Global Health News Last Week

POLITICS AND POLICY

Human Rights Watch has urged the Bahraini authorities to halt what it said was a “systematic campaign” to intimidate doctors and other medical staff suspected of sympathising with recent anti-government protests.

PROGRAMS

  • The GlobalPost has been doing an excellent series of stories examining President Barack Obama’s Global Health Initiative (GHI) is focusing on in Guatemala. Slow in its implementation and hampered by little new money, GHI was supposed to be an example of Obama’s new, innovative commitment to global health.
  • The King of Swaziland has called for all of the men in the South African nation to get circumcised in order to prevent the spread of HIV/AIDS.
  • Results from a pilot program in Philippines have shown that deaths from rabies can be dramatically reduced when taking a community driven bottom up approach.
  • A child in Khartoum, Sudan is the first to receive a rotavirus vaccine, kicking off a campaign to vaccinate children in 40 low and middle-income countries.

RESEARCH

  • A recent report from UNAIDS cites data from a recently released South African study that shows the effectiveness of male circumcision reducing HIV prevalence in men.
  • A campaign to encourage African men to get circumcised to prevent infection by HIV gained a powerful boost on Wednesday by three new studies unveiled at an international AIDS forum in Rome.
  • A new study has found that women in conflict areas want to utilize
    contraceptives, but only 4 to 16 percent are able to gain access.
  • At the International AIDS Society, one of the big stories is a CDC study showing the drug Truvada prevented HIV transmissions in more than 60 percent of heterosexuals. The study’s author Dr. Michael Thigpen discusses how much Truvada costs, why HIV is so pervasive among women in Botswana, and how much people must take the drug for it to be effective.
  • Researchers have discovered that chloroquine, often used to treat malaria, may be effective in treating other autoimmune diseases.
  • An antiviral drug to combat HIV/AIDS synthesised by genetically modified plants is being tested on a small number of women in the UK to establish its safety, reports the Guardian.
  • A recent study has shown that stress experienced by a pregnant mother can have a negative impact on the development of the child in the womb.
  • Researchers presenting at the 6th International AIDS Society Conference on HIV Pathogens, Treatment, and Prevention in Rome, say that they have inched closer to a vaccine by leveraging a genetically altered version of SIV.

DISEASES AND DISASTERS

  • The World Health Organization is sounding the alarm on hospital safety and infections acquired while patients are in a health care facility, saying that a hospital  stay is riskier than air travel.
  • Researchers have determined that Hepatitis C can be transmitted sexually, after performing a 5 year study on HIV positive MSM.
  • Famine in parts of southern Somalia has killed tens of thousands of people, mostly children, the UN said Wednesday in an official declaration of what aid officials describe as the worst humanitarian crisis in the troubled country in two decades.
  • A new study warns that Pakistan “risks becoming the last global outpost of [polio], this vicious disease.” The disease has also resurfaced in four other countries.
  • Even in developing countries where child mortality is falling, the poorest under-fives are at high risk of dying from entirely preventable diseases because they do not receive basic immunization and have no treatment for diarrhea.
  • Peter Hotez, president of the Sabin Vaccine Institute, says new studies indicate a parasitic infection, schistosomiasis, may be one of the most important — and least recognized — co-infections increasing the risk of HIV transmission.
  • An All Africa editorial examines how the price of drugs leads to deaths that could be otherwise averted.

Reflections on Community Based Participatory Research

Guest Blogger: Xeno Acharya

As an MPH student at University of Washington, Seattle, I have often wondered if Community Based Participatory Research (CBPR) is a philosopher’s stone in the academics’ head. Having worked in Ethiopia and Sudan (as the researcher) and having been born and raised in Nepal (as the researched), I have come face to face with both sides of this idealistic myth.

In short, CBPR is a research method that has three core elements: participation, research, and action. It emphasizes “authentic partnership” between the researcher and the community, in which perspectives, knowledge, resources, and skills of both are combined.

It is important to remember that most of the time it is the researcher that initiates the research, no matter how participatory. For purposes of convenience, let’s call the researcher M and the researched N. M brings in research funding, manpower, technology, and white man’s knowledge. N (hopefully) brings in local experience, networks, subjects, manpower, and consensus to have been intervened/researched. When I was in Sudan and Ethiopia, I was a Caucasian-looking male who was struggling with the language and cultural nuances, but who was also clearly better paid than most staff working in the same company although I neither had the educational background or the experience the local staff members did. My positionality affected the way my colleagues spoke to me about their work and about themselves, and no amount of CBPR could overcome that.

In Nepal, too, the same power dynamics played out. Although I am a native there and speak the language, I look “white,” and the clothes I wear and the way I walk scream the fact that I have clearly not been around in Nepal for a while. I work for a small non-profit based in Portland, Oregon, that runs a school for untouchable refugee children in Kathmandu. When I visit the school every couple of years, I get the attention (I like) from kids and parents alike, not just because I am the founder but also because of the same power dynamics that comes back to bite at me again and again. So I have settled for the fact that the imbalance is always going to be there no matter what. To me, CBPR is a theory that can never fully come to fruition. Like communism, the idea itself is good and is meant to do well, but a hundred percent CBPR is only a goal to strive for, never a reality.

That said, I think CBPR is still an idea to strive for. There are things I (as a researcher) can change to reduce the imbalance of power between myself and the researched/intervened, and they are still important to do. Reflecting on my own positionality and being aware of this power dynamics is something that I can constantly incorporate in my work; so can you!

Xeno Acharya, originally from Kathmandu, Nepal, is an MPH candidate at the University of Washington. In Nepal, he has worked with local NGOs on awareness campaigns on disability among children, taught in mobile schools for displaced populations, and currently runs a school for children of victims of the civil war (1996-2008) through Namaste Kathmandu; he has also worked on short-term projects in Ethiopia and Sudan. He is currently a research assistant in the Health Systems Strengthening division of a Seattle-based non-profit called International Teaching & Education Center for Health (I-TECH) and is interested in infectious disease prevention, refugee populations, and health systems strengthening.