Guest Blogger: Amanda Hirsch
Research and data are a necessity to execute public health agendas – to identify populations in need, pinpoint existing gaps in healthcare systems, and to track and monitor progress. Data collection exists to ensure these necessary details are documented and not forgotten as every person, health affliction, and need is logged as a number, a figure, a statistic.
Data collection, although crucial, can also become highly counter-productive as this, a vast collection of numerated people and needs, can cause these people and needs to become just that – numbers.
Dr. Binagwaho highlighted the experience of West Africa during the recent Ebola epidemic, one in which the identities of thousands of individuals were lost to the tool most necessary for successful public health interventions.
When the faces and stories of West Africa became blended together through numbers and statistics, the potency of the cause and the intervention became lost. Data can allow people to disappear as their identities take-on a range of figures that highlight their poverty, poor health outcomes, and perceived failures therefore undermining their humanity, discouraging action and perhaps encouraging inaction by those that cannot see the direction nor the importance of the aid that is necessary.
Inaction, when these figures display what appears to be a hopeless and trodden population, is lethal to the real-life humans that the numbers account for.
The Rwandan Experience
In honor of David E. Barmes, renowned public health dentist and epidemiologist, the National Institute of Health (NIH) in Bethesda, Maryland hosted the annual Barmes Global Health lecture featuring Rwandan Minister of Health Dr. Agnes Binagwaho on “Medical Research and Capacity Building: The Experience of Rwanda.”
As the sole presenter, Dr. Binagwaho spoke upon her experience as a physician, researcher, and government health official in her native Rwanda and the country’s substantial improvements in public health following the Rwandan genocide of 1994 that took the lives of over 500,000 citizens.
In need of rapid and effective reconstruction efforts after the end of the civil war, the country was pushed to reinvent its public health systems and infrastructure to make Rwanda a stronger and healthier country than it had ever been before.
Since the genocide, Rwanda, a country smaller than most American states with a population of slightly over ten million, has achieved health outcomes for its people that far surpass those of many developed nations. After reconstructive efforts, the under-five mortality in Rwanda decreased by three-quarters, life expectancy nearly doubled, vaccination rates skyrocketed to 90% for vaccines such as HPV for both young boys and girls, and over 90% of Rwandans acquired health insurance coverage.
“Rwanda is a clear example of what is now possible in sub-Saharan Africa”- Dr. Agnes Binagwaho
How were such great achievements accomplished? An emphasis on resilience- a concept that requires not only a strengthening of health systems, but a focus on strengthening the backbone of those health systems as well- the people.
Research and data collection were key to Rwanda’s reconstruction efforts. In Rwanda, Binagwaho explained that public health workers used this research and data to the population’s advantage, maintaining a scientific and moral responsibility to the people, leaving no one behind and holding research to a new standard: an impact- focused standard that would not allow for inactivity.
The people maintain culture, infrastructure, morale, and economic wellbeing. When the people are healthy and stable, the benefits to the country are immense. According to Dr. Binagwaho Rwanda recognized this connection, encouraging vast vaccination campaigns, emphasis on maternal and child health, and a reach for universal health coverage to protect the country’s most valuable asset. In turn, Rwanda experienced substantial economic growth, social rest, and improved population health- a feat that would not have been accomplished had the needs of the people not been put first.
You can hear Dr. Agnes Binagwaho’s presentation at the NIH here.
Amanda Hirsch is a summer Global Health intern for APHA. She is starting her final undergraduate year at the GWU Milken Institute School of Public Health. Her passion for global health began in rural Honduras, and she is particularly interested in disparities in healthcare systems that affect the Latino community. She intends to pursue an MPH degree with a dual concentration in Community-Oriented Primary Care and Global Health. You can follow her on Twitter at @amandahirsch12.