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Five Northwestern Students Attend Emory Global Health Case Competition

This past March, five Northwestern students traveled to Atlanta, Georgia to compete in the Emory Global Health Case Competition. The diverse team, which was comprised of students hailing from Feinberg School of Medicine, Kellogg School of Management, and Weinberg College were tasked with creating an initiative to address mental health issues in Liberia. With a small budget and limited time constraints, the students had to pilot their mentoring program “Da Me” (Liberian English for It’s Me) in a nation ravished by mental health stigma, gender inequality, and a recent civil war. The team believed that Liberian women, survivors of rape and mourning the loss of family members during the recent civil war, would benefit the most from mental health programming . Thus, the program “put girls first” says Kellogg student Ferrona Lie, and worked to reduce mental health stigma and increase support for those who experienced trauma from recent events and those suffering from mental illness.

While the team did not place at the competition, Ferrona Lie and Sedoo Ijir both felt that they learned a lot from their experience. Lie, originally from Indonesia, felt that the skills she acquired from the competition furthered her goals to develop medical devices which will impact countries in need of better healthcare. While she commends American global health actors for their work in Africa, she urges key players to expand their impact to the far reaches of the world: namely, southeast Asia. But unfortunately, just as the case competition provided the team a limited budget, she feels that she does not currently have the financial resources to make an impact quite yet.

Sedoo Ijir, a Global Health Studies student, said herself “In our global health classes we critique…a lot. But when you are actually coming up with the initiative yourself, you have to take into account time constraints, target populations, government regulations, among other factors. Unfortunately, sacrifices have to be made. I think that is why no global health program is without flaw or need for critique.” Ijir said the team struggled over the budget and time constraints which forced them to develop only a year long pilot program in the city of Monrovia, which had minimal research efforts to ensure the program was effective. Ijir highlights that these issues reflect broader challenges in the field of global health. As she aspires to return to her parents’ home country of Nigeria to pursue global health work, she feels sure that the Emory case competition and her studies through the Global Health Studies program will allow her to more effectively address these obstacles.  “This is how it [global health] works” Ijir claims “but this is not to say that is how it should work.”

 

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“Let’s talk:” World Health Day 2017

Every year, the World Health Organization marks the anniversary of its founding with World Health Day. The organization, which officially came onto the international stage on April 7, 1948, uses World Health Day to call attention to important health issues impacting a large portion of the world.

Topics for World Health Day vary considerably, reflecting the vast number of health problems and related factors in an increasingly globalized environment. In past years, World Health Day focused on aging, high blood pressure and vector-borne diseases.Today, the WHO is highlighting depression.

According to the Mayo Clinic, depression is a “mood disorder that cases a persistent feeling of sadness and loss of interest.” The condition changes the way people feel and behave, touching many areas of emotional and physical health. 

More than 300 million people suffer from depression, according to the WHO. Between 2005 and 2015, the number affected individuals increased more than 18 percent. It is now the leading cause of ill health and disability worldwide. While mental health conditions can frequently be seen as a problem for the Global North, middle and low-income countries actually bear more than 80% of the disease burden.

The WHO’s tagline for World Health Day is “Let’s talk,” encouraging a global audience to have conversations about the causes, risks and treatment of depression. Clinicians don’t know the exact cause of depression, according to Mayo, but hormones, changes in brain chemistry and genetically inherited traits can play a role in the condition.

Outside the body, factors like traumatic events and social stresses can trigger or lead to the development of depression. Risks include poverty, unemployment, physical illness, problems caused by alcohol and drug use and difficult life events, like the loss of a loved one.

Campaign materials from the WHO emphasize that depression is not a weakness, can affect anyone and should be treated. An open approach to depression is key to addressing the issue. People suffering with the symptoms are often hesitant to come forward because stigma surrounding mental health conditions still exists in many countries. Adopting a more informed and understanding look at mental health disorders could increase proper diagnoses and get individuals the treatment they need, whether it is medication, talking therapy or another type of therapy.
For those who are depressed or think they may be depressed, the WHO recommends talking about their feelings, keeping connected with family and friends and reaching out for help. At Northwestern University, students can reach out to CAPS or connect with a trusted figure to seek assistance.

Around the world, individuals should take interest in others, and notice any loss in energy, changes in habits or statements of worthlessness that may indicate their friend or family member has depression. Communities should recognize the strain mental health conditions place on their members and advocate for better resources to assist and treat disorders and more information to help reduce any stigmas.

Additionally, it is important to address outside factors that exacerbate depression. Northwestern Global Health professor Noelle Sullivan calls specific attention to the world economic conditions that result in increased cases of depression in her piece for truthout. Advocacy should also be directed to removing social and economic burdens on populations worldwide to combat this issue. 

World Health Day challenges people throughout the globe to more thoughtfully consider their health and the health of the global community. Through education and action, the Northwestern community can observe World Health Day, changing the outlook on depression and becoming better global citizens.

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Northwestern takes a field trip to a Baby-Friendly hospital

Students in Professor Sera Young’s class met with some of Advocate Trinity Hospital’s staff as they toured the facility. (Photo courtesy of Advocate Trinity Hospital)

Early in March, a group of Northwestern students in Professor Young’s “Ecology of infant feeding” class had the chance to visit Advocate Trinity Hospital on the southeast side of Chicago. From the outside, it looks like a regular clinic, but the hospital is really quite special–it’s Baby-Friendly.

Shouldn’t all hospitals where mothers deliver be “baby friendly”? Turns out, out of thousands of hospitals in the United States, approximately 418 hospitals and birthing centers carry a Baby-Friendly designation, according to Baby-Friendly USA.
Trinity Advocate Hospital is one of 17 Baby-Friendly hospitals and clinics in Illinois.

So what does it mean to be Baby-Friendly?

“’Baby-Friendly’ means that the hospital has adopted the practices set forth by Baby-Friendly USA,” said Mary Ann Neumann, A.P.N, M.S.N., R.N.C.-O.B., an advanced practice nurse at Advocate Trinity Hospital.

Baby Friendly USA is an organization that helps implement the WHO’s Baby Friendly Hospital Initiative. Part of the initiative requires adopting ten steps for successful breastfeeding, including allowing the mother and baby to remain together in the hospital, educating women about the benefits and management of breastfeeding and helping mothers initiate breastfeeding within the first half-hour of birth. Through these steps, health workers aim to increase the number of women who breastfeed.

“It is a culture; it takes a lot of work,” said Michele Roe, R.N., B.S.N., M.B.A, N.E.-B.C, the nurse manager at Advocate Trinity Hospital. “Many of our patients come here adamant that they are not going to breastfeed because their families do not support it, in their culture they don’t breastfeed or [they] have never breastfed; so many times it’s a battle for us to change that perception from the family support system and their beliefs…it’s a way of life, so to speak, here at the hospital – you have to live it in order to maintain and sustain it.”

Advocate Trinity Hospital promotes breastfeeding as much as possible, even for babies that must spend time in the nursery, away from their mother. They give mothers recliners and chairs to assist them with breastfeeding. (Photo courtesy of Advocate Trinity Hospital)

Advocate Trinity Hospital was Baby-Friendly designated in January 2016. The process for certification took four years, according to Roe, but already, the community is seeing increases in breastfeeding rates. Such an increase means that more mothers and babies are experiencing the benefits of breast milk, including lower infection rates for babies and reduced cancer risks for mothers, among other benefits. In the long-term, breastfeeding is thought to decrease the risk of diabetes and obesity, two conditions that affect many people in the community surrounding Advocate Trinity Hospital, as well as other areas with limited resources. It’s one of the key reasons why the hospital decided to become Baby-Friendly.

“Where the incidence of diseases are highest and the resources are the lowest is where you see the least amount of Baby-Friendly hospitals and we just wanted to set about changing that in our community,” Neumann said. “If it can be done here then it can be done anywhere –and really that’s where we started – we wanted our community to be healthier from the very first moment of birth.”

Professor Young’s class had the opportunity to hear a little bit about Advocate Trinity Hospital before seeing the structure behind its mission, touring the site’s labor and delivery rooms, C-section recovery rooms and the level 2 nursery. On the path to becoming Baby-Friendly, the hospital had to make some changes, training nurses and physicians on new procedures, creating resources for mothers and modifying the facilities. The level 2 nursery is one example. Most of the windows are covered with pictures and quotes. Inside, the space contains only a few beds, and even fewer babies.

Mary Ann Neumann adjusts a baby warmer in a maternity suite. (Photo courtesy of Advocate Trinity Hospital)

“The most important thing is our goal of keeping moms and babies together from birth to discharge, so where you see on TV shows people going to the window and all the babies are lined up in their cribs at the nursery window – we try to do away with that,” Neumann said. “We don’t just send the baby to the nursery so mom can get a nap or things like that, we keep them together and we promote that bonding breastfeeding and family togetherness.”

Such a short trip, though it didn’t cover full array of resources Advocate Trinity Hospital gives women, before and after delivery both within and outside the hospital itself, provided a new perspective into the world of Baby-Friendly procedures and challenges for all the students. Many of them plan to go into the medical field, including Ann Oler, who wants to become a perinatologist, helping high-risk mothers and babies with the birth process.

“This was my first time being in like a labor and delivery ward and like a nursery which is super exciting because that is probably where I am going to end up spending most of my career,” Oler, a Weinberg sophomore, said. “I got emotional while we were there I almost started crying.”

Neumann and Roe said they appreciated being able to promote breastfeeding practices for another audience, expanding the number of people familiar with Baby-Friendly goals.

“I think for everyone to be exposed to what were doing, what we are trying to do with breastfeeding, it would not only normalize breastfeeding to the general population but [also] focus on health from the very beginning of life,” Neumann said. “Instead of trying to take care of it after the health problems start let’s start by preventing.”

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GlobeMed Panel Discusses Health Challenges of the Syrian Refugee Crisis

GlobeMed at Northwestern hosted a panel Monday to discuss the continuing Syrian crisis and its impacts on the health of Syrian refugees as part of its aims to learn about health and social justice issues locally and internationally. The student group invited Sufyan Sohel from the Council on American-Islamic Relations and Dr. Mufaddal Hamadeh of the Syrian American Medical Society for a brief roundtable in Fisk Hall. Professor Peter Locke asked both individuals questions about their work assisting Syrians in the crisis and actions students can take to advocate for Syrians.

Students at the panel enjoying dinner from Mumbai Indian Grill

Students attending the panel enjoyed dinner from Mumbai Indian Grill.

For nearly five years, fighting and unrest has plagued Syria. Hundreds of thousands have died in the conflict, and many more are now displaced, forced to leave their homes to avoid the violence.

According to the United Nations High Commissioner for Refugees (UNHCR), more than 4.9 million Syrians are registered as refugees. Countries like Turkey and Lebanon have taken in the most Syrian refugees to date, but countries in Europe as well as Canada and Australia are also working to resettle displaced people. America’s involvement in helping resettle these refugees has become less certain. Although the Obama administration aimed to increase assistance to world refugees, Trump’s recent executive order banning travel from seven countries including Syria has cast doubt upon America’s dedication to assisting Syrian refugees.

Sohel and Dr. Hamadeh’s firsthand perspectives on the crisis were sobering. Dr. Hamadeh, whose organization provides care for Syrians, said that nearly endless challenges exist for doctors in the country that used to offer citizens a stable health system.

“The regime, and the Russians also, have targeted health care facilities in the war,” Dr. Hamadeh said. There is a deliberate targeting of clinics, hospitals, healthcare workers…using health as a weapon of war. It was used in an unprecedented way in the Syrian conflict and its very unfortunate because it’s led to a total devastation of the health care system.”

Dr. Hamadeh presented slides on the state of health in Syria.

The direct targeting of health care has led to an underground hospital movement, but the doctors still struggle to find adequate resources to care for the Syrian refugee population, which continues to have a high birthrate.

Many refugees understandably attempt to get out of the situation. Working as an attorney in the Chicago area, Sohel deals with the difficulties Syrians face trying to reach America.

“What people don’t understand is the lengthy process it takes for someone who applies for refugee and asylum status before they’re allowed in, an 18 to 24 month process as it is,” Sohel said. “Those who get on a plane and get refuge once they get here, even for them, they’re getting temporary protected status if they qualify and then it’s a multi-year process for them to become citizens so these are individuals who are heavily, heavily vetted by the government already.”

Trump’s recent attempts to ban travel and heighten security will likely make asylum application even more arduous.


Sufyan Sohel discusses the challenges of applying for asylum in the United States

“We’re seeing the real effects of what this executive order created…the empowerment of a lot of our federal agencies to make these anti-immigrant, anti-minority decisions of not allowing people in and speeding into this mentality that certain groups of people are no longer welcome here and that we aren’t this land that is…open for all communities,” Sohel said.

Once in America, things are still far from easy. Though all Syrian refugees are covered by Medicaid, they have few resources and face large amounts of discrimination, according to Dr.Hamadeh.
Locke asked the panelists how Americans, especially students, could make a difference in light of such a negative picture.

“Everybody can do something it can be something simple by donating five bucks or 10 bucks or maybe giving up your…allowance to help a Syrian refugee kid,” Dr. Hamadeh said. “It could be by spreading awareness and talking to your politicians; it could be by volunteering on medical missions or other missions.”

“Share what you are learning today,” Sohel said. “Speak out against injustices and use the power that you have, collectively use your education, use your influence, to really advocate for these marginalized communities.”

With such a bleak picture painted by the presentation, one student asked how it’s possible for humanitarian groups to carry on their mission. Despite the challenges and seemingly insurmountable obstacles to helping all those displaced, Dr. Hamadeh said he believes that organizations will remain optimistic.

“I can tell you from experience…there’s nothing [more] exhilarating and fulfilling than saving a human life,” Dr. Hamadeh said. “When you go there and deal with the people in need and refugees and you see how much relief you give them and what you can do for even one single life you can never stop–you’ll be addicted to it.”

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Participating in the 4th Annual Intramural Global Health Case Competition

Participants and judges of the 2017 Global Health Case Competition.

On February 18, 2017, Northwestern held its 4th Annual Global Health Case Competition (NUGHCC). Graduate and undergraduate students from various disciplines come together and respond to 21st century global health challenges by developing innovative solutions. Every year, a different “case,” is presented: these could range from infant HIV testing in Tanzania to drug crimes in Honduras. The purpose of this competition is to cultivate awareness about the issue as well as encourage creative thinking and interdisciplinary cooperation. The 2017 Competition brought together 30 students from 8 schools divided up into six teams. The teams then presented their solutions to a panel of judges: Kara Palamountain, MBA (Research Associate Professor at the Kellogg School of Management), Sera Young, PhD (Assistant Professor in Northwestern’s Department of Anthropology) and Maxwell Akanbi, MBBS, MSCI (Center for Global Health International Fellow at the Feinberg School of Medicine).

The 2017 case focused on reducing neonatal mortality in Nigeria by adopting widespread use of an antiseptic gel called chlorhexidine. The case was authored by Kara Palamountain, one of the judges in the panel. Infection and sepsis are among the top leading causes of neonatal death in Nigeria, and the umbilical cord is a major entryway to infection. Because chlorhexidine is cheap, locally manufactured and proven to be effective, the goal was to integrate this drug into Nigeria’s healthcare institutions, culture, and maternal care regime. The six teams each developed a range of solutions, from implementing mass distribution operations to launching marketing campaigns.

The winning team was made up of five members: Maria Clark (WCAS), Sedoo Ijir (WCAS), Emmanuel Darko (WCAS), Max Wang (FSM) and Courtney Zhu (Medill).

This year, I participated in the Case Competition and had the experience of being part of an incredibly diverse, dynamic team. My teammates all came from varying backgrounds with different areas of expertise, and my most valuable takeaway was getting to learn from them. Together, we educated ourselves on the issue of neonatal mortality in Nigeria as well as the sociocultural forces that perpetuate this high rate of neonatal death.

After many group meetings and a mentor session with Peter Locke–an Assistant Professor of Instruction in Global Health Studies, we were named the winning team of the 2017 Competition. Our team’s approach centered around the creation of a birth kit, a unified package of essential items necessary for home birth including chlorhexidine. Sustainability was one of our core values: creating a demand for the birth kit and normalizing chlorhexidine in Nigeria’s maternal care culture. The three-year implementation timeline included tactics such as capturing interest of Nigeria’s key stakeholders, establishing a partnership with a non-profit, non-governmental organization, utilizing effective marketing strategies and finally, launching the production and distribution of birth kits.

From this experience, I gained insight into the mechanism of tackling modern health challenges and realized just how valuable collaboration is in a multidimensional field like global health. The Case Competition–in its entrepreneurial and energetic form–gave me knowledge a traditional classroom could never provide. I learned that every global health operation is like a machine: there are many gears and components working simultaneously in motion.

NUGHCC pushes every participant to put their existing knowledge to practice. It encourages everyone to think imaginatively about global health challenges and how to approach them. There is no single “right” answer. Rather, it is through collaborating that real innovation is born.

The Case Competition is co-sponsored by the Program of African Studies, Program of Global Health Studies, Feinberg’s Center for Global Health, Pritzker School of Law’s Center for International Human Rights and the US Department of Education.

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