I had the chance to sit down with CFHI’s Medical Director, Dr. Jessica Evert, at our offices in San Francisco, just before she was honored with an award from the Global Heath Education Consortium (GHEC) at their annual conference in Cuernavaca, Mexico. Dr. Evert began her role as CFHI Medical Director in January. Her education career includes studies at Emory University, The Ohio State University College of Medicine, and the University of California at San Francisco, where she continues to serve as a clinical faculty member of the Department of Family and Community Medicine.
We spoke about her introduction to Global Health, how she integrates her work as a physician in the San Francisco Bay Area with her Global Health Activities, and what attracted her to CFHI. She talks about how CFHI’s model is one that changes the dynamic by empowering local communities through actively building on their strengths in ways that lead to sustainable solutions.
Please click on the links to listen to our conversation and you are invited to join the conversation through adding your comments below.
Dr. Jessica Evert, the Medical Director of Child Family Health International, received the Christopher Krogh Award at the GHEC – INSP Conference today.
Dr Jessica Evert Receiving Special Award from Dr Anvar Velji GHEC Co-Founder and Dr Richard Deckelbaum GHEC President at Global Health Conference in Mexico
The award, honoring the memory of Dr. Krogh, a founding member of GHEC, who died in 1994 in a plane crash while traveling as a physician for the Indian Heath Service, is given to an individual who shows dedication to serving the undersered both domestically and internationally.
Dr. Evert has worked in various places around the world, and also works on a daily basis treating patients in several underserved communities in the San Francisco Bay Area. Prior to becoming the organization’s global Medical Director, she volunteered with CFHI for several years so we are well aware of her talents and her dedication. CFHI extends a hearty congratulations to our new Medical Director as she receives this distinguished honor!
This is my second report from the Global Health Conference happening in Cuernavaca, Mexico. The conference is the joint effort of the Global Health Education Consortium (GHEC), based in San Francisco, California, and the Instituto Nacional de Salud Publica (INSP), here in Curenavaca. I spoke with Lisa DeMaria, Investigadora en Ciencias Medicas of INSP and she told me about a perhaps lesser known part of the Global Health field. “There is a sophisticated network in Latin America of middle income countries with similar health issues that are working closely together to address common challenges.” “The face of Global Health is changing,” she told me as we discussed that there is much more happening today in Global Health than just the very wealthy countries attempting to help the very poor countries.
The conference this weekend is a good manifestation of this with at least 22 countries represented. It is also the First Latin American Caribbean Conference on Global Health and so the extensive regional network of health professionals is strongly represented. INSP and GHEC have championed the effort to establish this first of a kind conference without knowing for sure if there would be a second conference but the momentum that has been created here seems to be sufficient to ensure continuation with countries like Brazil, Chile, and others stepping up to carry on the tradition.
One of CFHI’s newest programs is a Dental Program set in Quito, Ecuador.
CFHI Global Health Dental Program
CFHI is happy to partner with the Sonrie Ecuador Clinics to provide an outstanding program for pre-dental and dental students who want to understand how oral health is approached in a different culture and a different healthcare system.
The “Sonrie Ecuador Clinics” provide dental care and promote oral health in Quito and its surrounding neighborhoods. The clinics have been operating for over twelve years and continually strive to better the services offered to their patients give attention to the dental health. In general, the main dental problem seen by Ecuadorian dentists is cavities. Ecuadorians are considered to be concerned about their dental health, although adequate oral hygiene is not, in reality, reported amongst the majority of the population.
This program will provide a rich and diverse experience for pre-dentistry and dentistry students, allowing them to view local oral health practitioners providing close to world class care in a developing country while at the same time improving their cultural competency and broadening their public health knowledge. Ecuadorian dental professionals who work in a country are interesting and thought provoking as they give context to the real challenges of providing the best possible dental care to the different socioeconomic classes of Ecuador.
It is true that Child Family Health International does not have any programs in Haiti. It is also true that we are part of the world community and, in a situation like this, if there is a way for us to help, we will do all that we can do, as we did in the Asian Tsunami and have done in other events over the years. CFHI has actually worked in the past with our friends at VIDA and a Haitian partner, the Consortium for the Development of Haiti, to send medical supplies to a number of grassroots clinics and hospitals. It was a very successful endeavor. And so when news of the earthquake came, we tried to re-initiate our successful partnership and get disaster relief supplies to Haiti as quickly as possible. We sent out a message to CFHI supporters, who were already contacting us to find ways to help, and they responded generously.
Our great friends at VIDA (Volunteers for Inter-American Development Assistance) were also right on it, and within about 24 hours of the Tuesday quake, they had assembled over one million dollars in urgently needed first aid and disaster medical supplies. Being on the West Coast, we found ourselves at a disadvantage as the access to the airport and other avenues to get supplies in were quickly clogged. It was also only later, by late Friday and Saturday, that the impact of the earthquake on the functionality of the airport and the seaport were really known. Once it was obvious that all avenues to get supplies in would have to go through the military (directly or indirectly) and staging areas in Florida and other close points, we realized that there was no way to get a shipment directly to Haiti.
We found great support from another wonderful NGO,MedShare, which recently opened a warehouse on the West Coast. They were dealing with the same issues, and through their East Coast connections, were able to get shipments into the pipeline for Haiti. We are grateful for all this collaboration and happy to be in such good company. Our role is very small but, as we are seeing, if we all pitch in and do what we can, a big difference can be made.
On a personal note, having spent some time in Haiti in the early ’90s, when I worked for Food For The Poor, I was moved by the earthquake through the memories that I carry. My visits to Haiti gave me an experience that has stayed with me ever since. The overall work of Food For The Poor was refreshingly simple: provide for basic needs, and develop ways for people to pull themselves out of poverty. Expecting to find people beaten down by poverty, I was challenged to reevaluate my assumptions. Sure the poverty was there, and it was among the worst I have seen anywhere in the world, and some of the people were caught in its clutches in a way that made it hard for them to break free. But, as I have seen in other places, that wasn’t the whole story. By and large, I saw, in Haiti, people who did not let poverty define them or their happiness. These are the people that don’t make the news but carry on their lives as best they can. I gained deep respect for people who perhaps had a better sense of the important things in life than I did. It was a lesson I have tried never to forget and one that I am reminded of again as I see images that trigger forgotten memories of sadness and beauty, despair and hope all mixed and juxtaposed in a society so abused by history, and so full of potential. The people of Haiti re-taught me lessons of never making assumptions, of never writing anyone off, and of the richness that comes from allowing another person, another culture, to change the way I think. I carry these lessons to my work today, even as I carry the memories and, too, the hope that the resounding resilience of the Haitian people and their great joy in living will raise them up, once again, from being dealt a terrible blow.
The anniversary of the great Asian Tsunami is December 26th. Do you remember where you were on that day in 2004?
The effects of the huge earthquake, estimated at 9.1 or greater, and resulting tsunami were devastating. Some reports say that about a quarter million people in some eleven countries, lost their lives, almost in an instant. For those who were left, they not only had to deal with the grief and loss but also with the fact that their lives and livelihood would be forever changed. Many made their living off the sea and now the trauma of this event made it hard for them to comfortably return to their work.
CFHI’s loyal donors and alumni were quick to respond. Within 48 hours, we had connected with other international organizations and had a disaster relief container with supplies for 10,000 people, on the ground in one of the worst hit areas in Indonesia. Our donors continued to give. We let people know that CFHI did not have any programs in the areas that were directly impacted and suggested several other organizations to which to donate. Many of our donors still wanted to give to CFHI, they said that they trusted CFHI to find the best way to use the donations. So after helping with the immediate disaster response, we started doing our homework.
With many programs in India, CFHI was asked to help in the areas of Southern India that were greatly impacted. CFHI met with local and WHO health officials by conference calls. There was great concern that widespread disease would be one of the effects of the tsunami so we were asked to wait while health officials conducted surveillance to see where disease would most likely occur, along that portion of the Indian coastline. As it turned out, preventative efforts held disease in check so we began looking for other lasting effects of the tsunami. For young children, the trauma was the most significant lasting effect. In a number of small coastal fishing villages, much was lost including the schools. One of the most important things to help children dealing with trauma, is to reestablish a routine that is safe and comforting to them. With the loss of the schools, there was a big hole in the day of every child. CFHI teamed-up with the service organization Round Table India –that was charged by the Indian Government with rebuilding the lost schools. CFHI’s donors were able to support the rebuilding of two schools that were lost in the tsunami, thus reestablishing this most significant daily routine for many children.
Sewing Class at Kovalam
Some of CFHI’s donors have continued to donate to make sure that efforts to help those so devastated by the tsunami would not fade away. As this fifth anniversary approaches, CFHI is happy to be continuing in this effort. Loyola College in Chennai started an outreach program to provide ongoing assistance to people affected by the tsunami. A successful community college effort has been established and is training people in skills to help them find jobs in many fields including culinary work and food service for the tourist industry, website design, mechanical work on air conditioning and refrigeration systems, etc. In addition, the Kovalam Community College is providing general courses in English, general life skills, health education, and working with the large population of widows created by the tsunami doing women’s empowerment workshops and helping the widows develop their skills.
During my visit to India earlier this month, I met Fr. Xavier Vedam, S.J. the Vice Principal of Loyoal College in Chennal and the Director of the Loyola Outreach program. I was very impressed with these efforts by local students volunteering to help in the villages that continue in their recovery from the devastating events of December 262004. I was struck by the passion of Fr. Vedam and the fact that they are not giving up but continuing to provide services, engaging the community, and helping people in real ways. To see that many people are now in gainful employment and that the self confidence and attitude of people in whole villages have been so positively impacted, is a wonderful accomplishment and we applaud these ongoing efforts that bring development based on the strengths of the local people.
CFHI’s program in rural areas of Northern India will expand in 2010 and our student programs will support a local doctor’s dream of increasing access to healthcare in this region. Dr. U.S. Paul has been working in the surrounding areas for many years and he knows well the needs of the people in rural villages. We are happy to help him in this new effort to serve thousands more people in the foothills of the Himalayas who have little or no access to healthcare. The effort is being conducted by a local nonprofit, the Indian Global Health and Education Forum. The village of Sirasu will be one of the areas served. The villages are accessible on foot after crossing the great river. This photo shows the crossing point at Gullar on the River Ganges, about 45 minutes drive north of Rishikesh.
Ganges Crossing Point at Gullar
As we made the drive along mountain roads tracing the edge of the gorge, with sheer drop-offs right next to you that are not for the faint of heart, Dr. Paul spoke of his excitement at being able to operate regular health camps for this remote population. The area around Sirasu is one of several village groupings that will be served Sirasu and its grouping have a population of about 1,500 people. Each village has its own identity and Dr. Paul is an expert at providing care that is respectful of the cultural differences that may exist even from village to village.
Crossing to the East side of the river Ganges in a simple rowboat, I looked over and saw Dr. Paul beaming with joy because he knows how important these services are to the people.
Crossing The River Ganges --Mr. Mayank Vats, CFHI Local Coordinator, and Dr. U.S. Paul board a boat to cross to the East side of the Ganges river
Once across the river, it is a 20-30 minute hike up the East side of the gorge to Sirasu. Dr. Paul meets with village leaders to discuss recent developments. An initial camp was held in November during which Dr. Paul saw more than 150 people in one day. The people ask Dr. Paul to schedule the camps as often as possible. With many other villages to cover, Dr. Paul says he will plan to make monthly visits. While they would wish for more, the people are very happy and express their gratitude.
Local School that serves as a site for the health camp
The camps are conducted at the few local schools as these are natural gathering points and are the largest structures around.
Everything is built on relationships. The local formalities of introductions and meetings to discuss the different aspects are a time to build trust and gain the valuable support of village leaders. These meetings over cups of tea are important times to size everyone up and get a feel for each other. It is the oral culture’s way of completing an application form.
Every meeting has to have tea
We look forward to these additions to our program and to developing these new relationships.
After meeting with local leaders of Sirasu to discuss health camps
David Liskey (in a photo by Jan Sonnenmair), was a 2008 CFHI South Africa participant that came to us through our Oregon partner IE3.
David Liskey photo by Jan Sonnenmair
David was featured recently in the Oregon State University President’s report. Read about his experience and “how race, culture and poverty affect health care in a country with one of the highest HIV infection rate in the world.”
David participated in an 11 week program with CFHI and received credit from his home institution. From his first-hand experience, he wrote a University Honors College senior thesis. David was perceptive and able to see how culture impacts health.
In the president’s report, he reflects, “The different experiences and topics I studied had an effect on how I see the world.”
The May-June issue of International Educator, the magazine of the Association of International Educators (NAFSA), contains an article by Karen Legget entitled: Teaching Medicine Without Borders. Ms Legget traces the movement from “International Health” to “Global Health” and the impact this is having on medical education.
She looks at various programs from medical schools to organizations (including CFHI) and conducts interviews with students and administrators alike. Her article can be found through the NAFSA website.
One of CFHI’s newest programs, Sight for All- Ophthalmology Rotation is unique in that it is based out of just one organization- a local NGO located in New Delhi, India. CFHI participants rotate through the various departments, learning how programs and treatment are implemented to reduce preventable visual handicaps. Participants are exposed to mobile eye care clinics, ophthalmic procedures in the operating theater, and take part in advanced level classes at the institute.