Those late night games of Candy Crush Saga in bed may be taking a toll on more than just your nightly sleep schedule. A recent medical review suggests that all of those nighttime texts and tweets could have an effect on our waistlines (and not in a good way).
Researchers suggest exposure to light at night, even electric light like the kind that pops off the screens of our iPhones, tablets and other devices, may disrupt our circadian system . This system helps guide our normal sleep and wake schedules by regulating rhythm within the human body and can alter functions in our metabolism that are related to nutrition .
A recently published study on mice found that even mild changes in light exposure altered circadian and metabolic functions, and could help researcher better understand its connection to obesity and disorders related to sleep and the circadian rhythm. .
New research suggests exposure to light during the night may have an impact on weight gain. Source: Katie Golde
An additional study published in 2010 found that exposing mice to light at night disrupted their food intake and other metabolic signals, resulting in weight gain. Mice that were exposed to either dim or bright light saw an increase in body mass compared to mice who were exposed to a regular light/dark cycle, despite being fed the same caloric intake and activity levels .
Study authors say the data is relevant to the increase in human obesity due to the use of light usage at night and shift work (or maybe pulling all-nighters the week before finals) .
While the data may be relevant, medical experts warn that we don’t have all of the information yet.
“It’s an intriguing observation and raises a lot of questions about how we might come to understand weight regulation,” says Dr. Joseph T. Bass, Professor of Medicine in the Department of Medicine of Feinberg School of Medicine and the Chief of the Division of Endocrinology, Metabolism and Molecular Medicine at Northwestern University.
Bass says that light exposure at night can affect the circadian clock, but the mechanism behind the relationship between light cycles, food intake and our endocrine system remains unclear.
“Appetite is regulated very differently at different times of the light/dark daily cycle and exactly how that influences body weight we don’t really understand,” says Bass, who also says the concept that there is some sort of relationship has been well proven.
Global health experts have also expressed concern about exposure to artificial light during the night. The 21st International Congress of Zoology met in Haifa, Israel in 2012 to discuss the possible ramifications of increased usage of artificial light and its affect on the circadian system.
The University of Haifa, where the conference was held, reported that an international panel discussed the extent and harm of artificial light usage after dark. A statement from the university’s media relations noted that conference participates, “were in full agreement that exposure to light at night affects circadian rhythms in nature – humans, animals and plants – which when thrown off can result in various illnesses and adverse symptoms.”
A growing collection of research highlights the health affects of light exposure at night. While more needs to be done to test its relation to weight gain, it might be worth turning off the iPad in favor of an extra hour of sleep (at least tonight).
by Amee Amin – Anthropology, Global Health Studies, WCAS 2014
Opening Keynote: Liana Woskie
A few weeks back I attended MIT’s Grassroots Initiatives for Global Health Conference, and I was very grateful to share some lessons on global health advocacy as a speaker during their break-out sessions. The conference brought together some amazing thought leaders in this field right now, like Jon Shaffer at Partners in Health, Liana Woskie of the Harvard Initiative on Global Health Quality, and Peter Luckow of Last Mile Health (Jon and Peter are both Northwestern alums). This conference stands out from many others for undergraduates because of its unique focus on bringing in an audience of current global health professionals. In my session alone, students were only half the audience.
Diverse attendees and speakers engaged in challenging discussions about the history of the HIV/AIDS movement and how it lead to the current field of “global health,” how barriers of power and privilege have emerged outside and inside the field, and how students and professionals can begin to shift power in global health back to those directly affected. Below I share three powerful lessons learned:
1. The HIV/AIDS movements, which began as a series of direct actions, became one of the most effective grassroots health movements in history.
On the night of April 15, 1987, hundreds of people were filing last minute tax returns at the New York City General Post Office, when AIDS activists filled the building with their SILENCE=DEATH slogan. Their demonstration was widely broadcast over media and began to challenge the overwhelming public apathy towards the HIV/AIDS epidemic at that time. Out of indifference and hate, they created partnership and hope.
Anyone who watched the HIV/AIDS movement unfold witnessed people take back power over their health and demand that decision-makers listen to those who were directly affected by the crisis. These direct actions and the political will they produced eventually led to the Global Fund and PEPFAR, which radically changed what was possible in the field of global health and development.
2. However, the HIV/AIDS movement was almost two decades ago, and we have seen power insidiously re-centralized behind closed doors.
The pharmaceutical and health insurance industry have spent more than $3 billion dollars combined over the last fifteen years. The industry’s main lobbying arm – The Pharmaceutical Research and Manufacturers of America (PhrMA) – by itself spent more than $200 million dollars over the last ten years on lobbying efforts (for comparison, that’s about 1.3 times greater than what the entire oil and gas industry spent on lobbying in 2011).
Source: OpenSecrets.org – Center for Responsive Politics
Moreover, the pharmaceutical and health products industry spends more than every other U.S. industry on lobbying, and in 2012, the pharmaceutical industry alone spend about $440,000 per member of U.S. congress on lobbying. This money continues to push people into poverty due to health care costs and keep essential medicines out of reach from the world’s poor. Unless we shift public discourse from viewing health as a commodity to health as a human right, we will not see fairly priced and accessible medicines and healthcare technologies in our lifetime.
3. Youth have the power to shape the next era of global health and development – and we need to seize this moment to raise our voices, engage in policy, and act in solidarity.
Closing Keynote: Peter Luckow, Last Mile Health
One of the largest critiques of the Millennium Development Goals (MDGs) was their failure to include voices from the marginalized populations that the goals aimed to serve. In its post-2015 thematic consultation paper, the International Planning Committee for Food Sovereignty stated, “the major limitation of the MDGs by 2015 was the lack of political will to implement due to the lack of ownership of the MDGs by the most affected constituencies”. Unfortunately, the post-2015 policymaking processes are also under fire for the same problems of accountability.
During my break-out session, I spoke to an audience of young professionals about my engagement with Article 25, a new campaign working to generate grassroots momentum and public support for the right to health in the post-2015 agenda. This October 25th, we’re working with young activists across the globe to organize the first Global Day of Action for the Right to Health. Collective action will enable these groups and individuals to come together and show – for the ﬁrst time – the true breadth and power of this right to health movement in order to hold politicians and policymakers accountable. Overall, the conference was an energizing experience and inspiring launch for the campaign.
Do business interests have to conflict with those of the public good? In light of recent corporate scandal, greed, and corruption, I frequently ask myself this question. As a Social Enterprise major at Kellogg, I believe it is a firm no, but we future business leaders can do more to be better citizens.
The desire to study socially responsible business lured me to Kellogg–while several MBA programs provide students with advanced management skills and functional knowledge, Kellogg’s Public-Private Initiative (KPPI) provides a socially-conscious MBA curriculum. Understanding the responsibility that comes with the power of leading major institutions, Northwestern’s faculty encourages its students to consider the social impact of the challenges and opportunities presented by an ever-changing, inter-connected world.
The intersection between business and policy fascinates me, particularly how both can work together to shape people’s lives. The Health and Human Rights course through KPPI was an opportunity for me to focus on public health, a crucible for public-private conflict and partnership. The course’s readings and lecture components focused on international health issues and the policies, programs, and business initiatives to combat them. In parallel, we worked in groups on research projects to address public health issues for the town of Douentza, Mali, taking our macro content knowledge of public health and implementing it at a micro level.
The course’s project in Mali was an opportunity to pool the wealth of resources from Northwestern and its partner organization, the Near East Foundation (NEF), to implement health initiatives in limited-resource environment. I was eager to test and implement my management and professional skills in a setting that could have such a profound social impact. In a corporate setting, change management and quality of life issues were rarely matters of life and death. With this project, I jumped at the opportunity to implement changes with such gravity, but I also hoped to bring those experiences back with me, allowing them to influence my decision-making as a more socially responsible and compassionate manager.
I was fortunate enough to travel with a group of students to Douentza, Mali, to conduct a project gap analysis with our NEF counterparts, seeing in person where our research fell short and where our public health interventions could have a lasting, powerful impact.
Finally, this trip and this project would not be possible without the resources and dedication of Northwestern University, its dedicated faculty advisors, Juliet Sorensen and Karin Ulstrup, the Near East Foundation, and the members of our project’s Community Advisory Board in Douentza. Thank you.
Swaroop and her team teach local police and firefighters safe ways to roll, evaluate and transport patients
It is easy to take for granted in the United States the advanced system of trauma care, especially here in Chicago.
If your were the victim of a serious car accident along Lake Shore Drive, for example, it is likely you would talk to a trained emergency medical dispatcher at 911, be quickly treated by professional paramedics, and rushed by ambulance to one of several Level 1 Trauma Centers (one that has trained staff ready 24 hours per day, specific medical equipment, specialists at hand, and other qualifications) within an hour. Once there, you would receive treatment in an emergency room, and, depending on your needs, have the option of surgery or a stay in the intensive care unit. A swath of nurses would attend to your needs, and, once stabilized, you would be privy to post-hospitalization and rehabilitative care. From beginning to end, you would be surrounded by a team of trained professionals and high-tech resources to guide you through your recovery.
This system of care does not exist in many countries, including Bolivia, which is home to a staggering number of fatal road traffic accidents each year due to its mountainous terrain and poor road conditions. In the country home to the Camino de las Yungas, the “world’s most dangerous road,” the trauma care system is severely underdeveloped and understaffed, with hospitals ill-equipped to handle serious accidents and limited trauma training for professionals
Accident victims in remote areas often have to wait hours for firemen to arrive from the city
This is a problem trauma surgeon Dr. Mamta Swaroop of Northwestern Memorial Hospital wants to solve. Building from the ground up, Swaroop and her team have been working in conjunction with her students and the Bolivian Ministry of Health to develop a comprehensive trauma care system in the country. It’s no small task, but Swaroop focuses on the incremental steps that will lead to her eventual goal of developing such a pervasive system.
“You have to be able to get a big picture and see the forest for the trees,” said Swaroop, who is also an assistant professor at the Feinberg School of Medicine. “But without the trees, there is no forest.”
The first tree in Bolivia was the lack of prehospital care. Many injured patients cannot access an ambulance due to financial constraints or distance, even in areas where access is feasible. Instead, they often rely on taxi cabs, volunteer firefighters or simply Good Samaritans– most of whom do not have any medical training, including basic first aid– for transport to a hospital. By the time a patient arrives, it is often too late.
With this in mind, Swaroop and her team have been delivering first responder training at the local clinic and hospital level in villages that see the highest number of traumas, with the goal of eventually spreading such standardized training to the entire country. Since the course began in March of 2013, Swaroop, her colleagues and local health care providers have educated more than 700 nurses, hospital workers, firefighters, and even average citizens on how to best treat patients before they arrive at a hospital.
A view from the entrance of Hospital Arco Iris, including the hospital’s two ambulances parked outside the Emergency Department
“If the current reality is that laypersons – taxi cab drivers, people in the village – first come to help out injured victims, it’s worthwhile to teach these laypersons the basics of trauma first aid,” says Dr. Christopher Richards, Associate EMS Medical Director at Northwestern Memorial Hospital’s Department of Emergency Medicine. Richards was brought onto the project by Swaroop for his expertise in prehospital care.
Determining these on-the-ground nuances, such as who responds to trauma and how trauma is perceived by citizens, is a vitally important prerequisite to any intervention, according to Richards. A 911 system, for example, doesn’t work if no one thinks to call it for medical care. “It’s not something we take from here and impose there,” he said. “We can’t put the Chicago Fire Department’s trauma response structure into Bolivia and expect it to work like it does here.”
Instead, the team is working with the local population and government to thoughtfully develop reliable trauma care that holistically integrates prehospital, emergency, hospital care, and post-hospital care for patients.
“Ultimately, the end game is to make sure that trauma patients get the best care they can,” Richards said. “If that works, we’re saving lives and I think that’s a success.”
Curtin, whose organization uses recycled food, culinary training and other measures to combat hunger, told his audience that in order to achieve change they must work together.
The Campus Kitchens Project and the Food Recovery Network co-hosted the summit, and students from university branches of those organizations descended upon Evanston for two days of speakers, panels, discussions and other exercises.
A major focal point of discussion was on food recovery, a process whereby good leftover food is re-purposed or redistributed to people in need. Often this food includes products that are past their use-by dates or have faulty labels.
Nicole Civita talks with a participant at the Food Waste and Hunger Summit on April 6.
Civita said the sell-by, use-by and expiration dates on food packages are not determinative as to whether food can be donated.
The goal of the presentation was to provide students with the correct legal information to use when approaching different facilities about starting to participate in food recovery.
Civita said there was food being wasted in other avenues, such as when food is confiscated from international travelers passing through customs and encouraged students to take action to correct the problem.
“Where is food being wasted and you can’t figure out how to recover it?” she asked.
One breakout session students participated in over the weekend focused on campus advocacy for food recovery. During a discussion called “Party for a Purpose,” students shared ideas from their schools and discussed better ways to engage their campus communities.
Plans included hunger banquets, hunger games, speakers, cooking classes, pledges and giveaways.
Students watch as Claire Cummings simulates a conversation with a campus dining services official.
An additional forum, “Navigating the Campus Bureaucracy,” was led by Ben Simon, founder of the Food Recovery Network. He had students map out all of the campus parties that might be involved in a food recovery program and discussed the Do’s and Don’t’s of working with school administrators.
Part of what makes a campus food recovery system complex, Simon said, is that “different departments are silos,” and therefore communication sometimes is an obstacle for students to overcome.
During the session, students also pitched their food recovery program to Claire Cummings, a waste specialist for Bon Appétit, a food service management company. Cummings played the role of a campus dining services director and pressed students for answers to questions they would be asked during an actual meeting.
By joining students and activists from across the country to discuss best practices in combating hunger and food waste, students left the summit with a stronger network and new tools to boost their food recovery efforts back home.
Up until this point, most of my coursework has focused on major global health issues like HIV/AIDS, maternal and child health, malaria, and collaboration strategies (to name a few). Of course, there are innumerable other global issues that need to be addressed, and I want to have some background knowledge of issues that I have not yet encountered. One that I think is universally significant and that I have heard about, but do not actually know much about, is diarrhea.
Diarrhea is not often heard about despite the fact that it is the second leading cause of death among children under the age of five. Besides that, diarrhea is a leading cause of childhood malnutrition and dehydration. All of these are unfortunate consequences given that diarrhea is both preventable and treatable.
Diarrhea is the frequent passing of loose or liquid stools, usually due to an infection in the intestinal tract. This infection is typically contracted from contaminated water or food sources or poor hygiene, and is aggravated by previous infections, malnutrition, continued poor sanitation, and lack of safe drinking water. The condition is treated by ingesting clean water and electrolytes to replace those expelled by the body, balanced nutrition, zinc supplements, and in some cases can be treated with over-the-counter medicines. Prevention is ideal to avoid diarrheal infections completely, measures which include clean or treated drinking water, personal hygiene, breastfeeding infants, and vaccinations.
Unfortunately, the people diarrhea affects the most tend to not have access to safe drinking water, electrolytes, or medicine–often children living in extremely impoverished circumstances. Children living in such conditions face higher risk of ingesting contaminated water or food in tandem with poorer sanitation and thus experience increased rates of diarrheal disease. Once contracted, diarrhea can exacerbate already existing malnutrition, cause malnutrition, or cause moderate to severe dehydration; all of which can, without proper treatment, result in death.
Diarrheal infections are more prominent in some regions than in others: for instance, one quarter of deaths related to diarrhea occur in India. Hundreds of thousands of impoverished individuals face a lack of access to safe water, food, and medical care, leaving them without prevention or treatment to prevent diarrheal infections. Though there is currently a surge in vaccination interventions, there are still high incidence rates of diarrhea in India because widespread environmental sanitation has proved challenging to achieve.
Another country exhibiting extremely high rates of diarrhea is Nigeria, which, like India, has unsanitary food and water sources and already high rates of malnutrition, all of which compound the contraction of diarrheal infections. However, Nigeria has taken a different approach to combatting high diarrheal rates, choosing to focus on hand-washing campaigns to encourage personal hygiene as a prevention strategy. UNICEF’s study of these hand-washing interventions have found that hand-washing can reduce diarrhea prevalence by about 30%.
Dr. Evan J Anderson of Northwestern University’s Feinberg School of Medicine has done extensive research on the prevention and treatment of viral diarrhea. His research investigates the viruses that cause diarrhea, identifying rotavirus and norovirus as the two leading viral causes. Dr. Anderson lists the prevention strategies outlined above, paying particular attention to vaccination. There are two new vaccines–Rotarix and RotaTeq–that have greatly reduced morbidity in the countries that use them. There are also efforts being made to develop another vaccine that combats norovirus.
Besides these prevention and treatment strategies, what can be done to help decrease diarrheal infections? First and foremost, investment in safe drinking water and sanitation must be a priority for growing infrastructures in developing nations. Present and future health interventions in regions with high prevalence of diarrhea-related issues can focus on sanitation, constructing safe wells, introducing iodine water treatments, and educating people. Furthermore, health workers can be trained to identify, treat, and prevent diarrhea and related conditions. Regardless, it is important to recognize the global severity of diarrhea–gaining a basic understanding of the issue can at least provide a foundation for more in depth action.
Last month The Chicago Council on Global Affairs hosted its second International Women’s Day Global Health Symposium. The event brought international health leaders together at the Fairmont Chicago for a day of discussion on international public health issues pertaining to women. Attendees included members of the Chicago Council on Global Affairs as well as a number of students from Chicago’s universities including Northwestern, University of Chicago, Loyola, and DePaul.
Dr. Funmi Olopade Image Courtesy: The University of Chicago
The day began with the keynote speaker Dr. Olufunmilayo “Funmi” Olopade, who is the Walter L. Palmer Distinguished Service Professor of Medicine and Human Genetics, associate dean of Global Health, and director of the Center for Clinical Cancer Genetics at the University of Chicago. Dr. Olopade’s work has focused on cancer risk assessment and found that on a global scale there is still little access to detection and treatment for cancer. Breast and cervical cancer are the primary cause of premature death in young women today. When she first began her practice here in Chicago Dr. Olopade noticed cancers similar to what she saw at medical school in Nigeria. The reality was that cancer was a death sentence for many at the time, for patients had to wait almost two years to get a mammogram at Cook County Hospital. If these issues existed then and still exist today, then why aren’t we galvanized to treat everyone with breast cancer? Dr. Olopade believes that it is a matter of access. She currently serves on the board of directors of Cancer IQ, which serves to use real-time clinical and genomics data to empower oncologists everywhere to deliver the highest level of care. Dr. Olopade believes that genetic analysis is the cheapest action we can take in the prevention of cancer, and should be applied to patients worldwide. Likewise, clinical trials should be applied to populations all over the world rather than just those that house large research universities such as the United States.
The first panel I attended was titled “Sanitation and Hygiene for All!” One of the speakers was Rebecca Fishman, the director of operations and special projects at WASH Advocates, which is a nonprofit initiative that focuses to solve the challenges related to safe drinking water, sanitation, and hygiene. WASH is currently working on a program in Indonesia to empower a behavior change that will increase toilet use within communities. Other projects include culturally appropriate books on menstruation and a “toilet park” in India. The other panelist was a social entrepreneur named Michael Lindenmayer, who confounded Toilet Hackers, an organization committed to the 2.5 billion people without access to a toilet. Lindenmayer sees proper sanitation as the “ultimate vaccination” and uses Toilet Hackers as a platform to promote grassroots awareness building and foster application and collaboration. The conversation made clear how proper sanitation is a sometimes under-emphasized global need, even though diarrhoeal disease is the second leading cause of death among children under five. Among the Millennium Development Goals, it was the furthest off its target.
More information regarding mDiabetes can be found here.
The next panel was titled “Collaborative Approaches to Non-Communicable Diseases.” It featured Nalini Saligram, the founder & CEO of Arogya World, a global non-profit organization working to prevent non-communicable diseases through health education and lifestyle change. Non-communicable diseases, or “NCDs,” became a familiar term after the WHO coined it in 2011. These diseases include heart disease, cancer, chronic lung disease and diabetes. They are linked by risk factors such as a sedentary work environment, abundant food, and long term chronic stress, but are largely preventable. Dr. Saligram emphasized how NCDs are not a first-world issue, but account for 2/3 of deaths in the world and 80% of those in developing countries. Through a partnership with Nokia Life, Arogya World has been using mobile technology to improve public health in a program called mDiabetes. This initiative in India has sent diabetes prevention text messages to over 1 million people. These messages were consumer tested and sent to all parts of the country, in areas both urban and rural. Another program is using mobile phones to survey 10,000 women in 10 different countries in order to better understand the impact that NCDs have on women. The panel made it clear that we will continue to hear about NCDs long into the future. It is an interesting public health issue where the solutions are known, such as healthier foods and more physical activity, but how we go about encouraging them is the challenge.
The day finished with a keynote conversation by some of the youngest leaders in global health initiatives today. Barbara Bush, the CEO and cofounder of Global Health Corps, was joined by Maya Cohen, the current executive director of GlobeMed. The discussion was moderated by Sheila Roche who is the chief creative and communications officer at (RED). In 2005 Roche joined Bono and Bobby Shriver to create Product (RED), the first business and consumer driven initiative to raise money and awareness for the fight against AIDS in Africa. Many may be familiar with (RED) through their products at Target. To put it simply, I found the discussion to be an inspiration in the emerging discipline of global health. More than ever is it clear that young people are developing an interest in utilizing their own unique talents in order to benefit the world. Global Health Corps selects an incredibly wide range of skill sets for their fellowship program. Likewise, GlobeMed is bringing its network to college campuses all across the United States in order to mobilize student advocates. Roche echoed this sentiment repeatedly, but if Bush and Cohen are setting the example then there is great hope for the future of global health.
Seeing as many of my courses and global health experiences have focused on the same few global health initiatives, I thought I would take a look at other conditions that I have encountered less frequently: for instance, pneumonia.
Distribution of deaths from pneumonia and other causes in children aged less than 5 years, by WHO region. Image Courtesy: WHO
Pneumonia–a respiratory infection in the lungs brought on by viruses, bacteria, or fungi that causes painful breathing and limited oxygen intake–is the leading cause of death in children throughout the world. The WHO measures the specifics of this data, detailing that 1.1 million children age five and under and killed by pneumonia every year; most of which are in sub-Saharan Africa and South Asia.
In sub-Saharan Africa, people living in extreme poverty are particularly susceptible to contracting pneumonia due to malnourishment, poor sanitation, and contaminated food and water sources. Furthermore, sub-Saharan Africa hosts some of the highest rates of HIV in the world, and HIV puts an individual at a higher risk of developing pneumonia. The deadly combination of HIV and pneumonia necessitates numerous and expensive medications, assuming these medications can be obtained in the first place. And even if patients obtain the right treatments, they are at increased risk of developing resistance to the drugs.
Like sub-Saharan Africa, people in South Asia are at higher risk of pneumonia due to extreme poverty. Indoor air pollution, smoking, and chronic obstructive pulmonary disease are other risk factors prevalent in the region. Again, high rates of HIV are problematic due to increased risk of contracting pneumonia, excessive medication, and drug resistance. While there are many existing interventions designed to combat pneumonia in South Asia, few of these interventions are present in places where they are needed the most: consequently, pneumonia remains a significant problem.
As with many common infections, pneumonia is easily prevented and treated given easy access to primary care and antibiotics. Immunization, good personal nutrition, personal hygiene, and a healthy, sanitary environment are all prevention strategies. Treatment involves a simple round of antibiotics. While these prevention and treatment are effective for those with access to medical care and who live in a stable, healthy environment, pneumonia often proves fatal for those already experiencing malnourishment or unhygienic living conditions.
What can be done? Because the bulk of pneumonia-related deaths occur in impoverished countries, attending to environmental risk factors (pollution, water sources, food sources, overcrowding) is one preventative measure. As far as treatment interventions go, there must be increased access to care via community health workers or clinics who can provide vaccinations, antibiotics, and/or clean oxygen. The WHO has taken steps to address both prevention and treatment strategies in regions where pneumonia is a leading cause of death with the Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea, which aims to end preventable deaths by pneumonia and diarrhoea by 2025. This initiative includes the dispersal of vaccinations, soap, clean indoor stoves, water treatments, promoting breastfeeding, and, of course, working to expand the reach of clinics and health workers.
Northwestern’s 2014 Global Health Case Competition focused on this often-overlooked problem. The Case Competition featured eight teams, all of whom were presented a case about childhood pneumonia and then asked to develop a solution. Elizabeth Larsen, a sophomore participant, emphasizes the significance of the issue, stating, “It’s important to give attention to the often overlooked problem of childhood pneumonia because it continues to kill millions of children around the world.” Because of this far-reaching impact, it is important for events like the Global Health Case Competition and individuals everywhere to continue to focus on pneumonia.
This past month, a team of students from Northwestern University competed in the Hult Case Competition in San Francisco. This annual competition is a start-up accelerator for aspiring young entrepreneurs attending universities around the world. It aims to identify and launch the most compelling social business ideas – start-up enterprises that tackle serious issues faced by billions of people. The winning team receives 1 million USD in seed capital as well as mentorship and advice from the international business community. The Northwestern team was sponsored by the Farley Center for Entrepreneurship and Innovation and Feinberg’s Center for Global Health.
Smitha Sarma, Justin Huelman, Jared Davis, and Amber Meriwether faced the particular challenge of reducing the burden of non-communicable disease in urban slums using a social enterprise that could impact 25 million people in 5 years. The Northwestern team’s pitch was to use microfinancing to increase access to nicotine replacement therapy and counseling in urban slums so that tobacco users had a way out.
I spoke with team members after the competition.
How did you get involved in the Hult Case Competition?
Amber Meriwether: Justin and I are both part of Northwestern’s NUVention: Medical Innovation program and thought this would be a great opportunity for us to further pursue our passion for improving healthcare. Once we formed our team, that consisted of Smitha Sharma (MD, 2017), Jared Davis (M. Ed., 2011), Justin Huelman (M.Eng., 2015) and myself (JD, MA 2014), we submitted a first round application in December. We were pleasantly shocked when we found out in January that we were one of 300 teams selected for the semi-finals from more than 10,000 around the world.
What was the preparation like leading up to the competition?
Smitha Sarma: Our preparation involved meetings and phone calls with doctors and business experts, hours spent googling articles on non-communicable diseases and social entrepreneurship, and countless flowcharts and lists drawn out on the white board trying to come up with a good business model. Our final idea looked nothing like our original one!
Describe the competition process and atmosphere, what was it like on the actual competition day? Give us a little background on the case as well.
Smitha Sarma: This year’s challenge was to create a business that addresses the burden of chronic disease in urban slums. Our idea was to create a tobacco cessation program that enables low-income populations to overcome their addiction. We learned that tobacco kills nearly 6 million people each year, and that 80% of the world’s one billion smokers live in low and middle-income countries. However, most of these individuals have no access to the proper medications or support mechanisms to successfully quit. Thus, if we figure out a way to introduce a comprehensive cessation program, we have the potential to impact many lives.
The regional competition took place at the Hult International Business School in San Francisco. There were 50 teams representing universities from around the world. Most teams consisted of MBA students; my team was unique in that regard. The first day, we heard from experienced entrepreneurs who gave us encouraging advice. My favorite talk was given by Adam Cheyer, the inventor of Siri. He spent 17 years coming up with his product, going through countless iterations. He told us that if you have a vision and you are persistent, you will go on to do great things. The next day, we woke up early, rehearsed our presentation over and over again, and gave our 12 minute pitch to an expert panel of judges, who were leaders in healthcare, innovation and consulting. Out of the 50 teams, 1 was selected to proceed to the accelerator. The winning team consisted of three women engineering/business students from MIT. Their business was to manufacture a negative pressure wound healing device that will help slum dwellers with foot ulcers due to diabetes and other complications. It was a brilliant idea! They will present their idea to President Clinton next summer, competing against 5 other teams for the $1M grand prize.
What would you say is the most valuable thing you got out of the competition? Is there anything you learned from the winning team’s solution?
Smitha Sarma: After the competition, Hult hosted a nice reception, giving the students and judges a chance to socialize. Our team spoke with the judges who heard our pitch and asked them for advice. I learned three important things that evening. First, if you have 12 minutes to give a presentation and host a Q&A session, limit your talk to 6 minutes. It is critical that you only spend half the allotted time giving your pitch, to allow the audience plenty of time to ask questions. Secondly, know your audience. If you are presenting to a panel of experts, don’t spent a lot of time giving them background information. Cut to the chase and wow them with your idea! And finally, if you notice your audience questioning a statement you made, don’t wait for the Q&A session to address their concerns. Explicitly say “Hey, I know you might be thinking this, but let me clarify.” It is better to dispel their skepticism or confusion up front.
The winning team had spent years developing their prototype, testing it out in low-income settings and creating a sustainable business model. This team was well on its way to creating a real company and the Hult Prize was its big break. The ladies from MIT inspired me to keep trying – to be passionate about a cause and truly run with it.
Finally, do you have any advice for other individuals hoping to compete in a global health case competition?
Smitha Sarma: If you want to compete in a global health or social entrepreneurship case competition, just go for it! It doesn’t matter if you’re new to such things. You will learn and grow so much in the process. Besides, it’s fun being the underdog
Five Northwestern University representatives attended the 6th annual Emory University Global Health Case Competition March 27-30 in Atlanta. The team consisted of undergraduate students Pooja Garg and Emily Drewry, Feinberg School of Medicine students Smith Sarma and Suvai Gunasekaran, and Northwestern School of Law student Abena Hutchful. Emory hosted 24 teams from schools across the country and abroad – participants traveled from as far as Sweden and Australia.
As the winners of Northwestern’s first case competition last month, our team was given the opportunity to travel to Atlanta to participate in Emory’s international competition during the final weekend of our spring break. The Northwestern competition was my first glimpse into solving a case – it was both difficult and rewarding, and I was thrilled with the opportunity to continue to develop my understanding of the process through Emory’s well-established competition. I was interested, especially, to compare the processes; having read about Emory’s past winners, cases, and participants, I had a healthy amount of nervous anticipation building up in the weeks before the process. Days before we began working on the case I was on edge – and when we received the case on the Monday the week of the competition, the edge turned into intimidation.
The case asked us to envision a new World Health Organization – to create a new vision, mission, and plan of implementation to give the renowned organization new life in the ever-changing field of global health in the 21st century. The case was daunting – all of us are aware of the incredible responsibilities associated with the organization and the great amount of aspects we would have to take into account during our work. But the case was the perfect level of challenge to spur our team into a frenzy, and the hours we spent brainstorming were some of the most challenging and inspiring I’ve had. We pulled together our solution; an information database researched and managed by the WHO, in a collaborative effort that required skills from each of our respective disciplines, undoubtedly one of my favorite aspects of the competition. The requirement of three disciplines within a team lends the opportunity for variance among past experiences, familiarities within the global health field, and a broader realm of cognizance that drastically strengthens the response to the case.
Our overarching response to the case was that the WHO is suffering from an information gap that is hindering their responses to both ongoing health crises as well as disasters. A database like ours, titled “The Global Hub,” would gather all the information available in the world of global health and organize it into one location for the convenience of the constantly growing amount of players involved in global health each year. The hub would house WHO’s research efforts, global health news, and most importantly, a sorted and thorough resource of the world’s nongovernmental organizations. Nothing like this resource currently exists, instead, pieces of the puzzle fill the internet and create a large amount of unproductive responses to health problems that could be streamlined by improved communication on behalf of the public, private, and civil sectors.
Per competition rules, we structured our response into a 15-minute presentation to present to judges early Saturday afternoon. I was incredibly proud of our results – our presentation was the result of each and every one of our efforts to put the best version of our solution forward. We weren’t selected as one of the four finalists to move on, but that wasn’t the only goal for the weekend. The goal was to commit to the idea of making changes in the world of global health, and we came up with a viable solution to do so – therefore creating an invaluable experience that will serve our careers someday down the road. Beyond that experience, I found great pleasure in the opportunity to work with four intelligent students in vastly different fields than mine, each of whom were driven by the same passion for global health that I am.
Representatives of the WHO may never see our solution, and we may never know what separated the finalists from the rest of the groups in the competition, but in my mind, the purpose of the weekend was absolutely fulfilled in the great efforts put forth by each and every participating team. I highly recommend the experience to every Northwestern student in future years, and will forever be grateful to the university for giving me the chance to experience both the Northwestern and Emory competitions
We have all heard about HIV/AIDS, malaria, and tuberculosis. We have all encountered global health organizations, political agendas, and awareness movements surrounding these and other prominent global health issues. But what about other global health initiatives for polio, obstetric fistulas, pneumococcal diseases, or diarrhea? Though all of these issues are addressed within the global health world, they are indeed less recognizable. But why? Why is it that certain global health crises receive more attention and funding than others?
This question has also come to the attention of Professor Jeremy Shiffman of Syracuse University, who decided to investigate why certain global health initiatives take priority. Shiffman, a political scientist, decided to focus his investigation on the political aspect of this issue, taking a look at why prominent global health issues like HIV/AIDS, malaria, and TB achieve more political visibility and funding than others. Shiffman concluded that there are several influences that dictate an issue’s political visibility: “One is the existence of credible evidence to prove the severity of the problem. Another factor is leadership—having effective global champions for the issue. The third factor is the existence of a set of institutions who are advocating successfully to promote the issue.” Additionally, he suggests that lesser known global health initiatives be framed not simply as a public health problem, but as serious threats to human welfare and economic and political stability.
These findings explain the prominence of famous global health movements—often, issues that receive attention have affected people worldwide and thus have a widespread foundation of advocates in a variety of positions to publicize the issue. In contrast, less conspicuous issues are often restricted to a region, population, or socioeconomic class. This effectively limits the amount of people who are aware of the issue, who can relate to the issue, and who are in positions of influence to boost the issue to the global forefront.
So how can we change this? For those global health issues that tend to remain localized to smaller, poorer, or less globally connected demographics, it is important for those in a position of education, access to an audience, or influence to continue to direct attention to such initiatives. Furthermore, based on Professor Shiffman’s assessment, lesser known issues can be framed more effectively—every global health issue is important and worthwhile, so to just say that does not set apart the initiative from any other. Instead, these unpublicized issues can be framed more urgently with a human rights, political, or economic appeal.
Of course, this is not an appeal to replace global health issues already in the spotlight—there is a reason that HIV/AIDS, malaria, TB, etc. are important issues that require global participation for eradication. Rather, this is a suggestion to expand the spotlight, allowing other less recognizable problems to gain visibility.
Dr. Ramona Bhatia speaks with Clinica de Familia La Romana director Dr. Leonel Lerebours Nadal about the HIV care curriculum. (Photo courtesy of Brendan Walsh)
As of 2012, roughly 45,000 people in the Dominican Republic are said to be infected with HIV, according to the UNAIDS Global Report.
In the same report, the Dominican Republic is listed to have “few” health facilities that provide HIV services integrated with other health services, leaving many in rural areas unable to have access to treatment centers and information about their conditions.
Dr. Ramona Bhatia, an infectious diseases physician and clinical research associate at Northwestern’s Feinberg School of Medicine Center for Global Health, returned from her third trip to the Caribbean island in early March. Each trip she makes, Bhatia spends a few days at the Clínica de Familia in La Romana, a small region on the southeast corner of the island.
Guaymate, a rural town just outside of La Romana, is one of Northwestern’s Access to Health Project sites. The project was created by the Northwestern Law School and the Center for Global Health to combine health and human rights studies. The Clínica works closely with Guaymate as part of their community outreach.
“The Clínica reached out to us because they wanted to continue to integrate HIV [care] into their primary care,” Bhatia said. “They wanted to make sure the HIV care they were giving to their patients was as up-to-date as possible.”
Derrick Lewis, clinic volunteer coordinator, completing his evaluation of the HIV course. (Photo courtesy of Brendan Walsh)
Supported by the Global Health Initiative through faculty physicians at the Chicago Lake Shore Medical Associates, Bhatia’s project with the clinic is to assess its needs as a healthcare center in order to improve patient care. From her first couple visits to La Romana, she spoke with the healthcare providers to pinpoint these specific needs. Aside from new equipment, what the clinic really lacked was guideline-driven HIV-care education for its primary care providers due to the lack of HIV-specialists, she said.
Along with her team, Bhatia created a curriculum that was specifically tailored to the providers at the Clínica. The curriculum, taught in Spanish, is a pilot program that provides healthcare personnel with comprehensive HIV care training, basic science fundamentals, and how to provide the best HIV treatment practices per patient. The next step, she said, is to speak with public officials in the region to scale up the program to teach other trainers and expand the curriculum to other similar areas.
“I would say their educational needs are definitely substantial based on what they told me,” Bhatia said. “There’s always room for knowledge improvement.”
Especially in a technological age when the Internet can be quickly accessed for frequently updated information, she said, outreach and education is strongly emphasized in places like La Romana, where Internet may not be readily available.
As for equipment, Bhatia said the clinic is set to receive a defibrillator and a centrifuge – things she said we take for granted here in America.
Those, along with other needed medical equipment and supplies were shipped out in January and once they have been cleared by customs, they will be delivered to the clinic later this summer, she said.
To Bhatia, this project is about integrating HIV primary care into resource limited settings and attempting to alleviate health disparities for vulnerable HIV patients, she said. She is looking to schedule her return to La Romana this summer.
“I think they truly do have their patients’ best interest at heart,” Bhatia said. “They’re really good people; they have good intentions. That is really one thing that distinguishes this clinic and community from perhaps other sites.”
This post was originally published on International Program Development’s NU in South Africa blog. Blogger Sarah Uttal is wrapping up her time in South Africa on IPD’s Global Healthcare Technologies program at the University of Cape Town and reflects on how her group’s work had an immediate positive impact on a primary care facility in Cape Town.
As our time in Cape Town draws to a close, we are all working hard to finish up our design projects we have worked on all quarter. This quarter has given each of us the opportunity to design a medical device to be used in South Africa, dealing specifically with South African health problems. Our classes here also taught us how to correctly think about these devices in a broader setting of health technology management and their potential cultural impact.
I got to work on a redesign of the current respirators used to protect against tuberculosis (TB) infection. We first came across these respirators during our time in KwaZulu-Natal when we had to wear them before entering a TB ward. Since TB is one of the top five causes of death in South Africa these respirators are used all over the country, but that does not mean they are the ideal way to protect oneself from the disease. We actually found them almost unbearable and decided there had to be a more comfortable solution to this problem. It was great to experience a problem first hand, hear the impact a better solution would have, and then begin to work on it in the setting where it would be implemented. We were able to speak to so many professionals around Cape Town and even around the country who gave us insights into why these respirators are not functional and how we could work to make them better. This is exactly what I was excited about doing before coming to Cape Town, working on a project that matters where it matters most.
Our entire group also worked on a waiting time study at the primary care facilities around Cape Town. People here wait for hours before being seen by a doctor and the government called us in to figure out why. We spent long days in clinics tagging patients and tracking clinic flow to determine where the system was failing. This meant hours of patient contact every day as people approached us telling us their problems with their healthcare system and letting us know how we could help fix it. This was another design project where we could really make a difference immediately. It is hard as an outsider to come into a South African community health clinic without much previous knowledge and try to change the system, which is why these patient anecdotes were so valuable. After multiple full days with 5:45am starts we began to get the hang of the clinic flow and figured out how to tag all the patients coming to clinic. We also began to observe some problematic trends and best practices we are now able to pass on to administration. We learned so much about the primary health care system’s successes and failures by being a part of this unique experience. It was definitely hard work but hopefully we made an impact and will have made those wait times a bit shorter for a frustrated patient population. It is great to know we are leaving having helped a country that has given so much to us these last few months.
Joseph Brown at the clinic in Kacllaraccay, Peru, where he volunteered. Photo from Joseph Brown.
Last year, Joseph Brown was working in a tiny emergency room with a single lamp—a lamp he said received electricity about 80 percent of the time. He treated malnutrition, the affects of polio, back pain and wounds from bull goring. After taking a year off from medical school to volunteer in Peru, Brown is encouraging other medical students to gain firsthand global health experiences, too.
Brown and fellow student Nicki Araneta described their decisions to take a year off from their studies at Northwestern’s Feinberg School of Medicine on Tuesday during a presentation sponsored by Feinberg’s Center for Global Health & the Global Health Initiative. Both also gave tips and encouragement to a room packed with medical faculty and students fresh from class.
Although their experiences varied in structure, both Brown and Araneta said they wanted to participate in programs that would create a sustainable, positive impact in the communities they served.
Araneta, who plans on going into family medicine, decided to journey to Guatemala. During her search for a program that would allow her to improve her Spanish and work in an underserved area, Araneta said she was careful to select a local program rather than a short-term medical service trip. “We all know now that when these [short-term] trips are done poorly they can have a negative impact on the community,” she said.
Instead, Araneta volunteered for seven months at Asociación Pop Wuj, a Spanish school in Quetzaltenango, or Xela, Guatemala. Araneta also spent time volunteering at a small hospital, Hospitalito Atitlan, and acting as a health advocate.
The trail to the clinic in Kacllaraccay. Photo from Joseph Brown.
Brown took a different approach to his year abroad.
“For me, I really wanted to see what it was like to start with a project from the ground up,” he said. Brown partnered up with a program called Crescendos Alliance, which he found while browsing the web one day during lecture.
Through Crescendos, Brown worked in the town of Maras, Peru and the tiny village of Kacllaraccay (don’t bother searching for it on Google Maps- it’s too small). In Kacllaraccay, Brown spent the majority of his stay preparing the village’s new clinic for the next set of volunteers. This included painting the clinic, wrangling medical supplies from the mayor of Maras, developing baseline health information for the town and building a relationship of trust with locals.
Brown said he hung out with the people of Kacllaraccay whenever he could to demonstrate that the clinic and its services would be in the village for the long haul.
Strong financial and academic support from Northwestern helped make their experiences a reality, said Brown and Araneta. Both encouraged the medical students in the audience to take advantage of such support.
While Araneta and Brown have no immediate plans to return to their sites, both hope to return someday. “Whenever residency allows,” Brown said.
Amanda Logan, assistant professor at Northwestern’s Anthropology Department, spoke Friday as a part of the Buffett Center Faculty/Fellow Series. Her talk, entitled “An Archaeology of Food Security in West Africa,” focused on her research in Banda, Ghana.
Amanda Logan wants to disprove a commonly referenced idea surrounding food security in Africa: the idea that farmers are in a time warp, stuck in farming techniques from the past, is “of course, terribly incorrect,” she says.
In an hour-long talk to a mixed group of undergraduate students and faculty, Logan laid out her research about food security pre-colonization. As an anthropologist, she focuses on data that is different than other ways of looking at food security. The materials left behind indicate food habits, so Logan is skilled in taking clues from remains of houses, bots, crops, and animal bones.
The area of Ghana where Logan completed her research is particularly interesting, she said, because of its location in an ecological transition zone. Her conclusions rely on a variety of sources – oral histories, food remains, and archaeological records to trace and identify a location on the spectrum of food security through time.
A home she excavated in Banda showed signs of high food security in the 1484-1660 ranges. A sign of this was proof of ivory production, a financially beneficial activity. At the time, the area was economically connected in the trans-Saharan networks.
The transition in Ghana occurred with the shift of trade networks to capitalize on trading possibilities at the outer coast. Changes in internal and external slave trade occurred, and the Ashanti state fell apart, as Europeans pushed onward.
Logan spoke about the resettlement of individuals between the 1890’s-1920’s and how under the control of the British government, areas with cocoa became the focus. In the meantime, other areas were expected to pay taxes and provide manual labor but saw decreases in economic stimulation. The food security, therefore, suffered.
Talks of food security often revolve around climate patterns, but Logan hopes her research will help transition the discussion to use the traces left behind to better explain that food security in West Africa has changed due to political, economic, and social transitions in time.
The data offered to support Logan’s conclusions, painted a fascinating picture of the concept of resilience to changes in crops and farming styles. She hopes to continue research in the area in the future, expanding the research to include land data, other regions, and social structures.