Having recently joined Instagram a few weeks ago, the first users and hashtags I looked for were those related to global health. I was surprised by the dearth of what I found– there are barely over 3000 photos tagged with the hashtag #globalhealth. Compare this to #medicine (nearly 900k), #healing (slightly over 600k), #health (over 10.5 million), #poverty (93k)– you get the picture (no pun intended). When looking through the users, the only recognizable name I saw was that of the World Bank, which posts great photos with telling captions. For those who are on Instagram, you are surely familiar with the numerous accounts that post the best pictures from around the web of different topics such as vacations, cars, people, nature, animals and the list goes on. I’ve taken the liberty (and opportunity) of starting one for global health.
The account is @SM_GlobalHealth and will be hosted and maintained by SM. We will be reposting the best photos of community organizations and individuals in action from around the world who are engaged in global health and medical work. We are hoping to see pictures that tell stories– this is a call for all to share the experiences, successes, challenges, hardships, and hopes of those overcoming disease and poverty. The intention of this account is to make known to the public what is happening in global health through pictures. Only appropriate photos with thoughtful captions will be reposted, with proper attribution given to the owners of the photograph.
There has been a fantastic influx of photographers in global health– I wrote previously about James Nachtwey and his photographs of people suffering from XDR-TB, and Project Through Their Eyes, a photojournalism project I authored sharing the stories of Indian villagers undergoing free cataract operations through an NGO’s outreach efforts. I have also been an avid photographer for the past several years, and I have many photos of work from Africa, Latin America, and India at my own photoblog, The Photographaar. The new instagram account is an effort to share the photographs of all of you out there who have a passion for global health, story-telling, and have some eye-catching photographs to tie it all together.
I recently returned from the Unite for Sight Global Health and Innovation Conference where I was selected to present my recent research in Mozambique and other projects in the works. One of my talks was regarding a non-profit which I’m currently designing called “The Global Health Write.” In short, 97.5% of research publications come from 31 countries worldwide, only 1 of which is located in a “low-income region” (that single country is South Africa, which is really a developmental anomaly relative to its neighbors). We can all agree that as part of global health equity, horizontal partnerships, and the goal of building local capacity, it is important that countries in the Global South and their accompanying biomedical institutions establish stronger research programs and increase their overall research output. There are of course many limitations to this which cannot be ignored– the lack of basic medical infrastructure, the absence of functional institutional review boards to protect human subjects, the limitation of an underdeveloped research ethic, and more– but there are still hundreds of researchers who, after overcoming these obstacles, have trouble publishing due to the basic issue of language. Most medical/public health academic publications are primarily written in English. Having served as a content editor for an African journal, and currently serving as the editor of an upcoming volume on global health with contributions primarily from authors in developing regions where English is not the main language, I can attest to the notion that the ideas and findings are out there, but are simply not being communicated as well as they could and should be. Continue reading →
I’m working with classmates at UCLA David Geffen School of Medicine, the Fielding School of Public Health, and the School of Nursing on an ongoing fundraiser to continue raising money for the Philippines to support the several capacity rebuilding projects currently in progress. We strongly believe that the weeks and months after catastrophe, when the media is no longer publicizing the aftermath, is the most important time to re-double fundraising efforts. We have hosted several social events in the Los Angeles area and met our initial goal of $3000– we are now aiming for $6000. Our funds are going toward the Super Typhoon Haiyan Relief Fund, which has currently raised nearly $1.5 million. We researched several fundraising avenues to ensure our partner was transparent and efficient with funds, the result of which was Global Giving, one of the top charities on Charity Navigator. Please share our effort widely, consider donating, and feel free to contact me directly if you have specific questions or would like to partner with us.
UCLA’s HIV expert, Dr. Jeffrey Klausner, and I asked ourselves this question a few months ago and since then began sorting through the numerous studies that have come out regarding HIV Pre-Exposure Prophylaxis, or PrEP, which was FDA approved back in 2012. In our most recent piece on Global Post, we discuss the findings of our research and outline recommendations for where we need to be headed as a global health community.
The topic is a controversial one, and the idea itself may seem overly ambitious to many. The basic premise is that people who are not HIV positive, but who are at high risk of contracting HIV (sex workers, men who have sex with men, those who don’t use protection, people with HIV+ partners, injection drug users and more) can take a pill (Truvada) each day to greatly reduce their chance of contracting HIV. This does not mean in place of using condoms, nor does it mean the user is 100% protected, but several studies have shown that when combined with counseling and high adherence, the effective risk reduction is substantial.
Our piece focuses on new data and models which argue against the biggest fears questioning PrEP. Some of these include: Will there be massive drug resistance if people don’t adhere, or if they continue using Truvada as PrEP when they are unknowingly infected? Will people become more sexually liberal and negate the protective effects by engaging in more frequent high risk situations? Are there long term health side effects of serious consideration?
The data we present rebuts all of these concerns. Unfortunately, there hasn’t been much publicity surrounding these newer findings, and general PrEP prescribing practices are still not as widespread as they perhaps should be. Check out our piece, share widely, and comment with your thoughts.
As some of you know, I’m an avid photographer. Although I primarily rely on the power of words when I blog, photographs have always struck me as particularly influential. In part, it is because of what they add– the color, the reality, the emotion. But at some level, I appreciate photos because of their limitations– unlike video, they only capture a moment, leaving the rest of the story to imagination. Photographs really represent both the mystery and the fragility of the human condition, and they have become a big part of my career in global health.
The last decade has seen an unprecedented growth in the number of students from the United States involved in global health and development projects. Students offer a very unique position and perspective in these disciplines and we must question whether the current paradigm is most effectively using this new development workforce. Many students work for short periods of time (3 months is standard, although some go for even less) and it is difficult to have an impact without proper planning and consideration of important aspects such as future sustainability, local partnership, and optimal contribution.
Fidel was the leader of the community health worker program at Newton-San Juan Sister City Project
One area where students have the potential to play a transformative role is in serving as a nexus between academia and activism. There is a dissonance in the fields of global health and development practice because research from elite universities often ends up being poorly translated from the format of highfalutin publications that may never have an impact on the ground where the people are. The irony is that students from these institutions are the same ones who often end up working for NGOs during their summers yet often don’t see the opportunity of leveraging their class work and academic connections to inform their internships or projects. Continue reading →
Avenues for participation and presentation in global health are growing rapidly– the following three conferences are ones that I highly recommend and that I will be attending next year.
The UC Global Health Institute conference, formally known as the UC Global Health Day, is going to be held on Saturday, April 26th 2014 at the UC Davis campus in Northern California. The abstract and proposal submissions open on October 14th. The UC Global Health Institute is a collaboration among all 10 University of California campuses to promote global health scholarship and activism. I am serving as one of the members of the student subcommittee that is organizing the structure and function of the event– if there is anything in particular that you would like to see featured or highlighted at the conference, please contact me via email.
The Consortium of Universities for Global Health (CUGH) Conference is being held on May 10-12, 2014 in Washington D.C. Abstracts are due by December 15th, 2013. The CUGH is a collaboration among several academic institutions around the world dedicated to improving global health education and practice through pooling intellectual capital and resources. I’m honored to be serving on the Trainee Advisory Committee of the CUGH which will be responsible for influencing the international global health education agenda. If you have ideas for ways to improve the current global health curricula from a macroscopic perspective, feel free to contact me.
The Unite for Sight Global Health and Innovation Conference, is held annually at Yale University. I’ve attended and presented at the conference for several years and it continues to expand and innovate– last year, the conference brought in over 2,200 participants from 55 countries. Particularly noteworthy, the UFS conference not only features academic presentations, but also social entrepreneurship and activism-related efforts in health and development. Abstracts can be submitted here, and the conference will be on April 12-13, 2014 in New Haven, Connecticut. This year, I’ll be presenting a social enterprise pitch I’ve been developing with regards to improving access to scientific and medical publication for authors from low-income countries.
If you are aware of other reputed global health conferences in 2014, feel free to leave a note in the comments.
A child born to a literate mother is 50% more likely to survive past the age of 5
The #1 cause of death for girls 15-19 is childbirth.
50% of sexual assaults in the world victimize girls under the age of 15.
Statistics such as these are the driving force behind the film Girl Rising, a narrative that follows the stories of 9 girls from low-income countries around the world. I had the privilege of watching the film as part of an event by the UCLA Center for World Health and was impressed by the work’s very unique artistic mastery that gives it both a sense of raw realism and yet a fantastical edge that makes us feel like we are seeing through the eyes of the children themselves.
A few points about the film were particularly interesting, the most notable that the stories of the girls were not spoken by them but primarily voiced over by a host of recognizable names. I don’t disagree that this added greatly to the cinematic appeal of the production, and perhaps it was the right decision in terms of reaching the film’s ultimate objective (which I understand to be for it to serve as a medium through which to educate and allow people to donate to selected NGOs). Still, the dilemma in telling stories through interpretation is a valid and complex concern. Continue reading →
Care for undocumented immigrants is an important topic that is especially relevant for those practicing medicine in Southern California. When the Affordable Care Act was revealed in 2010, one of the first circumscriptions I noticed was that expanded coverage did not include those who were undocumented. Given that this group comprises over 11 million people in the US, it’s not an insignificant limitation. As physicians, a deep ethical question is whether our duty to treat and serve all supersedes the interests of American immigration regulation and our country’s laws on this topic.
The current situation and the way it will be impacted by the ACA was covered by Harvard’s Dr. Benjamin D. Sommers in his NEJM perspective article last month. Currently, 80% of undocumented immigrants are in the labor force, but most are in very low-income fields that generally don’t offer health insurance. Moreover, their immigration status excludes them from both the traditional Medicaid and Medicare programs. Some, depending on their state and chief complaint, are covered by Emergency Medicaid, which finances cases that are deemed by a medical review board to be “life-threatening” in nature (the most significant being child-birth). However, in reality this covers very few people in very few situations. The health impacts of limited care for these people are quickly noticeable: Dr. Sommers mentions the “immigrant paradox“– the unusual observation that most immigrants to the United States, particularly from Latin America (75% are from this region), are healthier and live longer than their non-immigrant counterparts–and how their health outcomes are quickly worsening due to both lack of access to care and American lifestyle factors.
Sommers BD. Stuck between health and immigration reform--care for undocumented immigrants. N Engl J Med. 2013 Aug 15;369(7):593-5. doi: 10.1056/NEJMp1306636. Epub 2013 Jul 24.
Hogerzeil HV. N Engl J Med. 2013 Sep 5;369(10):896-9.
Do big pharmaceutical companies have a role to play in global health? Yes. Is it a role they want to play? Maybe. When the idea for a new drug is born, it is nurtured by the financial potential and robust future markets that will be there to welcome it. Reasonably so– many drugs, from start to finish, cost over $1 billion. This is why drugs that won’t last for long, such as antibiotics that are constantly at the whim of AB resistance, and drugs that won’t be terribly profitable, such as those for Neglected Tropical Diseases, do not have a strong force driving innovation and research for their development. Continue reading →