At least one Congressman is being reasonable about Syrian refugees

by ihsection, posted in APHA IH Section, Conflict and Health, Guest Blog, Human Rights, Policy and Advocacy

In response to an online petition, Dr. Amy Hagopian, our Section’s Nominations Committee Chair, received the below thoughtful reply from her Congressman, Adam Smith (D-WA). The petition asked that U.S. welcome refugees from Syria, despite opposition from xenophobic governors around the country. Here’s a link to a petition YOU can sign!

Dear Amy,

Thank you for contacting me with your concerns regarding the situation in Syria. I appreciate hearing your thoughts on this important issue.

The civil war in Syria is a highly complex struggle between Bashar al-Assad’s authoritarian regime and the fragmented groups that oppose it. As the conflict in Syria has become more violent and protracted, radical elements that directly and seriously threaten our and our allies’ security have become more powerful. It has also become an enormous humanitarian catastrophe. Since the unrest and violence began in 2011, the number of Syrians seeking refuge in neighboring countries or Europe has increased above 4 million. The United Nations Refugee Agency reports that 12.2 million people inside Syria have been affected by the conflict, with nearly 7.6 million displaced internally.

The tragic terrorist attacks in Paris have complicated the situation even further. Our number one priority must be protecting the United States and the American people from terrorist attacks. In the strongest possible terms, I condemn the cowardly attacks in Paris and send my deepest sympathies to the victims. I also welcome the French government’s increased efforts to combat terrorists in Syria. It is important that as we fight terrorism, we must stay true to the values enshrined in our Constitution, remember that we are a nation of immigrants, and not let terrorist groups define or change who we are.

Amidst the conflict, radical groups – like Jabhat al Nusra and the Islamic State of Iraq and Syria (ISIS) – have established safe havens and where, they have attracted substantial financial resources. The strongest and most violent group, ISIS, has continued a campaign of terror and has launched violent and deadly attacks in Northern and Western Iraq. ISIS victories over the Iraqi armed forces have made them a real and dangerous threat to the government in Baghdad and the region. Additionally, the civil war in Syria has attracted a large number of foreign fighters, including from Europe, many of whom are fighting with forces affiliated with ISIS or al Qaeda. As we have seen, these foreign fighters may eventually return to their home countries or go to others where their new combat skills and increased radicalization can be used to subvert other governments.

The civil war in Syria has devolved into a protracted conflict that is dangerously destabilizing. The increasing flows of refugees to neighboring countries place a real strain on already over-burdened public services. Sectarian tensions are on the rise and can lead to further displacement of refugees as host communities become increasingly frustrated with the length of their stay. The humanitarian crisis is quickly shifting from being a consequence of the Syrian conflict to being a potential driver of conflict itself, threatening regional stability. Additionally, the increased activity of Hezbollah, the Iranian-allied militia within Lebanon, and its involvement in the Syrian conflict has escalated tensions between Lebanon and Israel, presenting a great security risk.

The United States has not turned a blind eye to the hurt and suffering of the Syrian people and has been the largest contributor of humanitarian assistance to the crisis, providing over $4.1 billion between Fiscal Years 2012 and 2015. These funds have been used to provide critical, lifesaving services for internally displaced populations within Syria and refugees in neighboring countries, including Jordan, Iraq, Lebanon, Turkey, and Egypt. Channeled through United Nations (UN) agencies and non-governmental organizations, U.S. emergency assistance provides Syrian families with food, medical care and supplies, shelter, and funding for water, sanitation, and hygiene projects.

Due to the worsening refugee situation and immediate need for increased assistance, on July 31, 2015, the U.S. Agency of International Development (USAID) announced an additional $65 million in emergency food assistance. These funds are for the UN World Food Program (WFP), which serves approximately 4 million people inside Syria and 1.6 million refugees in neighboring countries every month.

To help address the refugee crisis, I have taken a number of steps. I supported increased funding for refugee-related program in Fiscal Year 2016 so that resettlement agencies have the resources necessary to help these refugees. I believe that helping our partners in the region and European allies cope with this stressful and destabilizing situation is in our national interest and ultimately helps keep this crisis from devolving into further chaos. I also joined a letter to Secretary of State John Kerry and Secretary of Homeland Security Johnson asking them to increase the number of people eligible to apply for refugee status. I have also called for the Department of State and Homeland Security (DHS) to improve coordination of the lengthy security check process for those applying for asylum, as well as informing families when some but not all of their members have been cleared. Finally, I have joined other members in advocating for the U.S. to increase the number of refugees we are admitting through our resettlement program from 70,000 to 85,000 per year.

To date, of the millions of law-abiding Syrian refugees, less than 1,800 have been resettled in the United States. Applicants for refugee status are held to the highest level of security screening through which we evaluate travelers or immigrants to the United States. If as a result of the security process, U.S. security agencies cannot verify details of a potential refugee’s story to that agency’s satisfaction, that individual cannot enter the United States. I will continue to pursue ways to make sure our vetting process is effective, without unduly burdening bona fide refugees fleeing the terrible situation in Syria and Iraq.

To be very clear, the United States thoroughly vets all refugees. Refugees are subjected to an in-depth interagency vetting process that includes health checks, verifications of biometric information to confirm identity, and multiple layers of biographical and background checks. Moreover, applicants get interviewed in-person. Members of the interagency team includes the FBI’s Terrorist Screening Center, the State Department, DHS, the National Counterterrorism Center, and the Department of Defense. The background check process takes between 18-24 months, happens before an application is approved; and occurs long before a refugee would be able to enter the United States.

The American SAFE Act of 2015, H.R. 4038, which was brought to the House floor for a vote by House Republicans on November 19, 2015, would effectively shut down resettlement of refugees from the Syria and Iraq region. It is wrong to deny asylum to refugees on the basis of inaccurate assumptions, fear, and prejudice, and that is why I voted against it. We must continue to stand strong as an international community and remember that refugees are fleeing terrible conditions and persecution. As we move forward, let us unite to use the tools at our disposal – diplomatic, military, intelligence, and development – to defeat extremism and the terrorism it breeds.

I have also heard several concerns regarding U.S. military involvement in Syria. I am acutely aware of the great cost we incur in both blood and treasure when we ask our men and women in uniform to secure our interests abroad. I share your concerns about becoming militarily involved in another costly conflict in the Middle East. Any consideration of the use of U.S. military force is not one to be taken lightly – especially considering our experiences in Iraq and Afghanistan and the limited ability to affect certain outcomes in those countries. Ultimately, this is a fight between the Syrian people about who will control the future of their country.

The best way to protect ourselves and our allies in the region from the chaos in Syria is by building the Syrian moderate opposition’s capacity so they can stand their ground and fight this war. There is no easy way to identify those elements in the opposition that we can work with, although we have some developed some local allies, such as the Iraqi and Syrian Kurds and some local Sunni allies and are working to identify additional such forces that we can support. By helping those who are fighting ISIL, the U.S. can ensure moderate elements have a chance at playing a role in the creation of an inclusive transitional government, if a peace deal were to be reached in the future.

Due to the extremely concerning developments in Syria and Iraq, the President has taken a number of actions. First, the United States has conducted literally thousands of airstrikes intended to degrade ISIS in Syria and Iraq, reduce their ability to raise money, and to support the local allies we have identified. We are also currently retraining and equipping a number of brigades in the Iraqi Army and Congress has provided over $1 billion for this process. The President also decided that training and equipping moderate elements of the opposition was necessary in Syria. On June 26, 2014, he requested $500 million as part of a supplement to the budget request known as “overseas contingency operations.” These funds would be used to train and equip vetted elements of the Syrian armed opposition to help then fight against the Assad regime. As you may know, this training program did not meet expectations nor objectives and the training portion has been suspended. Since that time, however, the approach has transitioned to equipping moderate elements in hopes of empowering them in this fluid situation, and the President has announced that fewer than 50 U.S. Special Forces will be deployed to Syria to help accomplish this goal. I will continue to monitor developments in the region, understanding that there are always risks involved in conflict and I do not take them lightly.

Moreover, I support the Obama Administration’s diplomatic efforts to find a political solution to the situation in Syria that respects the rights of people. While those efforts have not yet produced any sort of agreement that would lead to an end of the war in Syria, I believe that it is helpful to have the major international countries that are involved in the conflict in Syria discussing possible ways to bring about a political transition and end to the civil war. Hopefully, such a course forward would also address the underlying causes of the refugee crisis. Until a solution can be found, we must continue to help those seeking refuge. We cannot let what happened in Paris cloud our judgement, drive policy or destroy the fabric of what America stands for. We need to be strong and smart to fight terrorism. If we turn our backs on refugees, then we risk making ISIS stronger.

Again, thank you for contacting me with your concerns regarding these important issues.. Rest assured that I will closely follow the continuing developments as they arise. Should you have any additional questions or concerns, please do not hesitate to contact me again.

Sincerely,

Adam Smith
Member of Congress

#APHA2015 Governing Council Report

by ihsection, posted in APHA IH Section

The following summary of the Governing Council session at this year’s Annual Meeting in Chicago was compiled by Carol Dabbs, the Section’s Whip for this year. We look forward to next year’s summary by Governing Counselor and 2016 Whip Caroline Kingori.

Seven members of the IH Section represent us on the APHA Governing Council (GC); the number of representatives is based on the number of primary members in the section. State affiliates and the other sections also are represented on the GC. Each year, we meet on Saturday afternoon and again all day on Tuesday. Many items are introduced during the Saturday session, with votes being taken on Tuesday. This provides an opportunity for GC members share the status of the agenda and options to be decided with the rest of the section during the Sunday afternoon and Monday morning IH Section meetings.

GC conducts the basic business of the Association, including setting bylaws; electing the President, Executive Board members, and Nominating Committee members; and approving APHA Policies. Because of the importance of these matters to the Association, serving as a GC member is rewarding for those who have patience with large meetings following strict parliamentary procedure. We also receive reports from the Executive Director, the Executive Board, and many APHA-wide Committees.

This year’s agenda was fairly typical. The following decisions were taken by the GC this year:

  • As discussed on our conference call in June, we approved revisions to the SPIG policy, which allow new SPIGS to have sufficient time to identify those who would join the SPIG if formed, and also a new policy regarding sections which details the process for a SPIG to become a section.
  • The Program Emphasis for the 2017 Annual Meeting will be Climate Change. Further refinement of the exact wording will be done in a smaller body. (Wordsmithing in a group of over 200 is not considered a good use of time!)
  • The proposed dues increase of 10% for each category, rounded to the nearest $5 was approved by a majority of 68%.
  • Bylaws changes to increase student representation on GC, and to improve wording concerning the editor of the AJPH and women’s issues were approved.
  • Proposals for archiving of older policies were approved, except for those relating to civil rights, which were instead approved to be reviewed for updating during the next year. Such updated policy proposals would be considered at the 2016 Annual Meeting.
  • Fifteen policy proposals were approved as part of a consent agenda recommended by the Joint Policy Committee. Two proposals were removed from the consent agenda at the request of GC members, for discussion during this meeting along with the two late breaking proposals. These were as follow:
    • B8: Cancer Prevention. The Joint Policy Committee (JPC) advised against passage of this policy for several reasons; it failed by a wide margin.
    • D4: Role of Health Educators. Amendments were offered and passed regarding the definition of Clinical Social Workers (CHW) and the relationships between Health Educators and CHW. The policy passed as amended.
    • LB1: Leveraging Community Development Investments to Improve Health. This passed with 96% of the vote.
    • LB2: Negative HIV Test as a Condition of Employment for Foreign Nationals. This proposed policy, developed by our own Jessica Keralis, passed with 95% of the vote. As with all approved late breaking policy statements, it will be considered (possibly in amended or refined form) for approval as a permanent policy at next year’s Annual Meeting.
  • The president-elect is Thomas Quade.
  • Elena Ong, Benjamin Hernandez, and Marc Guest were elected to Executive Board. The new chair will be Lynn Bethune.

#APHA15, Day Four: Wednesday is for Breakfast, Presentations, Moderating, and Final Thoughts

by Jessica, posted in APHA IH Section

The final day of the conference is normally a pretty relaxed. Section members have typically eaten a good meal (and had a good laugh) at the Awards Dinner and social, the Governing Council has convened to pass policies and elect APHA presidential and executive board candidates, and they have had plenty of time to scope out the expo for the best SWAG. For me, however, this was not the case: the highlight of my Annual Meeting experience was presenting my very first abstract on Mandatory HIV Testing in the Republic of Korea at the International Health and Human Rights session.

Global Health Leaders Breakfast
My last day began early with the Global Health Leaders Breakfast hosted by APHA and coordinated by Vina HuLamm, our Global Health Manager on APHA staff. This year’s featured speaker was Dr. Sir Michael Marmot, arguably one of the most well-known and respected epidemiological researchers in the world. Unfortunately, I could not stay long enough at the breakfast to hear him speak, as my presentation was the first one of the session and began at 8:35 sharp, but I did have enough time to snap a picture of him with some of our Section leaders.

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Alas, one drawback of being the Section’s Communications Chair is that I am usually behind the camera. Maybe I can hire a Co-chair in time to be in the picture next year.

I also got a chance to hear Dr. Jim Chauvin, a Canadian public health professional and former president of the World Federation of Public Health Associations, introduce Dr. Marmot and share his excitement about the election of new prime minister Justin Trudeau, which he hoped would bring a revival of public health and its prioritization. It is too soon to tell whether Trudeau will usher in a public health renaissance, but videos like this one lend some optimism to the prospect:

Presenting on International Health and Human Rights
After Dr. Chauvin finished his remarks, I dashed off to the International Human Rights session to present my abstract on Korea’s discriminatory policy of mandatory HIV tests for foreign English teachers and EPS workers. I was the first presentation of the session and was followed by two presentations on Palestinian human rights violations by the IDF in the last Gaza war, a talk on women’s rights with the Beijing Declaration as a framework, and an overview of USAID’s efforts to promote gender equality within its development projects (e.g., an indoor residual spraying program). Palestinian human rights is obviously a hot topic, and our Section in particular is active on the issue (and even has a Palestinian Health Justice working group), so most of the discussion with the audience focused on those talks. However, I did get one question from the audience that allowed me to discuss the difficulty in overturning HIV-related travel restrictions in national immigration policies.

Moderating M&E
I volunteered to moderate our Section’s session on Monitoring, Evaluation, and Quality Improvement, which is of particular interest to me as an epidemiologist and a research specialist. This session was a bit shorter, featuring three presentations on different monitoring and evaluation programs, including a health and microfinance intervention in Tanzania, adapting an existing system to monitor the WHO’s efforts to mitigate the Ebola outbreak in West Africa, and an effort to improve data usage by reducing the number of indicators used in data collection to only those which are absolutely essential (always a win in my book!).

Final Thoughts
APHA 2015 marked the fourth Annual Meeting that I have attended, and the second that I attended as a member of the Section leadership. This one was one of the most successful for me personally: I had an abstract accepted and authored a late-breaker that was adopted (and will hopefully pave the way for a permanent policy position on the issue for APHA to adopt at next year’s meeting). I met lots of interesting and engaging people, made connections with emerging Section leaders, and even planned a global health jobs analysis as a joint effort between the Communications and Global Health Connections Committees (stay tuned for more details; we will be seeking volunteers soon!).

The Section leadership’s next hurdle is to make sure that interested members get plugged into the Section’s activities that interest them. There are always ways to get involved, put yourself out there, and gain valuable experience in global health advocacy, research, fundraising, and networking. Please contact any member of the leadership for more information on how to get more involved!

#APHA15, Day Three: Tuesday is for Science, Policy Victories (with T-shirts), and Awards

by Jessica, posted in APHA IH Section

Ever since my first meeting in 2009, my favorite aspect of the Annual Meeting has been the scientific sessions. It is a really great opportunity to keep track of emerging research and developments in your area of interest, meet other public health scientists and advocates (and potential collaborators), and get exposures to new ideas and approaches to public health issues.

HIV Prevention with an emphasis on PrEP
My first session of the day was International Issues in HIV Prevention, which featured presentations on PrEP and PEP access in Japan, elevated HIV risk among MSM in China, conception and family planning among HIV-positive women in South Africa, and the intersection of conflict, substance abuse, and HIV risk. (Basically, it had just about everything that interests me – HIV, human rights, refugee issues, and East Asia.) I was particularly pleased to have the chance to chat with the speaker who presented his work on PrEP and PEP in Japan, as I imagine that many of the same sociopolitical and cultural barriers to effective HIV prevention programs in Korea also affect Japan. I am hoping that his work will help to inform mine, and he took great interest in my work once he figured out that I was the person behind the late-breaker that his section had endorsed and was following very closely (he is a Governing Councilor for the HIV/AIDS Section).

After that, I dashed over to Chinatown to replace my phone at the T-Mobile store after the screen on my faithful Galaxy S3 bit the dust when I dropped my phone at a Spanish tapas bar last night, and to grab lunch. When you are the Communications Committee Chair, being without a phone (and unable to access social media and a phone camera at a moment’s notice) simply will not fly…and if the nearest T-Mobile store is in Chinatown, it seems only logical to get lunch in the neighborhood.

I made my way to the second PrEP session of the conference with my new phone in hand and had a chance to listen to presentations on provider perspective and challenges in prescribing PrEP and helping their clients get access to it, as well as studies on awareness and attitudes toward PrEP among high-risk groups, particularly MSM. PrEP is obviously a hot topic in HIV prevention and has unique implications public health in the US vs. globally (as approaches to approval, coverage, and provision will differ by country and depend how well a given health care system functions), and these presentations will be informative to my day job.

Policy Victories do Ninjas Make, so I Bought a T-shirt
After meeting a very nice red panda, whom I noticed on Twitter earlier in the day and who happened to be in the PrEP session at the same time, I had another shift at the IH Booth. It was there that, to my delight, one of our Governing Councilors e-mailed me to let me know that our late-breaker opposing mandatory HIV tests for foreign nationals passed with overwhelming support. Naturally I was thrilled, but unfortunately I was only halfway through my shift at the booth, so I resisted the urge to do my victory dance in the Expo (and potentially scare off interested members). After finishing my shift, however, I decided that getting a late-breaker resolution passed qualified me as a Public Health Ninja, so I treated myself to a t-shirt identifying me as exactly that.

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Afterwards, I headed to International Perspectives on Healthcare Administration, mainly to listen to the two presentations on research done on South Korea’s healthcare system.

Section Awards Dinner: Putting Faces to Names
The highlight of the day, of course, was the IH Section Awards Dinner and Social. This was a nice chance for me to unwind a bit, chat with other Section members (including some, like the chairs of the Global Health Connections and Student Committees, whom I had only spoken to by phone until now), and enjoy Gopal Sankaran’s great emcee skills and Paul Freeman’s delightfully Australian sense of humor. We had fantastic turnout even despite having the same time slot as the social for the Global Health Fellows Program.

My own Annual Meeting magnus opus is yet to come, however. Tomorrow morning I present my abstract on Mandatory HIV Testing for Foreign Nationals in the Republic of Korea: Human Rights Violations and Bad Public Health Policy. Stay tuned!

#APHA15, Day Two: Monday is for Networking (and @ninjasforhealth)

by Jessica, posted in APHA IH Section

After dashing hither and thither on the first day of the conference to ensure that our HIV testing late-breaker was ready, I woke up early on Monday morning to be ready for the real meat of the professional conference experience: networking.

International Health Section: Second Business Meeting 
The second IH business meeting – always held delightfully early at 7 a.m. – traditionally focuses on reports and updates of Section activities, both at the Annual Meeting and throughout the year. Most of the activity involves the elected leadership and committee/working group chairs. This year we had several observers, both regular members and students, which I thought was great, as it allows members to see the meat of what the Section does. GC Whip Carol Dabbs presented policies of interest that will go before the Governing Council today (including one on climate change), and Governing Counselor Caroline Kingori gave an overview of the candidates for APHA President-Elect and Executive Board. Program co-chairs Mini Murthy and Vamsi Vasireddy then discussed successes and reflections of the Program Committee in reviewing abstracts and putting the Section’s program together for the AM, which includes both scientific and invited sessions. (This committee is a great way to gain experience reviewing abstracts and always needs help – students, take note!) Finally, Global Health Connections Committee Chair Theresa Majeski engaged section members and leadership on how to better engage students and new members, including some strategies for improving how our Section communicates its activities (I guess that’s me). I personally plan to take those suggestions to heart, so readers will hopefully see some changes to this blog in the coming weeks, once the AM irons cool and we all recover from traveling.

Students Want Jobs: IHSC’s Career Roundtable
My next stop was the Career Roundtable session, where the Student Committee asked me to lead a discussion table as a freelancer and still-aspiring global health professional. My personal goal was to show that landing that “perfect job” in global health can sometimes take more time and persistence than originally anticipated, but there are different paths a professional can take to get there (including working in domestic public health to gain experience). I also wanted to provide a “Millenial” perspective on breaking into the field, as paths of entry now look very different than they did for Gen X. I also feel like my publications and freelance history in global health work speak for themselves, but I get that not everyone is interested in doing freelance work.

This was a very interesting experience for me. As predicted, students were hungry for tips on how to get an edge in the application process, how to get applicable volunteer experience (like participating in IH section activities), what types of short-term experience abroad are valuable for a resume, how to frame their domestic public health experience when applying for global health positions later (if they chose to go that route), and – always the key question – how to make themselves stand out from the (massive and ever-growing) pile of applications for the highly-coveted global health full-time jobs. There were questions about the Peace Corps (whose recent re-vamp of the way volunteers are recruited is much improved, thank God), how to secure valuable internships (and what those look like), the value of short-term missions trips, and where to find post-graduate fellowships that provide the initial year or two of experience required of most permanent positions. I also strove to keep the discussion candid, which gave me a chance to glimpse both the zeal and frustration of aspiring professionals of my generation. Stories of applying to dozens of jobs with a steady stream of rejections, worry over servicing student loans post-graduation, and outrage over the abundance of unpaid internships were common. I strove to emphasize that experience in state and local health departments and domestic non-profits can go a long way in building skills required by global health jobs, and that volunteer experience with global health and development organizations (like working with the IH Section!) is just as valuable as paid work. One student even asked me if I put my work with the IH Section on my resume, and I was proud to say that I do – and I usually put it first.

Public Health Expo: Staffing the Section Booth, Scoping out Schools, and Networking with Ninjas
The expo is one of my favorite parts of the AM. I love the bigness and busy-ness of it, and I have a hard time resisting the SWAG (though I was mostly successful this time since I am flying with Spirit). I started out by staffing the IH Section’s booth (many thanks to members who volunteered to do this, btw), engaging members and attendees interested in Section membership and promoting our Section activities at the during the meeting.

Section leaders at our booth in the Expo.
Section leaders at our booth in the Expo.

After my shift, I spent some time collecting information on doctoral programs from schools of public health, as I expect to be in the market for a Ph.D. or DrPH program in the next year or two. I got some great information on how to seek out funding and even got to practice my (rusty) French with the outreach coordinator of the London School of Hygiene and Tropical Medicine.

Unfortunately, I can never resist the LSHTM mugs, so I will have to find space for it in my oh-so-professional Hello Kitty bag.

I also chatted with several global health employers and programs, including PHI’s Global Health Fellows Program with USAID, Abt Associates, and the Public Health Institute. But my favorite booth by far was Ninjas for Health. This duo focuses on bringing emerging tech and development talent into public health and impressed me by calling for improvement and a wider variety of talent to the APHA Codeathon, which debuted this year (I think). These guys speak my language, and I highly encourage any members interested in technology, ICT4D, programming, and social media to check them out.

Note to self: Go back to this booth and buy a ninja t-shirt.

Next up: Tuesday is for Science!