Guest Bloggers

  1. Feinberg Global Health Day gathers panel to discuss Ebola outbreak

    September 11, 2014 by Arianna Yanes

    Ebola has been on the global radar the past few months and the current outbreak in West Africa continues to spread rapidly. As a part of the Feinberg School of Medicine’s Global Health Day, hosted by the Center for Global Health, a panel of experts from the university came together for a presentation and panel on the current state of the ebola outbreak.

    Chad Achenbach explains the basics of the ebola epidemic to attendees

    Chad Achenbach explains the basics of the ebola epidemic to attendees

    Chad Achenbach, Assistant Professor in the Division of Infectious Diseases, started the presentation with foundational knowledge about the virus, describing how it started and how it continues to be transmitted. In 2004, he said, this particular strain of the ebola virus, EBOV, was circulating around animals. It remains unclear how it was introduced into humans in this outbreak. This is the largest outbreak of ebola in history, with 42% of the nearly 4,000 cases from the past month, he said.

    The virus strain of the ebola outbreak doesn’t appear to be more virulent or have higher case fatality rates than other outbreaks- so, why does this outbreak have more cases than all other ebola outbreaks combined? As Achenbach described, unlike past outbreaks in more rural areas, this virus has made its way into dense urban areas, as a result of increased mobility of populations to move within countries and across borders.

    The Center for Global Health at Feinberg is currently collaborating with a laboratory in Mali to test samples for the presence of the ebola virus. Of twenty samples received thus far in Mali, all have been negative. Achenbach anticipates this lab will be “active and very involved” in the coming months.

    “It’s been done before. We can do it- it’s just going to be a massive effort,” Achenbach said in regards to controlling transmission.

    After Achenbach’s presentation, the discussion was opened up to the panel, moderated by Robert Murphy, director of the Center for Global Health. Panel member Juliet Sorensen, Clinical Associate Professor at Northwestern Law School, described the role of the World Health Organization as that of a “global coordinator” to control the virus in the short term. However, the WHO is only as strong as its member countries, she described.

    “Now is the time for the international community to step up,” Sorensen said.

    The panel had Baldwin Auditorium at capacity with members of the Northwestern communit

    The panel had Baldwin Auditorium at capacity with members of the Northwestern community

    Jennifer Chan, Assistant Professor of Emergency Medicine at Feinberg, identified communication as one of the greatest challenges in this outbreak. Difficulties arise not only in getting messages to local communities about what to do, but also in getting the communities to trust the messages they receive.

    Mike Schmidt, also an Assistant Professor of Emergency Medicine at Feinberg, addressed the protocol of Northwestern Memorial Hospital’s Emergency Department in regards to ebola. Each patient is screened for travel history and potential exposure to the virus as part of the initial evaluation. Though no patients have presented at the hospital with the virus, Murphy described Chicago as a city with many travelers to and from West Africa.

    “If the person had a travel history that was concerning, those patients would be placed in particular areas of the emergency department where we can isolate them,” Schmidt described.

    Following the panel, a poster session showcased student research and projects in global health. In the evening, the Global Health Social Hour gave students and residents the opportunity to share abroad experiences and discuss project successes and challenges. On the Center for Global Health’s Facebook page, images capturing these travels are displayed as a part of a photo contest. Take a look at what the medical students have been doing and “like” your favorites to vote.

    Feinberg students presented global health projects and research from all across the world

    Feinberg students presented global health projects and research from across the globe

  2. Mobile health: Uses and growth at home and abroad

    September 10, 2014 by Arianna Yanes

    Source: gsma.com

    Mobile health (mHealth) is the use of mobile phones and technologies, such as tablets, to improve health access, outcomes, delivery, services, and research. The field requires individuals from multiple disciplines, such as medicine, public health, business, computer science, to come together and produce products that serve in both developing and developed nations.

    Cell phones are increasingly prevalent in low and middle-income countries (LMIC), while access to health care systems and providers can be challenging. In this way, mHealth can be a valuable tool for improving health access and outcomes and filling in some of the gaps which providers cannot. mHealth can also be useful for delivering care and education here in the United States, though the technologies serve different functions than in LMIC.

    With the growth of mobile phone usage and the needs of patients around the world, mHealth will continue to grow and serve diverse purposes. A report by Grand View Research estimated the value of the global mHealth market to be $1.95 billion in 2012, with an estimated annual growth rate of 47.6% from 2014 to 2020. Monitoring services, such as chronic disease management and vital signs tracking, accounted for 63% of the market.

    Just earlier this year, researchers at Northwestern and the University of Illinois published a report in Science detailing the design of a new soft, adhesive patch for physiological monitoring. A 2013 graduate of the Feinberg School of Medicine, Diana Cohen, developed an app called diet & acne to deliver information about connections between foods and acne, based on peer-reviewed literature. From April 1, 2013 to Aug 31, 2013, the app was downloaded in 98 countries.

    The NIH currently has a research funding opportunity entitled “Mobile Health: Technology and Outcomes in Low and Middle Income Countries,” under the R21 Exploratory/Developmental Research grant category. This demonstrates the perceived potential and need for the new technologies for use in these nations.

    Additionally, an annual mHealth Summit is held to bring the minds working in the field together. This year, innovation and evidence will be emphasized as delegates share successes and challenges in their endeavors.

    One mHealth platform, emocha, demonstrates the variety of potential applications of mobile health. Here are five brief examples of projects with diverse methods and objectives.

    1. Weight management (Maryland, USA)- A platform was created to send users motivation and tips via text message. As a follow up, the data will be analyzed and managed.

    2. TB screening (Panama and Mexico)- emocha used WHO guidelines to create an interactive TB symptom screening application. This project also included educational tools to keep providers up to date on TB care.

    3. Chagas control (Bolivia and Mexico)- If the Chagas insect is found during household assessments, emocha coordinates appointments to decontaminate the homes.

    4. Domestic violence intervention (Maryland, Virginia, Wisconsin, USA)- Using a tablet, patients are shown informational videos and screened. Questionnaires in the application assess the risk of domestic violence and also provide care referrals.

    5. Dengue control (Colombia)- Once water containers are tested for bacteria, photos are uploaded to the emocha platform with geo-locations and are managed there.

    These examples are just a few of the numerous examples of mHealth. The projected growth of the industry makes it worthwhile to stay updated with the latest in mHealth.

    To find out more about NIH’s funding opportunity for mHealth, visit http://grants.nih.gov/grants/guide/pa-files/PAR-14-028.html. To learn about the mHealth Summit, visit http://www.mhealthsummit.org/. To discover more about emocha, visit http://www.emocha.com/.

  3. Equipping Dominican HIV providers with the tools for best patient care

    August 13, 2014 by Guest Bloggers

    Guest post by Dr. Ramona Bhatia, Clinical Research Associate, Center for Global Health, and Instructor of Medicine, Feinberg School of Medicine

    The Project CURE shipping container arriving at the Clínica de Familia La Romana

    Arrival of the Project CURE shipping container at Clínica de Familia La Romana

    Physicians such as myself practicing in high-income countries are privileged to utilize the latest medical technologies for patient care. In the majority of healthcare settings globally, however, even the most basic medical supplies, such as gloves, gowns, and gurneys, are limited, and more sophisticated technologies are exceedingly rare.

    In my role as a global health clinical researcher in the Center for Global Health at the Feinberg School of Medicine, I had the pleasure of traveling to the Clínica de Familia La Romana in October 2013. Located in the La Romana province in the southeastern part of the Dominican Republic, Clínica de Familia is the second largest HIV clinic in the country. It provides subsidized care to approximately 1,600 patients, including a large proportion of vulnerable Haitian migrants living in neighboring bateyes (sugarcane labor camps). My initial task was to develop and implement a Spanish-language training course on the latest HIV care updates for Clínica providers, but from my conversations with Clínica leadership and site visits I quickly realized that more than a care update was needed. A lack of medical equipment, such as an EKG for heart tracings, was preventing Clínica staff from providing the best care possible to their patients.

    The container was fully stocked with needed medical supplies

    The container: Fully stocked with needed medical supplies

    To address the supply shortage, the Center for Global Health, with support from Northwestern Memorial Hospital, formed a partnership with the not-for-profit group Project C.U.R.E. Project C.U.R.E. is the largest supplier of donated medical supplies to developing countries around the world. One of my responsibilities was to assist with the on-site Project C.U.R.E. needs assessments in the Clínica de Familia and neighboring hospitals, including one in Guyamate, a bateye and Northwestern University Access to Health site. Conducting detailed assessments was important to ensure that donated supplies would be needed and could feasibly be used. We interviewed providers for first-hand accounts of the supplies that were most needed and discussed logistics with Clínica leadership, including availability of regular maintenance for large equipment, proper storage facilities, and personnel to safely and effectively utilize certain technologies.

    Three months later, in January 2014, a large shipment of supplies was loaded onto a shipping container in Denver and set sail from Houston for the Dominican Republic. After travel and customs processing, the shipping container carrying tens of thousands of dollars worth of medical supplies arrived at the Clínica de Familia in July 2014. The community came together for the large undertaking of unloading the supplies at Clínica de Familia.

    Today, just a few weeks after the arrival of the shipment, providers are already utilizing some of equipment: The EKG machine is being used for heart rhythm examinations and the colposcopy equipment is set up to begin women’s health exams, all due to the targeted matching of supplies with the Clínica’s needs.

    We plan to return to La Romana next year with the first group of Feinberg medical students to engage in HIV and primary care medical rotations at the Clínica de Familia. I’m hoping to see these supplies contributing to a sustained improvement in health care for HIV patients in the La Romana community.

    Unloading the container: A community effort

    Unloading the container: A community effort

    CommunityEffort

    Clínica de Familia La Romana staff checking supplies

    Setting up the colposcopy machinery for women's health examinations

    Setting up the colposcopy machinery for women’s health examinations

  4. A Toxic Cycle

    August 7, 2014 by Haley Lillehei

    As a student of global health, I pride myself on keeping up to date on the various challenges to public health around the world, especially the most potent issues. I know about AIDS and malaria, I know about the problems with health insurance in China, and I know the struggles resource poor nations face in giving care, to name a few. So imagine my surprise when I came across a topic I knew nothing about.

    This past May, over 100 people died in a toxic alcohol outbreak in eastern and central Kenya. Others woke up blind after sleeping off the alcohol’s effects or lost their sight over the course of a few days. In Kenya, and other countries in the area, bootleg liquor is extremely common, as factory made alcohol is too expensive for most people to buy. Many of these locally made brews are laced, both intentionally and unintentionally, with industrial alcohol to increase their potency.

    How does this toxic alcohol kill? What makes it so much worse than the ethanol that so many people across the world drink? I spoke with Dr. Patrick Lank and Dr. Vinoo Dissanayake in an attempt to wrap my head around this deadly poison.

    Ball and Stick Model of Methanol. Source: Wikipedia

    Ball and Stick Model of Methanol. Source: Wikipedia

    Dr. Lank, a toxicologist at Northwestern’s Feinberg School of Medicine, explained to me what happens to the body after one consumes methanol. Methanol, or methyl alcohol (CH3OH), is widely used as an industrial solvent and paint remover. It is also commonly used as a component of photocopying fluid, shellacs, and windshield-washing fluid. When ingested, methanol is primarily metabolized in the liver into formaldehyde via alcohol dehydrogenase. Formaldehyde is then metabolized into formic acid, which ultimately breaks down into folic acid, folinic acid, carbon dioxide, and water. Formic acid is responsible for the toxic effect of methanol in the human body.

    In the United States and other developed countries, there are very specific treatments in response to toxic alcohol poisoning. These include hemodialysis, oxygen and breathing support, gastric lavage, and fomepizole, an antidote intended to reverse the effect of the poison. Another remedy is consumption of ethanol, or the alcohol we typically drink, like beer, wine, or whiskey, to name a few. When ethanol is ingested, it competes against the methanol to be metabolized, and the body digests ethanol instead. This prevents the formation of the toxic metabolites that result from the digestion of methanol. Often times when we see alcohol poisoning involving methanol in developed countries it involves individual cases: someone is suicidal, addicted, or another isolated cause. A hospital can focus on using all the available interventions to save a life. This is not the case in developing countries.

    Dr. Dissanayake, a medical toxicologist at Loma Linda University Medical Center in Loma Linda, California, explains that alcohol poisoning is a good example of the struggle behind resource limitations in developing countries. There is often limited access to hospitals and doctors, and if one does make it to one, it is often at the very last possible minute, once they have exhausted all home remedies and they are still alive. Dr. Dissanayake has spent time in Uganda doing global health work. During her time there, she has experienced first hand the burden a methanol-poisoning outbreak would place on communities.

    Uganda Waragi. Source: Wikipedia

    In Uganda, illicit alcohol is called waragi, and was introduced by the British to give Ugandan soldiers courage to impose the Queen’s policy on their countrymen. It has since become the drink of choice for most Ugandans. According to a 2004 World Health Organization ranking of countries based on per capita alcohol consumption, Uganda has the highest alcohol consumption in the world, with adults consuming 19.5 liters of alcohol per year. “If someone in the village is sick from drinking, they are one of many drunk patients, and it would be nearly impossible to determine who may actually be poisoned rather than just drunk,” says Dr. Dissanayake. An additional strain on the already resource-poor medical facilities is created through excessive alcohol consumption.

    With a high number of intoxicated patients and limited professionals, the most common response is to let an intoxicated patient sleep it off, and thus the cases of those who have been poisoned by methanol are often discovered too late. Alternatively, if the poisoning is discovered in time, and if a person does make it to a hospital, the best option is to fight the poison with ethanol. However, methanol has a half-life of 40 to 50 hours, so according to Dr. Lank, a patient must be kept drunk for about 10 days to survive the toxic methanol. Most patients do not have the resources to pay for this treatment.

    The other option is to have the patient transferred to a referral center where hemodialysis can take place. Dr. Dissanayake explains that hemodialysis is a medical procedure that will filter the patient’s blood and remove toxins, preventing toxic metabolites from forming. This procedure would happen without hesitation in the US, however only certain hospitals have this capability in Uganda. “The closest referral center to Nyakibale Hospital [a hospital in Uganda where Dissanayake has volunteered] is 3 hours away by motorbike,” says Dr. Dissanayake. There are very few ambulances available in rural Uganda.

    So why is this happening in places like Uganda and Kenya? Drinking is a highly political issue, as alcohol is one of the largest sources of revenue. Local politicians are reluctant to partner with law enforcement based on a fear that stricter laws will be bad for business. At the same time, the government doesn’t see toxic alcohol poisoning as a large public health issue. Drinking is viewed as part of the culture in Uganda. However, according to Ioannis Gatsiounis for Time Magazine, some observers estimate the costs of alcohol in the country, both economic and social, are worse than those of HIV and malaria. “It’s a double-edged sword,” Dr. Dissanayake says, “people are so depressed that they can’t make enough money to make ends meet so they drink. But then they can’t go to work the next morning and the cycle continues.”

    Ultimately, the ripple effect of a failing economy is felt in the limited resources of the medical system as well. One answer to the problem lies in global partners to try and educate local providers on the best way to manage these poisonings and stop the cycle. However, enforcement of the policies by the government may play a more meaningful role.

  5. A New Way Forward

    August 6, 2014 by Elizabeth Larsen

    Chicken - Piura - Peru (1 of 1)

    Though they lie thousands of miles apart, the countries of Guatemala and Peru continue to fight against the same seemingly unconquerable struggle: childhood malnutrition.

    In both countries, nationwide data masks the severity of the problem. In Guatemala, childhood stunting affects around 50% of children under five, yet the prevalence soars to 70-80% in many indigenous communities. The disparities in Peru are equally as stark. In fact, the country is often overlooked by agencies providing nutritional support as the overall prevalence of childhood malnutrition is only about 15%, even though indigenous communities continue to see rates of 40, 50, even 60%.

    As you can see, the problem of childhood stunting in Latin America is extremely prevalent, but it is not widespread. It is concentrated in impoverished indigenous populations that have faced years of racism, marginalization, and abuse. How can we begin to solve the nutrition crisis that was created by decades of political, economic, and social oppression?

    The answer is not easy or immediately obvious. As you can quickly see from examining the data on stunting over the last few decades, the world has struggled to make significant progress despite the best efforts of governments and bilateral aid organizations. For example, malnutrition rates in rural Peru fell 0.3% in the ten years from 1996 to 2005. Even though change seems to be accelerating in the majority of countries, it is not fast enough, nor consistent in its reach. In fact, as of 2010, fifteen countries now have a childhood malnutrition prevalence that is higher than it was in the 1990s.

    Luckily, hidden in the shadows cast by governments and foreign aid, small grassroots organizations have been hard at work achieving remarkable success at improving the nutritional health of their communities’ children. For the past month, I have had the remarkable privilege and honor to investigate some of these programs first hand. Though their strategies are incredibly diverse, their passion for nutrition is identical.

    For example, Wuqu’ Kawoq runs a patient centered nutrition program completely in the indigenous language of Kaqchikel, the language of many Mayan Guatemalans. In one community named Paya, the mothers of the children enrolled run the program themselves, taking all of the height and weight measurements to be recorded in the system. In another one of their communities, the director of the nutrition program was unable to find additional children to be admitted, as they were all growing adequately. This is what success looks like.

    Close by in the highlands around Panajachel, Mayan Families runs an innovative and unique nutrition preschool program. Mothers are able to drop off their children for a daily program of Spanish lessons, supervised playtime, and a healthy breakfast and lunch. Looking at the data, many kids aged three to five years have made substantial growth gains, a big step toward overcoming the infantile malnutrition that many suffered. This is what success looks like.

    An entire hemisphere away in the high altitude mountains of Peru, a young organization called Sacred Valley Health is training women to become health promoters in their communities, providing basic primary care and education about nutrition, sanitation, and disease prevention. They have more than doubled the number of health promoters in the last two years, allowing for important lessons about nutrition to be disseminated to more and more communities. This is what success looks like.

    Toward the middle of the country, Future Generations is proving that a nationally sponsored health program called Community Health Administration Associations (CLAS) can be reformed to provide citizens with first class primary care. By developing accessible and accurate materials to train nurses to train community health facilitators, Future Generations has increased the rate of exclusive breastfeeding in Huancayo from 71.8% to 95.3% and has decreased the rate of malnutrition in children under two by almost 7% in just one year. This is what success looks like.

    And last, but certainly not least, Feed the World is re-imagining agriculture in Northern Peru, one of the world’s most arid areas. By distributing loans of seeds and agricultural tools to farmers, along with providing extensive education on dry farming techniques, Feed the World equips farmers with the tools necessary to cultivate nutritious crops to feed their families even working within difficult circumstances. After the first year of the program, the regional and local government, along with the local university have taken over 74% of the project’s costs, a substantial investment in a previously ignored problem. This is what success looks like.

    As I hope is clear by the examples above, the power and impact of small community based organizations to affect change cannot be underestimated. If we wish to make a profound difference in the prevalence of malnutrition around the world, we must not only wholeheartedly embrace the lessons on how to achieve large scale impact with a small scale, community approach, but we must continue to invest in these grassroots organizations and their fearless leaders who are working day in and day out to create a way forward.

    If you are interested in learning more or inspired to support one of the causes above, you can access their websites at the embedded links throughout this post. 

  6. The Ebola Outbreak: Fast Facts and Resources

    August 4, 2014 by Emily Drewry

    The global health world is abuzz this summer with the frightening spread of Ebola, a deadly virus that has emerged in frightening force over the past few months in West Africa. Officials are labeling the outbreak responsible for 826 deaths as of August 4, as organizations across the globe are stepping in to try and contain the spread before the count grows.  As the media coverage continues to escalate, so does the challenge of keeping up with it, especially the quick facts. Read on to get a quick overview, then follow the links under each question for further information.

    Ebola Virus

    Ebola Virus. Source: Associated Press

    What is Ebola? Ebola is a group of viruses that cause deadly hemorrhagic fevers. According to the WHO, the virus has a case fatality rate of 90%. It can be transmitted by direct contact with blood, body fluids, and tissues of infected people or animals, and is known to be one of the world’s most virulent diseases. The current strain is considered to be the most lethal strain of the group, but in many cases, can be treated if identified.

    (More: http://www.who.int/csr/disease/ebola/en/)

    Background information: Ebola is named after the river in Zaire where it first emerged in 1976. The virus produces a protein called ebolavirus glycoprotein that attacks the body’s cells and creates the hemorrhagic symptoms that often appear in patients. However, not all cases of Ebola are identified with extreme hemorrhaging – instead, the cases generally begin with flu-like symptoms. Therefore, much of the danger of the outbreak lies in the challenge of containing those who carry the virus and avoiding exposure, which often takes place in funeral circumstances or through the work of health care providers.

    (More: http://www.huffingtonpost.com/2014/08/02/ebola-symptoms-infection-virus_n_5639456.html)

    Where is the outbreak? The cases of this summer’s outbreak have been located along the shared borders of the West African countries of Sierra Leone, Liberia, and Guinea. There is fear of the virus spreading after an infected man flew on a commercial airliner from Liberia to Nigeria last week, but as of now, officials have yet to report any cases. On July 31 the CDC issued a travel advisory for the three countries where Ebola has been identified, urging a temporary halt to nonessential travel.

    (More: http://abcnews.go.com/Health/ebola-/story?id=24733669, http://time.com/3065176/ebola-outbreak-cdc/)

    How does this outbreak compare? This year’s outbreak is now officially the largest in history, with over 1,300 infected this year. Past outbreaks have been reported across the world since the first recognition of the disease in 1976. An outbreak in 2000-2001 in Uganda infected 425 individuals, with a 53% death rate reported.  Ebola has been identified in three continents since 1976, and has been a collaborative research project for the CDC and various national health departments for years.

    (More: http://www.cdc.gov/vhf/ebola/resources/outbreak-table.html)

    What is happening in the US? Two Americans, who were infected with the Ebola virus while working in Liberia, are being transported to Emory University Hospital in Atlanta for treatment this week. A 33-year old American doctor arrived in Atlanta on Saturday and a 59-year old aid worker is scheduled to arrive in the US tomorrow. The news created a stir of responses from individuals afraid of the healthcare system’s abilities to keep the virus contained. A Pentagon spokesman confirmed the move, acknowledging that specially trained teams will be handling the cases. This is the first time an Ebola patient has been brought to the US, according to the CDC.

    (More: http://www.washingtonpost.com/national/health-science/us-confirms-2-americans-with-ebola-coming-home-for-treatment/2014/08/01/c20a27cc-1995-11e4-9e3b-7f2f110c6265_story.html)

    What does the WHO have to say? The WHO has kept their updates quite frequent, updating their website with response plans and resources as the outbreak has progressed.  Most recently, they informed the public of an intensified Ebola outbreak response plan to be put in place by Dr. Margaret Chen, Director-General of the WHO and the presidents of the West African nations affected.  The $100 million response plan will “require increased resources, in-country medical expertise, regional preparedness and coordination,” says Dr. Chen.

    (More: http://www.who.int/mediacentre/news/releases/2014/ebola-outbreak-response-plan/en/)

    Where can I get more information? All the links above will bring you to articles with coverage of the current outbreak. In addition, the CDC (cdc.gov) and WHO (who.gov) websites contain valuable background and updated information.

  7. Community Health Administration Associations: Community Health empowerment for Peruvians

    July 28, 2014 by Kathleen Ferraro
    San Jeronmino CLAS center

    San Jeronmino CLAS center

    I am currently researching the community health worker model in Peru, a project which has necessitated extensive background research on Peruvian health care and the community health worker model’s past, present, and potential in the country. This background research included information on the Community Health Administration Associations (CLAS) program, a program that diverges from the conventional community health worker model but provides community-based primary care nonetheless.

    As a background, the community health worker model is a primary care model wherein local community members are trained to administer basic health services to other members of their community. This model is steadily gaining popularity worldwide, often commended for its potential for community empowerment and accessibility. In Peru, studies of the community health worker programs in place acknowledge the efficacy of the model on paper, but criticize the fact that the bulk of Peruvian community health workers are males with little to no education that exhibit high dropout rates from their community health work (Brown et. al. 2006).

    However, the CLAS program, implemented in 1994, is proving to heighten the potential of efficacious community health work. The WHO defines the CLAS program as a system of “private, non-profit civil associations [(legal non-profits)] that enter into agreements with the government and receive public funds to administer primary health-care (PHC) services applying private sector law for contracting and purchasing” (CITE). These individual community CLAS associations effectively identify local social determinants of health and health inequities, and then reinvest their Ministry of Health-supervised budget in community outreach programs and infrastructure development.

    As it relates to the community health worker model, the CLAS program is essentially a government health initiative with authorized and integral community participation. Health personnel working at CLAS associations are formally hired by CLAS and are held accountable by the community members their center works with, thereby necessitating transparency and communication with service recipients. In that way, community members influence the health services offered, and CLAS associations respond to the needs and health disparities specific to their localities.

    All in all, the CLAS model has proven to have favorable impacts on health, health services development, and community outreach. CLAS association clinics boast significantly higher numbers of staffing physicians in comparison to non-CLAS clinics (and therefore shorter waiting times and more personalized treatment) with a higher average of annual clinic visits among their target populations. The centers also exhibit higher access and more customized primary care, especially for poorer rural populations that tend to be dissuaded by unaffordable fees. They do so by focusing on what the individual community needs and responding to only the relevant inequities and necessary services–in short, affording accessibility by efficient service development and implementation.

    Government and organizational initiatives continue to develop in the hopes of further strengthening the CLAS program by monitoring impact, fostering community-based education, broadening the reach of CLAS centers, and increasing CLAS partnerships with schools, organizations, and other relevant institutions.

    With initiatives like this in place to strengthen a program that already demonstrates significant impact, it is exciting to see where this community-based primary health care system goes in the future. Likewise, it will be interesting to see how non-CLAS community health worker programs interact with, borrow from, and impact the CLAS model to continue to expand the reach of community-based health care in Peru.

  8. Questioning Domestic Violence

    July 25, 2014 by Haley Lillehei

    According to the National Coalition Against Domestic Violence (NCADV), one in every four women will experience domestic violence in her lifetime. This violence is not confined to any one group – it is an epidemic that is affecting individuals from every background, regardless of age, economic status, race, religion, nationality, or educational background. The consequences of domestic violence seep into many areas of life and can have remarkable effects beyond the immediate act.

    The NCADV released a domestic violence facts sheet in 2011 that gives a brief discussion of the issue within the United States. 85% of victims of domestic violence are women, and most of these females are victimized by someone they know. Most cases of domestic violence are never reported to the police and can have lasting repercussions – intimate partner violence is a substantial public health problem in the US. Last year (2013), the House renewed the Violence Against Women Act, which is legislation to offer protection to victims of domestic abuse. In response to the passing of the act, Obama said “Renewing this bill is an important step towards making sure no one in America is forced to live in fear.” This is a measure towards addressing the issue, but intimate partner violence is still a large problem that needs to be confronted to a greater extent.

    The challenge thus remains how to most successfully prevent domestic violence. One of the greatest challenges to overcome is the patriarchal norms in the society we live in. Domestic violence, although most often perpetrated by individual men and boys, is a product of a larger system. Jackson Katz, a gender violence prevention educator, has an interesting perspective on the issue of domestic violence.  In a TedTalk titled “Violence Against Women – It’s a Men’s Issue” Katz explains how the problem of domestic violence is usually categorized as a woman’s issue, but, he says, it is time for a change.

    “They’ve been seen as women’s issues that some good men help out with, but I have a problem with that frame and I can’t accept it. I don’t see these as women’s issues that some good men help out with. In fact, I’m going to argue that these are men’s issues, first and foremost. Now obviously, they’re also women’s issues, so I appreciate that, but calling gender violence a women’s issue is part of the problem for a number of reasons” (Katz, 2012).

    Katz goes on to describe all the problems with calling gender-based violence a “women’s issue” – some men hear that term and tune out.

    Jackson Katz

    Jackson Katz

    Katz uses a linguistic model to illustrate his point. The phrase “John beat Mary” changes, through a few steps, into the phrase “Mary is a battered women.” John has entirely left the conversation, and the violence that was perpetrated against Mary has become her identity. “Mary is a battered woman,” Katz points out that our whole cognitive structure is set up to ask questions about victims. What did Mary do that made John upset? Did Mary forget a responsibility? The questions continue, and they are all focused on Mary. Instead of asking questions about Mary, we need to start asking a new set of questions. “What is going on with men? And then what is the role of the various institutions in our society that are helping to produce abusive men at pandemic rates?” (Katz, 2012). The questions need to shift to focus on the causes of violence, as that is how we will truly figure out how to prevent it.

    Domestic violence is a deeply rooted and systematic social problem. Katz wants to know “how can we change the practices? How can we change the socialization of boys and the definitions of manhood that lead to these current outcomes?” (2012). These questions are hard, because they rock the boat and challenge the status quo, but they are the only way to make a real change. They will be resisted, but the more people that can join the conversation and ask the questions, the more momentum gained.

  9. 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.

  10. 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/.

     

  11. 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.

  12. 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

  13. 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.

  14. Mainland Chinese “Birth Tours”

    June 2, 2014 by Haley Lillehei

    Source: New York Times

     

     

    In the past thirty years a phenomenon of “birth tourism” has arisen, describing Mainland Chinese mothers and their families traveling to Hong Kong to have their children. As the world has globalized, individuals have more access to information and more mobility. Medical tourism has stemmed exchange, as people become interested in seeking out healthcare in other areas of the world. It is primarily the result of the globalization of healthcare and the globalization of tourism. The observed phenomenon of birth tours fits within this categorization – in 2009, 50% of the births in Hong Kong hospitals were to Mainland Chinese women.

    It is argued in current literature that there are several reasons for why this is happening: the higher quality of Hong Kong’s hospitals, evasion of the One Child policy, and so that the birthed child receives the benefits of Hong Kong citizenship. These reasons are enough to attribute to the increase of births, but the cost side of the equation explains why Hong Kong’s hospitals, both public and private, are also benefiting from the occurrences.

    Local residents in Hong Kong giving birth at a public hospital pay about HK$100 (US$13) pr day, while a non-local resident will pay up to 33 time more (US$423 per day). In a private hospital, a delivery can cost up to $110,000. Hospitals have a lot of economic incentive to keep the flow of birth tourism coming.

    Despite benefits hospitals in Hong Kong are receiving, there has been a huge public outcry towards Mainland Chinese mothers who are seen as overcrowding the obstetric facilities. In a New York Times article, Sharon LaFraniere describes the experience of Maggie Wong, a 31-year-old Hong Kong resident who felt as if she had been pushed aside by Mainland couples. She tried to schedule a delivery at a public hospital near where she lived when she was three and a half months pregnant. According to Ms. Wong, she had to spend her husband’s savings and borrow from her parents because the public hospitals were too full of Mainland Chinese women. “I am a citizen of Hong Kong. I pay Hong Kong taxes. I kept thinking, what is this? How can this be? Of course it create bad feelings.” Hong Kong people, especially those attempting to use the obstetric services in hospitals, are increasingly irritated with the lack of room in public and private hospitals.

    In response to the continual public outcry, in January 2013 the Hospital Authority, responsible for the management of public hospitals, general outpatient clinics and specialist outpatient clinics, instituted a “zero-birth quota” that did not allow Mainland Chinese mothers use Hong Kong’s obstetric facilities.

    This restriction has done more than open up beds for Hong Kong women. The exclusion has significantly reduced the overall number of births taking place in Hong Kong. Baptist Hospital, which has one of Hong Kong’s biggest private obstetrics wards, reported a loss of more than HK$200 million and an 80% drop on delivery rate.

    There clearly is a mismatch between public opinion and what is most practical for the state and hospitals. With a large number of high quality obstetric services and a declining Hong Kong fertility rate, the hospitals have a larger supply than Hong Kong citizens can fill. They are now pushing back against the ban that popular opinion so eagerly pursued. The government has not yet lifted the ban, but due to pressure the restrictions have loosened. It remains to be seen whether economics or popular opinion will win this battle.

  15. HIV/AIDS Learning Institute: An Interdisciplinary Perspective on Important Health Issues

    May 30, 2014 by Janka Pieper

    Guest Post by Kate Klein. This post was originally published on the Northwestern Public Health Review Blog.

    Screen Shot 2014-05-30 at 11.10.04 AMFor the past year I have been working with the Interdisciplinary Health Network (IHN), a collective of public health and medicine students from all over the country, interested in creating free courses on important health issues from an interdisciplinary perspective. The IHN was founded on the core belief that an integrated approach across disciplines to combating disease is needed. IHN’s mission is to create a training program that addresses this need and to develop a network across different academic sectors.  The goal of the IHN is to empower students to achieve their goals as future global health professionals by providing a holistic educational environment that allows for innovative thinking in global health.

    As someone who has worked on HIV prevention issues, I was particularly keen to develop a course that would bring together lecturers from a range of disciplines all working on HIV/AIDS. I was able to recruit and record lectures from leaders in the fields of advocacy, laboratory work, social entrepreneurship, clinical care and operational research. I was lucky to bring in leaders in these fields who, collectively, provide a fantastic history of HIV/AIDS, what we know, how we are fighting it (in the lab, the hospital and the field) and where vaccine and prevention research is going.

    Besides the HIV/AIDS Institute, my colleagues are developing Institutes on Tuberculosis and Neglected Tropical Diseases. Each Learning Institute will be a three-week online course, with lectures that you can view at your convenience and live interactive Q&A sessions. Dates and links to the full curriculums can be found here:

    AIDS Learning Institute: June 23rd – July 12 Curriculum

    Speakers Include:
    ▪    Mitchell Warren, Executive Director, AVAC: Global Advocacy for HIV Prevention
    ▪    Alice Gandelman, MPH, Director, California STD/HIV Prevention Training Center
    ▪    Dr. Shannon Galvin, Director of Clinical Programs and Training, Center for Global Health, Northwestern University
    ▪    Dr. Laila Woc-Colburn, Director of Medical Education, National School of Tropical Medicine and Assistant Professor, Infectious Diseases, Baylor College of Medicine
    ▪    Dr. Joseph Tucker, Assistant Professor, University of North Carolina School of Medicine, Director UNC-China Programs
    ▪    Dr. Dorothy Lewis, Professor of Infectious Diseases, Internal Medicine, University of Texas-Houston

    TB Learning Institute: July 7-July 25 Curriculum

    Speakers Include:
    ▪    Dr. Amy Bloom, Senior Technical Advisor, USAID
    ▪    Colleen Daniels, TB/HIV Project Director, TAG Zeroes Campaign

    NTDs Learning Institute: (pending -TBD in July) Curriculum

    Speakers Include:
    ▪    Dr. Peter Hotez, Founding Dean, National School of Tropical Medicine

    These courses are meant for just about anyone with an interest in the topic. If you are would like to apply, the application can be found on the IHN website, http://www.ihealthnetwork.org.

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