology.

   When the CDC gets budget cuts, the cuts trickle down to state and local health departments. If a department isn’t testing for a disease during an outbreak because they can’t afford to, then there’s no way to determine where the disease has gone.

   McKenna said new diseases emerge almost every year. Just last week researchers discovered a new Ebola-like virus, Lloviu virus, in bats from northern Spain.

   The U.S. health care system received an overall performance score of 64 out of 100 for 2010 in a report released Tuesday by the Commonwealth Fund. The failing grade, says McKenna, speaks to larger gaps in preparedness.

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   2. Halting pandemics in their tracks: EpidemicIQ
   3. One drop at a time: Northwestern students tackle water sanitation in a far-flung Indian desert
   4. Northwestern students advocate access to treatment on World AIDS Day
   5. Interview with Dr. David Serwadda, HIV/Aids Researcher and Former Dean, School of Public Health, Makerere University, Uganda

   Category: Community Health, Healthcare Industry, Infectious Diseases, Public Health | Tags: autism vaccinne scare, avian flu, bird flu, cdc, centers for disease control and prevention, commonwealth fund, contagion, global health, infectious diseases, Public Health, sars, us health care, WHO, world health organization | Comments (0)

4. Northwestern student researches plastic surgery needs in Kenya

   September 26, 2011 by Patricia Hastings
   

   Feinberg medical student David Grant (right) with Erick Owor, a youth peer educator from Carolina for Kibera, an NGO Grant's team hopes to partner with to execute burn prevention programs in Kibera.

   When David Grant walked the plastic surgery wards in Kenyan hospitals, he noticed most patients were burn victims.

   “The high incidence of burn injuries and their acute management forces reconstructive surgeons to turn away other patients with non-burn related reconstructive needs, like cleft lips or cub feet or trauma patients from road traffic accidents,” says Grant, a Feinberg medical student and Satter Scholar researching burn injuries in low- and middle-income countries (LMICs) with the University of Toronto, the African Medical and Research Foundation and the University of Nairobi.

   Roughly ten reconstructive surgeons serve Kenya’s population of more than 41 million to treat disfigurement resulting from congenital deformities, disease or injury. Severe physical deformities can impair a patient’s ability to work and participate in society, which Grant says is particularly devastating in poor and developing countries like Kenya.

   He says many people in Kenya believe injuries from road traffic accidents or cooking or house fires cannot be prevented. Grant and his colleagues want to understand these attitudes and how to change them, so people will adopt preventative behaviors.

   Stove designs have improved and jikos, charcoal stoves set on the floor, are used more often. Despite making the kitchen a safer place, Grant says burns are still so common that plastic surgeons are overwhelmed.

   “The wards are literally packed with kids who have devastating injuries and scars that consume whole bodies and faces,” Grant says. “Our group’s and others’ efforts are now discovering that missing piece might lie in the attitudes that guide how people go about cooking in their congested environments.  This makes sense when you think about how rich countries started stopping burn injuries or road traffic accidents decades ago.”

   LMICs are just starting to take these approaches.

   In Kibera, a large slum in the heart of central Nairobi, families live in small homes or shacks where everyone cooks, eats, washes, sleeps and socializes. They heat up water or milk in a large pot on top of a jiko.

   Unintentional injuries can occur in these close quarters, especially among children.

   

   Jikos, charcoal stoves set on the ground can often get knocked over by children as they play, Grant says.

   “I heard of one young five-year-old girl who put her hands into [a] hot pot of oil, was startled by the pain and jerked back, spilling the whole pot of oil over her torso and upper limb,” Grant says.  “Luckily the girl was taken to hospital straight away, and has not suffered contractual deformities. However she’ll soon grow up and as a young women might feel socially ostracized by the tremendous scars across her body.”

   Grant is developing frameworks for prevention programs as well as improved data acquisition and surveillance tools to better measure the incidence of burn injuries.

   “In regards to burn injuries, there’s plenty of room for prevention, and there’s hope,” Grant says.

   Grant collaborated with other researchers to analyze expert interviews and reveal opportunities for targeted prevention, particularly cooking-related injuries in children.

   Improper first aid is often used to treat injuries — if first aid is given at all.

   “Patients most often use traditional remedies, like corn meal, urine, charcoal ash or mechanical grease that lead to infection,” Grants says.

   These infections can delay wound healing and cause systemic problems for patients, which then drives up the cost of medical care.

   Marketing experts, community health, proper first aid, basic improvements in charcoal jikos and electric cooking stoves, physiotherapy and tertiary prevention of burn-related disability can all help keep families safer, Grant says.

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   2. AMPATH: An Academic Partnership Changing Kenya
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   4. Learning through Field Experience: Northwestern’s Program in Public Health Open House and Poster Session
   5. Flexibility and Confidence are Essential – Tips and Recommendations from Global Health Student Researchers

   Category: Community Health, General, Kenya | Tags: burn victims, Kenya, kibera, low and middle income countries, plastic surgeons, plastic surgery, poor countries, reconstructive surgery | Comments (0)