APHA IH-MCH Working Group Conference Call: Wednesday, March 11 (12-1 p.m.)

All section members are invited to attend the next Maternal and Child Health (MCH) Working Group conference call this Wednesday, March 11 from 12-1 p.m. (EST)

GUEST SPEAKER ON THE TOPIC: Global Strategy for Women´s and Children´s and Adolescent Health for the Post-2015 Agenda

Our guest speaker will be:
DR. OSCAR CORDON
Health Practice| Director, Chemonics International
Governing Councilor – APHA International Health Section

Call-in information:

USA/Canada (toll free): 1-888-757-2790
For those calling from outside of the US: +1-719-359-9722
Guest Passcode: 424573

This conference call is being organized by the IH-MCH Working Group of the International Health Section of APHA, but all section members are invited to attend!

For more information and supplemental materials, please contact Laura Altobelli, MCH Working Group Co-chair, at laura [at] future [dot] edu.

Now Accepting Nominations for this year’s Section Awards!

Our Awards Committee is now accepting nominations for this year’s Section Awards, to be presented at the Awards Ceremony at this year’s Annual Meeting of APHA, which will be held in Chicago in October. Each year, our section recognizes outstanding contributions of its members through four awards:

  • The Lifetime Achievement Award for Excellence in International Health honors the visionaries and leaders in APHA who have shaped the direction of International Health.
  • The Mid-Career Award in International Health recognizes outstanding emerging professionals in our section.
  • The Gordon-Wyon Award for Community-Oriented Public Health, Epidemiology and Practice rewards outstanding achievement in community-oriented public health epidemiology and practice.
  • The Distinguished Section Service Award honors outstanding service to the International Health Section.

The Lifetime Achievement Award in International Health was created by the IH Section to honor the visionaries and leaders in APHA who have shaped the direction of International Health. The evaluation criteria for the Lifetime Achievement Award include: (1) the quality, creativity, and innovativeness of the individual’s contributions to the field of international health; (2) the individual’s contributions to the development of APHA or the IH Section; (3) application of the individual’s work to service delivery (as opposed to primarily theoretical value); (3) the individual’s contributions as a leader, visionary, or role model; (4) the volunteerism or sacrifice associated with the individual’s contributions; and (5) membership in APHA (preferably with primary affiliation with the IH Section), a State affiliate, or a national public health association that is a member of the World Federation of Public Health Associations. No self-nomination is allowed.

The Mid-Career Award in International Health is intended to recognize outstanding emerging professionals in the IH Section. The evaluation criteria for the Mid-Career Award include: (1) the individual’s commitment to the promotion and development of primary health care in a cross-cultural setting over a period of 5-15 years (with primary health care encompassing a broad array of public health issues, including HIV/AIDS prevention and environmental health); (2) demonstrated creativity in expanding the concepts pertinent to the practice of public health with an international focus; and (3) membership in APHA (preferably primary affiliation with the IH Section), a State affiliate, or a national public health association that is a member of the World Federation of Public Health Associations. No self-nomination is allowed.

The Gordon-Wyon Award for Community-Oriented Public Health, Epidemiology and Practice is intended to reward outstanding achievement in community-oriented public health epidemiology and practice. This award was established in 2006 by the IH Section and is administered by the Community Based Primary Health Care Working Group. John Gordon and John Wyon were pioneers in this field, so encouraging and recognizing others in this field is one important way of honoring their memory. The evaluation criteria for this award include: (1) a central role in an outstanding achievement in community-oriented public health and practice; (2) demonstrated creativity in expanding the concepts pertinent to the practice of community-oriented public health with an international focus; and (3) membership in APHA or one of its affiliates (either a State affiliate or a national public health association that is a member of the World Federation of Public Health Associations). No self-nomination is allowed.

The Distinguished Section Service Award is intended to honor outstanding service to the IH Section. Award criteria are: (1) dedication to the IH Section mission and goals as demonstrated by continuing exceptional contribution to its activities; (2) service on the section elective positions or chairing its committees with remarkable or unusual effort and achievements; (3) distinguished achievement in the international health field with a remarkable career; and (4) excellence in leadership and strong ability for team work with peers in the IH Section and APHA. Current membership in APHA is essential.

Award nominations should include a detailed letter explaining why the individual nominated should receive the award, addressing the criteria for the specific award and the curriculum vitae of the nominee. Both documents (the nomination letter and the curriculum vitae) should be submitted electronically as a Word document or PDF. Only nominations with the required documentation will be considered for the awards. Nominations should be submitted by e-mail to the Awards Committee chair, (currently Gopal Sankaran, gsankaran@wcupa.edu).

Tools of the Trade: GPS Assisting in Exploring the Challenging Environments by Mary Louise Tatum

The expansions of peri-urban environments are occurring without any strategic development or management which places its inhabitants at risk for environmental hazards.  In 2013 I was fortunate to develop a partnership between Kent State University (Geography Department) and The University of Zambia (Public Health Department) (please look for my next blog discussing in further detail creating international opportunities). As a result, I was able to observe various environments in Lusaka in close detail. This included illegally settled peri-urban areas on the outskirts of Lusaka, Zambia.

Zambia is a landlocked country with a population of approximately 13.1 million located in southern Africa. The capital of Lusaka has a population of 2,191,225 and has seen disproportionately higher growth compared with the national average: Lusaka has an annual population growth rate of 4.6% compared with 2.8% nationally (Central Statistical Office Ministry of Health; 2013 Zambia Demographic and Health Survey). As a result, there has been rapid growth in illegal settlements. Due to rural urban drift many people have settled in unoccupied land in the peri-urban areas. “Six-Mile” is one such peri-urban community in the outskirts of Lusaka.  As residents of an unofficial settlement, residents lack municipal support and basic needs conceivably leading to increased disparities in environmental health related diseases.

Assessing and documenting public health risks have proven to be a challenge in such environments.  Minimal information is currently available regarding Lusaka’s peri-urban environments. Fortunately, advanced technologies, such as, Google Earth and cameras equipped with a Global Positioning System (GPS) can be used to capture, analyze, manipulate, and understand patterns and relationships between people and their environment. Geography and public health unite to utilize geospatial techniques to explore the construct of a specific peri-urban environment. Utilizing a vector-based system, a real world (Local Map) map will be created demonstrating the “real” environment for analysis. This is important as currently there is no paper map documenting this settlement. Data was collected using cameras equipped with a GPS during walks and drives through the area in August 2013 and July 2014.

Preliminary data collection demonstrates Six Mile residents may be at risk for exposure to malaria, cholera, and other bacteria, as a result of the pools of stagnant water and piles of waste observed during the walks and drives through the area. The one closet-size toilet, shared by a community of approximately seventy-five people, is a tiny areas surrounded by discarded plastic pieces that rest on wooden posts of various dimensions. The toilet, which also doubles as a bathing area, is in close proximity to the source of water collection for drinking and household use. During the walk-through and drive-through it was noted that children played in the stagnant pools of water and piles of trash without interruption.

Our partnership is planning to continue data collection this year and to add to our evolving map. Our goal is to develop a visual tool that may be used by agencies to educate residents in healthier practices and for improved development practices that will mitigate environmental hazards that lead to infectious disease.

With advanced technological tools, such as GPS, Google Earth, and other mapping systems we can capture real-time information to analyze how the environment impacts residents and vice versa. As noted during this field study there are numerous hazards which may be mitigated with government and/or nonprofit environmental organization involvement. Promoting behavior change is one aspect of addressing this issue, but the stark lack of adequate water, sanitation, and hygiene facilities is a major public health threat that needs simultaneous attention for risks to be alleviated.

The expansions of peri-urban environments are occurring without any strategic development or management which places its inhabitants at risk for environmental hazards.  In 2013 I was fortunate to develop a partnership between Kent State University (Geography Department) and The University of Zambia (Public Health Department) (please look for my next blog discussing in further detail creating international opportunities). As a result, I was able to observe various environments in Lusaka in close detail. This included illegally settled peri-urban areas on the outskirts of Lusaka, Zambia.

Zambia is a landlocked country with a population of approximately 13.1 million located in southern Africa. The capital of Lusaka has a population of 2,191,225 and has seen disproportionately higher growth compared with the national average: Lusaka has an annual population growth rate of 4.6% compared with 2.8% nationally (Central Statistical Office Ministry of Health; 2013 Zambia Demographic and Health Survey). As a result, there has been rapid growth in illegal settlements. Due to rural urban drift many people have settled in unoccupied land in the peri-urban areas. “Six-Mile” is one such peri-urban community in the outskirts of Lusaka.  As residents of an unofficial settlement, residents lack municipal support and basic needs conceivably leading to increased disparities in environmental health related diseases.

Assessing and documenting public health risks have proven to be a challenge in such environments.  Minimal information is currently available regarding Lusaka’s peri-urban environments. Fortunately, advanced technologies, such as, Google Earth and cameras equipped with a Global Positioning System (GPS) can be used to capture, analyze, manipulate, and understand patterns and relationships between people and their environment. Geography and public health unite to utilize geospatial techniques to explore the construct of a specific peri-urban environment. Utilizing a vector-based system, a real world (Local Map) map will be created demonstrating the “real” environment for analysis. This is important as currently there is no paper map documenting this settlement. Data was collected using cameras equipped with a GPS during walks and drives through the area in August 2013 and July 2014.

Preliminary data collection demonstrates Six Mile residents may be at risk for exposure to malaria, cholera, and other bacteria, as a result of the pools of stagnant water and piles of waste observed during the walks and drives through the area. The one closet-size toilet, shared by a community of approximately seventy-five people, is a tiny areas surrounded by discarded plastic pieces that rest on wooden posts of various dimensions. The toilet, which also doubles as a bathing area, is in close proximity to the source of water collection for drinking and household use. During the walk-through and drive-through it was noted that children played in the stagnant pools of water and piles of trash without interruption.

Our partnership is planning to continue data collection this year and to add to our evolving map. Our goal is to develop a visual tool that may be used by agencies to educate residents in healthier practices and for improved development practices that will mitigate environmental hazards that lead to infectious disease.

With advanced technological tools, such as GPS, Google Earth, and other mapping systems we can capture real-time information to analyze how the environment impacts residents and vice versa. As noted during this field study there are numerous hazards which may be mitigated with government and/or nonprofit environmental organization involvement. Promoting behavior change is one aspect of addressing this issue, but the stark lack of adequate water, sanitation, and hygiene facilities is a major public health threat that needs simultaneous attention for risks to be alleviated.

After 30 years, @WHO finally begins pushing single-use syringes

Yesterday, the WHO officially updated its injection safety recommendations to call for the widespread adoption of single-use syringes, as well as a reduction in unnecessary injections (e.g., administering medications orally if they do not need to be injected):

A 2014 study sponsored by WHO, which focused on the most recent available data, estimated that in 2010, up to 1.7 million people were infected with hepatitis B virus, up to 315 000 with hepatitis C virus and as many as 33 800 with HIV through an unsafe injection. New WHO injection safety guidelines and policy released today provide detailed recommendations highlighting the value of safety features for syringes, including devices that protect health workers against accidental needle injury and consequent exposure to infection.

Transmission of infection through an unsafe injection occurs all over the world. For example, a 2007 hepatitis C outbreak in the state of Nevada, United States of America, was traced to the practices of a single physician who injected an anaesthetic to a patient who had hepatitis C. The doctor then used the same syringe to withdraw additional doses of the anaesthetic from the same vial – which had become contaminated with hepatitis C virus – and gave injections to a number of other patients. In Cambodia, a group of more than 200 children and adults living near the country’s second largest city, Battambang, tested positive for HIV in December 2014. The outbreak has been since been attributed to unsafe injection practices.

WHO is urging countries to transition, by 2020, to the exclusive use of the new “smart” syringes, except in a few circumstances in which a syringe that blocks after a single use would interfere with the procedure. One example is when a person is on an intravenous pump that uses a syringe.

Setting aside my horror that repeat use of non-sterile needles in still a thing in healthcare facilities here in the US, I saw this as a positive move on WHO’s part and assumed that the “smart” syringe referred to in the press release and several headlines was something only recently developed. After all, injection drug use has been the primary driver of HIV and hepatitis infections in Eastern Europe and Central Asia for years, and it is a significant component of the epidemics in southeast Asia and China’s Yunnan province as well.

Imagine my chagrin when I came across this piece from the Guardian‘s Global development professionals network. It tells the story of Marc Koska, the British inventor of the K1 single-use syringe, who has apparently been trying – unsuccessfully – to get the global health community to jump on this bandwagon…for 30 years.

Using existing technology Koska came up with a syringe that falls apart after one use, and sold his first one in 1997. Even though he’s sold more than 4 billion auto-disable syringes since, he has been repeatedly frustrated in his attempts to make the world aware of the problem caused by reusable syringes. “It’s been a very frustrating journey. Thirty years to get WHO turned around. Thirty years to get the manufacturers turned around. You’ve got too many parts to expect it to be a three year journey.”

“There is a very basic reason why it hasn’t happened and that is because the manufacturers haven’t had a market,” he argues. “If the manufacturers could sell a product and it was identified where they were going to sell it and who was going to pay for it, they would make it.

“Today, [WHO Director Margaret] Chan is a hero, but I think the next chapter might be just as challenging as the first bit,” he says.

“My gut feeling is that the ministries of health will be most resistant, because they’ve been saying for so long that they don’t have a problem of reuse in their countries. They’re never going to say that ‘we’ve got a terrible problem with hepatitis C because I can’t be bothered to buy enough syringes’. So now ministers have got to change their position and say, from Tuesday, we’re only going to buy auto-disable syringes.”

The frustrations of market forces blocking the development or widespread adoption of critically-needed global health resources is an old hat to most in the field, but this seems particularly egregious…WHO really should have caught on much sooner.


Note: This was cross-posted to my own professional blog.

John Oliver takes on Big Tobacco in Last Week Tonight

Many thanks to Dr. Don Zeigler, who passed this on through APHA’s Trade and Health Forum listserv. In a recent episode of Last Week Tonight (har), John Oliver explains how the tobacco industry is compensating for the fall in smoking rates here in the US by utilizing impressively convoluted international legal tactics and taking its business to developing countries in its usual style – shady as hell. The video is long (about 18 minutes), but is seriously worth every second.

Tips for students and young professionals embarking on their first international health experience

Guest blogger: Geoffrey Horning

As members of the APHA and specifically as students in the International Health section, none of my colleagues find the thought of living and working overseas all that strange. In fact, they quite often find the thought exciting, intriguing and something they aspire to do. Many of us, myself included, already have work experiences outside of American borders. In this two part posting, I thought I would share a little of the perspective that I have developed as a “westerner” currently working in the Middle East and North Africa.

On November 11th 2011, I boarded the first of three flights from St. Louis Missouri that would ultimately land me in Riyadh, Kingdom of Saudi Arabia. News media, YouTube and the rest of the internet do not do Saudi Arabia justice, but I thought I had some idea of what to expect from my previous travels…I was wrong. Here are some of the things I’ve learned about living in another culture, and especially one completely different from your own.

First Things First: Know your surroundings and be aware of your situation at all times. The last thing I want to do is scare you or encourage you to stay inside. Neither of those things is necessary, and in fact they are both counterproductive. However, it is important for your safety that you remain alert. Failure to do so can make you the target of groups looking to exploit your naivety, whether it be for a simple street hustle, unlicensed taxi ride that keeps getting more expensive, bribes or more nefarious robbery and kidnapping. Always make sure someone knows where you’re going and when you will be back, register with your embassy in the countries you’ll be visiting, and always keep an eye on a possible exit.

Roll with the punches: Nothing is what it seems, you are a foreigner, a stranger in a strange land, and you learn daily. If you crave the stability of familiar things, this is going to be rough. Every time you think you’ve figured something out, it changes, or more likely, you realize you were just wrong about your previous assumptions. When you laugh things off, or regroup and try a different approach, when you finally realize the “punches” aren’t directed at you and in fact are simply cultural differences — then you’ve made it.

Know the Law-BEFORE you arrive: Two of the “silliest” things I see here are people who have no knowledge of the laws, and worse, people who flagrantly violate the laws and then expect a United States Passport to get them out of trouble. This doesn’t work; it understandably annoys the State Department, and reflects poorly on all of us from your home country. Please follow the law of the land.

Know your health status-and respect it: Consider any medical conditions that you have that require specialized treatments and or medication. Do a quick internet search and see what you have to do in order to get those treatments or those prescriptions filled in the host country. Never, stop taking a medication without a doctor’s advice. Items of specific concern are analgesics/painkillers which may be considered illegal narcotics where you’re headed and psychotropic medications that may just not be available. If you have a history of cardiac problems, it would behoove you to look into the state of cardiac care in the country and region you’re going to.

Learn the language: A vast majority of people in Saudi Arabia are already bi or tri-lingual. English, French, and of course Arabic are commonly known. My Arabic is probably best described as “atrocious”, and the Saudi dialect of Arabic can be quite a bit different from Modern Standard Arabic, which is what you’ll usually get from a language program. That being said, I know enough to get around, and it helps. Start working with it from day one. Your supervisors, co-workers, cashiers, waiters, driver and hotel bellman all speak two or three languages; you might want to go ahead and try to catch up. It’s appreciated.

Check your privilege at the customs counter: The idea of “privilege” is a contentious topic in modern day America. However you feel about it, I assure you that it exists. You’ll see it up close as you process through customs and immigration the first time, and you will probably realize that you have more travelling money in your wallet than some of the people in that line make in a month. If a customs officer recognizes that you’re American/Canadian/British (i.e. “Westerner”), he might pull you out of line and take you to the front, bypassing the 100 people in front of you. Don’t argue with this man – but don’t act like you deserve it. If you’ve been recruited as I was for your abilities in a specific area, then prove it through your performance, but do not act as though you deserve it just because your first moments of life were in a Western hospital. As you learn, as time goes on, you’ll figure it out. Keep the great aspects of your home country and culture, leave the rest: Remember, you just became an unofficial ambassador!

Hurry up and wait: Life in the United States and other Western nations is often a little more: go! go! go! than it is elsewhere in the world. Whether you call it the “rat race” or “climbing the corporate ladder” or what have you, many parts of the world don’t do this. Time is more fluid here, and as an example, work starts at 8 for me which, means I arrive between 7:30 and 8:30. For the first year, I was vigilant about being on time. Now I make sure I’m within reason, which is what my co-workers do. This is what makes me part of the group, rather than an outsider. Learn to interpret signals, take things as they come, and just relax. You might find that you really enjoy the more relaxed pace.

Watch what you say, watch what you write: You should be culturally sensitive anyway, but sometimes it takes a little bit to figure out what’s culture and what’s not. I actively wrote a blog the first 18 months I was here; I really enjoy going back and reading it now, as I can see my development and change over the months and year. There’s nothing wrong with doing this, and I actually encourage it. The reason I gave it up was the time commitments of work and school, not fear of Saudi government intervention. That said, it is always a good idea to be aware of what you say. Not every country in the world, including some western ones, recognizes your “right” to say whatever happens to pop into your head today. Insulting a nation’s government or royal family may be illegal, insulting the culture is poorly regarded, and insulting the state religion and/or proselytizing is treated as blasphemy and can be punished severely. If you make it public, anyone can read it.

These are some tips to get you started in your planning process, In my next post, I’ll talk a little bit about the steps to cultural adjustment that you’ll be taking, as well as give some real life examples of people who’ve been both successful and failed miserably in their transitions.

GHorning

Geoffrey Horning is an Emergency Medical Services (EMS) Training Consultant at the Al-Ghad International Colleges for Applied Health Sciences in Riyadh, Kingdom of Saudi Arabia. His expertise is in EMS/Fire and EMS/Fire Training with specialization in HazMat and Disasters. Geoff’s objective within the Department of Academic and Educational Affairs is to improve and assure the quality of the educational processes and thereby provide the best possible learning environment for students and faculty alike. A veteran of the United States Marine Corps, Geoff is simultaneously working on his MPH at the George Washington University which he will be complete in August 2015.  

Lancet reminds us to include health in #humanrights analysis

This should go without saying, but it is always nice when a respected, high-impact journal reminds us that health should be a central consideration in every human rights discussion and “necessary component of resilient human security.” In its most recent issue, British health journal Lancet published an editorial on HRW’s World Report 2015, lauding it for drawing attention to health-related human rights failures around the world while expressing disappointment that it “did not identify health as a core element in its analysis”:

In his opening essay, HRW’s Executive Director, Kenneth Roth, writes, “The world has not seen this much tumult in a generation…it can seem as if the world is unravelling”. Indeed, this 656-page report is a grim read in a year marked by extensive conflict and extreme violence. But when one delves deeper, there is a hidden story that often does not make the headlines. That story is the health dimension of human rights. Viewed through the lens of health, the report contains several compelling and disturbing themes.

The editorial noted numerous examples in the report of attacks on healthcare facilities, both in conflict zones and in the areas of West Africa struck by the Ebola outbreak, as well as spotlights on gender-based violence, a dearth of mental health services, targeted killings and persecution of health workers, and inadequate access to palliative care. While the report contains valuable analysis, the editorial contends that it does not go far enough in incorporating health as a human rights foundation:

This latest HRW report is an important call to arms to protect health as a fundamental human right. It is a pity that HRW did not identify health as a core element in its analysis, not only as part of a comprehensive package of human rights protections but also as a necessary component of resilient human security. Their analysis should prompt all governments and international health organisations to reflect carefully on their actions to make health a core responsibility and right of all citizens.

Agreed.


Note: This was cross-posted to my own professional blog.