The Journey Continues...

A picture taken by my son on our Hawaiian vacation before the start of school.


It’s my last semester in the Master’s Program in Public Health at USC and I feel the need to revive my blog. This will serve as my journal and countdown to the end of my experiences in the Global Health Leadership track.

It’s hard to believe that I started the program one year ago. The year has passed very quickly, but not without much sacrifice, challenges and pain. I have learned so much and am so grateful for the learning opportunities that I have had. I know that my learning will not end at the close of the semester. And, that’s really the exciting part. I know that I have so much to learn in my quest to help improve the health of disadvantaged populations around the world – it will be an exciting journey!

Speaking Out for Public Health

On Thursday, we had guest speaker who’s doing a lot of work with the Department of Homeland Security. He mentioned that most of the disaster and bio-terrorism planning is being done without any public health professionals at the table. That’s a real scary thought to me. Not so much because we are the people who should be there because we are the ones to respond in an emergency, but more so because the designated leaders don’t think to include us.

How can we reverse this blatant disregard for our profession? I attended the last APHA meeting and there were thousands of public health professionals there. Surely someone must recognize that we are being overlooked when it comes to important policy issues. I hope that my up and coming colleagues will work hard to make sure that our voices are heard more often when it comes to influencing policy and changing the awareness level of our profession.

Better Global Health Through Telemedicine

The term Telemedicine is the delivery of medicine at a distance. The term is composed of the Greek word τελε (tele) meaning 'far', and medicine. Telemedicine may be as simple as two health professionals discussing a case over the telephone, or as complex as using satellite technology and video-conferencing equipment to conduct a real-time consultation between medical specialists in two different countries.

Major investments in this technology can help delivery high quality medical services in some of the most remote areas of the world. Telemedicine can also provide access to care where health care professionals are in high demand, but low supply. I see this as a real opportunity to improve health in poor and developing nations.

Here is an example:

A telemedicine project in Rwanda that will allow doctors to conduct their medical services via the Internet has been launched by the Rwanda Ministry of Health. The details regarding the significance of the telemedicine project in medical services were recently unveiled by the Minister of State for Health Dr Innocent Nyaruhirira. Dr. Nyaruhirira said that patients can access the telemedicine services at King Faisal, Kigali Central and Butare University Hospitals but more centers are to be opened across the country.


The development that has been underway since 2003, was delayed by the training of manpower who are to handle this new technology in medical services.


"The government has provided a useful tool to expand the quality of medical services regardless of geographical access. It is now the duty of all institutions and service providers to make use of facilities offered by online hi-tech device in order to make e-medicine efficient and sustainable" said the minister.



Telemedicine will allow the sharing of the limited resources available among health institutions to treat as many patients and teach more students as possible using with the few doctors and teachers available.


State Minister for Energy and Communication, Eng. Albert Butare urged the concerned parties to utilize telemedicine saying that "It should go beyond demonstration, and you extend it to patients in need."



Butare noted that the service could eventually transform the health sector. The Country Representative of the United Nations Development Programme (UNDP) to Rwanda, Moustapha Soumare noted that telehealth will help improve the quality of health services through teaching and linking Universities in Rwanda to others worldwide.


"That's why it is vital to create an environment where the world can follow online what is happening in Rwanda's health sector," he said promising UNDP commitment to support the telemedicine project.



In the presentation on how e-medicine works in his home country 'South Africa' Prof. Maurice Mars from the University of Kwazulu Natal pointed out the consideration of local and international legal clinical guidelines and standards in the use of e-medicine.



"It is crucial to consider local and international legal clinical guidelines which go hand in hand with human resource change management", Prof. Mars said, noting that South Africa is now collaborating with six African countries, including Rwanda to promote telehealth.



(Source: AllAfrica.com, March 4, 2007)


Read more at:
http://tie.telemed.org/news/

Creativity: A Prerequisite for Addressing Global Health Issues

Last night's class on Environment, Sustainability and Global Health left me with the same feeling that I leave with on most nights: "There's so much to do and only one me!" Thankfully, I have some pretty awesome classmates who will add to the workforce of professionals who are also dedicated to making a difference in global health.

However, even with that knowledge, often I have a heavy heart regarding the health and well-being of our global neighbors, especially the poor and disenfranchised. I want to speak for those who have no voice, bring clean water and food to those who go without, and empower women and girls so that they may have the tools to improve the lives of their families and communities.

I received an email from a friend this morning and it inspired me to shift my paradigm. I know that I can't do it alone, but instead of having a heavy heart about it, I can creatively unite with others to make a difference.

Here's the email text:

Be Creative

Creativity is not reserved just for those who engage in artistic pursuits. In every life, in every situation, there are opportunities to be creative.

Being creative means acknowledging that there are many possibilities beyond the obvious. Being creative means having the courage to consider doing things in a way that's different than the way they've always been done.

Creativity gives you the ability to solve multiple problems with a single course of action. Creativity transforms weakness into strength, and builds value where there was none before.

Imagine the possibility of a connection between things that don't appear to be connected, and creativity will start to take hold. Look at life from a new perspective, and it will further nourish your creativity.

Creativity refuses to accept limits. And as such, with sufficient creativity you can move beyond any obstacle.

There is always room for improvement, and there is always a place for beauty, for achievement, for fulfillment. Be creative, and you'll continue to add richness to life (and might I add:) and change the world.

Shifting the Paradigm for Global Mental Health

Consider the following. We humans are social beings. We come into the world as the result of others' actions. We survive here in dependence on others. Whether we like it or not, there is hardly a moment of our lives when we do not benefit from others' activities. For this reason it is hardly surprising that most of our happiness arises in the context of our relationships with others. - The Dalai Lama

The topic of discussion this week was Mental Health. This subject is fascinating to me and has been since I took psychology as an undergrad. However, because of stigma and discrimination, we often sweep the subject under the rug. The funny thing is that the issue is so big, we just keep tripping over the rug. If we invested more in mental health and well being, we could invest less in other health care services since we would be addressing many of the issues that cause people to engage in risky and self-destructive behavior. Just think of all the good that could be achieved if we focused on happiness and emotional well being instead of all of the sickness that is primarily caused by our own actions.

Is it possible to shift the paradigm for global mental health to change the future course of obviously related problems such as alcoholism, drug addiction and domestic violence; and the not-so obviously related problems like, obesity, heart disease, cancer and diabetes?

Spread the Word

“There’s enough on this planet for everyone’s need but not for everyone’s greed.”
Mahatma Gandhi

This was one of the quotes from Dr. Shahi’s February 8th lecture, and it pretty much sums up my take home message for the night.

The Millennium Development Goals are as follows:
1. Eradicate extreme poverty and hunger
2. Achieve universal primary education
3. Promote gender equality and empower women
4. Reduce child mortality
5. Improve maternal health
6. Combat HIV/AIDS, malaria, and other diseases
7. Ensure environmental sustainability
8. Develop a global partnership for development.

One of the discussion questions for the class centered on how we as a global community can meet these goals. Thinking about this took me back to my January 25th posting, Shifting Paradigm Starts With You and Me. One of the most important things that you and I can do is spread the word about the goals. We must get others thinking and talking about the goals in order to affect policy and bring greater attention to help change the lives of the more than 850 million people in the world who go hungry everyday and the 1.1 billion who live on less than $1 a day.

I know that I paid little attention to the Millennium Development Goals until I began the MPH program at USC. There are many, many others out there who have never heard of them and have never thought of them. Let’s all do our part and spread the word!

Correcting the Course

Our February 1 class left me with a thought I can't seem to get out of my head. The United States is a leader and we can do so much to lead the way in helping developing countries avoid some of the tragic health consequences we face in our nation today as a result of our lifestyles. The evidence is clear that others are following in our path with growing rates of obesity, cardiovascular disease, diabetes, cancer and other life-threatening ailments that can be greatly reduced by changing the way we live our lives. We know the problems, but we can't seem to reverse the trends. Is it possible for us to shift the paradigm in the US and stand as a lighthouse to the world and prevent others from crashing on the perilous shores that all too often lie just beyond "developed nation" status?

Shifting the Paradigm Starts With You and Me

There was a moment in class tonight when I felt like I was in the twilight zone. Some of the comments I heard were absolutely amazingly frightful coming from supposedly “educated and enlightened” individuals. I guess what was even more shocking was the fact that few others seemed bothered by some of the things said.

So here I go in an effort to voice my opinion. I probably won’t be very popular after this, but that’s never been a concern for me anyway.

There was a statement made something like “that’s because African men are more promiscuous” regarding the higher HIV infection rate among men in Africa.
Please don’t make statements like this unless you have data to back them up. Where is the evidence? Have you looked at what’s going on here and in China? China has the potential to be the next center for an HIV epidemic? Could it be because Chinese men like to spread the love around too, or could there possibly be something else going on????

In response to Jennifer’s statement regarding the risks associated with female genital mutilation and the spread of HIV infection, some one unleashed a fury against religion and the damage it does to public health in developing nations. I believe the poor people in these circumstances were referred to as “irrational” and “barbaric.”
Hmmmm. I could speak volumes on this one and would have had it not been for the fact that the speaker did not have time to address everyone’s comment.
I’m trying to figure out how you can be a public health professional focusing on global health when you view those you must help with such Western imperialistic disdain. We can’t help anyone unless we try to understand them, their values and their culture. Yes, we need to help them change their paradigm, but we can’t help them until we change ours. And remember, it's hard to shift your paradigm when you live on less than a $1 day. I’m also sure our less enlightened neighbors can look at us and the horrors that we accept in this country as “irrational” and “barbaric” as well. Racism, homelessness and hunger in a land of plenty is “irrational” and “barbaric.”

To quote one of my favorite teachers:
“Either how canst thou say to thy brother, Brother, let me pull out the mote that is in thine eye, when thou thyself beholdest not the beam that is in thine own eye? Thou hypocrite, cast out first the beam out of thine own eye, and then shalt thou see clearly to pull out the mote that is in thy brother's eye.” Luke 6:42

Shift the Paradigm.

Sharing the Wealth

Dr. Shahi, thanks for the quote from Plato…“There should exist among the citizens neither extreme poverty nor again excessive wealth”, he wrote, “for both are productive of great evil.”

I thought this was a great quote. I reminded me of one of the articles I reviewed in PM 566. The article was entitled “International Efforts to Control Infectious Diseases, 1851 to the Present.” The authors noted the comments of Columbia University economist Jeffrey Sachs regarding the MDG’s. He commented that if all the wealthy nations devoted 1/10th of one percent of their GNP to support health services for the world’s poor that this would translate to about $25 billion annually. These funds could markedly reduce the world’s disease burden and save about 21,000 lives each day. WOW!

They also closed with a statement that I really liked: “Public health is purchasable. But it is an investment that works best when purchased in advance rather than paid out as each crisis arises.”

New Insights

In PM 565 (Emerging Trensds in Global Health), we were assigned to watch this truly amazing video by Professor Hans Rosling that really puts the need to think about health in global terms into perspective. We cant 'afford to make generalizations anymore. There is so much data out there that challenges our traditional thinking about what's going on in the world. This video really made it clear to me that I found my calling. Read the book "The World is Flat" and watch the Rosling video and let me know what you think.

http://www.ted.com/tedtalks/tedtalksplayer.cfm?key=hans_rosling&flashEnabled=1

Introducting Me...

One of my new found friends and me in Ghana.