Category Archives: Global Health

Toward Planetary Health

By Anne-Gaëlle Jacquin

What could a phycologist (an algae researcher) possibly do at CFHI? If you type this query into an Internet browser, it will probably ask “Do you mean psychologist?“ The link between global health and algae doesn’t seem obvious at first but there are definitely some common threads, specifically around sustainability.

I am a marine biologist. When I was in grad school, there was a daily barrage of news about the unprecedented scale of environmental and ecological damage  to our planet. While working on my PhD in algal biotechnology, what struck me was how algae had so much potential to help mitigate some of our sustainability challenges. Inspired by this, I founded The Algonauts Project in 2010 to chronicle algae innovations for sustainability. I met with more than 150 specialists, whom I call Algonauts, living in over 17 countries. These Algonauts are scientists, entrepreneurs, NGOs, fishermen, farmers and inventors. They develop applications with algae which help with food production, wastewater treatment, environmentally friendly aquaculture, CO2 offset, biomaterials, new medicines and many more innovations. To help spread their knowledge and enthusiasm about algae, I document these innovations and the stories of the Algonauts at www.algonauts.org.

When Dr. Evert, CFHI’s Executive Director, told me about the concepts of Planetary Health and One Health, I wasn’t familiar with them. In the subsequent weeks, the more I learned about these concepts, the more I found myself jumping with the excitement of a breakthrough!

Over the last few years, a common theme has emerged in sustainability science: to reach universal objectives of sustainability and address the complexities of global problems, there is a clear need for transdisciplinarity approaches and an integration of knowledge from experience and from science. The archetypal convention of separating natural and social science in academia had conducted in an incomplete understanding of nature-society interactions and the integrated dynamics of the ‘Earth system’ as a whole.

And often times, in such transdisciplinary work, weaving a compelling narrative across complex disciplines isn’t always possible.

This is where the concepts of Planetary Health and One Health make so much sense – they offer a powerful bridge between very different disciplines – health of the human population and the health of our environment, including animal health. This emphasis on the human health consequences of the degradation of natural systems throws into sharp relief the urgency and fragility of our current situation, and emphasizes that the health of one can not be examined without examining the other.

The concept of Planetary Health, recently formalized through the launch of a new journal, The Lancet Planetary Health, is defined as the achievement of the highest standard of health, wellbeing and equity worldwide. It encompasses a wide spectrum of disciplines for investigating not only the effects of environmental change on human health but also the human systems (political, economic, social) that govern these effects.

One Health recognizes human, animal and environmental health as interconnected and particularly emphasizes the interdisciplinary collaboration between human and veterinary medicine.

CFHI has long been committed to the promotion of Planetary Health and One Health and the diversity of its nearly 40 programs offer students and faculty the possibility to explore these transdisciplinary and integrated approaches and to acquire an intercultural literacy which is also fundamental for sustainability.

Offerings include the “Community Medicine from Rainforest to Coast” program in Ecuador, where students gain exposure to rural and community medicine in both rural and urban settings, exploring chronic, acute, and infectious and tropical diseases. The program provides anthropological insight into indigenous communities by learning the unique worldview of the Shuar tribe and their uses for traditional medicinal plants combined with spiritual practices. In this program, students will learn from local experts about a wide range of environmental disciplines (botany, animal husbandry, forestry, entomology) and the sociocultural and political aspects of jungle preservation.

In Kabale, Uganda, with CFHI’s “Nutrition, Food Security, & Sustainable Agriculture” program, students learn about veterinary approaches developed in the Rabbit Breeding and Training Center in Kabale, exploring how proper care and hygiene for raising rabbits are the grassroots for integrated economic, social and health improvements. Students also learn about ground-breaking integrated approaches for improving food security and nutrition. From primary care clinic to rural communities, students observe and contribute to the implementation of practical solutions in health, farming and education and the positive impact of these programs on maternal and child health.

You can explore CFHI’s offerings in Planetary and One Health here: CFHI Planetary Heath & One Health Initiative

Looking at sustainability through the lens of global health has been a very enriching experience, opening lots of new prospects. I can foresee algae in some of them and can’t wait to explore them further!
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Anne-Gaëlle is a marine biologist from Plogoff, a village in Brittany at the Western tip of Europe where the ocean is all around! In this end/beginning of the land, there is wilderness, quiet, wonderful lights and powerful storms. Anne is fascinated by nature, the universe and life as a whole, from the complexity of cellular mechanisms to human societies. She obtained her PhD from the University of Western Brittany in France and afterwards she felt the need to look at the bigger picture.  She saw that microalgae and seaweeds are fundamental in ecosystems and could play an even bigger role in the future for sustainability. After her PhD, when the reputation of algae was very negative due to green tides, she started a journey around the world to share the wonders of algae.  Learn more about her project at www.algonauts.org

A Recap of CFHI’s Time at PEGASUS 2016

Pegasus-logo

CFHI was proud to send their Program Coordinator, Lyndsey Brahm, to the 2016 PEGASUS Conference that took place in Toronto over May 13th to 15th.  PEGASUS is an acronym derived from the conference’s three main themes of peace, global health and sustainability. Leaders, change-makers, professionals and students from multiple disciplines convened to share their expertise in research, education, field experiences, advocacy and policy in order to address unacceptable levels of poor health nationally and internationally.

CFHI hosted a workshop on asset-based community development (ABCD) and introduced our vision into how recognizing assets within a community as opposed to what is lacking can prove to be a successful global engagement approach and can lead to communities feeling more empowered. CFHI has numerous partnerships throughout ten different countries and prides itself on fostering sustainable relationships and not being “fair weather friends.” We want the communities we work with to take ownership of their own development and to be enthusiastic about sharing their expertise with our global health scholars who come seeking new perspectives in health and medicine, outside of their own system.

Program Coordinator, Lyndsey Brahm asserts, “We want people to challenge their way of thinking and to see past what may initially appear as image2chaos and devastation; to lend time towards learning about innovative ideas already in place and community strengths that are critical to overcoming health challenges that persist within their community.”

A buzz was in the air as this thought-stimulating conference carried on throughout the weekend. One presentation that stood out from our perspective belonged to Matt DeCamp, Assistant Professor at the Johns Hopkins Berman Institute of Bioethics and in the Johns Hopkins Division of General Internal Medicine. He spoke on the subject of global health ethics, encouraging students and trainees to go abroad for longer, and the development of appropriate pre-departure materials. He shared his experience about a global health trip he undertook as a medical student at Duke University, where he faced challenges cultural differences and was exposed to human rights. He remembers feeling unequipped and under prepared to deal with such circumstances. He now contributes to the development of adequate pre-departure materials for those seeking an international health experience and runs focus groups for returnees at Johns Hopkins University.  CFHI recently gave a webinar on this very subject.  Which is available by clicking here.

CFHI was excited to be a sponsor for this year’s PEGASUS conference.. It is a valuable space for CFHI and others within the field to challenge one another and generate new ideas, actions and policies to improve the health and well being of the world’s citizens, whether on a small or large scale. The commitment is fierce.

The Joys of Motherhood: Sharing CFHI’s Impacts with my Children

Mother’s Day post by Jessica Evert, MD, CFHI Executive Director

It’s been said that “having kids- the responsibility of rearing good, kind, ethical, responsible human beings- is the biggest job anyone can embark on” (Maria Shriver). The challenge of mothering is monumental, yet there are precious pieces of this world that aid us in the journey. For me, one of those pieces is Child Family Health International (CFHI). IMG_7937 Jess & the kids

Through my involvement with and support of CFHI, my daughter has come to learn about a world beyond her imagination and comfort zone. I have been able to support mothers in 10 countries; community leaders who are passionate about making those struggling in their midst better off; and young people who are embarking on a transformative experience abroad that will raise their consciousness of global citizenship and make them feel a “a little softer about places that are not as economically well off,” as one CFHI Medical Director put it.

The day in and day out of mothering is a frequently overwhelming cacophony of whining, laughter, hugs, and shrugs. There are moments that intersperse our daily routine and allow us to expand our children’s worldview. These moments make us feel like super mamas. Through CFHI I am able to be the mother I want to be for my children and the children of the world.

Although my financial support of CFHI is modest, it is steady. Through this steady giving to CFHI, I am confident I am contributing to a better world. Through modeling generosity for my children, I am confident I am shaping the kind, ethical, responsible humans that I hope they will become.

Seeing India Through New Eyes: An Indian-American Student’s Study Abroad Experience

In December 2014, I left the comforts of San Francisco to take part in the Public Health & Community Medicine in India program through Child Family Health International (CFHI). During my 4 weeks in northern India, I had the opportunity to engage with and learn from various non-governmental organizations that are tackling public health challenges like injection drug use, sanitation, and prostitution. For the first week, we worked with a WHO-recognized organization in Chandigardh that focuses on women and children’s health care. One of my fondest memories from this experience was being able to interact with the female sex workers that this NGO helps. I had the opportunity to sit down and talk with Aditi*, who told me how her hardships from back home forced her to become a sex worker in order to keep her children in school. Listening to Aditi’s story really put my life into perspective. Aditi, who is a mom, sister, wife, and daughter, was literally sacrificing her own body for the sake of her children, something only a strong individual would be able to do. I couldn’t help or stop Aditi from being a sex worker, however what I could do was be someone she could talk to, someone who would listen to her, even if only for a short amount of time. It was an exchange of hellos, an exchange of respect, and an exchange of appreciation that I could give Aditi, and ironically, in the end, what she gave me. This experience taught me that it is impossible to understand a public health issue like prostitution without understanding the human beings whom it affects.

DeepaWhen I embarked on this experience, it had been 6 years since my last visit to India. The transformation I saw in the country was phenomenal. I noticed improvements in infrastructure and cultural changes. Years ago, the topics of HIV/AIDS or sex workers were very taboo. No one liked to acknowledge any health risks and the government wasn’t doing much to spread awareness of such issues. Visiting the country now and witnessing the many programs the government has implemented within each state was inspirational. Programs such as NACO have made such a difference in the lives of countless people across northern India by providing necessary services and supplies to lead a healthier and safer lifestyle. Apart from HIV/AIDS, I also witnessed changes in the caste system in India. In this system, “untouchables” are deemed to be the lowest caste because of their occupation of being scavengers (individuals who clean up human waste from homes due to lack of toilets). This program gave us the opportunity to work with a UN-recognized social service organization based in Delhi that is committed to getting rid of the untouchables caste by creating a toilet complex system to implement in villages across the country.

Being an Indian-American, I was able to appreciate India in a manner I never had before. I had always heard about various problems in India, whether it was about the spread of HIV/AIDS or the controversial caste system, but I always felt helpless living more than 8,000 miles away. Through CFHI, I was lucky enough to meet people like Aditi, and listen to their stories to understand what really is going on in the world outside of our own bubble in America. Often times, I have heard my very own friends and family who are Indian-American comment on how “backwards” India is in terms of development and simple progressive ideology about issues pertaining to HIV/AIDS. By experiencing India first hand, I now have the knowledge and experience to educate my friends and family and help them be more aware of important public health issues. Reading and hearing the news about India is one thing, but actually being within India’s space and engaging with the people of that country helps put these issues in perspective.

UntitledAs a senior graduating college soon, I am at the crossroads where I have to choose what I want to pursue for the rest of my life. After my 4 weeks in India, I realized that this trip wasn’t coming to an end for me, it was just the beginning.  CFHI not only gave me clarity, but also a sense of direction. The CFHI program solidified my decision to pursue a career in the field of public health. Prior to the program, I knew that I wanted to obtain my MPH, however I wasn’t clear on what specialty to emphasize in. This trip exposed me to the world of global health and made me realize that it would be the perfect field within public health for me. CFHI not only helped me fall in Iove with India again, but it also helped give me a sense of purpose that I perhaps would not have found without this trip.

*Name has been changed to respect privacy. 

Special thanks to our guest blogger, CFHI alumna Deepa Mistry, for authoring this post.

CFHI Convenes Pre-health Advisors for Workshop on Global Health Best Practices

Advising Students on Health Experiences Abroad

On June 26th, I collaborated on a workshop entitled “Beyond the Basics: Advising Students on Health Experiences Abroad,” led by Child Family Health International (CFHI) Executive Director Dr. Jessica Evert and Tricia Todd, MPH, Assistant Director of the University of Minnesota Health Careers Center. The workshop coincided with the National Association of Advisors for the Health Professions (NAAHP) Annual Conference, held this year in San Francisco. Advisors arrived at CFHI’s San Francisco headquarters in to a full house with over 20 attendees representing 15 different colleges and universities. Small Liberal Arts colleges from Maine were particularly well represented, with advisors from Bates, Bowdoin, and Colby College in attendance.CFHI Advising Health Students Workshop

As a grad student of International Education Management, I was interested to observe the backgrounds represented amongst the attendees. Some were faculty in science departments, some staff from career development offices, and others from programs specifically geared towards global health. What everyone had in common was knowledge of issues relating to advising pre-health students, and all expressed worries regarding the growth of an “industry” to meet the rapidly growing demand from students seeking health-training programs abroad.

Health Students Doing Too Much, Too Soon – How to Choose Reputable Programs

The issue of the commodification of education abroad, which I was familiar with from graduate courses, took on greater significance when discussing health-related programs where issues of medical ethics and patient safety come into play. In such cases, not only are students being sold an education abroad “experience”, but unethical program providers tell students that they will be able to perform clinical work that exceeds their training and “change the world” through their work, effectively putting patients’ lives at risk.

Advisors were eager to discuss strategies for guiding students towards reputable programs and avoiding companies and experiences where students are encouraged to “do too much, too soon.” Case studies were presented, based on actual incidents from the field. Some were particularly alarming: undergraduates delivering babies, students conducting hospital rounds unsupervised, even instances of students scrubbing in for surgery! Unfortunately many students are under the erroneous impression that participating in this type of hands-on clinical experience will give them a leg-up in the competitive world of medical, nursing or other health professions school admissions. Part of the messaging to pre-health professions students therefore needs to focus on how performing clinical duties beyond what they are authorized to do here in the U.S. is highly unethical, and could jeopardize their own careers.

CFHI Advising Health Students

Before the evening was over, Dr. Evert, playing the roll of the advisor, and I, playing the part of a well meaning (but naïve) pre-med student, acted out an all too common scenario for the group. Fortunately, in our fictional advising session the student wasreceptive to ideas. The advisor convinces the student to re-examine motivations for wanting to go abroad, and suggests the right questions to ask when choosing a global health education program. The role-play emphasized the many tools available for students to examine their motivations for taking part in a health experience abroad. I think advisors in attendance left the CFHIUMN Health Careers Workshop with new resources, a feeling of community, and a better sense of how to guide students to help them make better decisions for their global health education.

 

Special thanks to our guest blogger, CFHI Intern Alex Nichol, for authoring this post.

Global Health Uncensored: Notes from Western Regional International Health Conference

I descended upon the city through drizzle in true Seattle fashion, the Olympic Mountains revealing themselves in the distance. A local next to me argued against Seattle’s reputation for unyielding damp weather and boasted that the previous four days were dry and full of sunshine.

Rain or shine Seattle was brimming with energy and dialogue, as The University of Washington hosted the 11th Annual Western Regional International Health Conference (WRIHC) April 4-6, themed “Uncensored: Gender, Sexuality, & Social Movements in Global Health.”  The largest student lead conference in the nation, nearly 600 attendees from around the country and the globe joined the dialogue around gender and sexuality, topics too often stigmatized and neglected. I was there as an alumna of three different Child Family Health International (CFHI) global health education programs, representing CFHI amongst an army of global health enthusiasts.

Jessica Stern, Executive Director of International Gay and Lesbian Human Rights Commission (IGLHRC), boldly declared, “It is not an option to silence sexuality. It’s everyone’s business to talk about these issues and more importantly, we need to talk about the sex we actually have, not the sex we pretend to have.”

The conference kicked off with a fiery presentation by keynote speaker Stella Nyanzi, PhD. A native to Uganda and a seasoned medical anthropologist, Dr. Nyanzi has worked extensively on youth sexuality and sexual and reproductive health issues in East Africa and contributed notable social science research and academic literature surrounding these topics. She encouraged the audience to not waste any time and to ‘uncensor’ gender, sexuality and social movements –the hardcore issues. She wasn’t kidding and even stunned the audience with the use of curse words, repeatedly followed by, “Pardon me, but I thought this conference was uncensored?” The diverse crowd immediately took to her, listening intently as she urged all in attendance to mobilize against issues that, whether we realize it or not, are relevant to us all.

Simply being in that room meant we were all comrades in the struggle for global health no matter what our focus, being that gender and sexuality permeate all aspects of health. Don’t forget, she sternly reminded us, that health transcends the mere absence of disease. “Become radical in a radical way and stop doing business as usual. Global health is about the global North and South. Arrive in foreign lands with a teachable spirit and empower everyone involved.”

Those with a teachable spirit can learn more about sexual and reproductive health issues touched upon during the WRIHC event. CFHI’s Sexual Health as a Human Right: Ecuador’s Unique Model in Quito, Ecuador affords understanding of sexual and reproductive health issues in Ecuador, the first Latin American country to guarantee sexual rights in the constitution despite a conservative societal context. Participants learn and help devise and execute educational and outreach strategies to take out into the community.

Going forward it’s imperative to continue ‘uncensoring’ topics, such as sexuality and gender. Jessica Stern from IGLHRC reminded us, “Sexuality is not just homosexuality. We all have sexual identities and sexual health is a human right.” Carlton Rounds, Founder of Volunteer Positive, urged the crowd to “lead with your stigma.”

 

Thanks to three time CFHI alumna Lyndsey Brahm for authoring this blog post.

Truth in the Spoof: Medical Voluntourism in The Onion

Truth in the Spoof: An expose of voluntourism in The Onion.

By: Aditi Joshi, MD

Newsflash!  This week’s headlines report a new humanitarian organization ‘Doctors Without Licenses’ will start providing substandard care by putting together a group of “decertified physicians, pre-medical undergraduates, and ‘people just interested in the human body’.” The organization states it will be sending their staff to conflict zones and underserved areas to incorrectly provide medical care.

Image from The Onion satirical article

This news was reported in The Onion, a satirical weekly publication, so it is, of course, facetious. The sad truth is that it refers to a very real phenomenon.

Voluntourism and Medical Voluntourism – Repercussions

Searching ‘voluntourism’ on Google, one finds a number of hits for organizations that set up volunteer opportunities for well-meaning individuals to work in underserved communities. Medical voluntourism refers to doing medical care within these communities; these volunteers can be physicians, nurses, residents, medical students and a growing number of organizations offer hands-on opportunities for pre-medical students, as well. More and more research as well as anecdotal reports state that these short term volunteer trips do more harm than good to the local community.  (If you’re interested in a great contrast between voluntourism and global health—this article is a must read. The volunteers may be providing direct patient care, giving medications, and doing procedures. In cases where the volunteer has no formal training, and would not be allowed to do the same in their home countries, this type of care is unethical whether or not the results are disastrous.  Even for those who are trained and skilled, the lack of knowledge of local infrastructure, drug formularies, culture, language and historical frameworks can actually lead ‘good’ actions to having negative consequences.

Solutions and Social Responsibility

Proposed solutions vary as the scope of the problem is large and not fully realized. However, organizations such as Child Family Health International – CFHI, try to decrease harm by giving students the opportunity to immerse within the culture, focus on broad global health competencies, observe native health care providers who are dedicated to their communities long-term health. This prevents the student from being a short-term ‘band-aid’ health worker or trying to get patient care experience that they are not licensed to undertake. The students are able to understand health concerns in other countries while minimizing possible harmful outcomes.

Voluntourism is most likely here to stay, however the importance of finding ways to reduce harm while giving the local community the help it requires is an ongoing challenge.

 

Thanks to our guest blogger, Aditi Joshi MD, ER Physician and Former President IFMSA-USA for authoring this post.

CFHI Salutes Medical Director Dr. Raj on World Social Justice Day

February 20th is World Social Justice Day. We would like to take this day to highlight one of our partners who has been working to achieve social justice. Dr. Rajagopal has been helping to reform the Hospice and Palliative Care laws in India through his organization, Pallium India.Through both personal visits to patients, and by building a strong system of doctors across the nation, Dr. Rajagopal has highly improved the state of Palliative and Hospice Care in India. Access to Morphine and Pain Killers is an enormous problem in India because of previous problems with morphine addictions. India has the highest amount of victims for mouth cancer, and it is estimated that less than 3% of cancer patients get proper pain relief. (1)

Dr. Raj conducting a home visit, Trivandrum Southern India

Dr. Raj conducting a home visit, Trivandrum Southern India

Fortunately, laws in India have been changed. Now, a policy has been set so that in Kerala, doctors with at least 6 weeks of training, such as Dr. Rajagopal, can prescribe morphine for palliative care. (2) The rule was introduced in June 1998 in Trivandrum, the capital city of the state of Kerala. Since then, the central government has recommended this new rule to all the states in India. The idea of easier access to morphine and other pain relieving drugs was initially recommended by organizations and committees such as WHO Collaborating Center for Policy and Communications in Cancer Care (Wisconsin, USA). The Center is currently attempting to simplify complicated state narcotic regulations to further improve the availability of opioid analgesics.

Through his organization, Pallium India, Dr. Rajagopal strives to provide Palliative and Hospice care to those that need it. Not only does Pallium India provide medical care to patients, but the organization also provides resources such as food and sewing machines to the patient’s family to help them get back on their feet. CFHI has partnered with Dr. Rajagopal to launch the Palliative Care In Southern India Program in Trivandrum, India that centers around Hospice and Palliative care. The CFHI participants involved in the program are given the opportunity to visit the patients and experience first hand how patients are treated and managed. Pallium India and CFHI have worked together to reform India’s Hospice and Palliative Care system.

(1), (2) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573467/

 

-Special thanks to guest bloggers Alexandria Tso and Nayanika Kapoor for contributing this article.

CFHI vs. Brigades: Defining “Helping” in Healthcare Abroad

A Doctor Walks Into a Community..

For healthcare professionals or those on that path, it’s tempting to drop into a community abroad and start treating patients.  The stark realities of poverty, lack of resources, and unaddressed illness provides an often disturbing (and therefore motivational) contrast to our Western frame of reference.  We are often shocked and saddened.  As a consequence, we want to help.

An important question arises however, when we are students or even when we are credentialed professionals visiting a faraway community, what’s the best way to help?

Two Approaches to Global Health aamcacademicmed

An article profiling Child Family Health International – CFHI’s Global Health Education Programs in the current online edition of the Association of American Medical Colleges’ journal Academic Medicine contrasts two interpretations of ‘helping.’  The article contrasts CFHI’s program structure to that of brigades.  Brigades are short-term (often lasting one or two weeks) international activities that set-up clinics in parallel to or completely outside of existing health systems.  These temporary establishments are meant to see many patients in a short period of time. Commonly, medications, often drug samples, are brought down from the home country of volunteers and dolled out to patients.

The students writing the article draw an important contrast between the two definitions of ‘helping’ represented by CFHI Programs and brigades.  Brigades aim to ‘help’ by directly treating patients using Western physicians and students.  But they do so often at the expense of follow-up and continuity of care.  Brigades define ‘help’ in a very immediate sense.  Contrastingly, CFHI defines helping as empowering local communities and using Western funds to develop and elevate the stature of the native health care workforce.  CFHI positions local physicians, nurses, and community members as local experts, in a unique role to teach outsiders about their approach and insight. CFHI  believes they are the sustainable solutions to global health challenges.

Humility and Knowledge Key

CFHI Student with Local Doctor, India

CFHI Student with Local Doctor, India

CFHI’s definition of helping is perhaps more humble, believing we need to first respect and attempt to understand the complexities that underlie global health challenges, rather than trying to address these challenges with immediate auxiliary patient care.  This admiration of local health care providers and the goal of first comprehending the complexities of global health disparities is fundamental to shaping the collaborative global health leaders of the future.  Before we try to change a reality, we must begin to understand it.  This understanding is afforded by CFHI’s Global Health Education Programs.

CFHI Voices: One Northwestern Med Student’s Summer in the Himalayas

In July of this year five students from Northwestern University’s Feinberg School of Medicine traveled to rural India as part of a unique global health program organized by Child Family Health International – CFHI, the second trip organized through their unique partnership.  Funded by Northwestern’s  Center for Global Health we set out to learn about public health, increase our cultural competency, and develop clinical skills by participating in a four-week clinical shadowing experience across Northwest India. We rotated in different settings, from tiny villages like Patti tucked away in the foothills of the Himalayas to the bustling city of Dehradun, in both public and private healthcare sectors.  During our time in the clinics, on the wards, and in the field we witnessed healthcare disparities as they are manifested between rural and urban regions, between private and public sectors, and between different socioeconomic groups. We were able to see, for cultural and economic reasons, how differently medicine is delivered half a world away.DSC_0918

That month spent in India was an unforgettable and magnificent experience: the medicine we witnessed, the physicians and nurses we worked with, and the patients we got to interact with brought the kind of perspective to my medical education that only an actual, immersive experience that being abroad could bring. We didn’t stay in hostels or hotels – we lived with Indian families in their homes or in dormitories within the hospitals.

Nothing can beat that kind of immersion; nothing can beat waking up in a tiny mountain village everyday at 5:30AM with my fellow travelers to do yoga, or getting woken up in the hospital by a nurse to aid in a delivery or assist in the emergency department. We explored palaces and temples, hiked through jungles, and sampled the multitude of sights and smells, the cacophony of sounds, and the delicious and exotic foods.  India brought piece and calm to my mind and body, it gave me perspective on the doctor/patient relationship, and reminded me what medicine is really about – one component of the greater endeavor to help ameliorate human suffering in the world.

India left a lasting impression – one that no doubt will shape my medical career, but also my personal life. It left me wanting to return to the more disenfranchised parts of the world to practice medicine, it left me a with a firmer perspective and appreciation of my own upbringing, and it left me with fond memories of a country I would dearly love to visit and explore again in the future.

Jason Chodakowski

Northwestern University Feinberg School of Medicine

MD Candidate – Class of 2016

How it All Began: The Early Days of CFHI

The Early Days of CFHI Featured at San Francisco Film Festivalfilmfest

This past July the documentary film “The Most Distant Places” was featured amongst others at the Bay Area Global Health Film Festival. This story, directed by Mike Seely, is depicted from the perspective of Ecuadorian doctor Dr. Edgar Rodas, then a medical school Dean in Cuenca, Ecuador. The film chronicled the importance of constructing a mobile surgical clinic and the team involved in bringing mobile care to remote communities in Ecuador.

The film festival was organized to shed light on a critical message in need of a strong voice: access to the most basic surgical care is a human right, not a luxury. Dr. Rodas shared his story and expressed an unwavering commitment to his fellow Ecuadorians. As the film came to an end and the audience allowed the weight of the story to settle, he delicately reminded everyone that every effort produces a result. These efforts would eventually result in CFHI- Child Family Health International as we know it today.

A Chance Meeting

A young Evaleen Jones, in Ecuador.

A young Evaleen Jones (right), in Ecuador.

As I sat across the table from Dr. Evaleen Jones, CFHI’s Founder and President, I marveled that even after twenty-one years, she tells the story of CFHI’s beginning with energy and excitement. She reminisced about her time in Ecuador as a third year medical student at Stanford University School of Medicine. At the time, Stanford University did not readily offer International Health opportunities abroad with a student focus. To best serve patients living in densely populated Latino communities within the Bay Area, Evaleen knew that Spanish language and cultural competencies were essential. And so, with only a modest amount of money she embarked on her first adventure abroad.

Once in Ecuador, Evaleen’s efforts to connect with local physicians led her to Dr. Edgar Rodas, the doctor who would be featured in the Distant Places film many years later.  She came to know him as a simple man who exuded a deep-seeded commitment to the well-being of his fellow countrymen.  As a surgeon he rejected the notion that a person cannot have an operation simply because they don’t have enough money. Regardless of the enormity of such an undertaking, he felt the status quo would not suffice.

As chronicled in the film, Dr. Rodas’ goal was to build a mobile surgical clinic. Evaleen, sensing the strength of his presence and understanding the value of his quest, jumped in headfirst and agreed to return to the States to arrange funding for construction of the mobile clinic.  According to Evaleen, “There are some people who you can sense very quickly are special individuals.” Even after only a week of knowing Dr. Rodas, she allowed her instincts to propel her forward.

CFHI Begins

The start of her fourth year in medical school Evaleen hit the ground running. Every conceivable connection was utilized- donations of all kinds– designing and constructing a surgical clinic, shipping the mobile unit. Evaleen’s fearlessness in asking gave her the edge that ultimately convinced others to help. Each someone told her “absolutely not Evaleen, this is impossible,” it motivated her to continue.

It was during this time that CFHI came to life. Approaching potential small-logo2_pngdonors as a recognized NGO lead to greater success. Evaleen had also not lost sight of her original intentions: CFHI was to be a platform to provide medical students (and later students of varying fields interested in health) with learning opportunities abroad, and to increase language and cultural competencies. Dr. Jones states again and again that the world is a classroom and students should pay for the privilege of learning.  Uniquely CFHI, she also saw that students could be a sustainable source of support for locally-run health care efforts that don’t breed reliance on Western ‘aid.’ While placed in the global classroom, students are encouraged to open their minds and listen well, and let the world change them. Even with the passing of time, Dr. Rodas and Dr. Evaleen Jones remain faithful to their belief that, “It has always been about the people, not the projects.”

 

–Lyndsey Brahm

Special thanks to CFHI alumna and volunteer Lyndsey Brahm for her work on this post.  Lyndsey will be attending the University of Copenhagen, School of Global Health in 2014.

Have some ideas and interested in blogging for CFHI?  Email info(at)cfhi.org for details.

Exploring the “Family” in Child Family Health International

You may have heard people refer to CFHI and those involved in the organization as part of a global family.  Our ‘family’ is made up of wonderful volunteers, health care providers, devoted  staff (stateside and abroad), as well as the fastest growing part of our family– more than 7,000 CFHI alumni and counting!India-Hands  We have been growing our family and projects for over 20 years.

CFHI is not only a global family, but we serve families.  Two projects that come to mind when I think about how our work affects families are projects that target the long-distance trucking industry in India and the illegal sex workers that support this industry.

In India, young men, and boys barely out of school, travel the highway system connecting the most distant corners.  The work is hard, the hours long, and the travel dangerous on the over-crowded highways connecting coast to coast.  While away from home for 2-6 months at a time, many truck drivers engage in sexual activities with prostitutes.  Two National Aids Control Organization (NACO)-based foundations that target this population are the Society for the Promotion of Youth and Masses (SPYM) and SWACH (Survival for Women and Children Foundation).

Actors performing skit on STD awareness at truck stop in New Delhi, India.

Actors performing skit on STD awareness at truck stop in New Delhi, India.

Both do amazing outreach and fieldwork with peer educators, some once truckers themselves. They captivate the young audience by performing skits (see photo, right), playing card games, leading monthly health camps, and offering the men free hair cuts and shaves while they talk about safe sex.  SWATCH peer educators target the high-risk female sex workers~ often widowed women (some still in their teens) who have been forced into sex work to support their children. Their main activities include teaching why condom use is important, the importance of regular HIV testing and resources are available if they test HIV positive.  They even teach the woman how to put on a condom on men in the dark by demonstrating how to put a condom on a model blind-folded!  Challenges ahead include rehabilitation training for the sex workers.

The family in Child Family Health International is both our global family of staff and local health care providers that make CFHI Global Health Education Programs the amazing experiences they are, and the network of folks, our alumni, who have been touched by CFHI’s transformative programs, as well as the families served by CFHI programs and reinvestment in host communities.

 

Student Essays Reflect Realities and Impact of Global Health

Student Essay Contest Winners with CFHI Executive Director Jessica Evert, MD (far left)

Student Essay Contest Winners with CFHI Executive Director Jessica Evert, MD (far left)

At CUGH’s Annual Meeting last week in Washington, DC educators and students from over 60 countries met to discuss the global health landscape.  Perhaps one of the most powerful and emotional sessions was one that captured power of reflection in global Continue reading

The Power of IFMSA & The Global Health Placebo Effect

International Federation of Medical Students’ Associations (IFMSA) is not just another acronym in a field laden with catchy abbreviations- it is a groundbreaking organization that despite its 60+ years of existence is doing something that remains innovative- bringing together medical student colleagues from around the world to work together as peers.

IFMSA Meets in U.S. for the First Time in Decades

Dr. Jessica Evert, CFHI Executive Director & IFMSA Alumna, with other IFMSA Alumni

Dr. Jessica Evert, CFHI Executive Director & IFMSA Alumna, with other IFMSA Alumni

This year the setting for the IFMSA General Assembly is Baltimore.  Medical students from Sudan work alongside colleagues from the US, those from Panama collaborate with Poland, the interactions are endless.  As an alumna of IFMSA I got the privilege to join the meeting and reconnect with old friends from my days as IFMSA-USA Vice President.  IFMSA’s US affiliate is the American Medical Student Association (AMSA), who is also partnered with CFHI.  IFMSA is a great resource for AMSA members, especially those interested in global health.  Often the global health dialogue is dominated by Western voices.  IFMSA allows 1,000+ medical students from around the world to work face-to-face twice a year.  It democratizes global health and allows for crucial relationship development that is necessary for a unified global advocacy voice for health equity and justice.  It has the secondary effect of humanizing perceptions of the developing world- rather that breading pity; it engenders mutual respect between colleagues from both resource-rich and resource-limited countries.

CFHI Global Health Approach Shared & Praised at IFMSA

Child Family Health International (CFHI) was in great company during the IFMSA alumni meeting.   Attendees praised CFHI for its gold-standard model for global health education.  Colleagues from Ghana, Serbia, Philippines, Nigeria, and beyond approached me with gratitude for CFHIs important advocacy voice in the global health education field.

I was equally as impressed by the candid discussion about advocacy provided by Predrag Stojicic from LeadingChange.  Predrag distilled buzz words and espoused a platform for grassroots champion recruitment and leadership.  A thoughtful organization, The 53rd Week, took the stage to describe their pragmatic approach to evaluate and maximize short-term medical trips.  These trips are characterized by volunteers going to resource-limited communities, usually for 1-2 weeks to deliver medical care and related services.  While well intended, the global health community is increasingly leery of short-term volunteer experiences, as their impact has been questioned and downfalls revealed.

 The ‘Global Health Placebo Effect’

Lawrence Loh, co-founder of The 53rd Week, calls the appearance of impact enabled by short-term medical missions the “Global Health Placebo Effect.”  Under the strong leadership of Loh and co-founder Henry Lin, The 53rd Week is creating a platform for the multiple, disjointed teams who visit a community at different times during the year to coordinate their efforts to created continuity, sustainability, and an overarching orchestrated approach targeted towards upstream interventions. Concurrently, they are raising awareness of the risks of short-term medical missions and suggesting alternatives that may lead to more tangible and sustainable ‘help.’

The efforts of these great colleagues and the synergy with CFHI philosophical approach and model of running Global Health Education Programs has been inspirational!

International Women’s Day- A Story From CFHI India

alwar2Evaleen Jones, MD is the founder of Child Family Health International (CFHI) and Clinical Faculty at the Stanford University School of Medicine.  Today, on International Women’s Day we feature an experience from her recent visit to CFHI partner sites in India, and a story from a woman she met while there.  Her story  carries the message of community empowerment that CFHI embodies.

January 31.  Today we visited Continue reading

CFHI: Asset-Based Community Engagement

Child Family Health International (CFHI) at 20 years old continues to be the gold-standard in forward thinking and innovative frameworks in global health education.  CFHI provides community-basedsmall-logo2_png education alongside local professionals via clinical and public health experiences for students and those interested in learning more about medicine and health-related fields, with more than 20 programs in 6 countries.  Programs cover a variety of topics from maternal health to palliative care.

What Makes CFHI Different?

After all these years CFHI remains unique, continuing to challenge paradigms in global health and advocating for local communities. CFHI partners with communities that are considered low-resource and underserved by global financial standards.  Rather than focusing on what is lacking, however, CFHI helps to identify community strengths, ingenuity, and passion.  In close collaboration with local teams, CFHI creates programs and funds community health projects identified and carried out by local teams. This practice is based on the asset-based community development approach, formalized at Northwestern University.  The CFHI approach positions local health practitioners and patients as the ‘local experts’—presenting global health realities through authentic experiences that help shape and transform young people who are interested in global health, equity, and global citizenship.

CFHI Student with Dr. Paul, Rural Urban Himalayan Rotation

CFHI Student with Dr. Paul, Rural Urban Himalayan Rotation

Not Just Talking the Talk, But Walking the Walk

Importantly, CFHI is a staunch proponent of compensation for local community contributions and practicing financial justice.  Uniquely CFHI, 50% or more of student program fees go directly to the communities they will be visiting, benefiting the local economy at large and specifically undeserved health systems.  CFHI is an active affiliate of Consortium of Universities for Global Health, United Nations ECOSOC and has authored literature about global health educational curriculum development at undergraduate and graduate levels.   CFHI encourages students to “Let the World Change You” in preparation for being a part of socially responsible, sustainable change they wish to see in the world.

Turning Dark Profits into Enlightened Transformation

From Skepticism to Hope: Turning Dark Profits into Enlightened Transformation

I’ve been a doctor now for 13 (lucky) years but I recently had the opportunity to reflect on my path towards becoming a physician and my involvement in Continue reading

CFHI & Northwestern University Students Impact Women’s Health in Mexico

A Global Team

Global Health Initiative (GHI) at Chicago Lake Shore Medical Associates is a nonprofit organization leading through philanthropic advocacy.  Funding from GHI provided medical students at Northwestern’s Feinberg School of Medicine (FSM) the opportunity to engage in a month-long global health experience in Oaxaca, Mexico with a lasting impact.  Beginning in 2011, Continue reading

CFHI Welcomes new Director of Research and Evaluation

In the rapidly growing field of global health education, looking at the effects and effectiveness of global health immersion on participants, host communities, and the larger health equity movement is essential.

Dr. Gieseker with CFHI Medical Director Dr. Jessica Evert

Karen Gieseker PhD, MS joins Child Family Health International (CFHI) with a passion for Continue reading

How Can We Think Globally & Act Locally?

Phrases like “Think Global, Act Local” and “Global Health is Local Health” are catchy, but it’s sometimes difficult to figure out what they really mean. Continue reading