WHO

  1. Obesity & Body Size Perception in Moroccan Women

    October 15, 2012 by Guest Bloggers

    Zabin Patel (WCAS 2014)
    Sara Kashani (WCAS 2012)
    Project: Obesity & Body Size Perception in Moroccan Women
    Fellowship: John & Martha Mabie Fellowship for Global Health Research
    Summer 2012

    Accessing care: Ibn Tofail is a public hospital in Marrakesh, Morocco.

    We are walking past a security guard at Hospital Ibn Tofail, the public hospital of Marrakesh. He stands in front of the white gates, barring entry to a group of women who are waiting under the burning Moroccan sun. It is 12 o’ clock noon. As we walk through the doors, there is a large waiting area to our right – with almost every seat filled. And to our left are the patient rooms – a few with their doors open. In the third dimly lit room is a man on a bed frame, silently moaning in pain. We hear a mix of languages—Arabic, Berber, French—while the staff and patients hurry by in a rush, the same sort of rush that envelops Djeema el-Fna, the city’s main square.

    Savory stews: Traditional Moroccan dishes of meat and vegetables are slow-cooked in a clay pot called a taj’in.

    According to the World Health Organization, obesity has become a worldwide epidemic,
    even in developing nations that had previously seen only under-nutrition. Some places face the dual burden of a gender differential—an obesity prevalence biased towards females—potentially mediated by individual behavior, the social environment, or other personal or cultural factors. In Morocco specifically, studies have found that obesity is four times more prevalent in women than in men (Prentice, 2005). Through funding from the John & Martha Mabie Fellowship, and with support from International Program Development at Northwestern University, United for Service, and Volunteer Morocco, we studied sociocultural factors that could help explain this gendered obesity prevalence. Our findings can provide insight into an issue that is not well understood and has the potential to inform health campaigns and improve interventions for obesity.

    Suited up: Zabin and Sara donned traditional Moroccan garb for the wedding.

    From the people to the architecture, everything about Morocco is zwen—beautiful! Lush gardens fill the cities and historical mosques that dot the old medinas are brimful with centuries of pride. Over cups of mint tea, the locals of the villages we visited cooked us taj’in, a traditional Maghrebi—Moroccan—dish, conversed with us about our work and Bollywood films, and even invited us to an elaborate Moroccan wedding!

    Not from concentrate: Orange Juice Vendor No. 41, also known as “Ultras Crazy Boys.”

    While in the U.S. we may turn a critical eye toward physicians and the healthcare system, in the rural health clinics we visited, the villagers looked at the doctors who volunteered with nothing less than reverence. Their gratitude touched us—even when we were not doing more than just measuring height and weight. The Moroccan people and their selfless generosity are enough to make us want to visit al-Maghreb—Morocco—again. That and also because Marrakesh has the best orange juice we’ve ever tasted.

     

     

  2. Global health: A political evolution

    March 30, 2012 by Rian Ervin

    Global health is a common buzzword among grassroots organizations, independent foundations and news outlets, but what exactly led to the popularity and creation of this term?

    Guest lecturer Richard G. Parker spoke about his most recent work, a study of the political history of HIV, AIDS and sexual matters and the invention of global health in a keynote address Thursday.

    Parker, a professor of sociomedical sciences at Columbia University, kicked off a two-day event, Libidinal Investments, organized by the Sexualities Project at Northwestern.

    Global health is a “boom” industry; there is nothing hotter on U.S. college campuses, Parker said. In order to unravel the meaning behind this popular label, Parker looked back on 50 years of history.

    He identified three key sets of processes leading to the invention of global health:

    Professor Richard G. Parker discussed his latest work, the invention of global health against a background of political history, at Northwestern University Thursday. Source: Rian Ervin

    - Population control, demographic thinking and the politics of international development

    - The politics of HIV, sexual difference and the imagination of the global

    - The struggle for reproductive rights

    Each of these three processes emerged during a specific period of political change. Increased health research, the invention of international health organizations and social advocacy formed and shaped politics.

    At the end of World War II, the concept of “developed” and “underdeveloped” countries emerged, resulting in the notion that international health problems existed, Parker said.

    International organizations such as the World Health Organization and UNICEF were created to solve these problems, and the field of international health was born.

    At the same time, an increased fear of population explosion placed new emphasis on the desire to develop third world countries, Parker said.

    Population dynamics and research became central units of investment. Three large surveys analyzing fertility, contraceptive use and demographic health circulated the world for the first time.

    The emergence of HIV in the 1980s resulted in a second wave of change.

    HIV took on an essential role in the shift from the programmatic to the global vision of health, said Parker. Instead of creating organizations to solve health problems, cultural activism emerged, he said.

    Population research shifted to sexuality research, bringing new focus to discussions of gender, sexuality and power. The HIV outbreak gave a voice to minorities, women and the LGBT community, Parker said.

    The creation of international HIV and AIDS organizations, along with a global network of those living with the disease truly connected people across the world.

    While Parker attributes HIV as the main historical element responsible for the invention of a global health community, he said there is still a long way to go in perfecting social and political mobilization.

    The struggle for reproductive rights is the latest issue, according to Parker, and has been evolving over the past 15 years.

    The ongoing abortion debate and 9/11 have caused huge shifts in how people think about health security and health rights, Parker explained.

    While he isn’t sure how this issue will evolve, Parker said women’s empowerment is at the center of debate in the international arena.

    Moving the ideas of feminism and LGBT sexual diversity across ethnic and cultural boundaries “is not simple,” said Parker. However, these fields are being discussed globally. “There is an expanding notion of inclusion,” he said.

  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.

  4. Is Circumcision the Best Way to Prevent HIV in Africa?

    October 8, 2010 by Shannon Mehner

    Robert Bailey, Professor of Epidemiology, University of Illinois at Chicago

    Circumcision is the most effective and promising tool that currently exists to prevent the spread of heterosexually acquired HIV infection in developing countries, an international health consultant and medical researcher said at a global health lecture on campus Wednesday afternoon.

    The lecture, entitled “The Cutting Edge of HIV Prevention in Africa,” was the first of the Global Health Lecture Series and was cosponsored by the School of Public Health, Feinberg School of Medicine, International Program Development, and the Center for Civic Engagement.

    Though there are several prevention tools such as behavior modification programs to promote using condoms or abstaining from sex, “The only truly evidence-based strategy that we have is male circumcision,” said Robert Bailey, who is also a professor of epidemiology at the University of Illinois at Chicago, a research associate at the Field Museum and co-director of the Chicago Center for AIDS Research. Other methods of prevention either don’t have the research to showcase their efficacy or have been found unsuccessful, he said, and a vaccine will not likely be invented soon.

    But with 34 million people worldwide infected with HIV and 68 percent of those in Sub-Saharan Africa, preventive measures must be taken immediately. 5,000 men are newly infected each day in Africa, a number that health care professionals must slow down, Bailey said to the audience of 30 students, professors and community members who gathered in the Program of African Studies building on campus to hear him speak.

    “We cannot treat our way out of this epidemic,” he said. “But we must find ways to prevent it from spreading.

    One of those ways is clear, he said: The simple, cost-effective surgery of circumcision has been clinically proven to be both consistent and powerful in preventing HIV. According to evidence from three randomized controlled trials undertaken in Kisumu, Kenya, Rakai District, Uganda and Orange Farm, South Africa, uncircumcised men are two and a half times more likely to contract the HIV virus than those who are circumcised. Plus, unlike daily pills or other therapies, “once you’re circumcised you’re circumcised for the rest of your life,” he said, which makes it a one-time, inexpensive treatment (it costs about $50) that has lasting benefits.

    After seeing the striking results of the clinical trials, The World Health Organization and UNAID threw in their endorsement in 2007, recommending that male circumcision now be recognized as an important intervention to reduce the risk of HIV.

    But surgery alone is not the solution and must be performed in conjunction with other preventative treatments, Bailey cautioned. He is currently leading efforts funded by the Bill and Melinda Gates Foundation and the U.S. Government to implement a comprehensive package of HIV prevention services that includes male circumcision along with other tools such as couples counseling and sexually transmitted infection diagnosis in western Kenya.

    Not only is circumcision effective in preventing the spread of HIV, it is also helpful in reducing sexually transmitted infections, genital herpes, genital ulcers and cervical cancer in women, among other things. And through implementing this comprehensive circumcision program, health care professionals will also have the opportunity to reach out and educate men and women on HIV and improve the health care infrastructure in Africa.

    Bailey and his team have already performed 140,000 circumcisions in Kenya during the last 14 months and hope to perform 900,000 over the next 10 years. “My goal since 1994 when I first got into this was to show that [circumcision] is effective and implement it,” he said. “And now it’s happening.”

    For more information on the Global Health Lecture Series, please visit http://globalhealthportal.northwestern.edu/news-and-events/events-archive.