global health

Project RISHI: Health and Lifestyle Analysis in Charniya, Hayana, India
October 1, 2012 by Guest Bloggers

Written by: Manisha Bhatia

Team Members: Varshini Cherukupalli, Apas Aggarwal, Shreya Agarwal

Location: Charniya, India

Project: Project RISHI: Health and Lifestyle Analysis in Charniya, Hayana, India

Fellowship: International Group Research Fellowship in Global Health

The Project RISHI summer trip was mind-blowing. Each student involved dedicated so much time and effort into ensuring the project successful started its India trek with a bang. Before we even started planning the summer trip, the Research and Education committee started developing an extensive needs assessment to determine how we could help the community. The exec board and members worked tirelessly through Samosa fundraisers, disease presentations, and donation letters to raise funds and educate ourselves to prepare for the community.

The community I am speaking of is Charnia, a village 45 minutes outside of Chandigarh. The village is comprised mainly of two populations: the farmers and the brick manufacture workers. After spending time in the village, however, we learned there were many other types of people there. We met people who worked on government projects while living in huts, construction workers who lived in sedentary homes, factory workers who lived in bricks stacked upon each other, and engineers who lived in beautiful permanent homes.

We spent over 8 days surveying different parts of the community, and as much as I dreaded a full day of survey each morning, it was one of the best ways to get to know the diverse community.

During my first day of the needs-assessment survey, I worked with another student, and as he asked questions, I recorded the families’ responses. The first house we visited seemed well-off; the family had a bed, electricity, a fan, and a sturdy building. They knew all of the answers to the infectious disease section of our survey which made me wonder if the population would benefit from our involvement. However, our next house showed the community’s need.

The family of nine lived in a small one bedroom home that had an extended porch. They were Harijans in the Hindu caste system; they were the untouchables. While the other families we surveyed had the ability to move upward in society, the Harijans did not have that opportunity. The family answered our questions as best they could; however, their knowledge was lacking. The mother of the family constantly added to her husband’s answers, and she looked to me for approval.

After the interview, we moved to the next house, a luxurious home with two foreign cars in the garage. During the interview, I could not stop thinking about the previous family. Just as we left the nice house, the woman from the previous house approached me and started talking about the treatment she received from the doctors and the below poverty card. I tried to note down as much as possible, but our community guide was hurrying us to the next house.

I almost forgot about the woman, but then she appeared at the site of the health camp as we were setting up. She was wearing a sling on her right arm, and approached me with tears in her eyes. She told me she and her husband had been in an accident the day after we surveyed them and they did not have a way to receive proper medical attention. She looked to me as her advocate but, the best I could do was to tell her was to come to the health camp and physicians would examine her. Each time I spoke with the woman, I was surprised by how much she opened up towards me. During our first encounter, I had just said hello, and let my RISHI partner ask the survey questions. Yet the woman approached me outside of the next house. At the health camp set up, there were five of us working on the organization but the woman once again approached me about her accident. In our 20 minute survey, I made a connection with this woman who truly needed medical attention; just by being the community, our group of NU students made a real difference.

The day of the health camp, however, was when we learned about all of the different medical issues the community faced. After meeting with the civil surgeon and numerous other doctors at the beginning of our trip, we learned the same practices applied to students – meaning, we were not allowed to do any invasive tests, including sugar and hemoglobin test. So, through our advisors, we found some MBBS students to volunteer their Sunday morning to help run this health camp.

It was raining cats and dogs as we set up for the health camp. Once it started, the weather cooperated, and the chaos on the ground began. The community members were lined up and ready to start the process, so we had them go through multiple stations: sign in with height and weight; vitals: blood pressure, hemoglobin, and sugar levels; then they waited for their name to be called. The patients would then see the specialty doctors for whatever ailment was the most severe; some patients saw a couple of doctors to make sure everything was checked up. We had a variety of specialties, but the most amazing thing was seeing the doctors from different institutions and with different ties to the community work together. Everyone relied on one of the volunteers to direct the community members to the right specialty station, and then each of the doctors relied on the pharmacy, staffed with multiple doctors, to allot the right medications. I was impressed seeing such a mix of people, doctors, volunteers, and students, unite for the community.

There are a ton of things to be said about our trip. But, the one the only thing I am thinking about is how lucky I am to have been part of this entire journey. I went to India for 20 days and each day has taught me at least one new thing. We are setting up the groundwork for an amazing RISHI project, and each trip member has shown their dedication to the sustainability and effectiveness of the project.

I am so thankful to have come on this trip with 10 other extremely driven NU students who always prioritize the needs of the community. I am so impressed that after each of our long surveying days, the extremely tiring health camp, and even while we are site seeing, RISHI trip members are willing to discuss our project at length. Monday evening we drove to Amritsar to see the Golden Temple, slept less than 3 hours, shopped around the city, watched the changing of the guard, and made our way back to Chandigarh. Though everyone was exhausted, we managed to have a serious discussion about the progress of our projects. Once we started the discussion, everyone chimed in because these people, my Northwestern peers, these 10 other NRIs truly want to help the people of Charniya.

I am looking forward to what the new RISHI generation will bring to Charniya!! This trip has really solidified our connection with the community, and as hard as we worked this past year, I know the Project RISHI members will work even harder, with a more defined goal this upcoming year. The diversity in Charniya begs us to look at the community with multiple lenses and slowly work with them on different solutions to their many problems.

I am so thankful to have had this opportunity and am excited for more students to experience this!
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Category: Community Health, Health Education, India, Public Health | Tags: global health, India, project rishi | Comments (2)
From Idea to Innovation: Insights from the 2012 Global Health Unite for Sight Conference
April 26, 2012 by Mary Poliwka
Sponsored by Unite for Sight, this past weekend’s 2012 Global Health & Innovation Conference at Yale University featured various speakers and panelists from diverse backgrounds in global health. The Acumen Fund, USAID, Management Sciences for Health, PATH, and the Bill & Melinda Gates Foundation were just a few of the many organizations present. Esteemed speakers such as Jeffrey Sachs, Director of the Earth Institute at Columbia University and Special Advisor to Secretary-General Ban Ki-Moon of the United Nations, inspired and informed the audience about the most pressing global health challenges.

This year’s conference theme was innovation. Clearly, innovation is a key to the future of global health. Take for example, Laura Stachel, Co-Founder of WE CARE Solar, who described her journey in “bringing light to maternal health care”, literally. Studying maternal mortality in Northern Nigeria after serving many years as a doctor in the U.S., she found that many state facilities only had sporadic electricity that was rationed among the various communities. Without the ability to predict when they would have light, doctors and nurses often found themselves unable to work at night, putting delivering women and critically ill patients at severe risk.  Her husband, a solar energy educator, designed an off-grid solar electrical system (the size of a suitcase) in response to this need. Put to use in a Nigerian hospital, the self-sustaining system was instantly successful and quickly led to improvements in local health outcomes. Demand for their product grew rapidly and now they supply their Solar Suitcases across the developing world.

Perhaps the most important takeaway from this conference was learning how one can pursue global health work without being a doctor or a nurse.  I was quite surprised to hear many speakers talk about how they had worked in medical practice for many years but then decided that global health was their next step. In fact, Laura Stachel was one of them. Actually, at the career panel I attended I was intrigued to learn that all five speakers had not originally pursued public health but either encountered the need in their current positions, such as with USAID, or altered their career trajectory down the line to pursue this interest. While I have felt concerned about my ability to impact health outcomes without pursuing medicine, here were all of these very accomplished men and women who were doctors and decided it wasn’t enough! So, to all of you global health students out there who are not pre-medicine, feel confident that you are also critical to advancing healthcare around the world.

But how you ask? There are so many avenues a global health practitioner can pursue! The conference’s speakers included engineers, designers, educators, environmentalists, energy and food experts, film producers, photographers, and artists, health policy and advocacy leaders, infectious and non-communicable disease specialists, and maternal and child health experts, organizational managers, researchers, philanthropists, social entrepreneurs, social media and marketing professionals, technology specialists, and water and sanitation authorities. Clearly, you should not limit yourself to the confines of direct service delivery! All of these presenters are working towards sustainable, significant, and culturally appropriate improvements to the health of populations across the globe with their diverse work. Through collaboration across sectors and specializing in specific interests, these individuals advance disease prevention and lessen the social, financial, and environmental factors that negatively impact access to care in very different ways.

Another conference-inspired insight to leave all of you readers with: if the professional opportunity you seek does not exist or is out of your reach, either create it or look elsewhere. To create it, you may pursue independent research in your interest or begin to mull around ideas about the practicality of starting your own organization with the global health emphases that are missing. You may also consider collaborating with an organization that already exists and developing an interest area that is lacking. When I say look elsewhere, I am referring to unconventional places for internship placements. You may want an internship with NIH in Washington D.C., but you are competing with many, many other like-minded applicants. So what should you do? I would suggest directly contacting lesser-known non-profits here and abroad or foreign public health government agencies. Offer to volunteer your time and contribute your skills. Perhaps you can work for a start up with a small staff; it may be less prestigious, but because it is small you may achieve more responsibilities as an intern. After speaking with many global health students both at Northwestern and at this conference, I find that many successful students took the path less traveled. Again, this approach takes initiative and time, but it is worth the effort when you gain unique professional experiences and real world insights that you may have otherwise missed out on.

Furthermore, if there is a need to be addressed and you know a solution, take the initiative to make a change. It doesn’t take millions of dollars and a large cohort of people to make a difference. If this conference taught me anything, it is that notion. All it takes is a simple idea plus perseverance and resilience. Plenty of college students start their own companies and non-profits with due diligence of research coupled with professional networking. Plenty of college students have also developed products that are either created by impoverished individuals in the developing world or aimed at reducing environmental damage and supporting local farmers. The difference between one of these inspiring conference speakers and you is not intelligence or money, but rather the idea, the persistence, and open-mindedness.  To further back up my claim, let me point out that many of the conference’s speakers were undergraduate, master’s, and PhD students presenting their own cutting-edge ideas and affecting change.

The Unite for Sight Global Health Conference is an annual event bringing together hundreds of people from all professional backgrounds and academic disciplines. As a Northwestern global health minor graduate and future health professional, I found it to be an extremely worthwhile experience and I know the other NU undergraduate attendees felt the same. Be sure to check out the event next year and consider contacting IPD/Global Health Studies for financial assistance in attending this inspiring conference!
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Category: Community Health, Health Education, Public Health, Social Entrepreneurship | Tags: global health, global health and innovation conference, Unite for Sight, WE CARE Solar | Comments (0)
From doctor to journalist, Feinberg alum discusses career in global health
April 18, 2012 by Marguerite McNeal
Panosian, a Feinberg alum, co-founded the global health program at UCLA, where she is a professor of medicine. She spoke about her career in global health Tuesday at Northwestern Memorial Hospital.

What do malaria, global health and main street journalism have to do with one another? Dr. Claire Panosian Dunavan, a Feinberg alum, wove together her experience in these three fields Tuesday morning for the annual alumni lecture at Northwestern Memorial Hospital.

Panosian had no medical expertise when she spent the summer of 1972 in Haiti. Little did she know the images of malaria, malnutrition and severe diarrhea she encountered would lead her to a career in global health.

Panosian, currently a professor at UCLA in the infectious disease department,
recounted stories from her experiences studying malaria in Africa and Asia. She also talked about her accidental role as a medical journalist and how it enables her to spread awareness about global health.

In 1993, Panosian was invited to participate in a major malaria policy report that recommended subsidizing artemisinin drug combination treatments for the entire global market.

“To see how the policy played out, both perfectly and imperfectly, has shaped my education,” she said. Subsidies for these drugs remain crucial for malaria control today.

Experts underestimated mortality from malaria, according to a February report from The Lancet. “The study shows that mortality from malaria is about twice what we thought it was,” Panosian said. “It’s very worrisome.”

During Panosian’s work with control policies, she noticed a surge of interest in the field of global health from young doctors. She co-founded the global health department at UCLA, where she teaches an introductory course every year.

“I expect my students to understand health and finance indicators, such as life expectancy and fertility rates,” Panosian said. “We should all understand these statistics as global citizens.”

The public, inundated with blogs, single-source articles and short health clips on the nightly news, is uncertain about what’s happening in medicine. “There’s a traditional role of medical experts to assist and advise professional journalists,” Panosian said.

She encouraged fellow medical professionals to harness their expertise and use their voice to help the public understand health issues. “It isn’t as hard as you think to write an op-ed for your local paper.”

Panosian writes about global health and other medical issues for Los Angeles Times, Scientific American and Discover Magazine. “Starting with a local audience is a great way to expand and to introduce global health,” she told the crowd of doctors and medical students. “People will turn to trustworthy sources and you are those sources for certain topics.”
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Category: General, Global Health Alumni Series, Infectious Diseases, Policy, Public Health | Tags: Africa, Feinberg, global health, journalism, malaria | Comments (0)
Climate change: Don’t blame the population, says Suzanne Petroni
April 2, 2012 by Marguerite McNeal
The solution to population growth issues lies in respect for women's rights, said Petroni in her keynote address at Northwestern's Summit on Sustainability.

Population growth speeds climate change, we are often told. Linking these two phenomena is complicated and could lead to population control strategies that jeopardize human reproductive rights, said Suzanne Petroni in her keynote address at the Northwestern University Summit On Sustainability.

“We want to make sure that if we make this connection between slowing population growth and slowing climate change we are careful to advocate only for rights-based programs that enable people to make their own choices,” she said.

Engineers for a Sustainable World held its 2012 summit, “Public Health and the Environment,” from March 30-31. Petroni, vice president for global health at the Public Health Institute, criticized efforts to control population growth at the cost of human rights in her speech, “A World of Seven Billion: What Does it Mean?”

China proudly announced that it reduced carbon dioxide emissions by 1.3 billion tons by preventing 300 million people from being born, Petroni said. “But this so-called simple solution had devastating effects on human rights, resulting in coerced abortions and forced sterilizations.”

Policymakers have long feared that overpopulation will lead to a “tragedy of the commons,” straining resources and stifling economic development. In the 1950s and 60s the United States created a population policy that set targets for fertility rates at home and overseas, Petroni said.

In the 1970s and 80s, women’s rights organizations began to associate such policies with dictatorial restrictions on human rights. “If the planet was overpopulated, they asked, who were the excess people? And who had the right to control everyone’s reproductive laws?” Petroni said.

The dialogue shifted in 1994 as a result of the International Conference on Population and Development, which stated that people should have the freedom to decide responsibly the number, timing and spacing of their children. This “rights-based approach” represented a radical change in attitude and shifted the focus from control to empowerment.

“When individuals are given the information and access to comprehensive health care, education and information they will usually choose to have smaller families,” Petroni said. “Respect for and attention to women and their rights is the solution for population issues.”

What does this mean for the environment?

“If we want to discuss links between population growth and climate change, we have to first acknowledge that slowing population growth may only play a limited role in mitigating climate change as long as resource use continues unchecked,” Petroni said.

Even if the population stabilizes, which experts predict might happen when we reach nine billion people, resource consumption will continue to rise as individuals demand a higher quality of life. Petroni asked the audience to look at the “whole elephant” of climate change, not just population growth.

“Urbanization, consumption and development are important factors for our planet’s survival – maybe more so than a few more babies being born in a rural village in Ethiopia,” she said.
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Category: General | Tags: climate change, global health, population control, reproductive rights | Comments (0)
‘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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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)