Week 3 - Reflections

On Wednesday evening in a class of 65, my yoga teacher said: "Isn't it hilarious to think about the fact that most of the time we are all walking around with this protective armour on and so concerned about keeping it together, that we don't realize that we are all doing that same thing. What would happen if we tried the opposite, and cracked that shell open, realized that we all are coming from different experiences and often the same feelings. What would happen if we were all open to one another?" She made a wise observation, and I think this is something we would need to work towards in order to accomplish some of the goals we have discussed in class such as those laid out on the MDG video, as well as something as simple as working together more cohesively. Last night Dr. Shahi spoke of the corporate committee mind at work within large public health organizations and those people believing that their meetings were their work. All too often this happens in large governing bodies of all domains and that lack of productivity eventually leads to failure of the system. So how do we become effective in an environment racked with frenetic cycles of latent energy? Some corporations have fired the top heavy management, cleaned house of the nonproductive teams, and outsourced work to those who were capable of completing it quickly, cheaply, and with quality. This way the people who want the work get the work, and the company gets to make decisions without so many politics getting in the way. While this causes immediate problems in having to lay off a stagnant workforce and leaving people unemployed, it allows for the small independent groups to get a chance at making a name in the market place. And so continues a cycle of growth and innovation. Can we then somehow take this approach to improve organizational functions in public health? Since we often face bureaucratic roadblocks and dissension between fields, is there a way to form a smaller governing unit, that we can trust to make good decisions, that will work with the satellite unit within each country to address appropriate needs? I know there are networks out there like this already, but they all seem like they get too big and become burdened with bureaucracy. We were discussing this in class, but I was wondering if anyone might like to expand on it? The last frame of the video on AIDS orphans says it all: "You have one life, Do something." I feel like that is why we are in this class, and writing these blogs, and getting a masters in public health, because we want to do something.

In other thoughts...
The video on BRAC makes a good point in relation to our class last week and our studies in general. As Dr. Calderon said in class this week, "you can not solve health problems in a population by public health interventions alone". Efforts must be integrated, as we saw in the BRAC example. During her presentation, Mana mentioned taking a holistic approach to solving problems which make sense, and has become an underlying theme in our discussions - especially in relation to globalization. We can not just look at the symptoms of a population suffering from poverty driven diseases, we must look at the whole picture. A population, especially if it is a state of extreme poverty, can not progress or remove itself from its circumstances if the people are not in good health, they are not going to worry first about health when they have to worry about where their food is coming from or being shot for walking down the street at the wrong time. I admire these organizations who are going out and giving support in terms of "teaching a man to fish", rather than just "feeding him for one day".
And finally....The part of the case study that really caught my attention besides the fact that signs point to a major pandemic some time in the not too distant future, is how those people outside of the medical and public health world are really not prepared for something of such a large scale disaster. From what we have seen of the response to the major environmental disasters in the last few years, some energy obviously should be focused on educating people on what to expect and how to react as well as enabling a surveillance system as discussed in the Brillant Tedtalks video from the past week. I believe there would be major problems with managing population flow, keeping people from traveling and working, how do you keep the entire planet from infecting one another? Yes, telecommuting can work, and systems have become less expensive and easier to use, but I can't get over the fact that despite these advances in technology, many people just feel like they have to make personal appearances at work or the world will stop turning. Email and video conferencing may not be enough to get them to stay at home, even in the face of a pandemic for there is always a sense of invincibility. I guess I don't have a better answer right now, except that currently businesses are required to have safety procedures in place, and they are usually quite inadequate and lack current information. I guess we would have to go back to disseminating more information.
Hopefully I haven't completely typed myself in circles on this one....

Week 2 - Globalization

I was so exhausted by the end of the class, but by the time I got home, I couldn't sleep because there was just too much to think about! The main thing that struck me after reading, watching videos and listening to everyone in class, was that as Hans Rosling said we just need to get this information out in simple, accessible ways. There are so many misconceptions and vague ideas of reality masking truth that it is nearly impossible to discern one thing from another. All I can say is that I am glad I am taking this class to get some concrete clarity that I can share and work from.
The presentation given by Andrea Rios was really great for so many reasons (love Manu Chao!!), especially since I have often questioned the numbers and accusations of undocumented immigrants using social services made in the media and the actual direct impact this has on us. I was not surprised by what the article had to show, and hope that others outside or our class will take the time to read it as well (HealthCareUseAmongUndocumentedLatinoImmigrants.pdf ). All in all, it seems that everything comes back to education, in one form or another, to bring opportunities to those who need/deserve them and to work towards more level playing fields. From the first video on globalization we can see that sweat shops are not necessarily the evil corporation way of exploiting cheap labor but rather an economy builder for those who may not have any other means. In the case of the Nike factories in Taiwan, the workers were thankful for the opportunity to learn a new trade and make money they would never have a dream of earning on a farm. If the activists were successful in closing down those factories, what would happen to those workers? Where else would they start? On the other hand we see the example of Kerala, where things were working out and then globalization introduced relatively unnecessary luxuries that threw off the equilibrium of the economy. So in the end I think we have to come back to education to help enlighten us on where to find a balance.

Week 1 - The Big Picture

Last Thursday we met for our first class in Emerging Trends in Global Health and I was amazed at the energy and enthusiasm generated in the class. My thoughts on issues raised are as follows...
This was the first time I had seen some of the charts shown on the lecture slides and they really helped put things in perspective. I knew that there were deficiencies in some countries as far as population growth, but did not realize that on the whole the world population was actually moving towards equilibrium. I knew that chronic/non-communicable diseases had over-taken infectious diseases in global mortality rates, but the fact that they afflict 60% of the world's population is still astonishing to me and I realized that not many people outside our realm of global health realize this. In fact, during a discussion over the weekend with some friends i relayed this information and they were as amazed as I was. Just getting this kind of information out to "every day people" who may not dig for information past the MSN home page would improve global consciousness immensely. I liked the video for the Millennium Development Goals established by the WHO (http://video.google.com/videoplay?docid=-8153215241403626500&q=development+and+health&hl=en) and found it to be especially effective in broadcasting its message. It is important to set high goals, and while they may seem difficult to achieve given the context of the present world (perceived apathy, confusion of information), it would seem that this gives us even more of an incentive to strive for these accomplishments. Even in attaining these goals we would never be finished, for things keep on moving and changing. I am sure as goals are approached, new ones will always appear.