Category Archives: Global Health

Nutrition Education in India

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“Hi! My name is Emily and I’m a rising sophomore in the Chemistry department at Princeton University. I’m also hoping to pursue certificates in Neuroscience and Consort Singing. I;m currently interning at CFHI to further my knowledge of public health, as it has always been a passion of mine outside of the classroom. As a pre-med student, my work with CFHI India has been of interest to me, and I greatly enjoyed writing this op-ed about nutrition in India. I hope you are able to get a glimpse of how healthcare and nutrition differs in India.”

Preventable diseases such as nutritional anemia, undernutrition, and obesity are a large burden on India’s adolescent population and healthcare system. Paradoxically, nutrition education is disproportionately lacking and is in dire need of improvement. Nutritional anemia affects almost 90% of poor children, adolescent girls, and women. In both urban and rural areas, many kinds of undernutrition are prevalent- every fifth adolescent 10-14-years is Vitamin A deficient, every third adolescent girl is B12 or folate deficient, and at least 1 in 3 adolescents is zinc deficient. In recent years the prevalence of both undernutrition and overnutrition/obesity have increased tremendously and are estimated to affect the health and quality of life of about 1.2 billion Indian citizens. A preventable illness, obesity has compounding effects as it increases likelihood for diabetes, cardiovascular disease, and a plethora of medical complications down the line.

But why the sudden change? Diet! Research has shown that most adolescents consume nutritionally inadequate diets characterized by a surplus of fats and sugars, and lessening consumption of fruits and vegetables. Fast food and junk food products like potato chips and sodas have become increasingly common, slowly replacing more traditional home-cooked staples. This is due in large part to urbanization. The burden of preparing meals and passing down cooking traditions falls largely on women, who are increasingly working out of the household, leaving less time to prepare healthy foods. To compensate for this cultural shift, processed foods have become more accessible in convenience stores and fast-food restaurants. In addition, school cafeterias often do not provide nutritious meals.

India’s next generation is faced with multifaceted nutrition deficit- a culture popularizing fast food, less traditional cooking knowledge and skills, accessibility of nutritionally inadequate foods, and insufficient nutrition education to help them realize the problem. Indian schools do not prioritize health education, instead focusing on natural sciences with an emphasis on rote learning. When nutrition is taught, it is typically taught as a part of a home sciences curriculum, which is often optional and not comprehensive. Again, the onus falls on girls and women to carry out this vital role. Most home sciences teachers are women, enrollment is substantially higher for girls, and the prevalence of home sciences courses is higher in all girls’ schools. In keeping with India’s academic culture, what courses are available are typically focused on memorization and fail to impart the critical thinking skills required to make informed nutrition decisions outside of the classroom. What results is a generation with an increased prevalence of a vast array nutrition related conditions on both sides of the spectrum, and no skills to combat them.

Various government and independent initiatives have tried to bridge this gap. Organizations like UNICEF focus on the first 1000 days of a child’s life to prevent stunting, as well as the adolescent girl population. Many other NGOs provide similar aid focusing on mothers and children in the form of folic acid supplements for pregnant women, counselling on breastfeeding, and micronutrient rich snacks to mothers and children. In 2001, the government launched a new initiative. The supreme court of India directed the government of India to provide cooked midday meals of no less than 300 kilocalories and 8-12g protein in all government and government-aided primary schools.. It has been estimated that daily nutrient intake of program participants increased by 49%, and with a cost of just 3 cents per child, the program reduced daily protein deficiency by 100% and calorie deficiency by  30%. The most dramatic improvements were made by those in the most dire states- children chronically affected by drought and very young children. The intervention yielded promising results, but unfortunately in the case of most participants, no long term affects were found.

The problem runs deep into the culture surrounding nutrition education. Indian academia also lacks an emphasis on nutrition. There are currently only 190 institutes in India that offer one or more nutrition courses. The discipline of public health nutrition does not exist as an independent discipline in any college/university across India. Culturally, the role of nutritionists is often seen to be limited to treating specific maladies on a case by case basis.

There is a resounding consensus among students, parents, teachers, and doctors alike that this is taking a toll on youth, yet action on all fronts has been insufficient. Undernutrition of children has lifelong impacts on cognition, which can affect career prospects in adult life. For these reasons, UNICEF recognizes ending undernutrition as a “national imperative.” A possible solution lies in shifting the culture around nutrition in the government and education sectors. It is necessary to institute policies that empower the people and shift the onus of nutrition from ill-equipped teens to large corporations. This could include taxing large fast-food chains with respect to how much fatty, fried food, sugary food, and large portions they serve. It could also  offer coupons for meals which qualify as nutritious under certain standards that could be used at restaurants and stores. Nutritional supplements could be provided free of charge to all children and expectant mothers. To empower people to make informed decisions about their diet, all schools should teach a comprehensive curriculum to all students covering exercise, diet, financing food, and cooking. This would lessen the disparity of responsibility between women and men, which would provide families with more hands in the kitchen capable of providing healthful homecooked meals. What India needs is a shift in the culture around nutrition studies. Entering the public health nutrition field could be incentivized and schools encouraged to consult with nutritionists when creating school lunches. This would shift the focus of nutrition to harm prevention rather than overburdening the healthcare system with preventable diseases like obesity and malnutrition.

Colonialism and Medicine in Mexico

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This podcast was developed as a part of CFHI’s virtual internship in Mexico. A group of three Princeton students sought out to better understand colonialism and its effect on medicine in Mexico.

“Hello! Our names are Matthew Trotter, Steve Lopez and Amy Cho. For our podcast we wanted to explore colonialism and medicine in Mexico as this is a topic widely discussed in the lectures we have been attending during our virtual internship in Mexico with CFHI. Colonialism as it relates to medicine is an important topic as colonials brought many diseases to Mexico, diseases which the natives did not have immunity to. This prompted the need for a variety of hospitals, each of which served different purposes. You will hear more about these hospitals and how colonialism continues to affect modern medicine in our talk. We hope you will enjoy our podcast!”

Access the podcast here: https://anchor.fm/amy-cho9/episodes/Medicine-and-Colonialism-in-Mexico-e133lot

Partera Influence on Health and Culture in Mexico | A Personal Story

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This piece was written and contributed by CFHI participant Carmen Simmons, who was a Medical Student at Meharry Medical College when she participated in the Women’s Reproductive Health program in Puerto Escondido, Mexico in 2018.

When first arriving at the Centro de Salud, I have to admit I was proud of myself. I had managed to find the right colectivo in a mountainous countryside in the quaint town of Río Grande. After exchanging various “Buenos Dias”, I made my way over to partera, traditional midwife, Señora Lucia Zaguilan Mayoral.

At our first meeting, Sra. Lucia patiently listened to my never-ending questions in – let’s be honest – broken Spanish. When she spoke I struggled with the speed of her words. After some compromise on both of our parts, we found a tempo that worked for us to communicate.

Sra. Lucia calls Colonial Villa De Tututepec home and is a Rio Grande native. She has been attending births since she was 13 years old (today she is 63). Coming from a long line of parteras, she started learning as her grandmother’s apprentice. To this day, her family is filled with an impressive variety of healthcare workers.

She has attended conservatively well over 5,000 births. INCLUDING HER OWN CHILD’S! Yes, that’s right, she delivered her own son. She recounted the story to me while laughing at its ridiculousness. In her last days of pregnancy, she was in the kitchen cooking when her contractions started getting too close for comfort. She can’t exactly remember why no one was home, but nonetheless she had her abundant knowledge of births to comfort her. As calm as anyone could be while delivering her own child, Sra. Lucia guided her son toward the light of life. She even cut the cord herself! By the time her family came back home, they were greeted by a nursing newborn.

During the partera training I was able to witness, Lucia reflected on the immense amount of knowledge her grandmother bestowed onto her. This particular partera training is an annual training co-facilitated by Child Family Health International, local staff and a group of Northwestern students in partnership with the Oaxacan Ministry of Health. As a young girl, Lucia learned many techniques from her grandmother including monitoring her patient’s hair, skin, and eye color and the various methods of moving a baby into the correct position for delivery.

At the partera training, I immediately noticed that all of the women were 60 years or older. I asked her what she thought had changed in the last 20-30 years since she began practicing as a partera to account for this . She comments that she, and others, have noticed a change in attitude with the younger generation. She states that “most young women (under 35) are scared of anything to do with childbirth. Many want cesareans now. And the others are too afraid to learn to be a partera.” The sociopolitical context on the increasing cesarean rate in Mexico is interesting in itself. Approximately 39% of all hospital births in the state of Oaxaca were cesarean births. The World Health Organization states when the cesarean rate goes above 10%, there is no evidence that mortality rates improve.

During my time with Lucia and other parteras, I learned of the integral role that Parteras play in women’s health in Mexico although it seems to be an aging profession. I also learned about the scarcity of resources (financial, equipment, etc.) that the parteras face and overcome daily in their work. I fear that communities will not truly understand the immense importance of their role until there are very few left. My hope is we don’t wait until then, and find a way to revitalize younger generations to strengthen the tradition and empower the existing parteras.  

The LGBTQ+ Population in Uganda

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Homosexuality is illegal in Uganda, but homosexuality is also illegal in 69 other countries worldwide, and the practice of labeling individuals as homosexual, gay, or lesbian was traditionally not a part of Ugandan culture. This topic was not politicized, and Ugandans accepted different practices. Recently, however, LGBTQ+ Rights in Uganda have become a prominent issue in politics and in the international media. In 2009, MP David Bahati proposed the Anti-Homosexuality Bill and in February 2014, it was signed into law by President Museveni. The Ugandan constitutional court struck down the law in August 2014, but civil rights activists say the situation for LGBTQ+ Ugandans is still worse than it was before the law. LGBTQ+ individuals, numbering around 500,000 in Uganda, often face consequences if they reveal their identity, so discussions about sexuality are rare.

While in country, focus on your safety and trust your gut. It is usually best to avoid questions about your sexuality and be ambiguous if asked. Please respect the local culture and assess who you are speaking to. Also, remember that travelers to Uganda often don’t face the same discrimination that locals do. As someone with “tourist privilege,” you may have slightly greater freedom of expression, but your actions may have repercussions for the locals you engage with, so please take that into consideration.

Traveling is always challenging, and LGBTQ+ individuals often face additional levels of complexity. The followingresources will help you to educate yourself on the local culture and social context. There are a wide range of resources available that will allow you to better understand the political climate and cultural nuances of a country. Some resources to explore include: ilga.org, the US State Department, the Geert Hofstede Center for Cultural Insights, the CIA World Factbook, alturi.org, ilgta.org, and HSBC Expat Explorer. It is also a good idea to register yourself with the State Department so they’re in a position to advocate for you. Staying in touch with friends and family back home who know your identity often helps travelers as well. Skype, Whatsapp, and Viber are good options for this.  

We also want to make explicitly clear that CFHI does not agree with or condone any discrimination based on sexuality. Our partners in Uganda are welcoming and do not practice discrimination, and students have not experienced any issues in the past. However, understanding the local context regarding LGBTQ+ rights will help ensure that there are no incidents in the future.

For more information, please refer to the following sources:

The OSAC LGBTQ Guide to Travel Safety

The State Department’s Website for LGBTI Travelers

The Human Rights Watch

The International Policy Digest’s Article on the Origins of Uganda’s Anti-Gay Law

Why Global Health Ethics Matter: A Personal Story

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Image result for antigua guatemala

In the summer between my sophomore and junior year of college (undergraduate), I participated in a medical volunteering program for 2 weeks in Antigua, Guatemala. As a pre-med student, I knew I wanted to do something during my summer that involved medicine and figured volunteering in a hospital or clinic would be my best bet. Unfortunately because I had a mostly full time job, I was unable to secure any type of volunteering program locally since they all required a certain amount of hours that I would not be able to complete before returning to my university in the fall.

I then decided to look online at volunteering abroad, and found a myriad of programs that fit my time constraints perfectly. I honestly did not do too much research and just clicked on the first organization I found that had a solid amount of positive reviews and wasn’t too expensive. Looking at the cheapest options, I saw that in Latin America they offered an affordable medical program in Guatemala. While scrolling through the program description, the phrases “gain hands on experience” and “provide check-ups and basic medical care” piqued my interest as the idea of actually getting to perform medical procedures sounded incredibly appealing to myself as a student interested in a career in medicine. I imaged working in a hospital with doctors and nurses and getting the opportunity to experience medicine directly. The program description made it seem that these “poor” communities needed any help they could get, so I figured that I could kill two birds with one stone-help this underserved country while also gaining medical experience. Even though there were red flags consistently throughout the program description-the program oozed “voluntourism” and provided very brief and limited information on what actually would take place during participation- I wasn’t suspicious at all because I didn’t expect anything that involved volunteering to be problematic.

After signing up, there was a very brief pre-departure guide I had to complete before embarking on my trip. The guide was just a general guide and mostly focused on the logistics of getting there (ie. visas, packing list, etc.). There was a short list on my responsibilities, but it didn’t really mention anything about ethics. There were also 2 optional pre-departure training modules that were more informative on ethics, but were brief and took less than 30 minutes to complete. I didn’t really feel that prepared for my program, but figured I would get more instruction and guidance once I arrived.

Once I finally made it to Guatemala, I started to see problems and holes within the program. Before starting my rotation, I met with the medical coordinator for the program to have orientation. The orientation was pretty short and consisted of a powerpoint on the kind of care we could provide. After telling him I had had no prior experience in medicine, he told me that I would act somewhat like a nurse, taking weight, height, blood pressure, heart rate and temperature, making beds, cleaning, talking with patients, preparing materials and sterilizing equipment. Even though I told him I didn’t know how to take blood pressure or heart rate, he assured me the other visiting volunteers at the clinic would teach me. This orientation started to leave me a little hesitant about the program since he asked us to provide medical care, but expected other volunteers to teach us instead of himself as a doctor showing us.

After arriving to the clinic where I would be volunteering at, I was sent to work at the nurse’s station. At my rotation, there were 2 other volunteers placed there as well who had been there for about 4 weeks. One was applying to medical schools in the United States and the other was a 3rd year medical student at a university in Ireland. Luckily, one of them spoke spanish fairly well and was able to translate for us when we interacted with both the nurses and patients.

After the other volunteers briefly taught me how to perform the basic nurses duties (blood pressure, height, weight, and temperature), I was mostly on my own. It was definitely very nerve wracking having these duties when I’d never done them before and was even more difficult considering I spoke very little of the language. I was especially confused on taking blood pressure and while I immediately should have said that I wasn’t sure what I was doing, I was embarrassed to tell the other volunteers since they insisted it was an easy task and that I’d get the hang of it eventually. This is definitely something I wish I could’ve gone back to and done differently because there is a large possibility that patients’ information was recorded incorrectly due to my lack of experience. This was when I started to realize that gaining hands on experience wasn’t what I imagined at all. In my head I thought that everything would go smoothly and I would be ready to help the professionals in anyway possible. In reality though, my lack of experience became even more apparent to myself and I started to become suspicious that the “help” I was providing wasn’t all too helpful.

Image result for antigua guatemala crossWhile my lack of training may have led to incorrect patient information being taken down, there were other pre-med volunteers who were given duties that were even further beyond their scope of understanding and led to medical complications for patients. Since there were other volunteers working at my clinic, they cautioned me right away that I shouldn’t help with procedures such as giving stitches or injections since we didn’t have the training for that (I think they figured taking down patient information was harmless enough that my inexperience wouldn’t be an issue). I was very thankful for that advice since I was already feeling uncomfortable with the duties I had, I couldn’t even imagine how stressed I would have been if I had to perform anything more advanced. However, other volunteers weren’t as reserved. I remember this one other volunteer bragging to me about how the doctor had allowed him to give injections to a patient. He said that he didn’t really know what he was doing and he ended up piercing her 5 times because he kept doing it wrong. Another volunteer told me she helped stitch a patient up and said she was concerned that her stitches weren’t done right since she had never done it before. It was at this point that I really started to question the program we were on. Why weren’t there more regulations enforced by the program? Why were the duties of the volunteers so ambiguous? Why was I starting to feel so uncomfortable with what I was doing and why weren’t the other volunteers having the same questions I was?  

Besides just the volunteer aspect of the program, there were a lot of problems with the program as a whole, in particular when it came to safety. We were warned to never travel by ourselves at night. In keeping with those rules, two volunteers on my program walked home together one night after hanging out downtown. On their way home, someone pulled a knife on them and took all their belongings. The volunteers were traumatized and felt very unsafe about what had happened and contacted the program to let them know of the situation. The program responded incredibly insensitively and told them it was their fault for walking home late at night and didn’t provide any support for the two. Their response to an emergency situation such as this really made me concerned about the legitimacy of this program. They had told us it was okay to be out at night as long as we weren’t alone, yet blamed the volunteers for what happened instead of offering emotional support and/or more information on how we could stay safer while out at night.

I left my program feeling differently than I had expected. While I loved the country I was staying in, I felt disconnected from what I was actually doing. I felt uneasy about what myself and other volunteers had done without any medical experience and questioned my helpfulness. My experience showcases how easy it is for medical volunteering programs to be problematic and harmful for the communities they’re situated in when there is not an emphasis on global health ethics.

 

Note from CFHI: Many thanks to Zoe for sharing her story. If you have questions about ethical engagement in global health experiences please visit the publications page on the CFHI website (https://www.cfhi.org/publications) or listen to a recent webinar (https://www.cfhi.org/cfhi-webinars). We are also always available to answer questions about ethical global health engagement- contact us at students@cfhi.org.

CFHI at the Forefront of Ethical Standards in Global Health Education

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As global health programs increase in popularity among students based in the Global North, an important conversation around “voluntourism” and intentionality in international health-related programs has emerged. Voluntourism often consists of students engaging in short-term volunteer work that they are not professionally, socially, or culturally equipped to take on, and – though well intentioned – often perpetuates hurtful stereotypes that low and middle-income countries need help from high-income countries. At their worst, global health voluntourism programs may offer students opportunities that end up harming patients and other community members. The pitfalls of voluntourism have been widely critiqued, including through popular satires such as the “Barbie Savior– The Doll That Saved Africa.”

How then, as an organization that promotes global health education, does CFHI make sure that our programs – as well as health-related global education programs more broadly – are ethical in theory, approach and practice? Part of the answer to that question is by getting global health organizations on the same page, ethically, and giving them the guidelines needed to run quality health education programs abroad.

CFHI Executive Director Jessica Evert, M.D. has recently co-authored two sets of internationally recognized guidelines for health-related experiences abroad which outline standards in programming that can improve global health programs for students and global partners. These guidelines shift the focus of global health programs away from hands-on clinical work (which can be dangerous and have long-lasting negative impacts for patients and visiting students) and toward cultural and contextual education of healthcare in different settings globally, as defined by local experts and community host partners. They also provide key frameworks for establishing long-term partnerships with host communities rooted principles like reciprocity, local leadership, and fair trade.

Guidelines for Undergraduate Health-Related Experiences Abroad was released by The Forum on Education Abroad, a conglomerate of US colleges and universities, organizations and foundations aimed at establishing standards of best practices in international education programs. Their newly updated set of guidelines is the first of its kind set forth by the Forum and is meant to be used along with the Standards of Good Practice for Education Abroad in order to promote ethical practices specific to health-related international education experiences.

In addition to the Forum Guidelines, Dr. Evert also recently co-authored the article “Guidelines for Responsible Short-Term Global Health Activities: Developing Common Principles” in Globalization and Health, which helps to summarize existing standards and guidelines in the field.  With the release of both sets of guidelines, Dr. Evert and colleagues focus on creating a common ground between institutions and organizations involved in global health education. With clear and concise standards of best practices in global health, organizations are given the opportunity to improve the ethical standards of their programs, and to keep the best interests of host partners and student trainees in mind.

By contributing to standards of best practice in global health education, CFHI is challenging the narrative around health-centered international experiences and pushing other global health organizations to do the same.

A BRIEF REFLECTION: CUGH 2018 ANNUAL CONFERENCE

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The definition of Global Health as a field can be traced to the 2009 Lancet article that reflects a consensus reached within a sub-set of CUGH leadership at the time.  There was an alternative definition put forth at the same CUGH meeting by a colleague from Kenya. He proposed that the definition of Global Health is a “concept fabricated by developed countries to explain what is regular practice in developing nations.”  Though an oversimplification, this perspective emphasizes a real risk in Global Health education and practice — the fabrication of a context outside our own frame of reference.
The Consortium of Universities for Global Health (CUGH) is the premiere gathering for academic institutions from the United States who are embracing the field of Global Health. As an academic field, Global Health is striving to better include institutions and colleagues from low and middle income settings, and to foster a burgeoning ‘walk the talk’ movement focused on representing “local” Global Health for health equity in our own backyards.  As I return from this year’s annual conference, I am struck by an evolution in the recognition of CFHI’s work and our growing Academic Partnerships.

Though we have long been at the forefront of conversations around ethical global health engagement, often helping to define standards in the field, Child Family Health International, (CFHI) as a non-profit “NGO,” has sometimes been perceived by faculty and academic institutions as inferior to colleges and universities.  This type of thinking has pervaded universities and has led to derogatory labels such as “ivory towers.” After more than 25 years, alas, I am happy to report an increasing recognition that CFHI’s rigor, evidence-based educational programs, and operationalization of best practices in Global Health education and partnerships deserve the admiration and respect of academia.  The conversations I am having are no longer in a spirit of convincing faculty and institutions of CFHI’s legitimacy, but rather constructive discussions about the how and the why of subtle, yet essential, nuances of quality, ethical, and transformative Global Health Education and Experiential Learning.

CFHI will continue to lead with research, constructive dialogue, and standard-setting programs. We will do so because this risk of fabrication of complex realities and global health contexts worldwide is a driving force behind our work. Gratefully, CFHI, a collaboration of community and academic-based educators from 10 countries partnering with universities to provide Global Health Education, is receiving well-deserved esteem from academia.  CFHI looks forward to continuing to strengthen our partnerships with universities to teach Global Health through mutually respectful collaborations and partnerships.

How to Engage Men to Advance Change

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“Finally, we can all be ourselves”

Peter Piot, the Director of the London School of Hygiene and Tropical Medicine, echoes these words to a Stanford University conference room consisting of 390 women and 20 men, all eager to absorb this simple, yet powerful, statement.

At the Women’s Leadership in Global Health Conference, the How to Engage Men to Advance Change panel addresses what many of us, as women, have grown to understand so well: an imbalance in power dynamics does not solely alienate women and minorities, but a lack of equity truly ostracizes and limits society as a whole. Creating equal opportunities for all genders sets the stage for a world of freedom, empowerment, gender fluidity, and empathy. It provides a world where men can express emotions as humans, rather than adhering to stringent and limiting stereotypes.

Equity presents a world where a woman can confidently write her name on a grant proposal for research funding. Currently, a woman’s name on a research grant decreases her chances of obtaining the grant by a striking 50 percent.

Contrastingly, Dr. Piot’s university ranks best in the UK for women obtaining research grants. At the London School of Hygiene and Tropical Medicine, women are actually succeeding their male colleagues in receiving grants.

What makes this university different?

Dr. Piot posits that the UK recently appointed its first female Chief Medical Officer, Dame Sally, also the founder of the National Institute of Health Research. Sally advised that all universities that wish to benefit from research funding need to show that they fully embody gender equity by 2020.

While this created panic in the country, it also enacted prompt change, which serves as an effective example of top down approaches benefiting gender equity within a short time frame.

Gary Darmstadt, Associate Dean for Maternal and Child Health at Stanford University School of Medicine, echoes Piot’s words, reflecting that men are already “giving up a lot” in a world without gender equity. By leveling opportunities for women, it provides avenues for healthy relationships, wholesome family dynamics, and more women leaders. Dr. Darmstadt reiterates that, rather than a “zero sum game,” imbalance in power itself is a loss. We have a lot to gain through women’s leadership.

How do we get there?

Steve Davis, President and CEO of PATH, believes that we need to stop taking the “easy way out” by letting comments, actions, or marginalizing words slide without correction.

Among what we read, the media, what we are exposed to, music, and the realities of day to day life, the fundamental issue is that men and women alike, don’t “call it soon enough when people cross the line.”

Taking action on a day to day basis, without underestimating transgenerational impact, will lead to a society that is mindful, intentional, and empathetic. It will create a world where all genders are valued based on the same principles.

Most importantly, it will give all people, men and women alike, the freedom to finally be their true, authentic selves.

Toward Planetary Health

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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

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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

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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

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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

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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 CFHI – UMN 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

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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

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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

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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

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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

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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

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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.