by Sasheenie Moodley
Co-authorship and co-ownership are becoming more and more relevant in conversations surrounding sustainable involvement in developing areas. The idea of authoring or owning intellectual and experiential information with another individual can be described in a single term: co-creation. Co-creation is imperative, as more and more countries move toward globalization, in an effort to preserve the uniqueness of self-identities within a ‘community,’ as described by Nana Anyidoho in ‘Communities of Practice:’ prospects for theory and action in participatory development. Recognizing self-identity is particularly significant as identity pertains to the ideology of a ‘good life,’ and how we define ourselves, and our relationships in society. The idea of co-creating something, an idea, research or narrative, strives to ensure that both contributors assume roles in a
sharing process, evident in Richa Nagar’s Storytelling and Co-authorship in Feminist Alliance Work. While co-creation allows the original author to claim agency and participate in shaping a narrative that will be shared outside the author’s realm of consciousness, subaltern narratives are likely framed subjectively due to individual self-identities, and unique experiences. Therefore, we should read all narratives with awareness in order to disprove generalized misconceptions, and guard against subaltern’s subjective opinions.
Central to research, co-creation aims to restore (some) power to the original author of a narrative or experience. Co-creation attempts to correct the cycle that has existed for many generations: a researcher from the more-developed country 1) listens to someone’s narrative, 2) writes an article retelling the narrative that inevitably transfers ownership and/or power to the researcher, and 3) inherently detaches power from the original author of the narrative. Without co-creation researchers not only assume ownership subconsciously or consciously, but they also risk painting one group of people with the same brush: “the individual is not correctly perceived as a dynamic being with multiple and shifting self-identities and social positions over space and time…differences between
individuals within the assumed community are obscured” (Anyidoho 2010:5). Thus, co-creation allows individuals in the same “community” to showcase their self-identities, and unique personalities. Anyidoho emphasizes the reality that individuals in the same area do not necessarily share the same opinions, values, beliefs or aspirations. Individuals around the world are in fact “dynamic beings” who have certain social and cultural obligations in their respective networks. Through co-creation, individuals have a space in which their self-identities can be recognized, actualized, and respected.
As we realize that individuals in other parts of the world have autonomy and unique personalities, we must also question our preconceived notions, and misconceptions. Nagar emphasizes this in her account of two Indian sex workers, Roopa and Seema. While Roopa offers a “fake story” of “victimhood,” Seema shares her personal experiences, and how she embraced the “terms and conditions of her profession” as a sex worker (Nagar 2012:2). Herein lies the complexity of each narrative, as each woman presents her narrative laced with subjectivity, and self-identity. Additionally, we should consider how applicable each narrative is to the larger sex worker population. While Roopa’s “fake” narrative may be indicative of another women’s experiences in the sex worker industry, her violation of the truth deems her narrative untrustworthy. If other researchers relate to all individuals in the community based on this fact Roopa’s dishonesty could endanger the validity of similar narratives in the future. While Seema’s honest account of the challenges, and jubilations in her life may be indicative of Seema’s experiences, other women who are her colleagues may not share her opinions. Researchers who relate to all individuals in the community based on Seema’s narrative could perceive the sex worker population as content, and untroubled in their situations. In this way, we see that neither account can completely describe all women in the population. The fact that we often risk generalizing a small population based on lone narratives highlights our prejudice, and inherent bias. We need to have awareness of such misconceptions, and “interrogate (our) own assumptions about marginality, oppression, liberation, and charity” (Nagar 2012:2).
Self-identity, situational factors, and self-expression are no doubt exhibited within existing social realms long before researchers arrive on the scene. In this way, while co-creation may grow ownership and agency, there remains some uncertainty regarding the type of information gathered in a collaborative process, because of inevitable subjectivity expressed by subalterns. In other words, co-creation tackles the ‘how’ of research such as the methods and dynamics of research, but the ‘what’ remains unclear as it pertains to the kind of information presented by the subaltern due to his/her unique experiences or personality. The ‘what’ is influenced by the way subalterns perceive various situations, and how they interact with researchers outside their usual networks, as well as how they interact with individuals within their everyday communities. For example, when we talk to our peers and friends at UVA about our summers abroad, or our field experiences we consciously decide what kinds of information we wish to share based on how we perceive those peers and friends. We carefully craft the way we convey our narratives based on who we are talking to, and their past experiences. We “frame” our narratives hoping that the listener can empathize with, and understand our experiences the way we express them (Nagar 2012:4). Similarly, subalterns consciously craft the narratives they share with researchers, as evidenced by Seema and Roopa’s stories: “altogether, the two responses highlight the complexities of subaltern agency and the ways in which the formulations of radical desire might be unruly, ill-tempered, incomplete, conformist, and/or seemingly contradictory” (Nagar 2012:2). Nagar nicely describes the process of carefully crafting a narrative using “complexities of subalterns,” as she conveys that most individuals offer subjective narratives. It is an archaic assumption that individuals in an area or network all share a common narrative simply because they belong to the same geographic region, or “community” (Anyidoho 2010:5). Thus, individuals in one region offer the kinds of stories that are not homogenous or standardized, because the individuals in that single region are not homogenous or standardized.
In conclusion, Seema and Roopa highlight the important reality that original authors do not always offer true, or expected versions of narratives. In Nagar’s article, both women consciously shaped their personal narratives according to the message they aimed to convey. This message was crafted because of how each woman wanted Nagar to perceive her, and how each woman wanted Nagar to perceive the people in the community. Such preferences likely developed from each woman’s comfort level with Nagar, perception of Nagar’s work and purpose, the types of questions and prompt that Nagar offered, life experiences, and relationships with Nagar given the social context of the interactions.
Thus, there are many external factors that affect narratives, in addition to careful crafting by the original author. By introducing co-creation to correct basic power dynamics, we must realize that we are not ensuring fair narratives. There are many others factors as play in ethnographic research. In fact, reducing the effects of power in research has uncovered other controversial issues such as the idea of a ‘community’ and conflicting narratives within it, and transparency of the interviewer (researcher) and interviewee (subaltern). It is important to remember, therefore, that writing with a balanced perspective through co-creation alone is not enough to correctly construct research. Additionally we, as readers, must be conscious of who is being represented in the research that we read. The articles we read are narratives offered by a few individuals, and often do not represent the narrative of an entire ethnicity or nation. Ultimately, the responsibility is two-fold: authors must consciously co-create narratives with balanced perspectives and minimal subjectivity, and readers must consciously read narratives with awareness of self-identities to challenge misconceptions.
Thursday, October 22, 2015
What’s in a Name? Disease Naming Guidelines set by W.H.O
The mission of many global health organizations is to promote health, cure diseases, build health system infrastructure, and implement pro-health equity policies. Recently, an article in the New York Times that caught my eye, “W.H.O Urges More Care in Naming Diseases.” The World Health
Organization recently made an announcement that “disease names may not include geographic locations, people’s names, species of animal or food, references to culture, population, industry or occupation, and ‘terms that incite undue fear’”. Making changes and implementing policy on the process of disease naming may seem insignificant at first when compared to the necessity of medicine and healthcare poverty-stricken areas desperately need, however W.H.O offered substantial arguments for why the name of a disease can have harmful effects and should render greater significance.
Disease names that include place, name, or any other signifier previously mentioned, can have the harmful effects of stigmatizing not only a disease, but the geographic location, culture, population or industry itself. Furthermore, it can lead to false conceptions of a disease that could lead people to think they are not subject to contract a disease due to a name that may be geographically confining such as is with the case of Middle East respiratory syndrome (MERS), which originated in the Middle East but has spread around the world. WHO is not suggesting to change the names of known diseases, rather, it effectively set guidelines for naming diseases hereafter that will “help counter stigmatization and faulty assumptions made by the public and decision makers when addressing emerging infectious diseases” (Dr. Jewel Mullen, Public Health commissioner).
This notion of disease naming brings attention to the idea of health as a component of ‘being’. It’s not just about disease treating. The name of the disease and the standing associations bound to the disease among people and society effectively influences how one not only perceives, but experiences the disease.
Contributed by Sedona Hoppe-Brosse
Organization recently made an announcement that “disease names may not include geographic locations, people’s names, species of animal or food, references to culture, population, industry or occupation, and ‘terms that incite undue fear’”. Making changes and implementing policy on the process of disease naming may seem insignificant at first when compared to the necessity of medicine and healthcare poverty-stricken areas desperately need, however W.H.O offered substantial arguments for why the name of a disease can have harmful effects and should render greater significance.
Disease names that include place, name, or any other signifier previously mentioned, can have the harmful effects of stigmatizing not only a disease, but the geographic location, culture, population or industry itself. Furthermore, it can lead to false conceptions of a disease that could lead people to think they are not subject to contract a disease due to a name that may be geographically confining such as is with the case of Middle East respiratory syndrome (MERS), which originated in the Middle East but has spread around the world. WHO is not suggesting to change the names of known diseases, rather, it effectively set guidelines for naming diseases hereafter that will “help counter stigmatization and faulty assumptions made by the public and decision makers when addressing emerging infectious diseases” (Dr. Jewel Mullen, Public Health commissioner).
This notion of disease naming brings attention to the idea of health as a component of ‘being’. It’s not just about disease treating. The name of the disease and the standing associations bound to the disease among people and society effectively influences how one not only perceives, but experiences the disease.
Contributed by Sedona Hoppe-Brosse
Tuesday, September 29, 2015
Reflecting on Global Health Week
by Eliza Campbell
A little over a week ago, the Center for Global Health hosted their second annual Global Health
Week. Global Health Week seeks to engage students in the study of global health as well
as encourage them to connect with health issues locally and globally through service,
research, and advocacy. We had an exciting schedule of speakers, discussions, and other
events and the week was a huge success! I attended a number of the events and thought
that they all provided an interesting perspective on global health but I particularly
enjoyed the discussion led by Professor Edmunds of the Global Development Studies
program about the role of technology in community collaborations.
Professor Edmunds is currently working on a research project where he is using
Skype and other technologies to connect women in Charlottesville public housing with
women in Cape Town, South Africa. The women connect over Skype to share their views
on community health as well as exchange ideas of what they do to live healthier
lifestyles. Their dialogue spans from tips for how to grow herbs to domestic violence and
it seems that Professor Edmunds has already gathered a wealth of information.
I was particularly interested by Professor Edmund’s research because I thought
that the idea of collective learning and exchange was a fascinating approach to
development as well as empowering for the women involved. I feel that often times there
is a perception of development as being a process of imparting our exclusive knowledge
onto others but Professor Edmund’s research demonstrates that development goes both
ways: we have as much to learn from the people we are working with as they do from us.
I think that it is important for us to understand that we can learn a great deal from the
communities we work with and that development is more effective and valuable for both
communities involved if it is a two-way dialogue. I applaud Professor Edmund’s research
not only for its focus on community collaboration but also because it empowers the
women of Charlottesville and Cape Town to be the bearers and leaders of public health in
their communities.
While this research project is still in its early stages, I am excited to see what
comes of it and how this compelling dialogue will transform the communities and
individuals it engages while also challenging common perceptions of the direction and
nature of development work.
A little over a week ago, the Center for Global Health hosted their second annual Global Health
Week. Global Health Week seeks to engage students in the study of global health as well
as encourage them to connect with health issues locally and globally through service,
research, and advocacy. We had an exciting schedule of speakers, discussions, and other
events and the week was a huge success! I attended a number of the events and thought
that they all provided an interesting perspective on global health but I particularly
enjoyed the discussion led by Professor Edmunds of the Global Development Studies
program about the role of technology in community collaborations.
Professor Edmunds is currently working on a research project where he is using
Skype and other technologies to connect women in Charlottesville public housing with
women in Cape Town, South Africa. The women connect over Skype to share their views
on community health as well as exchange ideas of what they do to live healthier
lifestyles. Their dialogue spans from tips for how to grow herbs to domestic violence and
it seems that Professor Edmunds has already gathered a wealth of information.
I was particularly interested by Professor Edmund’s research because I thought
that the idea of collective learning and exchange was a fascinating approach to
development as well as empowering for the women involved. I feel that often times there
is a perception of development as being a process of imparting our exclusive knowledge
onto others but Professor Edmund’s research demonstrates that development goes both
ways: we have as much to learn from the people we are working with as they do from us.
I think that it is important for us to understand that we can learn a great deal from the
communities we work with and that development is more effective and valuable for both
communities involved if it is a two-way dialogue. I applaud Professor Edmund’s research
not only for its focus on community collaboration but also because it empowers the
women of Charlottesville and Cape Town to be the bearers and leaders of public health in
their communities.
While this research project is still in its early stages, I am excited to see what
comes of it and how this compelling dialogue will transform the communities and
individuals it engages while also challenging common perceptions of the direction and
nature of development work.
Wednesday, September 23, 2015
Surgery in Global Health: Not an Open-and-Closed Case
Imagine a scene in which ‘global health’ is occurring. What do we see? Perhaps a physician is down on bended knee, delivering vaccines to small black children, set against a blurred backdrop of village. Or we see looming figures in blue Hazmat suits hanging an IV bag to rehydrate an Ebola patient. Maybe a community health worker sits cross-legged among a group of women discussing pregnancy and distributing prenatal vitamins in sealed pink pouches. We don’t initially think of surgery. Increasingly, however, the scene of ‘global health’ will be set in a windowless sterile room, its providers will wear green masks and gowns, and its patients will receive life-saving laparotomies, open fracture treatments, and caesarean sections. Surgical services are greatly needed across low- and-middle income countries, and could reduce the global burden of disease by an estimated 77.2 million disability-adjusted life-years annually (Lancet Commission 2015). However there are numerous challenges facing this growing field including difficulty of health system scaling, scarcity of training sites, difficulty obtaining equipment, and lack of inclusion under the traditional umbrella of global health.
Surgery is an atypical topic in global health. Global surgery has historically been overshadowed by
movements to eradicate certain communicable diseases and bolster community health - movements which focus on preventative measures, not surgery. Indeed, while the UN Millennium Development Goals and its 2015 revision focus extensively on combatting HIV/AIDs and reducing infant/mother mortality, neither document includes any mention of surgery (link here:
http://www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG%202015%20rev%20(July%201).pdf) That surgical interventions are absent from these goals is perplexing: increased access to caesarean delivery is demonstrated to reduce neonatal mortality by between 30-70% (Molina, Esquival ,Uribe-Leitz et al 2015). Considering that among the Millennium Development are reduce child mortality and improve maternal health, perhaps our picture of global health should include a surgeon?
Many voices are now calling attention the absence of surgery as a global health priority. Among these: Paul Farmer, Atul Gawande, and the Word Health Organization. Perhaps the most prominent voice is the landmark Lancet Commission on Global Surgery (2015). The Commission states that an estimated 16.9 million lives are lost each year from conditions that can be treated surgically (by comparison HIV/AIDS and tuberculosis claim 1.46 million and 1.17 million lives respectively). At the same time there is a vast inequality in the delivery of surgical services worldwide: 90% of global injury deaths occur in low-and middle-income countries (LMICs), while the poorest third of the world receives only 3% of its surgeries (Lancet 2015). These figures identify both a clear need and a vast inequality in surgical infrastructure globally. But is it necessary – or possible – to build infrastructure where needed?
To the first question, “is global surgery necessary?” To some observers, surgery seems an unnecessary byproduct of Western medicine: it is invasive, highly technical, and involves little patient autonomy (besides signing “X” on a consent form). Unnecessary surgery occurs frequently in the Western world where it is readily available, and the surgeons may become wealthy by gaming a fee-for-service system. So why should we impose this product of Western medical excess upon the non-Western world? The answer: because surgery, when used as a life-saving measure, is never unnecessary. In cases of trauma, appendicitis, and births requiring a cesarean section, surgery is truly needed to save a life. Surgery, whenever is the only treatment option, is by definition “necessary.”
To the second question “is global surgery possible?” Frankly, the cost associated with scaling up health systems infrastructure in LMICs to parity with US systems would be astronomical. While surgery itself is a very cost-effective intervention - which will come as a surprise to many - the investment in system strengthening for safe surgery would be expensive. It would occur through academic partnerships with Western institutions. Presently, a number of US medical colleges have sustaining commitments to health systems in LMICs (i.e. UVA surgeons spend time in Rwanda training residents and developing surgery programs). This brings us to our final question, the million (or multi-billion) dollar question: who pays?
We all do, either by shouldering the global burden of disease, or paying for the health system
strengthening necessary to address this burden. This kind scale-up through sustaining partnerships is a pressing problem global health today. In sum, while a global need for surgical services is present, there remains an equal need for funding through sustainable partnerships. It is uncertain at this time whether or not these partnerships are attainable under present models of global health. Importantly, for global surgery to become viable, it should be prioritized by UN Development Goals. There are numerous conceptions that may prevent surgery from falling under the aegis of ‘global health,’ not the least of which holds surgery to be a luxury item misused by the Western healthcare system. Our picture of global health may not include a gown or scalpel, but if we are serious about delivering necessary care to all people, we ought to consider sketching in a surgeon or two (or about 20,000 by the year 2030).
- Michael R. Novack
Surgery is an atypical topic in global health. Global surgery has historically been overshadowed by
movements to eradicate certain communicable diseases and bolster community health - movements which focus on preventative measures, not surgery. Indeed, while the UN Millennium Development Goals and its 2015 revision focus extensively on combatting HIV/AIDs and reducing infant/mother mortality, neither document includes any mention of surgery (link here:
http://www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG%202015%20rev%20(July%201).pdf) That surgical interventions are absent from these goals is perplexing: increased access to caesarean delivery is demonstrated to reduce neonatal mortality by between 30-70% (Molina, Esquival ,Uribe-Leitz et al 2015). Considering that among the Millennium Development are reduce child mortality and improve maternal health, perhaps our picture of global health should include a surgeon?
Many voices are now calling attention the absence of surgery as a global health priority. Among these: Paul Farmer, Atul Gawande, and the Word Health Organization. Perhaps the most prominent voice is the landmark Lancet Commission on Global Surgery (2015). The Commission states that an estimated 16.9 million lives are lost each year from conditions that can be treated surgically (by comparison HIV/AIDS and tuberculosis claim 1.46 million and 1.17 million lives respectively). At the same time there is a vast inequality in the delivery of surgical services worldwide: 90% of global injury deaths occur in low-and middle-income countries (LMICs), while the poorest third of the world receives only 3% of its surgeries (Lancet 2015). These figures identify both a clear need and a vast inequality in surgical infrastructure globally. But is it necessary – or possible – to build infrastructure where needed?
To the first question, “is global surgery necessary?” To some observers, surgery seems an unnecessary byproduct of Western medicine: it is invasive, highly technical, and involves little patient autonomy (besides signing “X” on a consent form). Unnecessary surgery occurs frequently in the Western world where it is readily available, and the surgeons may become wealthy by gaming a fee-for-service system. So why should we impose this product of Western medical excess upon the non-Western world? The answer: because surgery, when used as a life-saving measure, is never unnecessary. In cases of trauma, appendicitis, and births requiring a cesarean section, surgery is truly needed to save a life. Surgery, whenever is the only treatment option, is by definition “necessary.”
To the second question “is global surgery possible?” Frankly, the cost associated with scaling up health systems infrastructure in LMICs to parity with US systems would be astronomical. While surgery itself is a very cost-effective intervention - which will come as a surprise to many - the investment in system strengthening for safe surgery would be expensive. It would occur through academic partnerships with Western institutions. Presently, a number of US medical colleges have sustaining commitments to health systems in LMICs (i.e. UVA surgeons spend time in Rwanda training residents and developing surgery programs). This brings us to our final question, the million (or multi-billion) dollar question: who pays?
We all do, either by shouldering the global burden of disease, or paying for the health system
strengthening necessary to address this burden. This kind scale-up through sustaining partnerships is a pressing problem global health today. In sum, while a global need for surgical services is present, there remains an equal need for funding through sustainable partnerships. It is uncertain at this time whether or not these partnerships are attainable under present models of global health. Importantly, for global surgery to become viable, it should be prioritized by UN Development Goals. There are numerous conceptions that may prevent surgery from falling under the aegis of ‘global health,’ not the least of which holds surgery to be a luxury item misused by the Western healthcare system. Our picture of global health may not include a gown or scalpel, but if we are serious about delivering necessary care to all people, we ought to consider sketching in a surgeon or two (or about 20,000 by the year 2030).
- Michael R. Novack
DELAYED POST: CGH Journal Club Recap: Hepatitis C Drug Affordability
The Global Health on Grounds committee had our first journal club meeting this
past week. An excerpt from the article from the Lancet that was discussed:
“The new generation of highly effective medicines to treat hepatitis C offers new hope
for those affected, but the high prices of these drugs block countries from integrating
them into their treatment programmes.”
A link to the article can be found here:
http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(14)70365-1/fulltext
This article prompted a lively discussion on equitable access to healthcare, what
the fair payoff for research and development for pharmaceutical companies is, the role of
insurance companies in funding this treatment, and government regulation of
pharmaceutical companies.
The group ended up being pretty divided. Some argued that pharmaceutical
companies need to have high economic incentives to invest in research and development,
otherwise life saving drugs would never be made in the first place. While currently many
people cannot afford the drug, if it wasn’t profitable then no drug would have been
developed in the first place and no one would have access to it. In addition, the price of
the drug not only makes up for the cost of developing that one drug, but the many drugs
before it that were ultimately not successful. Hepatitis C, when left untreated can lead to
liver cancer and ultimately rack up extremely high medical costs in the future. Because of
the efficacy of the drug and its ability to prevent higher medical costs in the future, some
people in the group argued that the price, ($85,000-$110,000 in the US and -$900 in
some developing countries) was actually fair.
On the other hand, many believed that people should have equitable access to a
life saving drug and one cannot quantify the cost of a human life. In addition, a lot of
research funding that ultimately leads to the development of pharmaceutical drugs is
funded by governmental agencies such as the NIH. Pharmaceutical companies also spend
more money on marketing their products than they do on research and development.
While this is necessary to get their product out, in the special case of the Hepatitis C
drug, the companies do not need to market the drug due to its high efficacy and need.
Therefore, there should be more regulation on how these pharmaceutical companies to
lower the price.
Whether you agree, disagree, or feel we missed out on some points that are
essential to the discussion, we’d love to hear from you! Feel free to email
ejj3xb@virginia.edu with opinions on this past book club or topics and articles you
would like us to feature next! Our next meeting will be this Thursday March 19th, 7pm at
the Center for Global Health and we will be discussing Global Health and Climate
change. As always, we will provide dinner and a lively discussion!
past week. An excerpt from the article from the Lancet that was discussed:
“The new generation of highly effective medicines to treat hepatitis C offers new hope
for those affected, but the high prices of these drugs block countries from integrating
them into their treatment programmes.”
A link to the article can be found here:
http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(14)70365-1/fulltext
This article prompted a lively discussion on equitable access to healthcare, what
the fair payoff for research and development for pharmaceutical companies is, the role of
insurance companies in funding this treatment, and government regulation of
pharmaceutical companies.
The group ended up being pretty divided. Some argued that pharmaceutical
companies need to have high economic incentives to invest in research and development,
otherwise life saving drugs would never be made in the first place. While currently many
people cannot afford the drug, if it wasn’t profitable then no drug would have been
developed in the first place and no one would have access to it. In addition, the price of
the drug not only makes up for the cost of developing that one drug, but the many drugs
before it that were ultimately not successful. Hepatitis C, when left untreated can lead to
liver cancer and ultimately rack up extremely high medical costs in the future. Because of
the efficacy of the drug and its ability to prevent higher medical costs in the future, some
people in the group argued that the price, ($85,000-$110,000 in the US and -$900 in
some developing countries) was actually fair.
On the other hand, many believed that people should have equitable access to a
life saving drug and one cannot quantify the cost of a human life. In addition, a lot of
research funding that ultimately leads to the development of pharmaceutical drugs is
funded by governmental agencies such as the NIH. Pharmaceutical companies also spend
more money on marketing their products than they do on research and development.
While this is necessary to get their product out, in the special case of the Hepatitis C
drug, the companies do not need to market the drug due to its high efficacy and need.
Therefore, there should be more regulation on how these pharmaceutical companies to
lower the price.
Whether you agree, disagree, or feel we missed out on some points that are
essential to the discussion, we’d love to hear from you! Feel free to email
ejj3xb@virginia.edu with opinions on this past book club or topics and articles you
would like us to feature next! Our next meeting will be this Thursday March 19th, 7pm at
the Center for Global Health and we will be discussing Global Health and Climate
change. As always, we will provide dinner and a lively discussion!
Tuesday, March 17, 2015
Being Mindful of Global Health
By Usnish Majumdar
When I try to imagine global health, I think of a vast and complicated network of people, institutions, and rhetoric. There are these huge hubs like the UN Refugee Agency, the World Health Organization, and Partners in Health, and there are the smaller hubs of academic medical centers and national advocacy groups, and then the tiny little pinpricks made up of student groups and incipient organizations. They all serve individuals in different ways and at different levels, adding to their perceived complexity. In my head, it all ends up looking a bit like the wiring of a brain. But it’s probably quite a bit more like a Jackson Pollock painting.
At UVA, ‘global health’ takes many forms. There are over a hundred different student groups devoted to a global health-related goal on grounds, and no real organizing principles. There are research groups across many different academic departments, not to mention multiple administrative centers that reach across multiple departments. Multiple national advocacy groups have student members on grounds. Occasionally you’ll come across a group’s educational or awareness campaign in one of numerous global-health related courses offered each semester. There are physicians and epidemiologists working as part of the hospital system that team up with students from multiple schools.
This glorious mess is part of why I love UVA, but the ‘network’ is plagued with many of the same inefficiencies that we see elsewhere. Even a cursory search reveals redundant student groups. Students that decide to engage with global health are faced with decisional overload – there are so many different ways of getting involved, some of which are far more visible than others. People working in a particular region will hear “through the grapevine” of other UVA projects in the same region, often after having done a lot of groundwork without knowing of potential collaborators. Research collaborations in global health are necessarily transient and spontaneous, but there are few structures that make this more likely at UVA.
Over the past few months, the Student Advisory Board has been working to build an interactive, sortable network of all the Global Health entities around grounds. We hope to have it done by the end of the semester, but mapping everything out visually is only the first step. A network map is a tool, not an end. With some effort on all fronts, perhaps we can make a Jackson Pollock painting look a bit more like a brain.
To be continued...
Saturday, November 8, 2014
Diabetes, Chili Beans, and A1C's: Project HOPE in Action
The A1C, or HbA1c, is a common test for diabetes that measures levels of glycated hemoglobin in an individual's blood stream. When diabetes is not controlled, sugar buildup in up in blood is detected as sugars are glycated, or bound, with hemoglobin. A chili cook-off in central Virginia might be the last place one would expect to find a group of medical students with handheld A1C machines. But among the steaming pots of chili - where tasters wore camouflage coats and a guitarist covered hits of The Band and Bob Marley - citizens of Louisa, VA checked their blood sugar.
On Saturday November, 1st, patrons of the Earlyhouse 10th Annual Charity Chili cook-off also checked their blood pressure, discussed healthy food options with a dietician, and checked their kidney function. It was overcast and windy, a perfect day for chili but also an ideal day for Project HOPE to do what it does best: interact with the local community and promote health through disease screening.
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