Improving LGBT Health Education in South Africa: Addressing the Gap

I first became interested in the topic of lesbian, gay, bisexual, and transgender (LGBT) health care and health education while working as a country lead for the Presidential Emergency Plan for AIDS Relief (PEPFAR). During my time there I had the opportunity to travel to South Africa and understand their community and health care system a bit better, with an emphasis on their HIV/AIDS epidemic. This post focuses on the LGBT history in South Africa, recent developments, addressing that there is a gap between homophobia and non-judgmental care, and the importance of health care workers understanding LGBT health education.

More and more countries around the world are opening their arms to welcome and embrace LGBT pride. South Africa has one of the world’s more progressive constitutions which legally protects LGBT people from discrimination, although current research indicates that they continue to face discrimination and homophobia in many different facets of life. The most recent milestone occurred in 2006 when the country passed a law to recognize same-sex marriages. Nevertheless, LGBT South Africans particularly those outside of the major cities, continue to face some challenges including conservative attitudes, violence, and high rates of disease. As the country continues to grow there seems to be an increase in LGBT representation (with approximately 4,900,000 people identifying as LGBT) whether it is through activism, tourism, the media and society or support from religious groups. So, what about LGBT health education? Continue reading “Improving LGBT Health Education in South Africa: Addressing the Gap”

Addendum: What does health reform have to do with IH?

While I am sure that most of you have been riveted by my recaps of APHA’s Mid-Year Meeting on health reform, many readers are probably asking what the heck I, your friendly neighborhood Communications Chair, was doing there, and why the IH section was asked to send a representative to this meeting. The whole purpose of inviting section representatives and state affiliate leaders was to stimulate discussion about health care reform as it related to each section or affiliate’s work, and how the sections and affiliates could get more involved in the effort. Upon discovering this, my mind drew a blank.

How does health reform relate to the work of our members?

After some thought, I can see two major areas in which our membership would be interested in health reform. The first is in border health: despite the increased coverage that came with the new law, it does not cover undocumented immigrants and even some classes of migrant workers with temporary work visas (for example, those who come to work during the harvest season).

The other area is in sharing information. Our health reform battle has received much global attention, and the international health community is interested in the way the new health legislation will finally take shape and how individual communities will implement it. Also, a lot of the population health and wellness challenges that are being targeted by the Public Health and Prevention Fund grants (e.g. obesity, diabetes, tobacco use) are receiving increasing amounts of attention in developing nations as professionals are realizing that these countries share a disproportionate burden of chronic conditions. IH members who work in communities outside the U.S. may be interested in seeing how communities here address these issues, and they could apply some successful programs to their own communities facing similar issues.

The section representatives and affiliate leaders attended a luncheon that served as a breakout session to discuss these very issues. We were divided into geographic regions by table (which did not seem to make a lot of sense for section members, but it was productive nonetheless) and hashed out our impressions from the meeting and how the sessions related to the work of the sections and/or affiliates. APHA plans to use the notes from these discussions to compile a report for the sections and affiliates to use in their work as it relates to the mid-year meeting.

International Health: A One-Way Trip?

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.

World Pneumonia Day

November 2, 2009 is the first annual World Pneumonia Day, recognizing the world’s leading child killer as a global public health issue. A network of nearly 100 IGO, NGO, research and academic institutions, foundations, and community-based organizations have joined forces to raise awareness and urge governments and policymakers to combat this preventable illness. Each year, over 2 million children under the age of five die from pneumonia and pneumonia-related complications.

Although this is a great venture, it is surprising to see that this is the first campaign of its kind. Being the leading killer of children, it is outrageous to know this disease is not only treatable, but preventable. It leads me to wonder: “Why hasn’t more been done?” Mary Beth Powers, Campaign Chief of Save the Children said in an interview about pneumonia, “The sad thing is this is a disease that is largely preventable, and highly treatable.” This is not a disease that requires decades of scientific research to find a cure. Watch the movie.

According to leading public health organizations such as the World Health Organization (WHO) and UNICEF, many deaths can be prevented through early vaccination, proper medication (antibiotics) and nutrition, and vitamin supplements, such as zinc that is not typically found in a lower-income diet. Read more about the cause, prevention and treatment of pneumonia at the World Pneumonia Day website.

I would encourage everyone to spread the word about World Pneumonia Day, so greater awareness is made. The coalition firmly believes these deaths can be avoided, and encourages others to join the fight against pneumonia by:

1. Signing the pledge to fight pneumonia
2. Joining the coalition
3. Donating to the cause
4. Educating others about pneumonia prevention, diagnosis and treatment
5. Participating in a World Pneumonia Day event

Dr. Sanjay Gupta for Surgeon General: a Smart Communications Choice

I was surprised when I first heard about Dr. Sanjay Gupta’s possible appointment to US Surgeon General by president elect Barack Obama.  What type of message did it send to young people in the field of public health that the pathway to leadership was through the lens of a TV camera rather than toiling in the trenches of public health programs?  Continue reading “Dr. Sanjay Gupta for Surgeon General: a Smart Communications Choice”