Category: Guest Blog

International Health: A One-Way Trip?

by ihsection, posted in Guest Blog, Maternal and Child Health

Guest blogger: Dr. Teresa Nwachukwu

This is my first blog ever, thanks to a hard-bargaining Jessica.  I knew that the International Health section of APHA was the right place for me when I saw that one of the burning issues for the section is the challenge of recruiting hard-earned health workers from poorer countries by richer nations. Having registered for the IH section, I raced around that colossal conference centre in Denver, trying to locate meeting rooms.  As the meetings progressed, I was dismayed to find that “international health” basically meant America sending health, aid, services, materials, people, or whatever to Africa and other resource-poor continents. It seemed to me that poorer countries had nothing to offer the richer nations.  International health seemed like a one-way trip to these nations with no return visits. The question I asked myself was, does Africa have anything to offer, or has Africa ever given anything, to Europe or America? If so, have these gifts been widely acknowledged? 

I can think of a lot of things we are doing right. For instance, Nigeria still has an amazing maternal social support system. A nursing mother hardly ever has to go it alone. Rich or poor, there is a neighbour, friend, mother or mother–in-law, or sister who is delegated, or who takes it upon herself, to mother and pamper the new mama for months. Might a practice like this contribute to mothers’ mental health shortly after delivery in richer nations like the United States?

In a country with so many challenges, getting through a pregnancy, while highly desirable, is an alarmingly risky business. Can you begin to imagine what the infant and maternal mortality rates would have been like without a powerful communal support system for every new mother? Fully-paid maternity leave for four months has improved what would have been a colossal disaster if working mothers had to return to work a month after delivery, or lose their jobs.

 I live and work in Nigeria and have been in the United States for four whole months. The question I ask myself is, “What can I offer in terms of ‘international health’ to America?” Quite a lot, I have discovered. One of them has been sharing hands-on experiences about the public health practice in Africa from a different angle.  Believe me, it is better than reading it in the books. Also, I have found a community centre in my neighbourhood where I volunteer once a week to set tables and help feed the homeless.  (And yes, people, there are homeless folks in America.)  Really, the greatest gift these ‘poor’ countries can give the United States is to look within themselves and solve their problems so that America can redirect some of the outgoing resources inwards. In my opinion, international health should mean the practice of sharing health information and services by all peoples with all peoples and not a one way trip by the rich to the poor.  After all, what is a relationship, if one partner only gives and the other only receives?

Dr. Teresa Nwachukwu is a Humphrey Fellow at Tulane School of Public Health and Tropical Medicine. Her area of research is Health Systems Strengthening with special focus on the human resource component system.

Transdisciplinarity: global health workers breaking down walls

by Eckhard, posted in APHA IH Section, Guest Blog, Health Systems, Maternal and Child Health

Message from Miriam (Section Chair)

As a lifelong international MCH professional, as a faculty member, and as citizen of the world, I am so excited about chairing IH Section this year. To me, what is so special about international health is that it is a transdisciplinary field. The term “transdisciplinary” may be new to some of you, so here’s the definition, developed by Piaget (yes, the same Piaget), translated by yours truly: “concerning interdisciplinary discourse, we hope to see a higher level emerge, “transdisciplinarity,” which would not settle for interactions or reciprocities between specializations, but which would internalize such interaction within an overall construct, and break down the walls between disciplines.” Continue reading “Transdisciplinarity: global health workers breaking down walls” →

Failed Leadership of the Health Sector in Addressing the 2008 World Food Crisis

by cteller1, posted in APHA IH Section, Food/Nutrition, Guest Blog

By Charles Teller

Where have international nutrition and health sector leaders been during this serious 2008 crisis of spiraling food crises that are worsening food and nutrition insecurity among the most vulnerable in the world?

At a lively, standing room only session (#3302) on the 2008 Global Food Crisis Monday at the APHA meetings, the 4 panelists and moderator agreed that it was much more than a crisis. It reflected a longer term structural and systems issue related to food poverty, international trade, climate change, energy and environment. Case studies on India and Ethiopia helped to contextualize the intra-country discrepancies in undernourishment, stunting and wasting.

On my Ethiopian case, I contrasted the apocalyptic press statements in September 2008 of the UN ( FAO, WFP,Humanitarian Affairs) with my Oct. 20th interview with the well-informed Minister of Health of Ethiopia who felt that overall high inflation and energy costs, as well as drought, were more serious shocks  to health and nutrition of his people.  In presenting the long and short-term trends in food access and malnutrition in Ethiopia, I found that this discrepancy in information reflects the lack of representative and reliable data on the evolution of the situation, causes and immediate effects. Continue reading “Failed Leadership of the Health Sector in Addressing the 2008 World Food Crisis” →

Community-Based PHC: So What’s New??

by Eckhard, posted in APHA IH Section, Community-Based Primary Health Care, Guest Blog
Trying to keep up with the flow of ideas
Participants Trying to keep up with the flow of ideas

By Janine Schooley

Sometimes I get the question, “So what’s new and innovative in CBPHC?”  The answer is that there isn’t anything new, and that’s the point!  We already know what we need to do.  We have the bullets, as someone said, but the gun seems to be elsewhere or malfunctioning.  I think it isn’t that we don’t have the gun.  I just think we have misplaced it, or it needs some tinkering to get to work, or we need to remind ourselves how to pull the trigger.  I really dislike this analogy for it’s militaristic and violent connotations, but I couldn’t come up with anything better….So, to continue this horrible analogy, we have several bullets and they are inexpensive, tried and true.  We know the power of exclusive breastfeeding, good antenatal care, immunizations, long lasting insecticidal nets, good nutrition, and other low cost, low tech interventions in terms of saving lives and improving quality of life.  We’ve been talking about this for decades, not just amongst ourselves, the practitioners in the field, but at the highest policy levels.  As the September 13-19, 2008 Lancet reminds us, a major milestone, the Alma-Ata Declaration, was issued 30 years ago.  So what’s new isn’t the need for what the Alma-Ata Declaration so eloquently calls for, but perhaps it’s the realization that we still haven’t gotten there.  In other words, we don’t need innovation.  What we need is inspiration and, as Nike so aptly puts it “Just do it!”.  Continue reading “Community-Based PHC: So What’s New??” →

APHA San Diego: A passion for Primary Health Care

by Eckhard, posted in APHA IH Section, Community-Based Primary Health Care, Guest Blog

By Monica Dyer

WHO World Health Report 2008
WHO World Health Report 2008

Attending the Community-Based Primary Health Care workshop yesterday was one of the most invigorating experiences I have had in quite a long time. It was so fantastic to meet people carrying out work that I have been constantly thinking and talking about the need for. As my colleagues and I struggle to establish a comprehensive community health center in Gatineau, Haiti we are constantly trying to figure out whether or not we are actually implementing best practices. While we all value the importance of making decisions based on evidence and learning from others’ mistakes, it is incredibly challenging to find detailed information. Through this process and past research, I have been made especially aware of the need for more accessible and thorough documentation of both effective and ineffective practices and implementation experiences in global health.

This is not to be unexpected as organizations carrying out this work are usually so over-extended and resource constrained that documenting their processes and practices often becomes low-priority unless it is to meet the requirements of funders. However, when this is the purpose of such documentation the tone changes from factual reporting of successes and failures to trying to demonstrate efficacy so that a donors will keep sending money, so financial survival is not the best motivating factor for the objective documentation needed. In my own experience so far, although we have said that documenting and sharing the entire process of establishing a community health center would be a very useful activity that we would like to do, we have thus far been unable to follow through while dealing with all of the day-to-day logistics of running a clinic, seeking/maintaining funding and the planning of future programs and community organizing. If we had a volunteer historian or could work with students to take the documentation process on as a project for course credit, it might be much more feasible. However, with limited time to coordinate such efforts and so many critical activities competing for our resources, this honestly falls relatively low on our hierarchy of needs. 

I was encouraged when I recently heard about the Global Health Delivery Online www.ghdonline.org but somewhat disappointed that it thus far only includes HIV, TB and Technology discussion communities. Understandably, these are in the scope of the founding collaborators’ chief interests but I hope they will continue to expand this venue into other important realms in need of increased attention. Continue reading “APHA San Diego: A passion for Primary Health Care” →