dr. bz' talk

hello all,

yesterday amineh & i attended stevie beez' 2 hour symposium about the social determinants of health at the school of social work. the majority of the people in the audience were social work students or social workers themselves.

dr. b went through spoke about his history & his metamorphosis from initially believing that individual actions begat specific health outcomes 2 later believing that socio-political & or socio-economic factors may be even more important factors. he stated that he came to that conclusion in 1993 but he did not go public with his beliefs until 1995. he told the story of how he harangued patients who were smokers when he saw them in the emergency room until he saw statistics from japan (the industrialized nation with the worlds' highest life expectancy) apparently the japanese have a much higher rate of both alcohol use & smoking yet..........there is a higher life expectancy. why??????? dr. b thinks that it has to do with" wa" a japanese idea of group harmony thus a built in social support network. he asked the audience members if they had ever seen japanese tourists taking pictures et al... by themselves.

1 of the audience members stated that the japanese idea of "wa" worked because japan is a homogenous society but............ the author interjected that it's just not true.

japan has always been multi-ethnic from ancient times there have been interactions with indo-malays, chinese, koreans indians etc... few people outside of japan or more precisely the japanese korean community are aware of the fact that that 25% of the people killed during the bombings of hiroshima & nagasaki were of korean descent. iinyhowz.......the author stated (when he was so mercilessly put on the spot by dr. b) that what is going on in japan is the belief that everyone can achieve (to a certain extent) whether they are multi-ethnic or not.
another audience member asked if there were similar examples of "wa" in the u.s. & dr. b told the story about an italian american settlement in rosetta , pennsylvania whose impoverished & oppressed inhabitants had higher health indicators than the general population while living in their isolated community but... upon moving out to the general populace their health declined.

he also talked about early childhood & even prenatal influences on lifelong health via biological embedding, secure attachments & even what our grandmothers stressors were when they were pregnant.

i'll wrap this up by saying that he emphasized that we must treat populations, not individuals. the countries with the best health outcomes are the 1z with the least amount of income disparities & with good social gvt. networks a.e. sweden, & that the 3 main factors that got japan to where it is today are democratisation, decentralization & demilitarization.

there was of course a lot more but....... if you want to learn about it go to the source.


a dyos
Santiago
p:s,

i don't know where dr. b findz the time 2 amass all of the in4m8shun that he duz...itz soooooo inspiring :)

Agathe' s talk this morning

This morning Agathe Jean Baptiste spoke about the Cuban and Haitian Health Systems including her training under the Cuban system and her introduction back in Haiti's health system. It was a fascinating talk and we all appreciate Agathe's insight, charisma, and experiences. If you missed the lecure, here's a picture of Agathe in action, and you are invited to post any questions for Agathe or the broader IHP community about this topic!

To view presentation, please click.

Irreverent words on Don’t Listen to This Show

There is a weekly show here of "Progressive Activism and Politics at UW" hosted by Matt Dundas that finished up its first year today. I was fortunate to be the last guest. Go the website:
http://dontlookatthiswebsite.org
for this outrageous hour.

Stephen

IBRD revisited or renewed

Has the World Bank become an anachronism? Is it out dated, out of touch or out of synch with "world" norms?

Originally the Internatational Bank for Reconstruction and Development arose from the cinders of WWII and an intention to recapitalize Europe's industrialied capacity. For almost 40 years this work has all but been completed leaving an increasing concentration of capital in its reserves to be leveraged at the whims of its governors.

A few structural problems accompanied this legacy that do not necessarily indict the utility
of such an organization, but nevertheless place it in a critical if not precarious position to influence global welfare. The first involves the changing nature of the "world" as bankers perceive it. The birth of a "public " bank that is dedicated to collecting, managing and redistributing the green power of public assets through leveraged lending is a new concept.

Banks have predominantly been privately held for profit businesses over the ages. Apart from credit unions and lending societies forund in smaller communities, banks remain a core tool of private capital dedicated to self-preservation and increased control. The World Bank has been an attempt at serving the economic development of nations rather than individuals or corporations. Has it succeeded? The answer is yes and no. As the soverignty of nations receeds into the hands of super elites, and as corporations in republics are afforded similar if not superior legal rights to individuals, the consequence of the Bank's policies and actions have trickled down to serve public welfare less well. In fact an identity crisis seems to have emerged as Bank officials scramble to redefine their mission and focus to truly assist populations rather than the infrastructure that serves them.

The second involves increased communication and subsequent awareness of eachother thanks to the development and application of new technologies. The World Bank is indeed a lush place from which to conspire for the benefit of global economic prosperity and it has access to the latest and greatest of these tools. As public health is seen more clearly as a concept through which individual and collective wellbeing/welfare can be improved, the link to better productivity for all expressions of human endeavor will follow. We must continue to work dilligently to demonstrate to our colleagues within the Bank how to leverage their assets to enhance health on the planet. Apart from those political appointees at the top, they are among the best educated and potentially thoughtful global public servants. They have the means to concentrate and invest resources where they can make a huge contribution to stability among the least secure regions of the earth. Let us conspire to influence their policies and actions by clarifying values that that bring people together and demonstrate that healing and empowering human beings is more profitable than fueling the conflict making machinery of the status quo.

The Cult of Powerlessness?

Hello IHP comrades.

We were fortunate to have Dr. Kevin Danaher of Global Exchange give another dynamic presentation here on campus about democratizing the global economy. His talk was well attended. Even Steve was present.



Dr. Danaher believes that a renewed commitment to social justice and human rights is essential for eliminating terrorism. A longtime critic of the so-called "free trade" agenda, Danaher explains how the US must work harder than ever with other countries to reduce poverty and inequality if we want the cooperation of the world's people in ending terrorism. Dr. Danaher is also the author/editor of 11 books, including his latest, Democratizing the Global Economy.

Here is a video I shot of Dr. Danaher answering important questions asked by Julia and Zied of IHP. Many thanks Julia and Zied!



The following websites Dr. Danaher shared in his presentation. They are neat and hope you check them out.

http://kiva.org
"Kiva lets you lend to a specific entrepreneur in the developing world-empowering them to lift themselves out of poverty"

http://secondlife.com
Second Life is an online global virtual world.

Looking forward to reading your thoughts.

Friday Seminar : Cervical Cancer Prevention in Kenya

Cervical cancer is the second most common cancer among women worldwide and one of the most preventable and treatable cancers. Dr. Vivien Tsu, a Senior Adviser for Research at PATH, presented last Friday at seminar about cervical cancer early detection and treatment programs in rural Kenya. She discussed strategies that worked and the challeneges involved.


Program for Appropriate Technology in Health (PATH)

Solar Powered Flashlight

Check this out: A flashlight that will run for 5 hours on 10 hours of solar charging.

There's an article in today's NYTimes about it as well, which you can find here.

Also neat is the "Buy One: Give One" strategy the company is taking; for $25 you can get one for yourself, as well as sending one to Africa (albeit through US charities, but it still seems like an innovative solution to me).

African Universities

The NY Times has a fascinating, tragic article about the state of Dakar's Cheikh Anta Diop University today. For all our discussions around the brain drain, the harmful effects of structural adjustment policies, and workforce issues, there is nothing quite so powerful as seeing how all these issues are affecting real people. It's hard not to contrast these Senegalese students' experiences to our own here in Seattle, and it seems to me critical that we keep human aligned with the macro policy issues that we concern ourselves with.

Link to article

21 solutions to save the world

As many people know, I think of large scale issues and consider what needs to be done as operating at that level, despite what I do on a daily basis. The May/June issue of Foreign Policy has a feature on what needs to be done. It can be accessed at http://www.foreignpolicy.com/story/cms.php?story_id=3783
and individual solutions read that way. One can also use the UW electronic journal to get to a pdf form of the journal is you want that.

There might be some interesting issues to discuss.
I liked chess champion Kasparov's global magna carta, because today's problems will require a new way of considering people on the planet.
My favourite piece is Gardner's look at inequality (for the US) and his solution makes eminent sense.
Eberstadt highlights the problem well, but is quite constrained in what to do about saving Russians. Their declining health had nothing to do with changes in medical care.
I was intruged by Duflo being a professor of poverty alleviation, a first to my knowledge. Throw money at it? No, stop exploiting!
I was not impressed with the professor of defense analysis at the Naval Post-graduate school's ideas.
Domain naming was something I hadn't considered before, so maybe this is a reasonable way to work. Or maybe the sugar bowl, or the sock?
Prahalad suggests the business model, exemplified by Amul in India is the way to go. Amul was successful because it was a cooperative. Maybe we can learn something there.
HOmer-Dixon espouses experimenting. That is what we have been doing since the dawn of civilization 5000 years ago. We know what works. It just depends on who it works for. The current system has produced phenomenal wealth very successfully.

Others' thoughts?

STephen

Response to Curse of Resources

Countries that have wealth such as oil, diamonds and other resources are now considered to have a curse. Interesting concept, namely that a country's resources should not be for its people, but for investors of corporate-centered globalization. Some countries in South America are considered economic nationalism, with Venezuela leading the way. Nigeria, with fabulous wealth is one of the world's poorest countries. Their oil wealth has been extracted but there is some resistance there that you won't read about in the mainstream press. It does reside, however, in the business press, since investors need to know what is going on in the world. The rest of us need to be told we are anxious, and suffering from Massive Insecurity requiring us to purchase the products advertised there (May issue of Oprah magazine). But the following piece from today's New York Times business section points out what some people in Nigeria are trying to do to recover from their curse. Their efforts are probably not supported by some grant from a charitable organization, as the revolution will not be funded. Stephen

NYT May 16, 2007

Nigerian Oil Production Falls After a Pipeline Hub Is Overrun
By LYDIA POLGREEN
NDJAMENA, Chad, May 15 -- Young protesters have overrun an oil pipeline hub in the volatile Niger Delta, the authorities said, helping to cut Nigeria's oil production by about 30 percent as the country weathers a period of instability after a deeply flawed election last month.
The protest, by activists of the Ogoni tribe in the Niger Delta, is the latest violence among ethnic militias that have attacked pipelines and other facilities since the election last month returned the ruling People's Democratic Party to power with wide margins.
The European Union called the election, which was marred by fraud and intimidation, not credible, and Nigerian observers demanded a revote.
Since May 7, a group of protesters in one of the oil-producing states has occupied a Chevron oil field, and in a neighboring state, Bayelsa, a militant group called the Movement for the Emancipation of the Niger Delta has bombed three pipelines, disrupting the flow of nearly 100,000 barrels a day for the Italian oil company Eni. The disruptions helped push oil prices in New York to $63.17, up 71 cents a barrel.
More than a dozen foreign workers are being held hostage in the Niger Delta, and dozens more have been kidnapped and released in the last year as violence in the oil region has escalated. Despite producing most of Nigeria's foreign currency earnings, the Niger Delta is one of the poorest regions of the country.
Militants in the region have said that they plan to escalate their attacks in the weeks leading up to the inauguration of Nigeria's president-elect, Umaru Yar'Adua. He was declared the winner of an election that international observers said had been marred by ballot stuffing, intimidation and incompetence by electoral officials. Mr. Yar'Adua has said he plans to make developing the Niger Delta a priority.
But these promises have made little impact on militants, who vow to increase their attacks. In an e-mail message, the Movement for the Emancipation of the Niger Delta said: "Our objective remains the same, to destroy the Nigerian oil export industry and compel the government to address the injustice in the Niger Delta."

Gaps in the Silk Road: Health Disparities in Northwest China

Brenda Schuster is an RPCV from Uzbekistan and Uganda. She lived in the Xinjiang Uighur Autonomous Region for 2½ years, and has traveled extensively throughout Central Asia and Western China.

The Monday brown bag seminar team had the bright idea to invite Brenda to share her experience and present some of her thesis results. I really enjoyed her talk. It was an amazing eye opening presentation on the reasons behind the poor health outcomes among the indigenous peoples of the Xinjiang Uighur Autonomous Region.

Dr Stephen Bezruchka recorded this talk ( available on this link) and Brenda kindly accepted to share her presentation

French PSA Condom Promotion

These (somewhat sexually explicit) animated French ads for condoms are fantastic. If only the US were half as progressive...

Check them out here.

The Responsibility of the Diaspora Communities

A few days ago IHP sponsored a talk by Dr. Alice Rothchild, an obstetrician-gynecologist from Harvard University. Alice presented narratives about issues of health and human rights violations in Palestine and read from her recently published book "Broken Promises, Broken Dreams: Stories of Jewish and Palestinian Trauma and Resilience". Alice told stories of Palestinian pregnant women and the effect the Israeli occupation has on their daily lives, specifically the effects of restrictions on movement. A recent example of what Alice talked to us about is the shooting of a pregnant Palestinian woman, Maha, by Israeli soldiers, killing her 7-month-old unborn baby. Emergency teams were prevented from reaching Maha's home.

The Israeli attacks pose immediate danger to mothers and children in particular, which ranks high as the cause for indirect deaths in the area. Access of mothers to post-natal health care services is frequently blocked due to Israel‘s separation wall and the presence of hundreds of Israeli military checkpoints throughout the West Bank. A recent study on perinatal and in
infant mortality published by John Hopkins University found that four out of every 1,000 Palestinian children born die before age one due to Israel‘s restrictions on movement on Palestinians in the West Bank and Gaza.

Alice wrote in a concluding chapter in her book "I wonder whether the ongoing occupation, dense matrix of bypass roads and checkpoints, and the growth of Jewish settlements have actually made a viable two state solution a physical impossibility. I wonder how two peoples with such a history of trauma and loss can heal their many wounds, and what is the responsibility of the Diaspora communities." In a recent conversation with Dr. Barghouthi, Palestinian Minister of Information and President of the Palestinian Medical Relief Society stated that Israel‘s continuous breaches of international law undermined the potential for peace. I believe that medicine is not separate from politics and a people's right to health in Palestine can only be achieved when there is peace in the region and when we see an end to the occupation.

So, "what is the responsibility of the Diaspora communities" and the international community? What can we do from here?

10 years later a new step

It was nearly 10 years ago in 1997 that we started a rudimentary IHP website on my own web account and later we moved it to ihp own location. The first website was actually for Steve's class and then we had one for MAM's class and then IHP website. Many people worked on these first websites and I am glad that today IPH is moving into this arena of Blogs.
Congratulations!!!!
Jawad

28

I got linked to the book's website from one of the emails Tariq forwarded to the ihp mailing list. I thought the book was a great way of capturing human stories - and not just statistics.

The website has the following in its 'About the Book' Section:

"For the past six years, Stephanie Nolen has traced AIDS across Africa, and 28 is the result: an unprecedented, uniquely human portrait of the continent in crisis. Through riveting, anecdotal stories, she brings to life men, women, and children involved in every aspect of the pandemic, making them familiar to us in a way they never have been before. In the process, she explores the effects of an epidemic that well exceeds the Black Plague in scope, and the reasons why we must care about what happens.

In every instance, Nolen has borne witness to the stories she relates, whether riding with truck driver Mohammed Ali on a journey across Kenya; following Tigist Haile Michael, a smart, shy fourteen-yearold Ethiopian orphan fending for herself and her baby brother on the slum streets of Addis Ababa; chronicling the heroic efforts of Alice Kadzanja, an HIV-positive nurse in Malawi; or talking to Nelson Mandela and his wife about coming to terms with his own son's death from AIDS.

These stories reveal how HIV works and spreads; how it is inextricably tied to conflict and famine and to the diverse cultures it has ravaged; how treatment works, and how people who can't get treatment fight to stay alive with courage and dignity against huge odds.

Writing with power and simplicity, Stephanie Nolen makes us listen, allows us to understand, and inspires us to care. Timely and transformative, 28: Stories of AIDS in Africa is essential reading for anyone concerned about the fate of humankind."

May be some of us will be able to capture such stories as we work in our respective fields. If not a book, this blog might be a place where we can share some human stories.

Friday seminar : Ethiopia and Pakistan under the spotlight

The friday seminar theme for this quarter is about " Global health successes and failures " and it was Tariq and Afework turn this week to share their experience and knowledge about respectively Pakistan and Ethiopia. I will try to make their presentations available on this blog as soon as I get them.

community

Afework is here. As is Zied and of curse Katie
For noe after the 510 class we have a moment in community. part is speaking in N AFRICAN FRENCH, others in Haitian Francais, Agathe et arrivee........ We will some of us go down to the library to create a logframe...... another extension, another projection, another expression to happen spontaneously.

Community: Catch it if you can!
It heals!!

Blogging IHP...

Thank you dear friends for supporting and joining this blog. Emily and Charlene just informed me about this blog and this one. These are two interesting example of global health blogging but, in my opinion, we should not try to resemble to what already exists and we should try to create our own thing. Certainly IHP Diaries is about global health but it is also about keeping a community connected. We share a set of principles of values, some of us are faculty and alumni based in Seattle, others are students and graduates working overseas but we are all part of the same community.
There is no need to be formal or conventional. feel free to share and this blog editorial line will come into view within the coming months.

Advanced Symptoms of Advanced Degrees

Humorous article from the Chronicle of Higher Education.

IHP into the Blogosphere

I am pleased to help launch our International Health Program's entry into the blogosphere. This new "IHP Diaries" blog provides yet another mechanism for the IHP family to converse and share experiences about the critical issues of our time. Over the years I have been continually amazed at the depth and breadth of ideas that emanate from our group - and how it helps all of us frame our understanding of the many global issues that relate to health, equity, and justice.

This new IHP blog will provide yet another forum for this exchange - and I expect the conversations to be as exciting and insightful as always. Moreover, I'm hoping that we can learn new and innovative approaches for our collective global health activism. A luta continua!

Congratulations to our IHP students, and especially Zied Mhirsi, for making this happen!

Steve