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Presenter Recap: Agriculture, Nutrition, and Health Academy Conference 2019

Posted July 26, 2019 by Guest Bloggers

By Hollyn Cetrone

I had an amazing experience attending and presenting at the annual Agriculture, Nutrition, and Health Academy conference in Hyderabad, India from June 24-28. There were a multitude of opportunities to meet new people, hear about their current work, and exchange ideas. It was a unique experience for me since I was the youngest person at the conference (only undergraduate presenting, let alone attending the conference), but I put myself out there and befriended PhD students, researchers, and policy makers from institutions around the globe. People with backgrounds in economics, agriculture, nutrition, and policy from over 30 different countries all came together to exchange ideas, share current best practices and project results, and discuss how we could come together to overcome barriers within the field of food systems.

I was lucky enough to have my abstract on a nutrition and agriculture project’s impact on women’s depression be accepted for an oral presentation at the conference. I had been working on this research since last summer, when I went to Singida, Tanzania for data collection, and have since been analyzing the data and working on turning it into a manuscript. I was nervous to be presenting my findings to a room of the world’s experts on agriculture and nutrition, so this opportunity at the conference allowed me to practice public speaking in a high-pressure environment. I was happy to learn that the academic community within this field is friendly, and I received comments from people who I hadn’t met before on how much they enjoyed my presentation. I definitely gained confidence from this experience and learned that there is good that can come from being comfortable with being uncomfortable.

In addition to presenting, the conference had two of the five days dedicated to “learning labs”, where conference attendees could sign up to have hands-on learning for new metrics and tools within the field. I signed up for labs like “Managing trade-offs: Methods and Tools for Policy Decision-making” as well as “System Dynamics in Researching Markets for Nutrition”, among others. From these learning labs, I learned not only content, but also what public health job opportunities existed, since I am interested in the intersection of research and public health policy. Unique from other members in the conference, one of my goals was to learn what a career in public health could look like. So, hearing individuals share their current projects at different institutions allowed me to do that.

I am thankful for the Program in Global Health Studies funding this opportunity and allowing me to disseminate my results to a community that appreciated hearing them and can apply my findings to their own work. I was able to apply my previous global health and research topical knowledge from Northwestern classes to real-world application discussions, so this was a valuable experience. This opportunity will help me in my future public health career, since I now have expanded experience with public speaking and conducting scientific conversations with leaders within the field as well as have deepened my knowledge base for the subject area of my research. I am grateful for the people I met during this conference, and the network I now am a part of.

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Presenter Recap: American Society of Nutrition’s Annual Conference

Posted July 10, 2019 by Guest Bloggers

By Sam Balka

Thanks to the Program in Global Health Studies’ Special Grant Funding, I had the opportunity to attend and present my research with Dr. Sera Young’s research group at the American Society for Nutrition’s annual conference in Baltimore, Maryland from June 8-10. For the past year, I have been working with Dr. Young and the newly hooded Dr. Santoso analyzing qualitative data from a nutrition-sensitive agricultural intervention in rural Tanzania, the Singida Nutrition and Agroecology Project (SNAP-Tz). Within my research, I have been looking into the benefits that a participatory monitoring and evaluation approach, which we call participatory dissemination, had on the results of the project. This work is what awarded me an oral presentation slot at the conference, where I summarized the results of our research, and advocated for uptake of the practice in attendees’ own projects.

Because my presentation was on the second to last day of the conference, I had ample time to explore the work of others. A conference on nutrition has a number of specializations within it: community health and research, obesity, nutrition and breast cancer, etc. With my passion for the intersection of health and the environment, I found myself drawn to sessions categorized under Climate/Environment, Health, and Improved Nutrition (CHAIN). I found the conversations really interesting surrounding this sector, including the challenge faced by professionals in these fields that emerges from such a variety of different working backgrounds coming together, and struggling to communicate between disciplines. Also illuminating was discovering the politics within the field. At the conference, a surprising number of speakers were sponsored or funded by various corporations or lobbying groups such as Nestle, Pepsico, or the National Dairy Council. It was astounding to me the kind of bias that went into so much of the presented research, or to hear an entire session with a speaker from California’s Department of Agriculture trying to convince the audience that meat production does not have a negative impact on the environment. It was eye-opening for me to recognize the amount of differing beliefs that can exist within a single, science-based field.

The oral session that my presentation was a part of was titled Public Health Nutrition Interventions in International Settings. Being the only undergraduate presenting orally in the session (and also at the entire conference), I was definitely fighting a case of imposter syndrome. Nonetheless, after my fifteen minutes of presentation and questions, the feedback on our work was the highlight of the conference. Numerous practitioners approached me to inform me of their intentions to incorporate this kind of work into their next project, and expressed interest in following up with me down the road to ask questions on SNAP-Tz’s methods. The presenter right before me also shared that we would have a guaranteed citation of our paper upon its publication to back up her research team’s decision to disseminate their work in a similar way to us.

Because academia can often become insular, and sometimes lose sight of the greater reasoning behind publishing papers and producing knowledge, it was refreshing to spend three days in an environment where it was all about sharing, absorbing, and discussing knowledge. I am so thankful for the Global Health Studies for helping me attend this conference. At Nutrition 2019, my passion for food security and environmental health was enriched, and my research for the past year was reinstated with purpose and intention.

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Kim Simplis Barrow and Cancer Prevention in Belize

Posted May 31, 2019 by Haley Lillehei

I graduated from Northwestern in 2014 and moved to the Bay Area where I currently work in health tech at a company called Collective Health. I recently reached out to the global health blog to see if I could cover some of what is going on in the Bay Area global health scene to stay connected to the Northwestern community. I attended an event a few weeks ago where the UCSF Helen Diller Family Comprehensive Cancer Center, the UCSF Institute for Global Health Sciences, and Global Oncology hosted Mrs. Kim Simplis Barrow, the First Lady of Belize, for a talk on global cancer prevention and thought it would be a great opportunity to share what I learned.

The talk began with an introduction by Franklin W. Huang, Assistant Professor of Medicine in Hematology and Oncology at UCSF and founder of Global Oncology, a non-profit comprised of physicians, scientists, and other professionals with a goal to bring the best in cancer care to underserved populations throughout the world. Dr. Huang spoke about some of the projects Global Oncology has worked on, ranging from an educational comic book on HPV and cervical cancer to thegomap.org, an online network of cancer-related projects. Earlier this year, Global Oncology opened the first public oncology unit in Belize, which is how Dr. Huang originally became connected with Mrs. Barrow.

A lot of global health and non-profit work focuses on communicable diseases. While those are important issues worldwide, I was surprised to learn that cancer actually kills more people in low and middle income countries than HIV/AIDS, tuberculosis, and malaria combined. In those countries, cancers that are usually easily diagnosed and treated are often deadly. According to Dr. Huang, there are many reasons why cancer is such a big issue, ranging from lack of awareness to limited resources that make it difficult to prioritize preventive or diagnostic care. Belize, with a population of about 375,000 people, shares many criteria with other low and middle income countries that makes cancer a widespread issue. 41% of Belizeans are below the poverty line and may not have access to primary care or other ways to detect cancer. Because of this, 44% of patients who receive cancer diagnoses at Karl Heusner Memorial Hospital (KHMH), the main public hospital in Belize, are at a stage IV diagnoses, meaning cancer has spread to other organs or parts of the body. Cancer that is treatable at stage I is much more difficult to cure at stage IV.

Due to the prevalence of late-stage cancer in Belize, the issue is close to Mrs. Barrow’s heart. She has spent a large portion of her career advocating for women and children through her role as the Special Envoy for Women and Children and as the founder and director of the Lifeline Foundation, a charity trust relief organization which “collects funds from the community and manages these funds, using the income to deliver food, medicine, clothing and other necessities to children who lack these essentials due to hunger, poverty or natural disaster.” While cancer does not solely impact women and children, the cultural climate can make it more difficult for women and children to get diagnosed or receive care.

Mrs. Barrow began her presentation by telling us the story of Maria, a mother of four who was diagnosed with cancer at the age of 45. Maria’s story highlights some of cultural stigma associated with the disease. Due to her diagnosis, Maria’s husband left her and she struggled to make ends meet and take care of her children, let alone pay for treatment. Maria passed away from a preventable and treatable form of cancer. Mrs. Barrow was extremely touched by this story, and it is has helped her come to understand both the magnitude of cancer in Belize and the vast number of undiagnosed or unreported cases that likely exist, making the number even higher. Not only is cancer already the leading cause of death in Belize, the number of cancer diagnoses is predicted to double by 2030.

Mrs. Barrow is a cancer survivor herself. In 2011 she was diagnosed with stage III breast cancer. As she went through the emotionally and physically challenging treatment process, she realized the degree to which her privilege and position gave her access to the care she needed. She was seen right away at KHMH and was also able to fly to Miami to get better care than she could have received in Belize. While Mrs. Barrow was thankful for her treatment and care, she was frustrated by the understanding that without her privilege it would be extremely difficult to access.

I imagine it would be easiest to privately focus on your health while going through treatment, but Mrs. Barrow realized she had a unique opportunity to put cancer care and prevention in the public discourse. She recognized there was misinformation and shame associated with cancer in Belize, which was one of the reasons cancer was taking so many lives. As she went through chemotherapy and lost her hair, she made a conscious decision to not wear a wig. She turned her cancer treatment into a message to the people of Belize: cancer is not something to be embarrassed about, as it could even affect the most important people in their country.

It was inspiring to hear about Mrs. Barrow’s personal journey and how she used her story to fight cancer’s stigma, but her work with cancer didn’t end with her recovery. She realized that while part of the problem is the lack of awareness she fought by making her cancer public, there is also a resource issue. Most people in Belize do not have health insurance, presenting a major barrier to care. Through a partnership with Global Oncology, she has worked on increasing access to cancer care in Belize, including opening the first oncology unit at a public hospital, KHMH. This new outpatient cancer treatment facility is making mammography and ultrasound services available to many people who were not able to go to a private hospital.

While the new oncology unit will increase access to care, it also highlights some of the economic inequalities of cancer screening. Not only can it be difficult to afford something like a mammogram, it can also be extremely challenging to travel to get to the one public imaging location. Furthermore, a lot of women in Belize are economically dependent on men. As highlighted in the story Mrs. Barrow shared about Maria, some men even leave their wives when they learn of a cancer diagnosis, putting them into a situation where they may have very little or no resources at their disposal. Even if that is not the case, a woman may have to decide whether to spend her limited resources on her children or herself. If she does not have a lot of awareness about the importance of cancer prevention and early diagnoses, it may seem relatively unimportant for her to spend the time and money to get a mammogram when she could instead spend the money on food or education for her children.

After Mrs. Barrow told her story, the room opened up for discussion. It was filled with UCSF students, medical professionals, and faculty who had interesting questions and ideas about how to increase cancer prevention and awareness in Belize. There was a woman who worked with Spanish speaking populations in San Francisco who mentioned she faced some similar issues in trying to spread cancer awareness in that group. There was also a radiologist who specialized in mammography who wondered if a mobile mammography van could help more women access mammograms without having to travel to KHMH. I’m excited to continue to follow Mrs. Barrow and Global Oncology’s work in Belize and see if any of the suggestions from the talk become implemented in their collaborative work.

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Student Reactions to CUGH 2019

Posted April 10, 2019 by Guest Bloggers

Each year, the Consortium for Universities in Global Health (CUGH) hosts their annual conference, uniting global health practitioners from around the world in discussions of global health issues. CUGH’s 2019 conference, “Translation & Implementation for Impact in Global Health”, was held in Chicago and co-sponsored by Northwestern University, Universidad Peruana Cayetano Heredia, the University of Chicago, and the University of Illinois at Chicago.

A few GHS undergrads were able to attend the conference and hear from doctors, journalists, researchers, educators, and international aid workers. Below are reactions from students on moments that were particularly impactful over the course of the weekend.

I am so lucky to have had the opportunity to attend CUGH, it was definitely an experience I will never forget. Perhaps my favorite part of the consortium was the Pulitzer film festival that took place Thursday night. I was lucky enough to apply and get a free ticket to the video showcase. When I first arrived, I signed in and started talking to many of the other people there. Most of the people I talked to were professors who were studying maternal health. They also were heading to the festival and we walked up together. Initially, I felt very out of place because I was the youngest student there.

However, when the presentation began, I felt instantly at home. A woman from the Pulitzer center in D.C. began the talk by explaining how they fund individuals to make short documentaries all over the world. In fact, they often work with the Medill School of Journalism, right here at Northwestern.

I have no words to describe the short-films I saw. They were inspiring, emotion jerking, and just plain real. The topics discussed included a wide range, from the leather industry in Bangladesh to the Indonesian War on Drugs. After the films were over, we even got to have a Q&A session with one of the directors. In her video, she discussed life inside Yemen and even visited a ship that was trapped for two weeks out at sea because there was no place to dock. It was an amazing experience seeing the woman on the screen right in front of me.

Over the next few days, I was lucky enough to talk and network with some of the smartest people I have ever met. The best is when I found common ground with women and men alike from completely different countries, all through global health. I am so honored that I was able to go to CUGH 2019 and hope students are given the chance again in the future.

–Sydney Bernstein (McCormick)

I am so very grateful to have had a chance to attend this year’s CUGH conference. It was amazing to be in the room with some of the same authors and researchers who have contributed to some of my favorite articles. I was able to explore subfields of global health that my education had not really exposed me to yet. My favorite panel was Gun Violence in the Americas. Gun violence is always a difficult subject to talk about, but this discussion was necessary to see how gun violence is actually a health epidemic, not just a policy crisis. Learning about the role that the United States plays in fueling the gun epidemics in countries other than our own— because of our intense gun production and smuggling industry—

just provided more insight into how big of a public health crisis the American gun violence epidemic is. The panel dove into the fact that gun violence is not just a health problem in the toll it takes in emergency rooms, but also in the impacts it has on the mental health of entire populations.

This panel helped me to engage with the overlap between health issues and political crises. I hope to be able to take everything I learned at the conference into the classroom for the rest of my time at Northwestern, as both an undergraduate and as an MPH student. These lessons are very applicable for me to use to make a difference in the real world.

–Amanda Rosner (WCAS)

One breakout that I found particularly fascinating during the CUGH conference was a debate between Stephen Luby, a professor of medicine at Stanford University, and Agnes Soucat, the Director for Health Systems at the World Health Organization. The pair were debating a resolution that stated the global health field should be prioritizing existential threats over more proximate health concerns.

Going into the session, I was not sure where I stood on the resolution nor did I fully understand its implications. However, as I listened to these leaders in their fields express the fears they have regarding the future of healthcare, I became extremely invested in prevention. For example, Luby believes in focusing on existential threats because it is his understanding that if humanity follows its “cataclysmic trajectory”, our species will be extinct by 2100 due to potential threats such as ecological destruction and climate change, synthetic biology, and nuclear war. On the other hand, Soucat believes in prioritizing proximate health concerns such as pandemics and adjusting human behavior because focusing simply on existential crises takes away from that of the individual.

While I found both of their arguments very compelling, I was actually most struck by a member of the audience who shared their input during the Q&A portion of the debate. This person said that addressing existential threats and addressing present threats actually go hand in hand; therefore, the resolution was really a moot point. They used the example of decreasing coal usage to illustrate their stance: if we decrease our coal usage, then air pollution will decrease, which helps prevent ecological disaster and health complications from lung irritation. This action is working towards both existential threats and proximate health concerns. In response, Soucat mentioned the importance of consideration of equity. That is, these goals can only be accomplished through coalition and said coalition cannot be achieved without equity first. No country nor individual will commit to a proposal without a feeling of validation and equitable treatment as indicated by the Yellow Vest Protests in France. When the French government attempted to skyrocket gas taxes as an incentive against fossil fuels, the suburban and rural areas violently protested such a change as inequitable: since these people rely on their cars for travel and the wealthier urban dwellers do not, they did not feel as though the wealthy were making the same sacrifices for the climate change efforts as they were asked to do. The proposal ultimately failed. From these words I began to understand that regardless of whether a threat is existential or proximate is not really the main focus in determining a solution. The focus must be on collective and collaborative action that leads to the building of equitable institutions and a shared common destiny. I am currently planning on pursuing a career in health policy analysis so these sorts of revelations are extremely valuable to me. I find that social determinants of health and equity are just as important as economical and logistical considerations when shaping policy, and this debate simply made this concept less abstract and more concrete . I am extremely grateful to have been able to hear such influential scholars in the global health field speak both during this session as well as the other breakouts.

–Emma Latz (WCAS)

On Friday evening, I attended a session co-organized by the Pulitzer Center and Global Health NOW called, “How to Tell Your Global Health Story”. The event gathered a diverse panel of veterans in the field of public health, a physician-journalist, and an award-winning science journalist. The intersection of medicine and journalism has taken me years to navigate, but this panel clarified just how inextricably connected these domains are. It was empowering to be in a roomful of people who believe in advocating for patients and recognize storytelling as a way to do so. This snippet of my weekend at CUGH is fairly emblematic of the whole conference: it celebrated the multidisciplinarity of global health. The diversity of backgrounds, ages, and disciplines that gathered in Chicago for the 10th Annual Conference is a statement in and of itself. One of my favorite conference pastimes was perusing the Research Exposition. These projects—ranging from investigating the utility of South African Triage scale for predicting emergency room outcomes in Ghana to assessing primary care capacity for cardiometabolic disease prevention in Vietnam—opened my eyes to what issues are most pressing in today’s global health landscape. I was amazed by the various forms of methodology employed by these researchers, as well as the scale of these undertakings.

As a graduating senior, entering the professional world of “global health” is a bit of a mystery. The field is rapidly growing, and I’m still learning how I will eventually fit into it. Indispensable to my global health journey has been Northwestern’s Global Health Studies department, which has supported me so much over the years. Opportunities to attend conferences like CUGH have given me more clarity on what I envision my future in global health to look like.

–Courtney Zhu (Medill)

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Is Nyquil a Form of Birth Control?: Health Education in Chicago Public Schools

Posted January 14, 2019 by Ruthie Charendoff

While teaching a health workshop at Rickover Naval Academy (a Chicago Public School) one of the students asked me “what does sex stand for and where was it first used?” Other questions and comments that other volunteers and I have received while teaching these workshops include, “I heard Nyquil is a form of birth control because it puts your sperm to sleep.” and “What is a period?” I was shocked to receive these questions and comments from 15-year old high school freshmen. How have our health education systems and infrastructure failed us so miserably that high school students don’t know what a period is by the end of ninth grade?

At the same time and in the same classrooms, I received the following questions and comments, “how can you stop someone from raping you?”, “I want to learn when and how to ask for help.”, “Are there male contraceptives?”, “How do I have a healthy relationship?”, and “Will having sex impact the feelings of family and friends in a positive or negative way?” The variety of these questions clearly shows the different headspaces that each of these students are in. Some students still don’t understand what menstruation is while others understand the physical aspects of reproduction and sex and want to learn about the emotional side. Some students are scared to talk about it, some are excited, and others are shy. Some students have never kissed anyone while others have had various types of sex with multiple partners.

While CPS mandates that high schoolers get 675 minutes of sex education each year they often don’t have the manpower or resources to ensure that this education is effective or even to check if the 675 minutes are met at all. Teachers are often overloaded already and the one or two sex educators or health instructors that schools may have on staff often don’t have the time to teach comprehensive curricula to the hundreds of students in each grade. This is where Peer Health Exchange (PHE) comes in. PHE is a national organization based out of several larger cities across the US with the mission to empower young people with the knowledge, skills, and resources to make healthy decisions. To carry out this mission, PHE trains college students to teach health workshops to ninth graders to fill in the existing gap in health education in these schools. At Northwestern, 85 student volunteers teach a series of 14 workshops per year in six public high schools in Chicago. Workshops cover everything from alcohol use to mental health to healthy relationships. Using a near-peer model (university students are only a few years older than the high schoolers we work with) often makes it easier for students to relate with their teachers, particularly around health issues.

But this isn’t enough. This summer, the Chicago Tribune uncovered massive problems of sexual abuse and assault in CPS. As a result, there was a system-wide overhaul, finding that multiple teachers were accepted into CPS despite having histories of child abuse. CPS students shouldn’t face prejudice and abuse regarding their sexual orientation and gender from other students, staff, and faculty members. Instead, school should be a safe space for students where their basic needs and rights are served so that they can learn without fearing for their safety. At a minimum, this should mean students being able to walk around without fear that their teachers may take advantage of them and that their questions about their health will be answered appropriately and with scientifically-correct information.

In Peer Health Exchange, we are trying to do our part to address the education piece of this puzzle. We are constantly adapting our curricula and our teaching methods to make sure we are being as inclusive as possible in the classroom. This means acknowledging and teaching about health that affects all types of people, people with different ability statuses, races, gender, religions, etc. This year’s curriculum explicitly includes images and stories of people of color and people with disabilities in an attempt to follow health education best practices and as a result of the feedback we have heard from students. As we think more critically about our role in the classroom and how it affects the students we work with, CPS must continue to do the same. CPS students deserve a comprehensive health education and a supportive school environment. Hopefully the steps being taken by PHE and now CPS are just the beginning of what will be an environment that students can feel safe and thrive in.

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