Center for Global Health

1. New Northwestern Institute for Public Health and Medicine (IPHAM) plans to double research activity of medical school

   July 25, 2012 by Janka Pieper

   Interview with Rowland W Chang, MD/MPH

   

   Dr Rowland Chang - Photo Courtesy of Feinberg School of Medicine

   Rowland W Chang, MD/MPH
   Senior Associate Dean for Public Health
   Director, Institute for Public Health and Medicine (IPHAM)
   Professor in Preventive Medicine and Medicine-Rheumatology
   Feinberg School of Medicine

   
   Q: What is the new Institute for Public Health and Medicine (IPHAM)?

   A: The new Institute is a collaboration of nine centers, five of which are based on existing entities and four of which are brand new. The Center for Healthcare Studies; the Buehler Center on Aging, Health, and Society; the Center for Global Health; the Center for Population Health Sciences (born out of Preventive Medicine); and the Center for Patient-Centered Outcomes (born out of Medical Social Sciences), are all existing centers and are being integrated into IPHAM now. New centers include the Center for Community Health, the Center for Behavior and Health, the Center for Engineering and Health, and the Center for Education in Public Health, which will coordinate the existing Master’s programs and also offer a new Health Sciences integrated PhD program starting this September.

   While some of the centers are new, all of the work that will be coordinated by each Center already exists in some form within the medical school. The Institute is re-organizing the work so that it is structured around themes and reduces redundancy, while promoting collaboration. The basic goal of the institute is to help double the research activity of the medical school. It is the dry lab approach to increasing the research we are doing in fields such as epidemiology, bioinformatics, biostatistics, health services research, outcomes research, community health research, and research in international settings, where we would like to become more prominent.

   Q: The IPHAM website states that the Institute’s ultimate goal is to “accelerate innovation at the interface of medicine and public health and achieve measurable improvements in health for patients and populations.” What does the interface of public health and medicine mean exactly?

   A: A lot of solutions to our community’s health care problems require that we are better at delivering healthcare when patients come to their doctor and are admitted to the hospital. We want to improve our physicians and our hospital systems, which will not only help the individual but also affect larger groups of people. At the same time it will help to incorporate the more traditional public health community health matters.

   Take smoking for example: there is an intersection between physicians treating a nicotine addition, public health campaigns discouraging people from starting to smoke, and policy changes on public smoking. Attacking the issue from multiple angles has made a great difference in reducing the smoking rates in this country

   We need to think of this kind of approach, clinic- as well as community-based, as a comprehensive means of strategy toward reducing healthcare costs by helping to prevent diseases that lead to high costs. Clearly, the work needs to be done on both sides: on the prevention side and on the healthcare side, and then also include the policy level. We need to look at these solutions in an integrated fashion, as opposed to having isolated sets of people working in silos that do not interface with each other.

   Q: How will the Institute facilitate interdisciplinary and cross-campus research and communication?

   A: The Institute will make it easier for other faculty, programs, departments, and schools to effectively interact with the medical school. We are interested in looking at broad topics such as health economics and health policy, so there is a lot of potential and interest in bringing together folks from, for example, Kellogg or economics from the Evanston campus. We plan to reach out and attract collaborators; the fact that McCormick’s Sanjay Mehrotra is the Director of the Center for Engineering and Health of the Institute shows that we are already working across schools, and will even further assist us in obtaining these desired cross-school, interdisciplinary partnerships.

   I, personally, have spent a lot of time encouraging collaboration and connecting people. I want to cross boundaries; my own work crosses at least four of these Centers. My research is out of the Center for Population Health Sciences, but it also involves behaviorally issues, and is done in the community. And I teach in the MPH program which is part of the Center for Education in Public Health. I am a strong example of what we are trying to achieve: people who are trying to find solutions to problems by involving a lot of other people.

   

   IPHAM Homepage

   Q: How does global health fit into the Institute?

   A: The Center for Global Health is a founding center of the Institute, but we are finding that there are international activities occurring in other centers of which the Center for Global Health had not been aware. Our expectation is that this collaboration will benefit all of the participating Centers by providing a platform for researchers to learning what is happening at Centers across the Institute. There are a lot of researchers and clinicians interested in global health, and expanding the participation in these international activities is essential for putting forward successful grant proposals.

   Q: This sounds like a big undertaking and certainly took years of planning, right?

   A: We have been discussing how to make public health a larger focus of the medical school, which culminated with a proposal to change the name to “School of Medicine and Public Health” two years ago. It started with the University’s strategic planning process. Though the proposal we submitted did not pass, it got the attention of the President, Provost, and Dean of the Medical School. We kept working at it. One of the first things Dean Eric G. Neilson did when he became the new Dean of the medical school last fall was to convene a group of leaders to create the new Institute. And we have been working on it ever since.

   Q: That’s an impressive quick turnaround. Finally, is there an official launch date?

   A: There will be an official launch date sometime in September. We have full commitments from all participating Centers, Directors and associated faculty. We will announce new faculty opportunities and make a national splash in the fall.

   Related posts:

   1. My Summer Internship at the Obesity Institute of Children’s National Medical Center
   2. Community Engaged Research: A Potent Strategy for Promoting Health Public Policy
   3. Learning through Field Experience: Northwestern’s Program in Public Health Open House and Poster Session
   4. The Road Less Traveled – Public Health Graduate School Fair
   5. ‘Contagion’ echoes the reality of public health outbreaks

   Category: Chicago, Community Health, Health Education, Healthcare Industry, Public Health | Tags: Buehler Center on Aging Health and Society, Center for Behavior and Health, Center for Community Health, Center for Education in Public Health, Center for Engineering and Health, Center for Global Health, Center for Healthcare Studies, Center for Patient-Centered Outcomes, Center for Population Health Sciences, community engaged research, Health Sciences PhD, Institute for Public Health and Medicine, IPHAM, Rowland Chang | Comments (0)

2. Good manners and common sense: Charity founder addresses Feinberg students at benefit for Pakistani flood victims

   January 15, 2011 by Lauren Everitt
   

   Neal Ball, Founder and Honorary Chair, American Refugee Committee and Terry Long, Department of Family and Community Medicine, Feinberg School of Medicine

   Neal Ball, founder and honorary chair of the American Refugee Committee, spoke to more than 30 students and faculty at the Feinberg School of Medicine as part of a benefit to raise funds for Pakistani flood victims Friday.

   Twenty million Pakistanis were directly affected by the flooding last summer, and large swaths of farmland are still under water, according to event coordinator Paul Battone, a Feinberg medical student.  The 24-year-old president of the Student Senate said lingering floodwater would affect next year’s harvest and exacerbate the disaster.

   Ball’s charity emerged from another disaster in the Eastern hemisphere more than thirty years ago.

   After sponsoring a Vietnam War refugee from Laos, Ball set about trying to find the boy’s family.  The search took Ball on a tour of refugee camps in Hong Kong, Malaysia and Thailand.

   The poor conditions in the camps motivated Ball to address the plight of refugees—an effort that culminated in the present-day American Refugee Committee.

   Ball pulled from his experiences with the charity to explain how humanitarian outreach can make a difference and to point out obstacles along the way.

   “Good manners and common sense. That’s what I think humanitarianism is,” Ball said when asked to define the term.

   But life often complicates simple and sound advice.

   Ronak Vashi, a Feinberg medical student, said people are often consumed by their everyday lives at the expense of what’s happening in the world around them. But she’s optimistic that small acts can have an impact.

   “People think that you have to do a lot to make a difference, but there’s more to be said for a larger number of people each doing a smaller part to help a bigger cause,” she added.

   It was this same lack of attention that prompted Battone to coordinate the benefit with first-year medical students Matthew Hire and Alex Sidlak.

   “Truthfully I’d heard of the disaster in Pakistan, but I didn’t know too much about it,” he said.

   Battone wasn’t alone. After researching the issue for the Feinberg Student Senate at the request of a professor, he noticed knowledge about the flood was limited.

   Pakistani student Hira Bai said she was also surprised at the limited US outreach, especially in light of American support for the country in other areas.

   ”We should all just be more aware of our international community,” she said.

   Battone partnered with Northwestern’s Center for Global Health and the South Asian Medical Student Association to host Friday’s benefit to raise awareness and funds for flood victims.  He also contacted local Pakistani restaurants to contribute food for the occasion.  Through donations the benefit raised $550 for Pakistani flood victims.

   While some might argue that a small gathering in Chicago might not make a difference in a region ravaged by flood waters, Ball would disagree.

   “No matter how big the problem is or how far away, don’t be shy about it,” Ball said.  “It’s never too big or too distant to give help.”

   Not all charities are created equal.  Make your donations count with Neal Ball’s suggestions:

   • Look for transparency and accountability. Find a charity willing to share information about their work.
   • Find the shortest line between need and aid. Middlemen can complicate things.
   • Put your charity to the test with Charity Navigator, an independent, online evaluator.

   Related posts:

   1. Culture of health: Feinberg students study medicine, Spanish in Guatemala
   2. Pakistan’s Floods: An Unprecedented Humanitarian Crisis
   3. Cross the border, and your human rights may stay behind
   4. NU students unite for global health
   5. Data collection can be good for your health

   Category: Natural Disaster, Pakistan | Tags: American Refugee Committee, Benefit, blog, Center for Global Health, Charity Navigator, Feinberg School of Medicine, Humanitarianism, Neal Ball, Pakistan Relief Efforts, Pakistani flood victims, South Asian Medical Student Association | Comments (0)

3. HIV in Nigeria

   November 22, 2010 by Shannon Mehner

   There are 22.4 million people in Nigeria living with HIV, said a Fogarty scholar at a campus lecture Friday on the state of HIV in Nigeria.

   And though 750,000 affected people require antiviral therapy, only 198,000 people were treated last year—about 10 percent.  “This is an area that really bothers me,” said Ifeyinwa Rita Onwuatuelo, who is a visiting Nigerian scholar on a Fogarty scholarship conducting research with the Center for Global Health.

   Onwuatuelo has worked since 2004 in the field of HIV/AIDS and is currently working as the Care & Support Officer at the Program Office of AIDS Prevention Initiative in Nigeria in Abuja.

   Unlike the transmission of the HIV virus in the U.S., which is mainly a result of same-gender sex, 80-95 percent of the cases in Nigeria are passed on through heterosexual intercourse. 15-30 percent are passed on to unborn babies through mothers during pregnancy.

   One of the key factors driving the rapid transmission rate is an overarching belief that individuals aren’t at risk for infection, which leads to less caution in making sexual decisions.  “People think ‘I cannot get it, only other people do,’” Onwuatuelo said, which is erroneous and furthers the current cycle.

   Some contributing issues include inter-generational sex, sex with multiple partners, inefficient services to treat sexually transmitted infections and poverty.  Another major problem is the stigma and discrimination that comes along with an HIV diagnosis, which can deter people from seeking treatment or telling others about their diagnosis.

   “This is one of the biggest issues,” she said.  “We need to do more to educate people so the cycle can stop.”

   Developing countries such as Nigeria are 19 times more likely to be infected with HIV than the general population. And the virus has a major impact on society and its institutions—“HIV places a major burden on families economically, socially and psychologically,” she said.

   It can cause families to reject infected members and cause issues in terms of family unity.  It can also affect a family’s economic status because diagnosed individuals might not be able to work, Onwuateleuo added. And 2.23 million children are orphaned because of AIDS in Nigeria, a number that is still growing.

   Churches and community organizations may also reject people who have been diagnosed.  “Religions may discriminate against the faithful [who have been infected] as sinners,“ she said, which isolates infected people who need a support system more than ever.

   Some of the treatment and prevention strategies the government and NGOS are employing are HIV counseling and sexual education testing, promoting the use of condoms and increasing media campaigns and public awareness.  These types of services need to be increased, she said, along with access to antiviral treatments drugs.

   But with the efforts of the Nigerian government, the U.S. government and organizations such as the Bill Gates Foundation, access to treatment and prevention programs continue to grow.  With a continued push for early diagnosis and treatment, education and awareness programs and more preventative strategies, HIV can be managed, Onwuatuelo stressed.

   “Attitudes are gradually changing,” she said. “But it’s not just a one day thing.  We have to continue fighting.”

   Related posts:

   1. Is Circumcision the Best Way to Prevent HIV in Africa?
   2. How to improve Reproductive Health in Africa
   3. Interview with Dr. David Serwadda, HIV/Aids Researcher and Former Dean, School of Public Health, Makerere University, Uganda
   4. AMPATH: An Academic Partnership Changing Kenya
   5. Tracking HIV: a Q&A with McCormick’s Benjamin Armbruster

   Category: HIV/Aids, Nigeria | Tags: blog, Center for Global Health, Fogarty, HIV/Aids, Nigeria | Comments (0)

4. How to improve Reproductive Health in Africa

   November 5, 2010 by Shannon Mehner

   Comprehensive, sustainable efforts must be taken in Sub-Saharan Africa to improve women’s reproductive and overall health, said the associate director for the Center for Global Health at Northwestern’s Feinberg School of Medicine at a campus lecture Wednesday.

   

   Carolyn Baer

   With 600,000 mothers lost annually to pregnancy-related causes and 80 percent of these deaths occurring in Sub-Saharan Africa, this is an important issue to address, said Carolyn Baer, who has worked with organizations such as the Centers for Disease Control and the Peace Corps program.  21.1 million AIDS orphans have died in Africa and 4.2 million unsafe abortions occur in Sub-Saharan African each year, she said.

   It is important to remind the public this is an issue that affects everyone, Baer added. “Reproductive health is not just a woman’s issue,” she said.  “It is a husband’s issue, a son’s’ issue, a father’s issue, a community’s issue.”

   The best ways to ensure a higher rate of survival is to invest in the education of boys and girls, train health care workers, end harmful practices, expand access to birth control methods, make abortion legal, safe and accessible, and improve and expand access to obstetric care, she said.

   She focused specifically on four steps that can be taken within communities to address reproductive health: Safe motherhood services, prevention of rape and violence, provision of family planning, and prevention and treatment of sexually transmitted diseases. Safe motherhood services include providing prenatal care, ensuring clean and safe delivery and then offering postnatal services.

   “It is that first 24 hours during labor that is the most critical,” Baer explained.

   Communities can also establish a referral system to get a woman in labor from home to a health care facility quickly.   “Clean delivery kits” which include items such as soap, clean latex gloves and a plastic sheet, are another easy and doable precaution and can easily be gathered in local environments.

   “Simple steps can yield big benefits,” Baer said.

   Sexual and gender-based violence within communities is another important area that needs to be addressed. But it is important to work within communities to see what they consider to be the biggest issues of violence instead of imposing a preconceived agenda on them, she cautioned.  Once definitions and concerns have been established, it is possible to put together medical services, including psychological support and counseling, as well as provide emergency contraception, Baer said.

   “A lot of people are so shamed and the stigma is so great, a lot of people don’t want to talk about it,” she explained. “Communities need to figure out how to help.”

   Improving family planning services means making contraceptives readily available and accessible, as well as offering patients a choice of which type is best for their lifestyle.  Health care workers must also ensure confidentiality, she said.

   “Gender relations needs to be considered,” she said. “And people need to be empowered to choose what works for them.”

   Because in Sub-Saharan Africa access to laboratory equipment is limited, The UN recommends diagnosis of STIs be done using a syndromic approach, she said.  Syndromic means asking what the patient’s symptoms are such as fever, swollen belly, etc and diagnosing according to those signs and symptoms.

   “Treatment protocol based on syndromic case management should be prepared and adopted,” Baer said.  “And the most effective drugs should be used at first encounter.”

   All of these steps should be taken when possible to ensure better reproductive health in Sub-Saharan Africa, Baer said.  “Healthy families and communities need healthy moms,” she said.

   Related posts:

   1. Is Circumcision the Best Way to Prevent HIV in Africa?
   2. HIV in Nigeria
   3. Working to improve lives: Northwestern’s Global Health Program
   4. Interview with Dr. David Serwadda, HIV/Aids Researcher and Former Dean, School of Public Health, Makerere University, Uganda
   5. AMPATH: An Academic Partnership Changing Kenya

   Category: HIV/Aids, Women's Health | Tags: blog, Carolyn Baer, Center for Global Health, HIV/Aids, Reproductive Health, Sub-Saharan Africa | Comments (0)

5. Pakistan’s Floods: An Unprecedented Humanitarian Crisis

   October 14, 2010 by Adela Mizrachi
   

   (from left to right): Dr. Asher Hasan, Dr. Rashid Chotani, Asad Hayauddin, Todd Shea

   If you widened the Mississippi River from Minneapolis to New Orleans by five times, this would be the scale of devastation that occurred due to the recent flood of the Indus River in Pakistan, said Todd Shea, one of the presenters at the October 14th Pakistan Symposium sponsored by the Northwestern University Center for Global Health. Mr. Shea, along with Dr. Rashid Chotani and Dr. Asher Hasan, participated in the symposium entitled “Pakistan’s Floods: An Unprecedented Humanitarian Crisis.”

   The three presenters painted a picture of the aftermath of the Pakistan floods to an audience of nearly 100 people. Also in attendance was Consul Trade and Commerce for the Consulate General of Pakistan Chicago, who participated in the final question and answer panel.

   Dr. Asher Hasan, of Naya Jeevan for Kids, a social enterprise that provides micro-insurance for the urban poor, began by telling the story from the perspective of two young girls whose villages were destroyed. He explained that “trade, not aid” is really the best way to help Pakistan recover from this tragedy. Dr. Hasan demonstrated the Pakistan Resource Finder (http://pakistan.resource-finder.appspot.com/), which is a tool that allows users to search for and map medical resources and infrastructure throughout the country. He then explained his organization’s hub-and-spoke method for providing healthcare to some of the most rural and vulnerable populations. Unfortunately, he said, the challenge, even before the floods, is that the health care infrastructure is just not there and current centers are not left un-staffed or staffed by under-qualified personnel.

   Todd Shea from Shine Humanity, a disaster relief organization, spoke next and discussed how his organization started immediately by using mobile medical teams to take services to people who could not get to medical facilities. As the situation has stabilized, however, they are moving toward providing support to existing medical facilities. “The system is totally overwhelmed,” said Shea, “….if this disaster had happened here in the States, even the U.S. couldn’t handle it.” His organization promotes consortium efforts between small organizations that do not have the typically high overhead that some of the large international organizations have.

   Dr. Rashid Chotani, Director of the Chemical Biological Defense Programs at TASC and a senior advisor to the U.S. Department of Defense on Pakistan, concluded with a presentation that relied heavily on hard data. He focused on the most vulnerable victims: women of child-bearing age, pregnant women, children and the elderly. According to his estimate, within the next three months we should expect an additional 3,000 to 9,000 deaths in expecting mothers, prenatal infants, neonatal infants, and children less than five years old due to the floods. He concluded with two quotes from UN Secretary-General Ban Ki-Moon: “I will never forget the destruction and devastation I have witnessed” and “In the past I have witnessed many natural disasters around the world, but nothing like this.”

   More on the symposium and the materials presented can be found on the Center for Global Health Website.

   Related posts:

   1. Good manners and common sense: Charity founder addresses Feinberg students at benefit for Pakistani flood victims
   2. How to improve Reproductive Health in Africa
   3. Will Butler: ‘Connect with your community’
   4. HIV in Nigeria

   Category: Natural Disaster, Pakistan | Tags: Asad Hayauddin, blog, Center for Global Health, Dr. Asher Hasan, Dr. Rashid Chotani, flood, humanitarian crisis, Indus River, Naya Jeevan for Kids, Pakistan, Pakistan Resource Finder, Shine Humanity, Todd Shea | Comments (0)