The Unite For Sight Global Health and Innovation Conference, 2012, provided a great opportunity for students interested in pioneering, initiating or working with global health related organizations to learn a team of successful field professionals. Among this team was Dr. Seth Wanye, my field supervisor for Lilly Project Medical Humanitarian Fellowship (http://wooster.edu/Academics/Student-Academic-Support-Centers/Lilly-Project/exploration/medical) with Unite for Sight (http://www.uniteforsight.org/) in Tamale, Ghana.
Lessons learnt from this panel discussion shed light on a fundamental aspect of global health that’s often taken for-granted. What does it take to establish a global health Non-profit or Community Based Organization etc in a remote setting? Why do well-meaning, highly funded programs often fail to impact, or sometimes under perform in remote areas?
One of the major ways that College of Wooster students have chosen to be global engaged is through initiating or working with Non-profits, Community Based Organizations (CBOs). By making such critical inquiries and assessments, students will be in a better position to effectively initiate or volunteer in organizations that positively transform the lives of under-served communities, and the students themselves. Some of the organizations where Wooster students have been actively involved as founders and active partners and change agents include, among many others, the Global Social Entrepreneurship Program and the Akaa Project. Click the links for more details http://global_se.scotblogs.wooster.edu/, http://theakaaproject.org/
The active involvement of Wooster students thus emphasizes the unique value of learning from these discussions that I am about to share. Dr. Wanye, a Ghanaian Ophthalmologist and Unite For Sight partner recommends that strategically choosing the right local team of individuals to work with is fundamental. He emphasizes, that foreign NGOs should not simply recruit volunteers for overseas missions simply because they are financially able. Only capable, well-trained volunteers who have demonstrated dedication should be allowed, as often times, well-meaning, but unprepared volunteers end up being a burden to existing local systems. College students should thus endeavor to get adequate training and orientation with methods and field of operation of the organization, and local culture prior to volunteering. Organizations should also hold prospective volunteers to the highest possible standards, before officially accepting them to work. Lakshimi Koran a Global Strategist with Riders for Health notes that the importance of reliability and predictability of volunteers and paid professionals to the local communities they serve cannot be overstated. People should show up ready to work with the locals in solving pressing issues on the agreed dates and locations. The local populace should never be taken for-granted, because no matter how poor they may be, the success of the programs largely depend on their co-operation and in-put.
Further more, its is not enough to simply donate equipment, or establish infrastructure and leave. Change agents and partners should place significant focus on maintenance, cost effectiveness and sustainability of all programs established. Students and change makers should remember that contrary to popular thought, money and technology are not silver bullets to solving problems in remote or under served places, they are simply a means. The ways in which we work with stakeholders, benefactors and concerned community members will most often determine the success of our efforts.
As I watch Prof Aydogan Ozcan, a Professor if Electrical engineering, move to the podium to make global health presentation to an auditorium filled to capacity, I wonder what he will speak about. I almost think that the moderator must have introduced the wrong person,after all, he is an electrical engineer: how can he possibly lecture an audience of global health scholars about their field of expertise
Dr. Ozcan recently invented the LUCAS device, a cellphone microscope. This is a lens free, compact and cost effective high through-put device that takes images of cell shadows using biophotonics technology. It is so small and portable that it can simply be attached onto and phone with a camera. The LUCAS device has a wide range of applications in globa health: It can be used for monitoring HIV positive patients in resource limited areas, performing CD4 counts, detecting water-borne parasites, bacteria and viruses. Because of its speed, accuracy, precision and versatility, the LUCAS device will greatly improve medical investigation and diagnosis. For more information on the LUCAS device, click this link: http://innovate.ee.ucla.edu/welcome.html
As Prof Ozcan went deeper into his presentation, I began to realize the diversity and multi-facted nature of global health. Global health, contrary to popular thought, is not simply about doctors and nurses treating patients, its a network of engineers, policy analysts, anthropologists, sociologists and all professions you can possibly imagine. So no matter what you major in College is, global health has place for you.
The Global health and innovation conference has turned out to something totally different from what I hoped for. I remember as I wrote down the list of speakers I would be listening to, as I completed my Lilly Mini-grant application. I didn’t really plan on moving too far from my comfort zone. I planned to attend sessions on health care policy, social entrepreneurship/ enterprise, and tropical disease research.
After attending one Technology and innovation session, there is no turning back. I am amazed by the buzz of innovation that’s going on across the nations’ research centers. But whats even more stunning is that these innovations are specifically tailored for rural global health care settings. Coming from an economically impoverished nation, this was very surprising. I had always believed that our hospitals were to large extent a dumping ground for outdated equipment from the developing world. So to meet top innovators, working to develop novel devices specifically tailored for under-served rural health care settings, like those in my homeland, was inspiring, to say the least. So join me on my innovation ‘bandwagon’, am sure you will be inspired as you read through my next blog posts.
As my third year of college has suddenly come to an end, I find myself shaking my head at how fast it is going, yet at the same time realizing how far I have come in envisioning my life after Wooster. Grabbing on to these opportunities offered by Lilly House and off-campus study has shaped the path I have taken through Wooster by opening my eyes to fields of study, careers, and parts of the world I would never have had the opportunity to come to know. Lilly Project, with its mission of giving students the opportunity to explore vocations and to find something out there that they feel is worth doing, has been so supportive as I have asked myself the difficult questions that are so exciting yet so disconcerting to grapple with.
I went to this Global Health and Innovation Conference to explore the field of Global Health, an area I was hardly aware existed until I did a Lilly Medical Humanitarian Fellowship. I wanted to learn more about the field, to learn more about the issues that professionals in Global Health work with, the get a sense for the career options within this field, and to connect with other students on various paths but all devoted to addressing global health issues. I was especially interested in learning more about current research and work with HIV/AIDS given my Lilly project experience with HIV/AIDS education in South Africa, as well as about issues of hunger and food after studying agriculture both at Wooster and during my semester with ISDSI in Thailand.
It was exciting to hear public health workers speak about controversial approaches to empowering sex workers in India and about how the stigma of AIDS affects people’s decisions about where to seek medical care. After spending a semester in Thailand and learning about the impacts of the Green Revolution and the commercialization of agriculture, it was very interesting to hear Kenneth Lee present on Lotus Foods and the System of Rice Intensification and to listen to Robert Lawrence, a doctor and professor at Johns Hopkins University Bloomberg School of Public Health, speak about the impact of the food system on the health of people around the world.
I have been struggling to decide which path within global health I want to take, be it medical school, a masters program in public health, a nurse practitioner program, a graduate degree in sustainable development, etc., and I hoped that this conference would help me take steps in figuring this out. I had the chance to speak with medical students, public health students, professionals in sustainable development work, and professors who were all eager to talk to me about how they chose their own path. I came away from this conference with greater confidence that I would love to pursue a career in global health and while I am still sorting out exactly what my one role will be in these efforts I am thinking more and more seriously about medical school. I will need more experience to make this decision but the excitement I felt as I ran across Yale’s campus trying to catch the next speaker was certainly eye-opening.
While I was searching for signs of where I might want to head in the next few years, I was also reminded of what attracted me to the field of global health in the first place: the interdisciplinary nature of the field and the holistic approach that those who work in global health take on health issues. Doctors, businessmen, public health workers, directors of global development programs, and undergraduate students spoke on topics ranging from the use of texting and cell phones to follow up with or notify patients in rural areas, to new projects teaching sustainable agriculture to AIDS orphans in South Africa or new approaches to addressing childhood obesity in the U.S. It was incredibly exciting to be in the middle of this exchange of innovative ideas for one weekend and I look forward to potentially entering this exchange in a larger way in the years to come.
Muteimu Zuneidu, a Masters in Public Health student at Northern Illinois University, gave a fascinating presentation on parents conception of illness and death in rural northern Ghana where child mortality is higher than in other parts of the country. He emphasized the web of interaction between child mortality, mothers’ perceptions, environmental and socioeconomic factors, and health-seeking behavior. Sixty to eighty-five percent of the mothers he studied had never been to school. Some of the most dominant beliefs of mothers that had a huge impact on whether or not they sought health care at hospitals or clinics included: (1) a child’s name can be a cause of illness, (2) A home remedy is better than a hospital, and (3) Only God protects children from illness. Only a small percentage of the women agreed with the statement: “I can protect my child from illness.” It would be disrespectful and ineffective for outsiders to simply tell these mothers that their beliefs are wrong. Yet Zuneidu emphasized the potential positive impact of female education on addressing this issue in a culturally sensitive and empowering way.
The food system is run by people who know nothing about health,
and the health system is run by people who know nothing about food.
Lotus Foods is an American company founded in 1995 by Kenneth Lee with the vision of changing the way people grow rice. Kenneth Lee spoke at this year’s Global Health and Innovation Conference, explaining the unsustainable situation of rice and the role of his business in empowering communities. Lotus Foods buys rice from small-scale farmers in seven countries (Cambodia, Madagascar, Bhutan, China, Italy, and the U.S.) at a fair trade premium and sells the rice to grocery stores and restaurants in the U.S. Lotus Foods focuses on heirloom indigenous varieties of rice, marketing them for their uniqueness, taste, nutritional quality, and environmental and social sustainability. Lee began by approaching chefs at high-end restaurants, but Lotus Foods rice is now sold in grocery stores across the country, and they import 700 tons of nine different rice varieties per year (Lee, 2012 GHIC). Lotus Foods offers farmers a fair trade premium 30-40 percent higher than the market price, allowing 10,000 farmers to access markets for indigenous varieties of rice off of which they previously struggled to make a living. Farmers set aside rice for family consumption, and only the excess, often just 6 percent of their yield, is sold (Lee, 2012 GHIC).
The access to markets is only one prong of Lotus Food’s mission of “changing the way people grow rice” (Lee, 2012 GHIC). The second is the introduction of the System of Rice Intensification, or SRI, to their suppliers’ communities. SRI was first developed in Madagascar in 1994, and the Cornell International Institute for Food, Agriculture and Development (CIIFAD) has been facilitating the study and expansion of the methodology ever since (Cornell, 2002). By changing the way rice fields are planted and managed, such as spacing the individual rice seedlings on a 25 by 25cm grid, flooding the field only periodically, and using compost to improve soil fertility, SRI often increases rice yields by 50 to 100 percent (Cornell, 2002). Most crucially, with SRI this increase in yield can be achieved without increasing inputs or changing the variety of rice farmers plant. Lee emphasized that with SRI water consumption is cut nearly in half and no agrochemicals are necessary. With the opportunity to preserve the genetic and cultural heritage of indigenous varieties of rice, farmers are less dependent on external suppliers of seed, fertilizers and pesticides and thus have more control over what they grow. Proponents of SRI emphasizes that it is “quite literally a ‘system’ rather than a ‘technology’ because it is not a fixed set of practices,” but rather “should always be tested and varied according to local conditions rather than simply adopted” (Cornell, 2002).
It was inspiring to see the work of undergraduate, masters, and medical students in addressing global health issues. Two presentations that I found especially interesting were given by Daniel Nassar, an undergraduate at Baylor University, and Kate McCalmont, a medical student at the University of New Mexico School of medicine, both of which centered around agriculture and malnutrition.
Daniel Nassar spoke about a community garden project in Habil Ogala, a community in rural western Kenya. Daniel, along with a small group of fellow students, are currently working on carrying out this project through Baylor University’s “Straw to Bread” program. Habil Ogala has a high prevalence of malnutrition but a great potential for agriculture. Nevertheless, Daniel explained that a negative perception of the farming lifestyle has developed among Luo young people, as more and more youth are leaving to seek employment in the city, with little success. In response to this situation, these students at Baylor University are working with community members to establish a school-based community garden at the Nyabondo Secondary School. Through the sale of excess crops, this garden provides supplementary funding for the school as well as environmental and nutritional benefits. This garden also allows the school to teach and engage students in sustainable farming and to emphasize the importance of biodiversity. This project is still in the beginning phases and it was great to see constructive feedback and ideas from the audience such as the suggestion of planting moringa trees, encouragement of seed saving programs, ideas for effective irrigation, and thoughts of asking young people who have left the village to work in the city to return and speak to youth about the reality of life in the city.
Kate McCalmont presented on her research in the Yalta District in the Eastern Province of Kenya where at least 16 percent of children under 5 are underweight and 35 percent are growth-stunted. Recent studies suggest even more concerning rates of malnutrition. Rain-fed agriculture in this area has been hard-hit by drought and the diet is dominated by maize flour which has a low energy density. Previous work has addressed the treatment of malnutrition but this solution is unsustainable, since these foods are not longer available when this external support is withdrawn. McCalmont emphasizes the importance of focusing on prevention. Collaborating with nurses in Kenya, McCalmont conducted research on children between the ages of 6 and 20 who were not acutely malnourished, enrolling them in a local food-based intervention program to assess the feasibility of addressing malnutrition with locally appropriate. Families of children in the intervention group were given food rations of millet, pigeon peas, milk, eggs, vegetable oil, mangoes, sugar, maize flour, and beans.
Mothers of children in the intervention group were also given group education sessions on breast-feeding, hand-washing, and other healthy practices. McCalmont saw a significant decrease in wasting and underweight statuses as a result of this approach, though no significant impact was seen on diarrheal disease or stunting. Longer breastfeeding was also seen as a result of this intervention program. McCalmont concludes that focusing on locally available and appropriate foods, when coupled with group education, is an effective and feasible ways to address child malnutrition. Further work should be done to develop the production of these locally available foods, as well as projects focused on irrigation and cultivation training and prenatal education.
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