Guest Blog: How Peace Corps Volunteers in Senegal address gaps in health delivery systems

This post does not reflect the opinions of the US Government, the US Peace Corps or Peace Corps Senegal.


There is usually a general misunderstanding of what Peace Corps volunteers do or are capable of doing in field. This misunderstanding comes from families and friends of volunteers back home, the communities the volunteers serve, and sometimes, in the earlier stages of service, the volunteers themselves. How much impact can a volunteer make? How can the most impact be made during such a short service? What are the limits of a volunteer and how is their work truly sustainable?

While I can not speak on behalf of the entire Peace Corps (PC) community, I believe I can shed a light on how Peace Corps Senegal Health volunteers work to provide basic trainings and services to improve the health status of the communities they serve.

Currently PC Senegal health volunteers work in the areas of Malaria, Maternal and Child Health and Water, Sanitation and Hygiene. Our development approach ensures that initiatives are sustainable, that they exhibit long term vision, that they are from the bottom-up and that they are participatory and inclusive. Along with guidance from PC leadership, volunteers use these guidelines to creatively impact their communities.

The PC Senegal health sector works to address 3 delays in health care:

  1. Delay in the decision to seek care
  2. Delay in reaching care
  3. Delay in receiving adequate available health care and correct diagnosis.

The first delay is addressed at the household level. When signs and symptoms of disease begin to manifest themselves, we ensure that people have the knowledge they need to seek the care that is required. The delay in reaching care is addressed through several initiatives that range from planting gardens, training more community health workers, working in supply chain to ensure the health structure has the medicine and equipment it should have, rallying up the community to contribute towards an ambulance, or building a health structure. The last delay can be addressed through a series of trainings for community health workers, working side by side with health processionals to ensure that tests are being administered and being administered correctly, and empowering the patient to ask questions about disease stages treatment and medication.

Baseline assessments, barrier analyses and volunteer reporting tools are beginning to show us where exactly the needs are and where the obstacles to the behavior change exist. A lot of work is focused on strengthening the capacity of community health workers, clinical staff and health structures as a whole. We come in with fresh eyes to identify ways health care can be done better and in many cases, solve complex with simple solutions. I like to think that we help people think outside of the box to identify their problems and solve them with as little help from the outside as possible.

But the work is not easy. In a process that begins with intensive language, cultural and technical training, PC Senegal Volunteers must learn how to integrate into their communities and develop meaningful relationships with potential work partners before their own projects may actual begin. Volunteers spend a good amount of time learning the lay of the land in their communities. What development groups have worked here in the past? What have they done? Who exactly did they help? Where did they succeed or fail? Was there a former volunteer at this site? What did they do? What relationships did they build? Who did they work with and who did the intentionally avoid? Then the research and programming questions begin. What does the community know about these heath issues? What does this community need?  What can I do to address the need? How I can do it with the least possible resources? How will I monitor it? How will it be sustainable? So when we finally figure out-with the help of community members- what project we want to implement, we design it, we justify to our community leaders and to our PC leaders. When necessary, we write grants, we rally the community behind the project, we implement, we monitor and we evaluate.

So what is it exactly that volunteers do? Well, we do not claim to change the world. This is not why we’re here. We will not eradicate malaria nor will we completely bring an end to the deaths of children under 5. But if we can reduce those incidences, if we can provide much needed trainings, if we can build a health structure that otherwise would not have existed, if we can get just 20 more moms to wash their hands when they’re supposed to, if we can improve sanitation practices, if we can get that many more mosquito nets out there, if we can prevent malnutrition in a handful of infants and children, if we can keep addressing these gaps that cripple health systems, then, we would have contributed to a much a larger picture of global health and we would have served.


taiwo adesinaTaiwo Adesina is a MPH candidate at Loma Linda University in southern California. She is also a Masters International student, completing the final part of her Masters in Global Health with Peace Corps Senegal. In Senegal, Taiwo works in the areas of Malaria, WASH, maternal and child health and nutrition-helping health structures and groups better address these issues through the use of community health workers. Her interests also include project design and management, grant writing, and M&E. She has working/living experience in Nigeria, Honduras, the Philippines, the Bahamas and Senegal. She blogs at travelgiveworklove.

APHA IH-MCH Working Group Conference Call: Wednesday, March 11 (12-1 p.m.)

All section members are invited to attend the next Maternal and Child Health (MCH) Working Group conference call this Wednesday, March 11 from 12-1 p.m. (EST)

GUEST SPEAKER ON THE TOPIC: Global Strategy for Women´s and Children´s and Adolescent Health for the Post-2015 Agenda

Our guest speaker will be:
DR. OSCAR CORDON
Health Practice| Director, Chemonics International
Governing Councilor – APHA International Health Section

Call-in information:

USA/Canada (toll free): 1-888-757-2790
For those calling from outside of the US: +1-719-359-9722
Guest Passcode: 424573

This conference call is being organized by the IH-MCH Working Group of the International Health Section of APHA, but all section members are invited to attend!

For more information and supplemental materials, please contact Laura Altobelli, MCH Working Group Co-chair, at laura [at] future [dot] edu.

Now Accepting Nominations for this year’s Section Awards!

Our Awards Committee is now accepting nominations for this year’s Section Awards, to be presented at the Awards Ceremony at this year’s Annual Meeting of APHA, which will be held in Chicago in October. Each year, our section recognizes outstanding contributions of its members through four awards:

  • The Lifetime Achievement Award for Excellence in International Health honors the visionaries and leaders in APHA who have shaped the direction of International Health.
  • The Mid-Career Award in International Health recognizes outstanding emerging professionals in our section.
  • The Gordon-Wyon Award for Community-Oriented Public Health, Epidemiology and Practice rewards outstanding achievement in community-oriented public health epidemiology and practice.
  • The Distinguished Section Service Award honors outstanding service to the International Health Section.

The Lifetime Achievement Award in International Health was created by the IH Section to honor the visionaries and leaders in APHA who have shaped the direction of International Health. The evaluation criteria for the Lifetime Achievement Award include: (1) the quality, creativity, and innovativeness of the individual’s contributions to the field of international health; (2) the individual’s contributions to the development of APHA or the IH Section; (3) application of the individual’s work to service delivery (as opposed to primarily theoretical value); (3) the individual’s contributions as a leader, visionary, or role model; (4) the volunteerism or sacrifice associated with the individual’s contributions; and (5) membership in APHA (preferably with primary affiliation with the IH Section), a State affiliate, or a national public health association that is a member of the World Federation of Public Health Associations. No self-nomination is allowed.

The Mid-Career Award in International Health is intended to recognize outstanding emerging professionals in the IH Section. The evaluation criteria for the Mid-Career Award include: (1) the individual’s commitment to the promotion and development of primary health care in a cross-cultural setting over a period of 5-15 years (with primary health care encompassing a broad array of public health issues, including HIV/AIDS prevention and environmental health); (2) demonstrated creativity in expanding the concepts pertinent to the practice of public health with an international focus; and (3) membership in APHA (preferably primary affiliation with the IH Section), a State affiliate, or a national public health association that is a member of the World Federation of Public Health Associations. No self-nomination is allowed.

The Gordon-Wyon Award for Community-Oriented Public Health, Epidemiology and Practice is intended to reward outstanding achievement in community-oriented public health epidemiology and practice. This award was established in 2006 by the IH Section and is administered by the Community Based Primary Health Care Working Group. John Gordon and John Wyon were pioneers in this field, so encouraging and recognizing others in this field is one important way of honoring their memory. The evaluation criteria for this award include: (1) a central role in an outstanding achievement in community-oriented public health and practice; (2) demonstrated creativity in expanding the concepts pertinent to the practice of community-oriented public health with an international focus; and (3) membership in APHA or one of its affiliates (either a State affiliate or a national public health association that is a member of the World Federation of Public Health Associations). No self-nomination is allowed.

The Distinguished Section Service Award is intended to honor outstanding service to the IH Section. Award criteria are: (1) dedication to the IH Section mission and goals as demonstrated by continuing exceptional contribution to its activities; (2) service on the section elective positions or chairing its committees with remarkable or unusual effort and achievements; (3) distinguished achievement in the international health field with a remarkable career; and (4) excellence in leadership and strong ability for team work with peers in the IH Section and APHA. Current membership in APHA is essential.

Award nominations should include a detailed letter explaining why the individual nominated should receive the award, addressing the criteria for the specific award and the curriculum vitae of the nominee. Both documents (the nomination letter and the curriculum vitae) should be submitted electronically as a Word document or PDF. Only nominations with the required documentation will be considered for the awards. Nominations should be submitted by e-mail to the Awards Committee chair, (currently Gopal Sankaran, gsankaran@wcupa.edu).

Disney, measles, and parents’ choice not to vaccinate: Who’s to blame?

Guest bloggers: Brittany Seymour and Rebekah Getman

The recent challenges surrounding childhood vaccinations in the United States have received notable attention in both popular and scientific press, illustrating a spectrum of parental concerns and resultant attitudes ranging from vaccine hesitancy to outright refusal. The current measles outbreak traced to Disneyland has contributed to the highest number of US measles cases in fifteen years and resulted in the Centers for Disease Control and Prevention’s release of an official CDC Health Advisory in January this year. Over half of the individuals who have come down with the illness are unvaccinated; of those, more than 80% are old enough to receive the MMR vaccine but have not, leading many states to reevaluate their personal belief exemption policies. Unsurprisingly, this now multi-state outbreak has reignited the emotional debate over vaccine safety, efficacy, and policy in mainstream and social media. While vaccinations are likely one of the most prominent health debates in the United States right now, health officials are increasingly battling unfounded controversy regarding several of public health’s greatest achievements.  The field that is tasked with controlling global disease epidemics is now up against what have been dubbed “digital pandemics:” the far-reaching, rapid spread of unrestricted, scientifically inaccurate health information across the Internet through social networks.

Researchers at Harvard University recently studied this phenomenon over another common public health intervention: community water fluoridation. A lobby to end fluoridation pushes on in communities across America, despite more than 3,000 studies confirming its safety and benefits. The researchers’ findings indicate that, similar to the anti-vaccination community, a small but vocal and very tightly knit network is driving the anti-fluoridation lobby. A well-known social theory describes individuals in the world as connected by six degrees of separation, and Facebook’s one billion users are four degrees separated; the study found that individuals in the anti-fluoride community are separated by a mere two degrees. Often, highly connected networks develop a strict set of norms and values, and any person or information in violation of those norms, such as scientifically accurate pro-fluoride information, will be quickly rejected, making rational discourse nearly impossible. The researchers also traced online social conversations about fluoride through the network. Members of the anti-fluoride network frequently shared and cited scientific studies to back their arguments; however, in more than two-thirds of conversations, the actual study cited was buried two or three links away from the online discussion, or was not reachable at all. This is concerning because, under these circumstances, the risk of evidence becoming misrepresented or misinterpreted likely increases with each link that takes readers further away from the source.

The researchers’ findings support the theory that highly connected social networks, and not science or evidence, are driving digital pandemics of health information on openly accessible Internet sites. In the digital information age, scientific fact is only one piece of the complex health decision-making process. When capable, intelligent parents encounter the sea of voices online while researching how to make optimal decisions for their children’s health, of course they become concerned with what surfaces to the top of their Google search. The Harvard study suggests that perhaps we need to stop blaming parents for choosing not to vaccinate their children or for lobbying to end fluoridation in their communities, an approach that only alienates parents with questions and shuts down dialogue. Moreover, corrective scientific information inserted into existing social communities without respect for norms and values, even if in response to misinformation, runs the risk of insulting those not readily convinced solely by the prevailing science, an ultimately detrimental approach.  Rather, additional research is needed to discover new, social health communication strategies that are more inclusive and acknowledge social networks’ differing belief systems. Digital pandemics are a part of our current, connected reality. Rather than fight against this trend (which may prove impossible), public health communication approaches must empower and partner with parents so that the voices of expertise, evidence, and experience are the ones they trust, and share within their networks, once again.

Getman HeadshotRebekah Getman is the Senior Program Manager for Education at the Harvard Global Health Institute, tasked with creating and implementing multi-disciplinary curriculum for students that supplements their in-classroom learning. These curricula combine global health knowledge with other disciplines to provide students with a broad lens through which to study and assess global health interventions.

SeymourHeadshotBrittany Seymour is an Assistant Professor of Oral Health Policy and Epidemiology at the Harvard School of Dental Medicine’s Department of Oral Health Policy and Epidemiology and the Inaugural Harvard Global Health Institute Fellow. Her research includes interdisciplinary global health curriculum development and pedagogy, capacity strengthening for oral health delivery systems in resource-challenged regions, and digital information transfer and impacts on health.

Ebola: The Ripple Effects (infographic)

For better or worse, Ebola is becoming old news. Aside from the initial case in Dallas that was transmitted to two nurses, there have been no more cases here in the U.S., and panicked predictions of a massive outbreak causing mayhem and catastrophe never materialized (much like public health experts said they would not – funny how that works).

The outbreak in West Africa is ongoing and continues to be a tragedy on a massive scale that is losing public interest. We previously posted an article by Mary Anne Mercer on lost opportunities and the weaknesses in the healthcare systems that the outbreak has laid bare. Now, the MPH@GW blog has kindly provided an infographic on the outbreak and its collateral damage.

Ebola-Public-Health-Crisis-IG