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Global Partnerships Lead to Empathetic Storytelling in Lebanon and Nigeria

Access to Health, Northwestern’s interdisciplinary health and human rights project, links Medill journalists with local partners, shedding light on global health and human rights issues.

This article was originally published by the Office of International Relations.

October 17, 2018
By Mira Wang

In 2017, Elijah Atinkpo and his entire community were forcefully and violently evicted from their homes in Lagos, Nigeria. About 800 homes were torched, and 10,000 people left homeless—all to create the royal Elegushi family’s new commercial development project.

Atinkpo, who works for an NGO called the Justice & Empowerment Initiatives (JEI), hadn’t had the chance to see his former home until July this summer.

“The return home had a huge emotional impact on Elijah, and he broke down after trying to determine the location of where his home used to be,” said Dan Order, who graduated from the Master’s of Journalism program at the Medill School of Journalism, Media, and Integrated Marketing Communications, in August.

Order and his classmate Kaitlin Englund traveled to Lagos in July to create a video documentary and print story on the eviction. As far as Order could tell, they were the only journalists to have returned to the land since the evictions—a feat made possible through a novel partnership between Medill and Northwestern’s Access to Health (ATH) program, and ATH’s local partner organizations.

ATH, a project supported by Northwestern Pritzker’s Center for International Human Rights, Feinberg’s Center for Global Health and Program in Public Health and the Kellogg Public-Private Interface, takes a unique approach to development work at a university. Instead of choosing its own projects, ATH only works at the invitation of local organizations or community leaders to assist with a particular health and human rights related problem.

This year, for the first time, ATH connected eight Medill graduate students and two faculty advisors with long-time partner organizations in Nigeria and Lebanon to tell stories on community evictions, child trafficking, LGBT issues, domestic workers’ issues, access to education and child marriage.

“A journalist’s perspective is vital to the communities in which we work, partnerships we forge and the issues we tackle,” said Juliet Sorensen, the Director of the Bluhm Legal Clinic at Pritzker and the founder and director of ATH. “The media has a way to advocate and shine a light on issues in a way that is different and less constrained than the law.”

ATH and Medill in Lebanon

In Lebanon, ATH linked Medill students to Basmeh & Zeitoonah, a local organization that works with Syrian refugees to develop revenue-generating activities for women.

Throughout ATH’s partnership with the organization, they have enlisted Pritzker students to delve into employment restrictions on Syrian refugees in Lebanon and Kellogg students to assist women’s workshops with marketing their artisanal work and refugee-empowerment message to customers around the world.

Four Medill graduate student reporters and faculty advisor Craig Duff, a Medill professor who specializes in video and broadcast journalism, visited Lebanon in the spring. Their stories focused on child marriage among Syrian refugees, domestic workers’ experiences, local efforts to address LGBT issues and access to education among Syrian children.

ATH and Medill in Lagos, Nigeria

In Nigeria, ATH works with JEI to address low levels of health literacy among slum inhabitants. With local collaborators, the ATH team designed a community health educator process and appointed a Lagosian project manager in the city to manage curriculum and training.

In July, Brent Huffman, an associate professor at Medill and documentary filmmaker, took four Medill graduate students to Lagos to make two character-based short documentaries on child trafficking and forced eviction. The documentaries will premiere on Al Jazeera Shorts in late 2018.

By the end of the trip, Huffman said the students didn’t want to leave.

“We all fell in love with the city and saw the amazing value of the kind of work JEI does and the value of the kind of reporting we were doing to spread awareness and be a catalyst for positive change,” said Huffman.

More about ATH

Throughout the years, ATH has assembled an array of diverse projects, including working with rural communities in Mali to address female genital cutting, collaborating with healthcare providers in the Dominican Republic to increase the quality of patient service, and assessing the health and human rights impacts of gun violence in Chicago. Currently, ATH has projects in Kenya, India, Nigeria, Lebanon and Chicago.

Using its cross-school connections, ATH gathers a mix of graduate students and business, medical and law faculty to work on impactful solutions to add value to the site in need.

An associated class, called Health and Human Rights, assembles law, business and public health students into teams of consultants to research and innovate new approaches to common issues, based on feedback from community-based partners.

Elise Meyer, ATH’s Schuette Clinical Fellow who assists with all ongoing projects, also helped actualize the partnership with Medill. Bringing journalists into the project was an important part of their advocacy work, she said.

“Journalism presents a powerful medium to advocate for change, highlight issues, and bring attention to marginalized communities,” said Meyer. “Journalism is especially important to communities like slums and informal settlements in Lagos and the refugee camps in Lebanon, both of which are isolated and (willfully) ignored by the public.”

“The new Medill-ATH partnership demonstrates the breadth of depth and expertise that a research university like Northwestern can offer, in not just providing technical expertise on the ground, but also providing an outlet for our local partners to tell their stories.” said Sorensen. “Health access takes multidisciplinary partnership to address complicated societal issues.”

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Young Research Group students attend American Society for Nutrition’s 2018 conference

On the weekend of June 9th, five students from the Young Research Group had the opportunity to travel to Boston, Massachusetts and present their senior research projects at the American Society for Nutrition’s annual Nutrition 2018 conference. Each senior was accepted to give a poster presentation and senior Jordan Harris was also nominated for the Emerging Leaders award. This award highlights promising research submitted by students and young investigators.

Funding was provided by conference travel grants within the Program in Global Health Studies, the Office of Undergraduate Research, and Weinberg College of Arts & Sciences.

(more…)

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The 2018 Emory International Global Health Case Competition: Diving into Infectious Disease Containment

Back in March, I participated in the Emory International Global Health Case Competition. The experience was, first and foremost, incredibly humbling. To be in a space full of experts and students of different disciplines but all converge on their commitment to global health was really invaluable. The competition was energetic and engaging, and made me realize how many brilliant thinkers are motivated by the same goals as me.

I traveled to Atlanta, Georgia, along with five other Northwestern students, to spend a weekend fully immersed in developing an innovative solution to a global health-related case. The Emory Global Health Institute invites students from all over the world to spend two days working with an interdisciplinary team to tackle modern health challenges. In the Northwestern group, three students from the Feinberg School of Medicine teamed up with three undergraduates of different majors – Biological Sciences, Psychology and Journalism.

Left to right: Supriya Rastogi, Courtney Zhu, Emilie Umuhire, Chen Chen, Matthew Doerfler and Giancarlo Atassi.

The 2018 case focused on emergency disease containment. The issue, in summary, was a coronavirus outbreak at the 2022 FIFA World Cup in Qatar, where millions of fans, athletes, celebrities and diplomats from all around the world will come together – potentially instigating an worldwide epidemic with fatal implications. Each team was called on to propose a comprehensive strategy to address the “FIFA Virus” with a 50 million USD budget.

Our team developed a five-fold strategy: containment, control and prevention, public education, collaborative network, and research for sustainability. Beyond controlling the outbreak, a cornerstone of our project was sustainability and how our response may help strengthen Qatar’s public health system.

I had never grasped the immense complexity of infectious disease containment until this experience. The outbreak response and surveillance protocol itself is full of complications. We asked hundreds of questions such as, “How can we prevent virus from spreading to non-infected persons?” or “How can we treat existing cases, while also delivering prophylactic care to those who have been potentially exposed?” In the process, a number of legal and ethical battles surfaced, especially with regard to quarantine and border control measures. I realized the urgency of infectious disease outbreaks and came to really admire the intricacy of epidemiology.

Perhaps most importantly, the Emory Case Competition did something a college classroom simply cannot replicate. It was one thing to read about outbreak responses, but attempting to create and implement one called for what I deem actionable thinking. Unlike emphasizing conceptual theory, actionable thinking is rooted in application and pushing those theoretical boundaries.

I also owe so much of this experience to my amazing team. Each person had different backgrounds and ideas, but we all united on our love for learning and global health. We spent late nights working in our hotel rooms – sleep-deprived and frustrated – but at no point did we want to give up on perfecting our solution. I am thankful to have learned so much from each of them, but also to share many laughs and memories along the way.

The Northwestern team on Presentation day.

At the closing reception, Jeffrey Koplan, the former director of the Central for Disease Control (CDC), remarked in his closing speech that the demographic of global health leaders is slowly evolving. He noted the contrast of his generation of majority-white, male-dominated professions with the incredibly diverse, majority-female participants of this competition.

That said, this weekend gave me hope for the future of global health. The fact that hundreds of people carved out three full days to address an invented virus is telling: people really care. Much of global health today is infuriating. Interventions can be ineffectual, or some may do more harm than good. But the dedication, thoughtfulness and diversity of the people I met this weekend assured me that the future is in good hands.

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Savior or Helper? Debating short-term volunteer efforts

It’s a typical image you might find in your Facebook feed. There’s a tall white man or woman, perhaps dressed in scrubs, surrounded by a group of smiling children in some remote part of Uganda or India. Maybe the individual is handing out some vitamins, or bandages, but it is clear that they are helping the impoverished children near them in a kind, selfless act.

Every year, tens of thousands of Americans travel abroad to take part in volunteer opportunities in medical facilities in the global South, coming home to post special Facebook photos like the one above and talk about how much they learned about living in poverty. For many, this type of medical volunteering seems like an enormous service. However,several questions and problems arise when dealing with short-term medical volunteering. Dr. Noelle Sullivan and Dr. Judith Lasker spoke Thursday night about many of the issues that come with the recent trend in “voluntourism,” asking whether volunteers are truly selfless “saviors” or “helpers.”

Lasker has been studying short-term global health initiatives for some time and recently published a book about her research, entitled Hoping to Help. In the text, she notes some of the problems that often come along with these short-term global health initiatives. For one, these short-term trips tend to reinforce stereotypes about developing countries. Lasker noted that many volunteers believe they are going to places of poverty, illness and ignorance.

“If you start with those stereotypes of ‘they have nothing and we have everything’ or ‘we know everything’ then of course you’re going to assume that if you go on a short trip, you’re going to be helping people,” Lasker said. “You are bringing something to people who have nothing – it must be helpful.”

Many Americans go to these countries believing that they can change the lives of the people there, promoting the concept of the “white savior” so ingrained in Facebook feeds and blog posts. In reality, most trips are so short that volunteers spend more time getting oriented to the facilities than they spend helping the people there. Certainly, these volunteers are not “saviors.”

Because they are unfamiliar with the spaces, volunteers tend to hinder medical efforts, rather than provide the life-changing medical help they envision themselves giving. Staff at the clinic or hospital must take away some of their time with patients in order to train the newcomers, reducing the care they normally offer patients. In more extreme cases, temporary trips to aid free clinics can take away local physicians’ paying patients, forcing the doctors to move to maintain their livelihood. When the volunteers leave after a few weeks, the area is left without an adequate number of physicians.

Beyond taking away medical staff time, volunteers can actively harm patients by participating in surgeries and other tasks that they are not qualified to perform. Both Sullivan and Lasker shared stories of students who jeopardized patients’ safety and trust, whether by giving health education lectures to adults or delivering babies without any previous medical education.

“Young people – as well-meaning as they are and as well-armed with a computer as they may be –can go to Uganda and teach adults in a language they don’t share, about sex? That’s mind-boggling,” Lasker said. “I try to tell my students, just imagine the reverse. What if someone came into your classroom that does not speak your language, has never been in your country before and knows nothing about you or your country and starts lecturing to you on how to behave…How likely are you to change your behavior because this person told you to?”

The evidence suggests that volunteers cannot even be considered “helpers,” let alone “saviors.” Yet, despite the potential dangers of short-term medical volunteering, the business is growing. In addition to the typical faith-based organizations, schools, private institutions and NGOs that send volunteers, brokers and tourism agencies have started offering trips. Sullivan mentions that when she first started analyzing medical volunteer work in Tanzania, most of the volunteers were medical students on rotation. Now she sees a wide variety of volunteers, some as young as high schoolers, coming to work.

Host countries and facilities are very aware of many of the risks and downsides that come with volunteer trips from the developing world. However, they seldom complain about the behavior of volunteers who break rules or waste professionals’ time. Sullivan had to try very hard to get Tanzanian medical staff to speak about their concerns with the unskilled volunteers coming to assist them.

“I often get asked, ‘why do Tanzanians allow this to go on?’” Sullivan said. “One is that the fees that the volunteers pay, which are $100 to $150 per volunteer regardless of how long they stay… that’s money that they can spend on the repairs they need to do and the equipment that they’re missing. I actually finally got to get a roster on how they spent the volunteer funds and it was on… things like petrol for the ambulance and a filing cabinet – really basic stuff that they don’t have money for in the budget but that they need in order to be able to operate.” 

Another reason why Tanzanians were hesitant to complain? They didn’t want to be bad hosts.

“They also talk about things in terms of hospitality. The Tanzanian culture is one of hospitality,” Sullivan said. “[They say] ‘if you’re not from my village, it’s my responsibility as a Tanzanian to bring you in and make you have a good experience.’”

Lasker’s research found similar attitudes from other host organizations. Because the volunteer trips also bring money and supplies, many host facilities do not voice their issues with the trips. Doing so could potentially end a relationship with an important institution and stop the provision of needed supplies.

Completely ending the practice of volunteering abroad would also diminish many of the other benefits the projects could potentially bring. According to Lasker, these experiences allow individuals from developed nations to see what poverty looks like and become better advocates for social change. They can also facilitate cultural exchange between volunteers and individuals from the host country. 

Instead, Lasker and Sullivan suggested that organizations running volunteer programs allow the host institution to define the needs and goals of the program. They list this principle, along with five others as important elements for volunteers to use to consider potential programs they might join and evaluate trips in which they participate. 

To avoid hindering local medical efforts, the organization should carefully recruit potential volunteers to ensure they are capable and should have a long-term sustainability plan. Additionally, all programs and volunteers should respect governing structures in the host countries, as well as the hosts themselves. There should be a sense of learning on both the part of the volunteers and of the host institution.
Learning is perhaps the most important aspect for Lasker and Sullivan, who do not think “helper” or “savior” are accurate terms for volunteers.

“We’re not really sure that it’s ‘helpers’ or ‘saviors,’” Sullivan said. “It’s certainly not ‘saviors’ and not everything is helpful, and sometimes its neither.”

“We had a little conversation about it and concluded that ‘learner’ is the best description,” Lasker said. “Really, the volunteers are not there to save or help and should really think of themselves as ‘learners’.”

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Sustainable Student Initiatives in Global Health

Trying to repair medical equipment in an area without a guaranteed power source can get frustrating. McCormick junior Aaron Shoemaker knows a lot about dealing with power and infrastructure issues after spending last summer in Tanzania volunteering as a medical technician.

“At the end of the day you could try your hardest to fix a heart monitor and still not have enough electrodes to run it,” he said.

The experience gave Shoemaker the chance to see firsthand the difficulties that clinics in developing countries face. While many Americans might think that the biggest obstacle these clinics encounter is the lack of medical equipment, Shoemaker said that frequently there are two problems: a lack of disposable pieces needed for large equipment and a lack of qualified personnel to run and service the machines. That, and a strong infrastructure to support many types of service, he said.

Shoemaker shared his experience last week as part of a sustainability panel hosted by AIESEC, Engineering World Health and Project RISHI. More than 30 Northwestern undergraduate student groups volunteer in health settings and work with health initiatives, many of which they implement abroad. The panel discussed the best ways for student groups to support health missions around the world.

Northwestern Engineering Global Brigades students assist with in-home infrastructure projects as well as provide health education and engage community members during their trips to Panama, Nicaragua and Honduras. (Photo by Northwestern Global Brigades)

Student representatives from four organizations, including Shoemaker, McCormick junior Ian Su, Weinberg junior Kyle Chan and Weinberg junior Rohit Allada, each spoke about their time working with Engineering World Health, AIESEC, Global Brigades and Project RISHI, respectively. Professor Peter Locke, current director of Northwestern’s undergraduate studies in global health, and Professor Mark Fisher, a clinical associate professor in Northwestern’s biomedical engineering program, provided their insight into solving global health issues as well.

All of the panelists agreed that sustainability in terms of longevity was essential to providing meaningful results.

“Having a great solution alone is not enough,” said Fisher. “With Northwestern Global Health, a big focus of ours is: how do we make it profitable for somebody in the country to maintain this going forward…[that] somebody is invested in making sure that this continues over time.” 

For Fisher, making a lasting impact requires that global health groups pay attention to details such as the supplies, training, personnel and services necessary to maintain health programs after they implement the projects.

Allada, a member of Project RISHI, knows how difficult it can be to keep a program running. He spoke about some of the initiatives that Project RISHI undertook in the Indian community of Charnia.

“One of the problems we run into a lot is the sustainability issue. For example, we found that a lot of the villagers in the area had anemia, so the initiative that we came up with was giving them iron tablets to help supplement them,” Allada said. “We found it was really hard to get them to continue to take the iron tablets when someone wasn’t there telling them to do it or why it was important. The information wasn’t disseminated as well as it could have been and once the iron tablets ran out [we didn’t know] how we were going to get more for them. That initiative didn’t really work out the way we had planned and we learned from that. So now going forward…we have in mind that we need to work within the limitations of the area.”

While Allada focused on working within limitations, Locke promoted the idea of analyzing limitations to create programs targeting the sources of health problems. In the case of Project RISHI’s anemia initiative, Locke noted that the widespread anemia was likely due to dietary deficiency. To truly fix the problem in a sustainable way, it would be necessary to help the village gain food security.

Image from Charnia, located in Haryana, India. Northwestern’s Project RISHI works with Charnia’s community to solve health challenges facing the rural area. (Photo by Sathwik Nandamuri.)

“What we say in all of our teaching in the global health studies program is that we need to take a much more systemic approach,” Locke said. “We need not just changes in policy structures and paradigms of intervention, we need a cultural change in ideology in how we relate to the rest of the world. We need to stop looking for quick fixes to individual issues and realize that all of these issues are linked.”

Of course, providing support to fix entire systems of health care left in disrepair from political struggles and lack of resources is an enormous challenge. Student groups are unlikely to be able to solve systemic issues on their own. However, many have found ways to benefit health systems on a wider level.

Global Brigades, for example, not only sends students on medical brigades, their national organization also helps fund training opportunities, according to Kyle Chan. By increasing the number of certified workers in these regions they fight chronic problems due to lack of personnel.

In addition to focusing on the longevity of projects, the panel also discussed how to minimize the environmental impact their projects carry. Shoemaker said student groups should consider the carbon footprint of flying students to project sites and determine how well their projects can be adapted to the local area without requiring regular international shipments of supplies.

“Is [the project] repeatable?” Shoemaker asked, “Is it something that can be maintained onsite?”

Fisher advised students to keep the environment in mind, but avoid trying to focus on too many causes at once.

“You can’t do everything, you have to choose your mission,” he said. “Environmental sustainability is one portion of thinking about global health…it’s an important thing but you have to think about it as part of design process as a whole.”

Although global health groups face major challenges in creating and implementing truly sustainable projects, both Locke and Fisher remain optimistic about the positive impact students and professionals can bring when they work with communities. Fisher said it all starts with becoming “aware.” He advised students to focus on understanding systems and the people who work within them. From there, according to Fisher, a strong relationship can grow, delivering lasting solutions.

“Until you’re aware you can’t have empathy,” Fisher said. “You can’t have a solution without empathy.”

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