Global Health Blog

  1. The Pebbles Project: A Reflection

    July 21, 2014 by Emily Drewry

    Emily Drewry participated in the Northwestern Public Health and Development in South Africa study abroad program in Spring 2014. As part of her studies, she spent six sessions working with a local NGO to integrate her understanding of South African health systems with understanding of community development.

    IMG_3026The Pebbles Project is a nonprofit organization whose offices are located on the Villiera Wine Farm in Somerset West, South Africa. Founded in 2004, the organization’s initial goal was to help the children of wine farm workers, many of whom are affected by alcohol abuse early on and throughout life. Children living in the Winelands communities have been identified as high risk for significant instances of Fetal Alcohol Syndrome and developmental delays due to increased exposure to pesticides from living on and near wine farms. Through working with this organization, we were able to integrate our budding understanding of South African health determinants. We were able to spend time with the nurse practitioner, an incredibly knowledgeable woman, as well as  one of the early childhood program teacher at Pebbles during our time there. Ending with a cumulative project about what we’d learned, the time at Pebbles left a lasting impression.

    The day we first drove up to Pebbles, the natural beauty of the Winelands around the office stunned us. We were so excited to meet the staff, tour the location, and get started with our work. It became clear that we would be working on a few projects while at Pebbles, but that our time there would be largely based on their needs on a week-by-week basis. We toured the facilities that first day and were excited to see a new clinic where families of wine farm workers could come to receive care. Because it just opened, the clinic wasn’t receiving many patients, but there’s no doubt that it will be an integral part of the Winelands community in the future.

    IMG_3037The Public Health and Development program focused on a different determinant of health each week, effectively introducing us to the status of South Africa within the realm of health, and creating comprehensive background for us to apply to our time at Pebbles. For example, the week of occupational health especially stood out to me as important progress in my understanding of South African health determinants. I was already familiar with the workings of Pebbles by that point in our time here, but I had never contemplated the occupational hazards present on the wine farms. After a week of coursework related to occupational health, I returned to Villiera with a broader understanding of concerns for employees and the required actions to remain in good health while working in jobs that require manual labor. Things I had never considered before, such as repetitive strain injuries due to long days of repeating motions, became illuminated and further highlighted the need for a clinic on site.

    As part of our work at Pebbles, we were tasked with creating a hygiene project for the young children of the crèches. After observing for a day, we noted that the biggest gap in hygiene came in the process of washing hands. Not only did the children fail to wash their hands at home, according to the teacher, but also when asked to do so at the crèche, they simply dunked their hands in water and considered it done. We worked on creating a presentation that would be understandable by 3-5 year olds that showed them why they wash their hands and how to do so effectively. Using a basic explanation of a germ and demonstrating how long to wash our hands to the tune of Happy Birthday, we presented on our final day at Pebbles and were thrilled with the responses we got from the kids. They sang along with us as we let them practice afterward, and we left the materials behind for the teacher to replicate the presentation in the future. For children so young, it is difficult to explain concepts as difficult as germs, but we hoped to have made a lasting impression on their habits that will greatly affect their health down the road.

    I could not have been happier with the placement at Pebbles; the wine farms were, to me, a fascinating community to learn about for the past ten weeks. Not only was it a group I had previously little knowledge about, I found the determinants were apparent within the community, but also being addressed by Pebbles. The organization offered a comprehensive look into the challenges of a specific community, and I appreciated the chance to identify each program and how the goals matched the health needs of the community. Pebbles offers a variety of programs, from early childhood development centers, to afterschool clubs, to parents workshops about finances, personal development, and positive parenting. The various parent programs, for example, worked well at addressing the psychosocial and occupational health problems seen among adults in the wine farm communities. The development of individuals within the Winelands communities will be forever improved because of Pebbles’ comprehensive goals and programs.

    I left South Africa with a broader interest in health – not only will I continue to seek out opportunities in nonprofits abroad, but I will bring to the table the skills it will take to join and learn about a new community, especially one I’d never considered before. Pebbles is one of those organizations that will stick with me for a long time, not only because of the opportunities we had to become a part of their team, but because of the complex task they have undertaken so positively.

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  2. Apna Ghar: Empowering Asian American Victims of Domestic Violence

    July 15, 2014 by Haley Lillehei

    Last quarter I took a class on Asian American women and different issues they face in the United States. One assignment was to look up an organization in the Chicago area serving these women. I chose Apna Ghar, an organization in Uptown Chicago, which tries to fill the gaps in domestic violence relief services in the Asian American community. After this project, I decided to reach out to Radhika Sharma, Community Health and Violence Prevention Specialist at Apna Ghar, to learn more.

    Apna Ghar first opened its door in 1989 with the goal to “provide comprehensive multi-lingual, multi-cultural services, including shelter, for South Asian immigrant women seeking lives free from violence.” Since it’s founding, Apna Ghar has worked to offer assistance to all women, regardless of their racial background, and provides a wide range of services that focus on South Asian immigrant women. Its founder recognized that Chicago shelters did not know how to deal with the issues specific to South Asian women. Their experiences were not the same as in white middle and upper income families, who are often the targets of domestic violence shelter’s services. There was also a need for legal assistance for immigrant women who are undocumented or whose residency in the US is dependent on their abusive spouses.

    Radhika Sharma notes that while gender inequities exist in almost all cultures,

    “the hundreds of distinct cultures within the Asian American category include the focus on the individual as part of a larger family unit. This means that some Asian American Domestic Violence victims refrain from speaking out about their abuse for fear of bringing shame to the family. It also means that the abuse might be perpetrated not just by the spouse but by the spouse’s family” (2014).

    The emphasis on family and traditional values can make the situation especially hard for immigrant women.

    To address all of the barriers Asian American women face while attempting to find relief from domestic violence, including cultural and linguistic ones, Apna Ghar aims to be a culturally specific space. This helps the abused women, who, according to Sharmila Rudrappa, often feel “a strong sense of wanting to be in a familiar cultural space where they could reconstitute their lives in ways that were culturally comprehensible and within their control.” Asian American survivors of domestic violence needed a space where they felt comfortable, and not like outsiders as they are receiving care and assistance. Apna Ghar provides a space with more flexible policies – one in which women can cook their own food and speak with the multilingual staff.

    Most importantly, Apna Ghar focuses on helping domestic violence survivors become self-sufficient and empowered. It offers a wide-range of services to accomplish this goal, including education, transitional housing, counseling, and legal services. For example, the organization provides a 24-hour hotline which addresses immediate safety concerns and provides referrals and information to callers. It also provides an emergency shelter with 15 beds, transitional housing for 18 to 24 months for those who are working to rebuild their lives, counseling to help women and children work through trauma associated with abuse, and legal advocacy geared towards helping both residential and non-residential clients through the United States legal system. Likewise, Apna Ghar has a Supervised Child Visitation and Safe Exchange Center, in which children are able to interact with a non-custodial parent under supervision.

    Apna Ghar’s website includes a section that discusses “success” stories of women who have utilized their services to escape abusive home situation and rebuild their lives. There are stories of women, like Maria, who was tricked into coming to the United States and becoming a sex slave, and Vijaya, who came to Apna Ghar to escape violence in her home while she was pregnant (names changed to protect confidentiality). The stories are touching and powerful, and show the good work Apna Ghar is doing within the community. To find out more about Apna Ghar or become involved, see their website at http://www.apnaghar.org/.

     

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  3. The Growing Crisis in Guatemala: Why Coffee Rust is a Pressing Public Health Issue

    July 1, 2014 by Elizabeth Larsen

    Agriculture Landscape (1 of 1)
    You may have noticed this week that your usual Starbucks coffee costs a bit more than usual (1). This slight price increase is, in part, a consequence of Roya, a fungal plant disease that is attacking coffee plantations around Guatemala and the rest of Central America. What you may not have known is that Roya is not only decimating coffee crops, but it is also having profound effects on the health of thousands of Guatemalans.

    Guatemala’s history with coffee is long and complex. It begins around the 19th century when Spaniards began stealing large plots of land from indigenous Mayan communities, converting them into plantations, and forcing the indigenous populations to work for them. Through colonial trade and tax laws, the Spaniards restructured Guatemala’s agricultural economy to be heavily dependent on coffee. In this way, coffee became the principal export of Guatemala, reaching 90% of the countries’ exports before 1900 (2).

    Throughout the 20th century land reforms and civil war in Guatemala, the coffee industry exacerbated the narrative of poverty, racism, and inequality among indigenous populations that had begun centuries earlier. Today, coffee production throughout the country continues to be marked by rich coffee finca owners using indentured servants and migratory farm workers to harvest their beans. As coffee remains Guatemala’s largest export to this day, there are thousands throughout the country that depend on the crop for their livelihood.

    The importance of coffee exports in the country is precisely the reason that Roya has been so detrimental to the health of Guatemalans. Roya is an airborne, fungal disease, sometimes referred to as coffee rust. It spreads quickly in humid environments, causing coffee leaves to become speckled with rust colored spots, before drying up and falling off. The only potential cure for the harmful fungus is multiple applications of expensive fungicides that are often ineffective.

    Since the 1970s, Roya has been a problem in the warm and wet Central American countries, such as Costa Rica and Nicaragua, but has left the cooler, mountainous Guatemalan coffee farms alone (3). However, in recent years, the region has experienced the effects of widespread climate change. The fungus began afflicting Guatemalan farms around 2012 and was recently declared a national emergency by the Guatemalan government (4). The fungus is estimated to have caused over $1 billion in damages since 2012 (5). It is now estimated that 70-80% of coffee crops are affected by the disease. This is among the highest rates out of any Central American country.

    Roya is affecting everyone involved in the coffee distribution chain — from Starbucks consumers to the rich coffee finca owners to the poor farmers working in the fields. Coffee harvests of Guatemalan plantations have plummeted to 1/20th of what they used to be (3). The only solution is to trim back the foliage of old plants in hopes that they will sprout new, healthy leaves. Even with this strategy, the plants will not produce the valuable coffee beans for two to three years. Because of this, many farmers have taken to planting new trees that are more resistant to the fungus, but will take years to become productive.

    The consequences of this plight of coffee rust reach far beyond increased Starbucks prices. Throughout the many coffee growing regions of Guatemala, including Sacatepéquez, Sololá, Quezaltenango, San Marcos, and Alta Verapaz, hundreds of thousands of people are now without work. Coffee planters and pickers have tried to switch to new crops such as plantains and bananas, but the value of these commodities is far less than that of coffee. Because a large portion of Guatemala’s population struggles with food security, this substantial amount of job loss from the economy will have widespread health effects.

    Employees of organizations that work with the indigenous poor around the highlands, such as Mayan Families, state that they’ve seen in increase in families struggling to feed their children. Given that the first two years of a child’s life are crucial for their long term development, one hard season can have devastating consequences on child growth, leading to impaired mental and physical development. In a country where 49.8% of children suffer from stunted growth already, the coffee fungus has the potential to undo much of the nutritional progress that has been made over the last decade.

    So far, the response to the epidemic has been varied. Since April, the World Food Program has been providing emergency food assistance to 14,000 families across Guatemala (6). While admirable, this is a small portion of the hundred of thousands Guatemalan families that are suffering from the outbreak.

    Then, just  two days ago, The U.S. Agency for International Development (USAID) launched a $23 million dollar fund in partnership with Keurig Green Mountain, Cooperative Coffees, Starbucks, and Root Capital to support the thousands of coffee farmers affected by the devastating fungus (3). The fund will be used to “provide on-farm, agronomic trainings on climate-smart, resilient practices to coffee farmers and farmer organizations” and to rehabilitate ”disease-affected fields and… stabilize coffee supply chains in Latin America and the Caribbean (3).” Though this support is crucial for the coffee industry, these solutions will take years to return farms to full productivity and do little to alleviate the immediate suffering of families.

    Clearly, the effects of the Roya fungus have rippled throughout the country of Guatemala. No one solution will mitigate the repercussions of this epidemic plant disease, but multifarious efforts that address both household income and food security, as well as large scale agricultural and economic factors will continue to make progress towards overcoming it. Though the challenges are great, in the words of longtime Guatemala resident and coffee shop owner, Michael Roberts, “Guatemala has been through a lot. What’s gotten them through is the resilience of the people.”

    (1) Wagner, Meg. “Starbucks Hikes Prices on Brewed Coffee, Lattes, Bagged Beans.” NY Daily News. N.p., 24 June 2014. Web. 27 June 2014.

    (2) “The Culture of Coffee in Guatemala.” Coverco – Commission for the Verification of Codes of Conduct. N.p., n.d. Web. 27 June 2014.

    (3) ”Devastating ‘coffee Rust’ Fungus Raises Prices on High-end Blends.”OregonLive.com. N.p., 31 May 2014. Web. 27 June 2014.

    (4) Davidson, Kavitha A. “Guatemala Declares National Coffee Emergency.” The Huffington Post. N.p., 09 Feb. 2013. Web. 27 June 2014.

    (5)  ”USAID, Texas A&M Invierten $5 Millones Para Combatir La Crisis Causada Por La Roya Del Cafe.” U.S. Agency for International Development. N.p., 19 May 2014. Web. 27 June 2014.

    (6) ”Guatemala: WFP Assists 16,000 Families Affected by Coffee Rust and Drought.”World Food Programme. N.p., 30 May 2014. Web. 27 June 2014.

    (7) ”USAID, Keurig Green Mountain, Cooperative Coffees, Starbucks and Root Capital Launch $23 Million Resilience Fund to Help Farms Fighting Coffee Rust Crisis.” U.S. Agency for International Development. N.p., 19 June 2014. Web. 27 June 2014.

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  4. Food for Thought | In search of solutions

    June 20, 2014 by Elizabeth Larsen

    IMG_8624

    Hey, everyone! My name is Elizabeth Larsen, and I’m a rising senior, studying Economics and Global Health.

    This summer, thanks to the Circumnavigators Travel-Study Grant, jointly funded by Northwestern University, the Circumnavigators Club – Chicago Chapter, and Weinberg Colleges of Arts and Sciences, I will travel to six countries across the world to pursue a research project entitled, “Tackling Childhood Malnutrition: A global study of scaling up grassroots approaches to catalyze world progress.” I aim to study how high impact grassroots nutrition programs can be scaled up to catalyze progress across wider populations.

    This project was born out of two experiences that I had last summer. First, I was able to travel to Uganda with the support of NU’s International Program Development Office. I attended the 2013 GlobeMed East Africa Forum, in which I met many grassroots change-makers from across Africa. After returning from Uganda, I spent two months in Guatemala with the support of the Global Health Initiative, conducting a research project examining the impact of a nutrition recuperation program in a nonprofit clinic called Primeros Pasos.

    These two experiences vastly expanded my knowledge and views on global development, but left me with many questions. One that especially stuck with me was, why is childhood malnutrition still so prevalent in our world when there are many grassroots programs achieving enormous success? The solutions are clearly out there, but they aren’t reaching a global audience. My project this summer investigates the implementation science behind these grassroots programs to better understand the key to their success.

    After months of planning and preparation, I can’t believe the trip is finally here! I will be beginning with case study sites in Guatemala and Peru, crossing the ocean to Uganda and Rwanda, and finishing with organizations in Nepal and Cambodia! I am so excited for the journey, and I’m looking forward to sharing my research, experiences, and thoughts with all of you!

    With endless gratitude and excitement,
    Elizabeth

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  5. The 10 Twitter accounts you should follow this summer

    June 16, 2014 by Arianna Yanes

    Wherever you find yourself this summer, if you can find Wi-Fi, you can get the latest on global health. Twitter has established itself as a valuable way to stay in touch with the global community and be in the know the instant something happens domestically or internationally. In a world more connected than ever, it’s possible to be a part of the conversation from around  he world. To follow-up on a recent post by my fellow blogger @EmilyDrewry2015, here are 10 additional Twitter accounts you should be following this summer to make sure you are in the know:

    1. @WHO – “Official account of the World Health Organization, the United Nations’ Health agency.”
    2. @BBCHealth – “Health news, features, analysis from the BBC, via an automated feed of website headlines.”
    3. @UNAIDS – “The goal of UNAIDS is to lead and inspire the world in getting to zero: zero new HIV infections, zero discrimination, and zero AIDS-deaths.”
    4. @JohnsHopkinsIH – “The Johns Hopkins Bloomberg School of Public Health’s Department of International Health is the oldest and largest global health department in the world.”
    5. @Laurie_Garrett– “Sr Fellow @CFR_org. Pultizer Prize Winner. Author: I Heard the Sirens Scream (2011), The Coming Plague & Betrayal of Trust. Views here are my own.”
    6. @MSF –“Médecins Sans Frontières is an international, independent, medical humanitarian organization.”
    7. @nprGlobalHealth – “News, trends, & conversation about global health & development.”
    8. @PIH – “Health is a human right. We provide high-quality health care to poor and marginalized people around the world and inspire others to do the same.”
    9. @agnesbinagwaho – “Minister of Health of Rwanda (moh.gov.rw); Senior Lecturer, Harvard Medical School; Clinical Prof of Pediatrics, Geisel School of Medicine.”
    10. @GlobalHealthOrg – “The Global Health Council is the world’s largest membership alliance dedicated to saving lives by improving health throughout the world.”

    Once you’ve followed these few, you will get suggestions to diversify your Twitter feed. Stay updated, retweet, and keep the conversations going through the summer and beyond.

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