Week 13 - Ethics

It was surprising to me when I looked at the curriculum for our MPH program and there wasn't a course dedicated solely to ethics. Even more surprising was learning how little time professionals in the world of health are required to spend considering ethical questions and that there is no continued compulsory education in ethics. I strongly support the adherence to the ethical contract we reviewed in class which Dr. Shahi helped to formulate, and I believe that training in ethics should be obligatory in the undergraduate years as it once was, as well as every subsequent level of higher education. Not only would this make for a contemporary, educated workforce, but also boost the professional image and credibility of those in health.
One thing I really enjoy about public health is that it is inherent in our work that we dare to address so many issues that ethically all people should recognize, but would often rather ignore. It is important to review the overall effect of interventions and aid in the name of public health however, because as we discussed in class, just going in and helping for a little while then pulling out does not make for a sustainable change.
I loved the fact that Christina acknowledged the subject of torture as a public health as well as ethical issue, and something that has drawn so much hypocrisy. We in the US can not call ourselves peace keepers when we commit the same acts, if not worse, as those we so strongly oppose.
The bottom line is that there needs to be more accountability and better education. People are not making good choices, especially those in power. In addition, something that Dr. Shahi's ethical contract addressed is the need for an enhanced system of trust among professionals. We discussed the need for extreme surveillance systems in top secret jobs, which can be somewhat helpful, but I have always found that environments of distrust tend to breed negative and suspicious behavior. People need to have a certain amount of responsibility and ownership, and know that others rely on them to be trust worthy. Again, there is a balance to be met here. I know this seems rather vague, but hopefully it makes a little sense!

Week 12 - Learning from Private Enterprise

If there is one thing that has really opened my eyes in this class, it's the role that the private sector can play in facilitating change and all that we in public health can learn from companies/organizations. It makes sense, if you want something to happen you had better work with the people who have the money and the various interests. Private Enterprise has been a major motivating force throughout history, right along side religion and government. This group deserves just as much attention. In public health we often tend to think of the business/for-profit sector as the enemy, but in fact if treated right "they" could prove to be quite power allies. Granted, they most often only see the bottom-line, but that's how they subsist. In order to attain assistance and interest from the private sector we must examine in each instance what their raison d'etre is and then provide a motivation for them to join our cause. My favorite investment is people. I think almost anyone can be an asset one way or another, it's just a matter of seeing how everyone fits. I really enjoyed the role playing game we played (well done Mana and Andrea!), and in my role as Chevron in Nigeria, I suggested that my only interests in the situation would be land and a stronger workforce that can withstand the environment better than foreigners. Our group found that this was a good way to look at the situation. If Chevron could have exclusive rights to drill in the land in exchange for better health care, monitoring swamps for mosquito over-growth, and better education for local workers, then it would be a win-win situation. The fact that we are getting the chance to analyze these situations and see the whole picture and who fits in has been extremely valuable to me, and I look forward to putting this knowledge to good use!

Week 11 - Financing Our Health

Our discussion regarding capitalist society and promoting change illuminated some interesting perspectives. It seems that in order for change to happen in a strictly capitalist environment such as the U.S., drastic and even tragic event must occur for people to pay attention and do something. People like their power and are unwilling to give up what they think are personal rights and freedoms. At the same time, many other countries are functioning quite well in comparison with several different types of government acting side by side. Most of the European market is based on capitalism, yet most countries there have socialist education and health systems. They have higher literacy rates, life expectancies, and higher scores on the Happiness Index. People are stubborn, but by revamping and regulating the system a little better, we will actually have more freedom. How long do we have to wait to show that our school and health care systems as they are now are actually doing a disservice to the community? We have the data, if cost-benefit analyses could be conducted on a state by state basis according to improvements to be made by socializing these two systems, I don't think change is too out of the question. Do we want to keep up with the rest of the world or become obsolete like so many other great nations of the past? We have enough money, now we need to invest in our people and in order to do that a major shift will needs to happen on a systemic level.