Week 10 - Surveillance

The topic of this class I found extremely interesting (not just because I gave a presentation!) for one reason that we never really discussed. We established that surveillance systems as they are now are not as effective as they ought to be, so vast improvement is needed. However, we really didn't get in to how to balance surveillance and personal privacy/individual rights. This will undoubtedly interfere with the ability to implement effective systems in the future as people will not want to give up their privacy. I think the only way to convince people that surveillance is necessary and to construct a system that works, will be to exhibit a transparency in information and procedures as well as a build a structure that is mindful of personal privacy. While steps must be taken to assure safety and prevent widespread panic, better and more in depth information must be available to establish a solid and trustworthy rapport between agencies and organizations and the public. The SARS problem in China is a perfect example. Because the government's immediate reaction was to hide what was going on, not only did the disease spread more quickly and through more people than necessary, but a feeling of mistrust was bred. We also discussed this same issue in relation to airlines and health emergencies. I see the reason for airport scanners that detect certain heat signals within the human body when illness is present, but is this a violation of personal privacy? And as a member of the public, how do I trust those machines, the people running them, and what happens to the information they collect? Already we have given up rights written up in the Bill of Rights upon which this country was founded in the name of national security, but is this right? A balance must be established between personal privacy and national security, especially when it comes to health. Health is a personal thing, but also a global thing, and as many other countries have defined it: a human right. Before we can moved forward with an effective plan for surveillance, the rights to both health and privacy should be recognized on a global level.

Week 9 - E-Health and more

This class was no less exciting than the others with innovation in case study facilitation presented in video format (great job Lawrence and Jordan!), and heated debate over the merits of remote physician-patient contact. I just have to say that I thought it was a great idea to use a different medium for facilitation since the long drawn out presentations, while informative, can be hard to follow after 3 hours of intense conversation. There are my two cents on that!
As for the idea of email, phone, and other types of remote communication between doctor and patient, I have mixed opinions. I think this could really facilitate relationships and efficiency in doctor-patient care, if done right. On the other hand it could distance people more than they already are, potentially depersonalizing communication. Ultimately, with the right balance I think this could really work. Email and sites like Myspace have actually brought people together, albeit in a way people 20 years ago probably couldn't have imagined. This would necessitate some multi-tasking on the part of certain office personnel, but it may also create new jobs and allow doctors and other medical professionals to help more people who need care. The home monitoring linked to online vitals tracking presented in the case study video seemed to be a great solution to many problems relating to seeing patients with serious conditions who can't all be seen at once. At the same time, it gives them the ability to monitor their own progress and take some responsibility in overcoming their illness. Because of this, I am in favor of these progressions in health communication.
Of course steps would have to be taken to make sure patients were still seen in person periodically and to prevent abuse of the system. But I guess this is like any other technological augmentation of a system. Check and balances are in order.

Week 8 - Innovation in Technoloy, the Road to Solutions?

After spending seven weeks discussing the major health issues of the world, it is a breath of fresh air to begin really discussing potential solutions. All of the presentations discussed technologies for improvement in biomedical sciences affecting many areas of life, and it was impressive to hear about the ideas that improved communication, access to care, and delivery of aid. Many of these inventions seem like no-brainers, but when I was listening to Farah's presentation and she mentioned one of the con's of Genetically Modified Crops it dawned on me that we really haven't touched much on the topic of ethics and whether we should be using these technologies. This has also come up in my research for my paper on the Implications of Intellectual Property Rights on Public Health. We are always asking questions to find solutions to problems: what is the problem, how can we address it, what is the best way, who is involved?? But we rarely ask: what are the implications for the future and how will this affect our environment on all levels?? These are questions no one asked during the industrial revolution and look what happened. That's not to say that what is arising from the Age of Technology isn't good, but we need more people, especially the innovators and inventors, to ask the tough, ethical questions that have to be addressed or we could end up in an even bigger mess. This is something that is not necessarily attended to in the patent/IP process and one point I will be examining in my paper, should we incorporate more of an ethics review into the patent process and even require this in the course of R&D? While there are some ethical hurdles an invention must overcome before a patent is granted, there are also many loop holes. Recently, a diagnostic test for locating a certain gene known to cause cancer in a particular group of Jewish women was granted a patent even after many appeals and controversy. Now the women who need or want to be tested have to go through this specific company or one of its designated subsidiaries and pay four times the amount of what this kind of test costs for other people, just to get a yes or no that could possibly save a life. We are also facing this problem with vaccines for flu, certain infectious diseases, and much more. So where do we draw the line???

Week 7 - The Environment and Promoting Sustainability

Last Thursday we talked about many aspects of environments great and small and how circumstances affect people's health. The case study regarding the inequities caused by access to enclosed bathroom facilities was extremely eye-opening and a simple luxury we definitely take for granted. In addition, the video illustrating what is happening to communities where there is no sanitation was horrific and it is an atrocity that situations like this still exist in today's world. I was very impressed that our discussion regarding proposed solutions kept leading back to renewable technologies and sustainability. My thoughts crept back to some issues of Dwell magazine (my favorite!) and examples of sustainable practices, mainly architectural, at work all over the world. By the way, I whole-heartedly recommend this publication. There is something about sustainability in every issue and it's printed on recycled paper. There have been some amazing articles about sustainable green houses built in various cities, architectural firms designing and building sustainable green modular homes, even some that can be retrofitted to protect against earthquakes, and sustainable green products like toilets and energy efficient appliances. What is great about many of these inventions is that they are extremely affordable and cut costs on bills in the long run as well. Unfortunately, technologies like these are moving slowly to catch on, but at least it shows that good things are coming out of private enterprise. So it made me think that it might be possible to get some of these "good" companies to impart their wisdom in order to work on solutions to the basic environmental problems and needs, which would only benefit their cause. This could help build economies and communities with better, sustainable futures as well as stimulate this kind of change and growth in developed nations by creating a new market. It seems like a great place to start considering these sustainable technologies have been proven to be cost-effective short and long-term which would inspire more research and bring more funding. Eventually, we could maybe even go beyond sustainability....

"Sustainability is just a minimum. If I asked you, 'How's your relationship with your wife?', and you said, 'Sustainable', I'd say, 'Oh, I'm so sorry for you!'" - Michael Braungart published in Dwell, Sept. 2006 issue, pg. 19

Week 6 - The Power of Mental Health

The quote Dr. Shahi used in the beginning of his lecture on this day really struck home for me. "All that we are is the result of what we have thought. The secret of health for both mind and body is not to mourn for the past, worry about the future, or anticipate troubles, but to live in the present moment wisely and earnestly." The Buddha (Hindu Prince Gautama Siddaharta, the founder of Buddhism, 563-483 B.C.) Much like the simple phrase coined by Descartes: "I think therefore I am". Our world is created by thought that leads to action. Everything begins and ends in the mind. We are constantly absorbing and producing new experiences, reliving the past and contemplating the future both consciously and subconsciously. I have found it necessary to detach myself from situations in order to see them more clearly. In fact, yoga has really been my saving grace, an amazing practice which allows me to cultivate the art of living in the moment and releasing myself from my actions and reactions. At the end of each class on Wednesday nights, the whole class says a silent prayer lead by the instructor dedicating the practice to those people who need the strength and clarity and who don't have the luxury of doing yoga in a safe and amazing environment. This little reality check is always a welcome reminder of just how lucky we are to be empowered that way. If everyone had the chance to take a little respite from the ever spinning wheel of life, I think the world would be a much better place. However, so many people, as we have been discussing, don't even have the basic necessities such as clean water, sufficient food supply, or safe living situations that allow for time to reflect on philosophical notions. It is clear that these problems must be addressed so that good mental health can have a fighting chance. This is clearly laid out in Maslow's Hierarchy of Needs which Dr. Shahi presented in his slides, and more than just needs, I believe they should be rights of every human being. The right to have the opportunity to have all of those things: Physiological well-being, Safety, Love/Belonging, Esteem, Self-Actualization. And so when we examine these problems every week in class and whether they can be solved, I guess the answer is best described as the following:

"Whether you think that you can, or that you can't, you are usually right."

- Henry Ford (1863-1947)

"I have come to believe that the whole world is an enigma, a harmless enigma that is made terrible by our own mad attempt to interpret it as though it had an underlying truth."

- Umberto Eco

"The significant problems we face cannot be solved at the same level of thinking we were at when we created them."

- Albert Einstein (1879-1955)

Week 5 - Hunger, Obesity, Paradoxes and Vicious Cycles

One of our best class discussions yet came out of this week's case study analysis. While we ended up somewhat up in arms regarding the feasibility of certain strategies to eliminate hunger, I think one thing we might all finally agree on is that it is possible to accomplish this, no matter how big the hurdles. In addition, I feel like we clearly established why it is so important to do this. Hunger, poverty, and health status go hand in hand in hand. All of them have to be improved, and for any one to be ameliorated and sustained all of them have to move in that direction. So it is in fact quite a hurdle. However, we have seen and discussed that it is possible to stimulate local economies, perhaps even through local food production, and that educating the women in local communities can improve poverty levels, health status, and therefore reducing the number of hungry people. We have also talked a lot about the roles of private and public domains and how they fit and will fit in to solving the biggest problems. I am of the mind that when presented with an opportunity to improve life that is also beneficial in other ways, I and most people would not hesitate to take part. However, there are people who will most likely never make the right decision, and who don't really care to improve life, so how does one skirt that issue? This came up when we were talking about war and violence in developing countries that has created major road blocks to establishing stability and positive, progressive change. I am not sure there is an answer, and maybe there will never be complete peace, but I do think there is a balance (yes, that word again) that can be struck so that the majority of lives can exist in positive environments. So what does all this have to do with hunger? Well, I truly believe the saying, we are what we eat. If people are suffering from malnutrition and lack proper nutrients in their diet, or if they are obese because they are eating happy meals and can't control their urges, then of course they are going to be unhappy and that will translate to the world around them. This is happening on all ends of the spectrum, both in poor and rich, and a major cause of distress, disparities, and perhaps even eventually violent conflicts. What if we could commence the road to solving some of our major problems just by growing and eating better food? Maybe this is a key catalyst we have been looking for to balance out the yin and the yang....

Week 4 - Non-communicable Diseases and more

Last week we had some pretty memorable moments in class and the reading was epic, though interesting. One thing that I really enjoyed (I know, not another video commentary!) was the video on reversing diabetes naturally. Yet one more affirmation that solutions can be simple and rather inexpensive in the grand scheme of things. To watch those people change physically, mentally, and emotionally as a result of a complete diet overhaul was pretty amazing, and something I have been researching this week for my presentation this Thursday. Don't want to spoil too much! But perhaps solutions to our biggest problems can be really simple. It's changing the way we look at our challenges and obstacles that is the most immense hurdle.
We talked about strategies of focus to eliminate infectious diseases versus non-communicable diseases and what is most important, and I believe the answer is that is it all equally important because it is all part of a precarious balance we have to achieve. That is what nature does, when one thing gets out of control another comes to balance it out, moving in a continuous cycle. Our checks and balances system has been thrown way off. In any case, in response to Payam's comments about letting the private sector take care of the things we can easily change by shifting lifestyle patterns, I agree however the public sector has to be involved in steering the ideas and the monetary resources in the right direction. We need to create interest for investment, people need to have a personal connection with a given situation in order to want to be involved. During class I kept thinking about Google and how they have little perks at work to make being there less stressful and more enjoyable. They get a better product from their employees and they are extremely successful. So why can't other systems large and small do that as well? They can, they just need to know the why and how. When we can finally shift away from the non-communicable disease trend into healthier ways of living, people will be happier, more productive, and able to contribute something instead of sucking the system dry. There are other assets we have lost as a result of this trend aside from money.