Private Sector – Making it work for the people

I steered away from business classes in college, and am still far from being business savvy, but the need for private sector involvement in global public health issues is undeniable. It seems as though the key issue here is creating the ability to reach an integrated relationship that builds on mutual trust, the kind Dr. Shahi expresses in his lecture. Equally important is the ability to recognize opportunities and being ready to jump on board while convincing others you have a solid profit building idea while valuing the social impact more than potential generated profits. This social entrepreneur ideology isn’t easy to come by, especially when profit driven Corporate America focuses primarily on profit margins. I like how Jordan’s presentation highlights the importance of collaboration between partners, not only to generate profits, but for a general betterment of global health that in essence is essential for international economies. Establishing this relevant interconnectivity between health and business is essential to the improvement of both.

Healthcare as a right for all

The recent experiences I have encountered with my boyfriend’s spinal cord injury have brought personal light to the fact that good health insurance coverage although somewhat of a luxury in this country is essential to get adequate health care. Healthcare expenses are so high, and in countries that are fortunate enough to have up to date technology that can benefit the patients, access to that care may be hard to come across. Although wellness and health expenditures do seem to be correlated more governmental spending does not always ensure quality healthcare as we sometimes see in this country. Although the US is the highest healthcare spender worldwide, some would argue that we do not have the best healthcare system. Other countries with well established ethics, stewardship, and health goals can manage to produce better health outcomes and provide more equitable healthcare with less personal and governmental expense.

The healthcare costs in California can be reformed by the proposed single payer universal healthcare system. The system seems promising, ensuring proper healthcare for everyone, and cost effective at the same time. The proposition highlights something that I am a big advocate of: quality healthcare is a right, not a luxury… check out this proposed reform at onecarenow.org

Response to Disaster

Public health is all about prevention, but it is equally essential to be well prepared for emergency/disaster situations since they cannot always be prevented. Airport security/safety is a great proponent of this prevention. The technology we have available allows for screening of explosives and other weapons. Something we face with increases in technologies is more advances threats. Bioterrorism and infectious disease outbreaks has become an issue that is difficult to control with the traditional methods. I recently heard about an Ozone machine that cleans the air in hospital rooms. One hospital that has used it for two years has not seen one case of staff infection since they started using the machines. Such machines also propose to be useful in killing/preventing the spread of infections on airplanes. With the potential of an avian flu outbreak, and the increased threat of bioterrorism, such machines that can detect viruses in the air and contain them in order to prevent a further, detrimental spread could be very cost-effective and beneficial in preparing/containing a disaster.

Controlling the financial issues associated with natural disasters seem to be just as important as the infrastructure system in place to react to the disaster. To take Katrina as an example… I was living in Houston around the time all the evacuees were sent to the area and directly witnessed the despair and inhumane conditions the victims of the hurricane encountered. The streets were filled with homeless evacuees and the shopping centers were surrounded with people asking for food, money, and housing for the night. The unemployment that followed the disaster, as is usually experienced in such cases did not have to reach such critical levels. The disaster itself created great job opportunities for people to rebuild their own community, both making it easier for them to sustain themselves as well as provide them with a feeling of ownership and ability to take back what they knew as home.

Surfer's Meylopathy

As some of you may have noticed I have been absent from class since spring break. Although this is not particularly relevant to the week’s topic, I wanted to share my story with you and hopefully prevent this from happening to any of you or your loved ones in the future.

My boyfriend, Joe, and I went to Hawaii over spring break for a wedding and decided to stay some extra days to enjoy the sun. The morning after all the wedding festivities were over we went surfing on Waikiki. I had been surfing a few times before, but this was Joe’s first (and unfortunately last) time. Joe suffered an extremely rare and scarcely studied injury called "surfer's myelopathy". There was no "accident" in the sense of a bad fall or crash. He was simply laying on the surfboard stomach-down look up for waves, paddling and standing up on the board. He was a great first time surfer, he caught the first four waves! Somewhere in that flow of movements, he apparently cut off blood circulation by hyper-extending his spine, resulting in a severe spinal cord injury. The paralysis took about 6 hours to fully set it. We had not idea it was as serious as it turned out to be. After surfing, we stopped by the lifeguard station because both of us were pretty badly cut up by the reef, I had a cut on my foot that was almost "stitch-worthy", and Joe had a sea urchin stuck in his foot. We got all that taken care of and we both limped back to the hotel room. We went to a Mexican restaurant to catch lunch and drink margaritas to make our pains go away. The pain in Joe’s back, something he thought was normal for a first time surfer using muscles not normally used, was beginning to concern both of us so we went to the on call hotel doctor. He immediately diagnosed Joe and showed grave concern for his condition, he was rushed to the hospital in an ambulance and was taken to get an MRI. The MRI showed severe swelling of the spinal cord from the mid thoracic (around T6) all the way down to the lower lumbar. Joe’s mobility and sensation in his legs slowly dissipated throughout the day, until he lost all mobility as well as pain and temperature sensation.

We spent almost two weeks in Hawaiian hospitals, getting the minimal care that a spinal cord injury patient needs, until he was transferred to Craig Hospital (great rehabilitation hospital specializing in spinal cord injuries) in Denver where we currently are. Despite the lack of improvement in his condition and the lack of available treatment or research provided by the doctors this last month, we are still hopeful. There is no real prognosis for this type of atraumatic injury, so we are just waiting, and being patient.

I wanted to share this story with you in hopes that you can pass it on to anyone you may know that will be trying surfing out for the very first time. Through this I have learned that the doctor who has seen the most cases of this warns first time surfers to stay in the water for only 30mins and to come out of the water immediately if they experience any lower back pain. We have been told that Joe’s condition would not have been as bad if he had come out of the water when he first experienced the pain in his back. Hopefully, this challenging experience that we have been confronted with will serve as a tool to help prevent future cases.

Thanks for taking the time to read this. Hope the rest of the semester goes well for all of you!

Health Improvements with New Technological Innovations

The Disease Management Strategies (DM) described by this week’s case study highlight interesting components of both the needs of our society and the ability we have with new technologies to aid in producing more productive and effective care. Many of the programs described have found cost-effective ways to manage patient health and address the needs of our aging population. The added management has helped patients control chronic diseases and as a result has saved a substantial amount of money that would have been spent to treat the patients individually. The patient centric, individualized care has brought a much needed focus to a personal responsibility that patients themselves need to address. Using various routes of program dissemination, such as other allied health workers besides doctors and implementation of technology use helps promote healthy, preventive aims for the patients that in turn have positive effects for all stakeholders involved. Disease Management sounds like a wonderful alternative to the way medicine is currently delivered; I know some of my elderly relatives could stand to greatly benefit from it.

Importance of Sanitation

Water sanitation as we have known for many years and was demonstrated by the broad street pump and cholera outbreak many years ago in London, is essential to the health and well being of the community. The readings and videos for this week make one thing clear, far too many people in this world lack adequate sanitation. It is no wonder why children are sick and are forced to miss school when their water system is contaminated by their own human excrement. I’m sure as we all know, our case study, http://www.un.org/esa/sustdev/csd/csd13/documents/bground_2.pdf points out that “Access to safe drinking water is a basic human right and essential for achieving gender equality.” When women have to travel several hours to get water, and then several hours back as they carry the water barrels on their backs, they are deprived of any potential promise of an education, and are continually subjected to multiple health hazards. The lack of healthy water not only posses a health risk to the entire community, but these societal norm have caused grave gender inequalities. Good, healthy water is an essential building block for all other health and wellness concerns; therefore, knowing that good water sanitation is part of the MGD’s is a start to alleviating the burden some of these developing countries are facing.

Addiction and Mental Health

Due to the large negative stigma that comes along with mental health, many people would not often consider addictive behavior as a mental health concern. Although some societies have made it acceptable to consume large amounts of alcohol, the acceptance of such behaviors does not dismiss the fact that addiction is a serious issue in many societies. As we saw from our presentation last week on the mortality of men in the former USSR, drinking has been hammered in as a significant part of the culture. Imagine sitting at a table with one other friend and feeling compelled to finish an entire bottle of vodka in order to avoid being impolite. Does this remind you a little of those good ole’ college days. During my undergraduate degree, I went to a school that praised drinking, lots of it… at tailgates, at dorm dances, at the bars that would let anyone in with a fake id. My friends and I all took advantage of this new independence one often finds in college and loved every minute of it. Like the Russians, college students binge drink, and may think it rude to leave a bottle unfinished. However, for most college students this behavior ends when college ends (or possibly until a reunion with your college friends at the next season’s football game). For others, the behavior known to them as a good time in college haunts them for the rest of their lives. Liver damage, prolonged alcohol abuse, inability to simply be a social drinker, AA meetings… I had a friend in college once tell me that her dad (an alum from the same school) was in AA, he would travel all over the country for work and would attend meetings wherever he was. Apparently, he found fellow alumni at every AA meeting he went to around the country… scary hu? So my point is, when a society makes something socially acceptable it is not viewed as a mental health issue, but when something is viewed as crazy (Britney Spear shaving her head perhaps) the action is ostracized. Do we need to make anxiety disorders, personality disorders, psychotic disorders as acceptable as alcohol consumption in order to make them less stigmatized? Or do we need to add a harsher stigma to addictive behaviors to emphasize the need of recognizing them as mental health issues as well?

Agriculture, Malnutrition, and Obesity

Our case study this week focuses on the importance of agriculture for implementing and reaching the MDGs. It seems very effective to address the vast poverty and malnutrition problems as the true interrelated issues that they are. It also occurred to me, as I was reading the case study and watching this week’s videos that an increased and developed agriculture industry in the developing world, would not only allow the local communities to flourish, but could also help with the increased obesity trends. Fatty foods are mass produced, causing them to be less expensive than fresh produce, so if the agricultural sector of these developing nations could be opened wide enough, and use free trade to their benefit, an increased amount of healthful produce can result in lower fruits and vegetable prices around the world. As a result, this would not only address the issues of malnutrition by providing both food and profitable revenue for the developing communities, but focus could also be redirected for the populations with high obesity rates to adopt healthier lifestyles at a lower financial cost.

Do we have to pick a battle?

Going through some of the class readings as well as my personal research for my review paper, the importance our 2nd week’s topic, Globalization, really has on everything we do in global health has become more visible. The impacts of globalization are so wide spread that they affect everything from the neglected diseases Mana talked about in her presentation, to the rise of human trafficking demands, and cardiovascular disease around the world. Globalization not only brings about countless of both positive and negative changes in developing countries, it also substantially increases the amount of interconnectedness around the world. As we learn about all the problems that affect people’s health, it becomes easier to see how everything and everyone is interrelated. This also brings about added challenges. How can we address ALL the pressing issues that are pertinent to global health? Do we have to pick some battles and leave others out of the fight? We are taught to look out for the well being of the global society, but is it possible to address everything? The increasing CVD in Russia, TB, Malaria, HIV/AIDS in Africa, the neglected diseases, the corruption, the plight for the poor, etc.? There is so much to be done, it can be overwhelming… it almost seems like in order to make a dent in any issue you have to pick one and accept that you are going to be indirectly ignoring the rest. Maybe by increasing our awareness of how truly “global” these problems are, we can pick our battles to include every individual and become global specialists that start looking at everything through a macro lens.

Koro, it may seem crazy at first but...

Koro, the belief that the genitals have been stolen or are shrinking, stuck me as a bit outrageous and unbelievable when I started reading about it. As I got further along in the article I realized that it makes complete sense for the thought of a stolen penis to be related a potential religious/cultural belief along with some psychological disturbance or disorder. As a psychology undergrad major, this should have been my first reaction to such an absurdly seeming topic. This realization was later confirmed by the article, and a possible association with Body Dysmorphic Disorder was also addressed. One of the reasons I enjoy global health is because it is completely multidisciplinary and we need to address each problem, disease, or disturbance we face in public health as such. It seems imperative to remember that psychology, sociology, medicine, economics... I could go on and on... play such a strong role in the way we perceive and fix problems. We need to keep our minds open and allow not only the knowledge and skills we have attained lead us to a solution, but most importantly, our creativity needs to take hold when we encounter situations that may seem a little absurd at first.

How can we stop the Avian Flu?

After class yesterday I kept thinking about how much money has gone into the war in Iraq (as mentioned by someone in class during discussion) and how the attention the threat of avian flu has gotten has paled in comparison. As I opened my browser this morning I noticed that Bush plans to invest additional billions of dollars into Afghanistan and thought to myself again... what about the pandemic that the WHO, MARSH, TED Talks, and so many other health officials/agencies are warning us about. The mutation of the H5N1 virus seems inevitable, but the disastrous events may be minimized if we are well prepared for it when and if it comes. We need to educate the public about the threat and give the possible pandemic the attention it deserves in the media by providing current and correct information. By limiting the misinformation out there, and increasing the awareness of the threat, people may be more responsive when the need for a control measure becomes necessary in the event of a pandemic.

Week 3

Video: Epidemics and Pandemics
"Early detection, early response" says Larry Brilliant is the key to the world's control of pandemics. His experience and success eradicating Smallpox sheds light on the possibilities of the eradication of Polio and containment of Bird Flu...

Just some other thoughts that came about during the video: What about the eradication of HIV/AIDS in the future? It is difficult to get communities involved in health care issues, especially when it goes against their beliefs, as he talked about cases in India. By using the rewards they gave as incentives, the community was encouraged to report cases of Smallpox, and it was only until then that a good handle on the disease could be attained. If an organization is created/improved that is large enough or strong enough to implement part of the same framework and put it to use for HIV/AIDS detection, the possibility of its eradication may not be so unattainable. I am aware of confidentiality laws, especially in the United States that some could argue would be breeched by giving incentives to disclose HIV/AIDS status... Not only does work have to be done to change the stigma attached to this disease, but health care professionals could benefit from working with the law to implement changes that would work towards the containment and eventual eradication of it.

Video: AIDS Orphans
I spent last year working for the only non-profit foster care agency in Houston, TX that never turns away an HIV+ or HIV exposed child... and this hit so close to home. I broke out in tears the second the video ended. This is so sad, and so true. It is sometimes overwhelming to watch something like this and not know what one can do about it. I have seen and lived the sadness that comes from homes that have been torn apart by HIV and AIDS... I came close to adopting the most precious child you could ever see, hug, or love who just so happened to have vertically contracted HIV... but then I realized that although I could possibly change her life for the better (and not without challenges) my life's road trip would not lead me to where I had always envisioned, so instead, I detoured to this Public Health program and am now a hopeful, and perhaps naive student that has a deep desire to promote change... but I know that I have "one life", a healthy, privileged, motivated life that I can use to make a substanitial imapct on the world... I just need the tools to guide me.

If you haven't already, please watch this... and let’s do something! World Vision: AIDS Orphans

Case Study: Avian Flu
The first time I heard of the Bird Flu, I was terrified… It was 2 years ago during my senior year in college. I read an article online on MSNBC and showed up to my Senior Seminar in Peace Studies eager to talk about it… My very knowledgeable professor stopped me in my tracks, telling me there was no need to worry since there was, at the time, no known evidence of human-to-human transmission. Although his statement had some truth behind it, my professor’s remarks did not put me at ease. Experts agree that human to human transmission is likely to break out and cause devastating effects around the world. As a concerned, and sometimes overly paranoid citizen, the idea of a Bird Flu pandemic still terrifies me… as a future public health professional, I am alarmed yet hopeful that once the virus mutates we will take the appropriate actions (Early detection and Early response as Larry Brilliant told us) to ensure the best possible reaction to a possibly catastrophic pandemic.

Week 2

Video 1: Globalization:
I found it appropriate that Johan Norberg decided to open his film in front of a Swarovski Crystal store, a store that symbolizes wealth and status. The Swarovski stores house exquisite crystals and jewelry sold to those why can dish out for their swanky price tags. Norberg's depiction of globalization was truly persuasive. He did a great job in convincing the viewer that globalization is needed in order to help developing countries realize their aspirations of becoming a developed, wealthier country. However, I would like to know who funded the video. I have never heard such a vast pro Nike argument. The video made the corporation out to be the best thing that could happen to Vietnam and it would be interesting to know how and why he choose to recognize them as such. I am also interested in learning more about how the people of Kenya can work on obtaining their property rights. It was amazing to me that cell phones have made such a wide impact on literally all social classes worldwide. Although the video was quite thorough and persuasive, I would have liked to see more of the opposing arguments. We are told what the globalization protesters are doing, but not precisely why.

Video 2: Globalization and Politics of Public Health
"Is public a dirty word?" asked one of the commentators. The constant indifference of many people to a community's well being has always astounded me... but it makes perfect sense if we consider "public" a dirty word. People want to live their 'private' lives and not have to worry themselves with the issues, regardless of how important, of others. This is evident in the issues surrounding the Marshall Islands that were discussed. How were they ever cleared to test the nuclear and hydrogen bombs on those inhabited islands? Someone is responsible for the health of those people and it is an understatement to say that the care and consideration they have received has been a disappointment. It is unacceptable to me to treat people as such disposable objects... moving them from their homes and then allowing they to live in known nuclear activity. Their life style along with their culture was destroyed by those bombs. The needs and demands of the people need to be fulfilled, and not by what the Americans deem necessary, but by what the real demands of the communities are. In the video we hear so much about the problem, but no suggestions as to how to alleviate it. What do we do to lessen the life expectancy gap? the health disparities? to better the health of the poor?

Week 1

Professor Hans Rosling's presentation was an incredible play on statistical modeling. Wouldn't it be wonderful if we all had access to that type of information? I wish all statistics could be presented in such an interesting way. Although the information presented seems to lessen disparity gaps and perceives the futuristic outlooks as optimistic for world health and mortality, it is important to remember the many who are still at the bottom of those charts in order to continue to aid in the improvement of those countries.

I found the second video to be very thought provoking and emotional, which is where I believe my passion for global health issues stems from. It is good to continue to see the improvements in health statistics as we saw in the first video, but it is imperative to recognize that there are still so many people without essential health care and less than adequate living situations around the world. I am excited to learn more about the problems and explore ways to mend them.