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Northwestern group helps bring fresh water to Honduras

Members of Northwestern’s student-led movement work in a Honduran streambed.

Getting a cool drink of water, especially at this time of year, is so automatic that most of us don’t even think about it.  It never crosses our mind that the glass is clean and the water is not only clear and tasty, but pure and safe.

Not everyone is so lucky, as the members of Global Water Brigades’ (GWB) Northwestern chapter know well.

“Unsafe water and lack of basic sanitation cause 80% of all sickness and disease worldwide, ending more lives every year than all forms of violence,” says their website.  It goes on to say that more than 90% of these deaths – 42,000 a week worldwide – are children under 5.

At Northwestern, students are doing something about it.

“Every year we fundraise money to take a trip of about 10-15 students down to Honduras,” said Ted Bakanas, co-chair of GWB’s Northwestern chapter and last year’s trip leader.

Why Honduras?

Because it is the poorest country in Central America, and lacks much of the infrastructure that more developed countries take for granted.

“Nearly one-fifth of the rural population does not have access to safe drinking water, and nearly half do not have proper sanitary facilities,” the website says.

Once down there, the group works with Global Brigades in-country staff to help rural villages without clean, running water build systems that will supply it in future.  Usually, Bakanas said, these systems are gravity-based.

Building the system itself is an intensive process that begins with an engineering orientation and a hike to view the village’s water source.  From there, students begin digging trenches, and threading and laying pipe.  Recently, the Northwestern chapter purchased its own pipe-threading machine.  Having a machine on-site to cut lengths of pipe and form the grooves that help them screw together is a huge benefit when doing the projects.

Fundraising is responsible for the pipe-threader, as it is for most of the costs associated with GWB.  Activism is also one of the group’s main pillars.

“We try and do different activism events to spread awareness of the water shortage issues in the world,” Bakanas said.  And these events aren’t limited to here in the United States.

“One of my favorite parts of the trip is the last day we do an education segment,” he said.  “GWB gives us a topic, usually dealing with water, like water and health, and we go into schools in the village and we teach the kids all about water safety and water sanitation.  It’s a fun time.”

GWB is just one offshoot of Global Brigades, an umbrella organization that encompasses medical, business, environmental, law and other branches as well as water, all non-profit. Global Brigades is in Central America, Ghana, Vietnam and India.

The Northwestern chapter is considering an expansion into Ghana in the future.

“But it’s a considerable price jump, so it’s something we’d have to talk about and plan for,” Bakanas said.

In the meantime, preparation for next year’s spring break trip is already underway.

Read more about Northwestern’s GWB here.

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A Q&A with Weinberg’s Thomas McDade

Thomas McDade is transforming the way biological data is collected abroad and in the U.S.

Thomas McDade, Northwestern professor and biological anthropologist, is revolutionizing the way population-based biological data is collected and studied.

Using biomarkers from finger-stick blood spot samples, McDade studies how social and physical environments affect immune function and inflammation, which contribute to the risk for disease. He is also the director of Northwestern’s Laboratory for Human Biology Research where such minimally invasive methods are being further developed.

His research, in places like Samoa, Bolivia, the Philippines and the U.S., is motivated in part by trying to understand how the circumstances in which people live their everyday lives affects their behavior and physiology.

In this edited interview, McDade talks about his research abroad, and how it will have an impact in the U.S.

Where are you currently working, and what is the focus of your work?

Now, my work is focused largely in the Philippines on a study that has been ongoing for almost 30 years. It began with the recruitment of pregnant women. They were interviewed, and their households and communities were surveyed. After they gave birth, both the mothers and babies were followed-up with on a regular basis for over 25 years.

We have a lifetime of information on the social and physical environments that these kids have grown up in, and lots of information about their health and their lifestyles. Now they’re having kids of their own, because they’re in their mid-twenties, and we’re following that next generation. So, we now have three generations in the study.

It’s a really unprecedented resource for understanding how prenatal and early postnatal environments affect the human life course, and human health and physiology, such as the regulation of inflammation in adulthood.

That’s also of particular interest in the U.S. because we’re coming to understand that inflammation may be an important contributor to cardiovascular disease, diabetes and the diseases of aging that we are concerned about.

If we can understand how environments early in life shape the regulation of inflammation in adulthood, we’ll have a better understanding of how inflammation functions, and how we can manipulate it in ways that help us prevent diseases from happening.

You work with biomarker data collection. How is this done, and why is it important?

Biomarkers work is the development and application of minimally invasive methods for measuring human physiology in non-clinical settings.

Right now our understanding of human biology and human physiology is based largely on research that takes place in clinical settings in places like the U.S. and Europe. It doesn’t typically happen in more remote community-based settings because the methods are not amenable to that kind of research setting.

By using saliva sampling or finger-stick blood spot sampling, we can collect biological specimens from large numbers of people at very low cost in remote places around the world.

Why are you using similar research methods in the U.S.?

Instead of relying on a subset of individuals to come to your lab or clinic, you can go to their neighborhood or home to collect blood samples.

So the exact same methods, saliva sampling and finger-stick blood spot sampling, which were developed for places like the Amazon basin, are being used here in neighborhood or community-based settings to understand how stress and diet, or other aspects of an individual’s neighborhood, matter to their health.

What are the main benefits of such data collection techniques?

They really reduce the cost associated with collecting the samples, but they also allow you to get information from a more representative sample of people.

If you want to do a study of how poverty affects health, it’s going to be harder to convince poor people in a really underserved neighborhood to come into Northwestern Memorial Hospital, for example, and give you blood.

But if you can go into their home or community center and just ask for a drop of blood from a finger stick, they’re more likely to give that to you. So you can get information from people who you otherwise wouldn’t be able to access.

Do you have any other projects in the works?

The study that I’m focused on in the U.S. right now is called the National Longitudinal Study of Adolescent Health. It includes over 15,000 young adults in the U.S. with about 15 years of information on their school environments, neighborhoods, individual levels of stress and depression, and the quality of their social relationships.

We have finger-stick blood spot samples from all 15,000 of those people. So it’s the largest ever research application of these methods, and really an unprecedented opportunity to gather rich information on the social and physical environments in which a group of people are living in the U.S. It provides an opportunity to link that information with objective physiological information.

Something else I’m studying, and will write some papers on this year, is why inflammation is so much lower in the Philippines even though they have higher levels of infectious disease.

I think it traces back to their early environments, and ways that the immune system develops in a certain microbial environment that allows it to regulate itself more effectively, and keep levels of inflammation lower in adulthood.

I think the work in the Philippines is a nice demonstration of the value of international comparative research, and how a human physiological system in a different environment gives us some insight into how that system develops and functions in the U.S.

Learn more about McDade’s work, and read recent publications, here.

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Global Health students work to perfect technologies that aid in kangaroo mother care

Eric Liu and Graham Marcy review community healthcare center (CHC) layouts with Professor Kelso during class.

Several students have recently returned from South Africa, where they worked testing various technologies developed for maternal and neonatal healthcare.

As part of the Global Health program, students from various levels – undergrads as well as graduates – are working on developing appropriate technologies for new mothers and babies.  Among the most important of these technologies are instruments designed to aid in kangaroo mother care, a process whereby premature infants are placed against the mother’s chest rather than in incubators.

“We’ve become pretty convinced that it’s the right way to do things,” said Matthew Glucksberg, professor of biomedical engineering at Northwestern’s McCormick School of Engineering. “Incubators are really pretty bad places for babies to be.”

The alternative?

Placing babies on the mother’s chest between the breasts ensures proper temperature regulation for the infant, since this area of the mother’s body automatically adjusts to the child’s needs.  Though an ancient and very natural practice, kangaroo mother care does have its drawbacks.

“The problem, among others, is that this isn’t going to spread until there’s instrumentation,” Glucksberg said.  In other words, there are problems the mother cannot administer to without the aid of technology.

Premature infants can stop breathing spontaneously, for instance.  They need phototherapy for jaundice (the blue light helps bleach out bilirubin, a natural compound that results from the breakdown of blood and can make preemies look yellow).  They need CPAP, or continuous positive airway pressure, to ensure proper breathing.

This is where project development comes in.

“We’ve been trying to build devices that essentially are a neonatal ICU all on the mother’s chest,” Glucksberg said.

The idea, he explained, is to bring the incubator to the mother and child, in bits and pieces.  Since the mother’s chest is such a better place for the infant to be, administering to various needs – proper breathing, blue light, etc. – should happen without separation.

In response to this need, students have worked on testing various products – a blanket that provides blue light, a breathing apparatus that attaches to the infant’s mouth without producing sores.

As David Kelso explained in a recent video live from Capetown, these projects were designed by previous students and some are in the process of being seriously appraised for their viability and market-readiness.

The program, which has been ongoing for the last six years, encompasses other technologies as well.

“What we do really falls into three general areas,” Kelso said. These areas comprise issues of preventing transmission of HIV from mother to child, saving lives at birth and upskilling healthcare workers.

Kangaroo mother care falls into the second category, but the other two are very important in a country rife with poverty and HIV.

The professors and students who work on these projects hope eventually to pass the results off to people within the healthcare system there.  By making sure the devices fit within already-used methods (like breastfeeding or kangaroo mother care), Northwestern’s contributions have a much greater chance of lasting impact.

“We end up building global capacity instead of just coming in and solving people’s problems for them,” said Michael Diamond, adjunct professor in McCormick’s biomedical engineering department.

Diamond, who has been instrumental to the development of student-driven global health efforts at Northwestern, said he believes strongly in the program’s emphasis on self-reliance.

“There is actually a philosophy behind all these initiatives,” he said.

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One drop at a time: Northwestern students tackle water sanitation in a far-flung Indian desert

A few weeks ago, three Masters students left for the remote Thar Desert in Rajasthan, India.

On the docket? Investigating the water that sources 140 villages in the salty, arid desert. As part of the Global and Ecological Health Program, a Master’s-level add-on to Northwestern’s biomedical engineering degree, the program is intended to help students learn to assess and learn from problems firsthand.

This is a skill engineers must learn from the ground up, said Matthew Glucksberg, a professor of biomedical engineering at Northwestern’s McCormick and one of the program’s coordinators.

“You can’t just come in from the outside and expect people to implement your great idea,” Glucksberg said, adding that this is a mistake many make when they are out in the field. “Good solutions are integrated into the way people are already doing things.”

In other words, understanding comes before solutions.

To gain that understanding, the students will be working with the Jai Bhagirathi Foundation (JBF), an organization that oversees these villages. As such, it is geared toward the “ecological, economic and social revival of the region,” according to its website, as well as instituting community ownership and empowering villages to take part in enacting these changes.

One of JBF’s major tenets is developing a water management system that provides clean, fresh water to all villagers. Since rains in the Thar Desert produce only 20-50 centimeters per year, “sweet” water (as opposed to saline) is a precious resource, and often hard to come by.

As this is Northwestern’s preliminary foray into the Rajasthan region, the trip is largely exploratory: what are the problems villagers are currently facing? What secondary problems follow? Which solutions have been tried, and which have not? Perhaps most importantly, what are the primary health concerns?

Diarrhea is a big one.

“A lot of the population doesn’t even know that diarrhea is a problem because they’ve never known anything else,” said Glucksberg. Yet it can be fatal.

Plus, the poverty there is unimaginable, said Kimberly Gray, a McCormick professor of civil and environmental engineering who shares oversight duties with Glucskberg.

The list goes on: water salinity, infectious diseases, bacteria, and fecal runoff from animals and humans.

And all of these problems have been exacerbated by recent population changes.

“These families have lived there for literally hundreds of years and have worked out a very fragile but sustainable relationship with the environment,” said Michael Diamond, an adjunct professor in Northwestern’s biomedical engineering department and president of World Resources Chicago.

Recent government intervention, however, has meant a significant reduction in infant mortality ate. This in turn has meant an exploding population, which the water table is having trouble coping with.

“Our students are starting to do the assessments,” Glucksberg said. “They’re going out to the villages, going to take the samples and do a catalogue to see what the extent of the problem is at this snapshot in time.”

Hopefully these assessments will, over time, provide opportunities to offer solutions. But that is not the main goal, Gray cautions.

“This isn’t just us helping them,” she said. “It’s them helping us in our educational mission.”

Glucksberg concurred, adding that the real goal of the program is student learning. “How do you make your idea stick, and not just leave a bunch of junk in a box?” he said.

Nonetheless, both professors have high hopes for the program.

“My greatest hope is to really develop a long-lasting partnership with JBF such that we can really develop a collaborative learning exchange program,” Gray concluded.

The students in Rajasthan are currently unreachable due to their remote location, but they will return later this summer. Please check back for an update on their progress and an inside look at some of their successes and challenges.

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A Map to Health, Happiness and Long Life

Michael Diamond (r.), here with other members of Northwestern's McCormick faculty, works hard to develop methods of ensuring the health of people at home and around the world.

Michael Diamond’s healthcare debate is a lot simpler than the one in Washington. For him, it boils down to one main question: how do we get available services to people right here at home?

“One of the biggest problems in Chicago is the tremendous disparity in health, not only in terms of outcomes, but also in terms of access,” said Diamond, who is an adjunct professor of biomedical engineering at Northwestern University. His solution to the access problem?

Community health asset mapping.

Though it might sound like jargon, this is actually a simple term: locating and recording the sum total of a community’s health resources.

“It’s not clear where people can go to access their health information,” Diamond said. Many people, especially those of lower socioeconomic status, are not only unsure about where to go on a cash basis or to use Medicaid: they are unsure about where to go at all.

Asset mapping has the potential to provide that information by putting it into a single, accessible database, available to all users. At least, that’s the goal.

Right now Diamond is focusing on two pilot areas in Chicago: Albany Park and Austin.

With Northwestern students’ help and the use of geo-coding, a process whereby he plugs address information into a database, Diamond is slowly but surely building a picture of the combined community resources in these neighborhoods.

Heather Polonsky, an incoming senior and Global Health minor at Northwestern, has been working with Diamond for two years now and has taken an active role in the project.

“It’s about raising awareness about resources that already exist rather than creating new resources,” said Polonsky, who worked in Albany Park to catalogue not only medical offices and hospitals but also grocery stores and pharmacies. Anything with bearing on community well being was recorded.

Polonsky also created a survey, to be distributed this fall at locations belonging to Healthy Albany Park, a community coalition. Its intention is to find out how community members use their services, satisfaction with those services, what they perceive as the most pressing issues in the neighborhood and how they meet a broad variety of health needs.

“Instead of a top-down approach, it’s more of a bottom-up,” explained Polonsky, who said that she’s enjoyed working with Diamond and was glad for a chance to apply what she’d learned in class.

As President of World Resources Chicago, a consulting firm that helps businesses and organizations respond to global challenges and opportunities, and the 2011 recipient of the Institute of Medicine of Chicago’s Public Service Award, Diamond is uniquely suited to combining community and medicine into a functioning whole.

The success of his projects so far relies largely on his cooperation with students, medical professionals, and community and citywide coalitions.

“Michael Diamond has done a tremendous job of organizing and leading numerous constituencies and groups of individuals towards wellness,” said James Galloway, Assistant US Surgeon General.  Through his work with Building a Healthier Chicago, a group dedicated to improving health citywide, Galloway has had ample time to assess Diamond’s contributions.

“Our work has been to expand great work throughout Chicago whenever we see it,” Galloway said, adding that Diamond has been crucial to these endeavors.  “We’ve been pleased to work with him and assist whenever we can.”

Diamond’s success is also a product of his approach.

“In addition to the technology, we have to remember the human element,” Diamond said. “The technology is there to help humans, has to be used by humans, and maintained by humans.”

In other words, if it isn’t working for people, then it isn’t working at all.

Someday, Diamond hopes to have a fully functioning system that will allow people to see the full picture of their health choices. Ideally, this will encourage people to get regular checkups instead of just going to emergency rooms in a crisis, to take their dental health seriously, to eat more nutritiously and exercise, and to fully engage with the health of their families and community as a whole.

Until then, and almost certainly after, Diamond’s work continues.

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