The Global Child

Earlier this summer I had the opportunity to visit a program called The Global Child (TGC) in Siem Reap, Cambodia, which was established to educate Cambodian street children and to provide a model for other programs designed to provide poor children an education, food, healthcare, and a new perspective that will allow them to have an active role in their communities and the world.  Begun in Phnon Penh, the program moved to Siem Reap in 2008 where now 25 students, pretty evenly divided between boys and girls, are gaining a broad education that supplements basic education with computer training, sports, music, art, and field trips, all designed to allow the students to "shape their own futures, as well as their country."

Housed in a lovely older home that has been adapted to provide classrooms, creative activities, and administrative offices, the students come together with teachers and volunteers for enrichment education and activities.  They earn a stipend for continuing their education, a subsidy of a dollar a day for every day they attend school.  This money, which is kept in individual student accounts, is then available and shared with their parents to offset the income the children would otherwise be earning from begging or selling items on the street.  These accounts can be very valuable to parents, allowing them to even start small businesses to support their families.

TGC is supported by a number of outstanding businesses in Siem Reap, a very busy tourist destination, including a cafe and a delightful boutique where beautiful hand-crafted items are sold for very reasonable prices (needless to say, I did a good share of my Christmas shopping there!). 

The director and administrative staff as well as volunteers of The Global Child are doing an excellent job with the resources available.  A connection to Union College in Schenectady provides fellowships to recent graduates who spend time teaching and developing programs for the students.  Now that our new semester has begun at the School of Public Health, it is my intention to get our Graduate Student Organization (GSO) involved in fund-raising activities to help purchase some items that are on TGC's wish list including white boards and other items for the classrooms as well as items for creative and fieldtrip activities.  It is programs like this that the Center for Global Health can readily and passionately support!

Today, July 19: Global Day of Action for Arash Alaei

Several major international organizations, both human rights and international health organizations, have joined together to call for the unconditional release of Dr. Arash Alaei from prison in Iran.

Today, July 19, marks the Global Day of Action to call for the immediate and unconditional release of the brother of our DrPH student.  As many of you are aware, Kamiar Alaei, a Doctor of Public Health student at our School of Public Health, was arrested along with his older brother, Arash, in June 2008 when he (Kamiar) returned to Iran for a summer internship.  They were charged with communicating with an enemy government, ours.  Both Kamiar and Arash had been internationally recognized and celebrated for the work they had done in Iran by establishing "triangular clinics," a project documented by WHO/EMRO as a "best practice" in the region, focusing on HIV, STD, and IDU prevention, harm reduction, and combatting stigma and discrimination against people living with AIDS.  After a sham trial, they were convicted and Kamiar was sentenced to three years and Arash was sentenced to six years, sentences to be served in the notorious Evan Prison in Tehran. 

A campaign to free them (http://www.iranfreethedocs.org/) was begun soon after their arrests and many human rights organizations were very vocal in calling for their release.  Late last year, we were filled with joy when Kamiar, who had served well over half of his sentence, was granted a conditional release and able to return to our community and his doctoral studies. 

Now Kamiar has completed the full term of his sentence and is able to lead the efforts being undertaken again by Physicians for Human Rights (PHR), Amnesty International, and other organizations, to free his brother who has completed half of his sentence and is, under Iranian law, eligible for a conditional release. 

PHR has said, "Dr. Arash Alaei has worked tirelessly to address HIV/AIDS, tuberculosis, and addiction and demonstrated unwavering dedication to helping improve the lives of his countrymen and women by protecting them from disease and death.  The Drs. Alaei are global leaders in programs to end discrimination against injection drug users in Iran and helped to develop and implement Iran's progressive policies on needle exchange and AIDS prevention and care inside and outside of prisons.

"Health professinals must be able to implement HIV and AIDS prevention and treatment without fear of reprisals and should not be imprisoned on the basis of their professional work for the prevention of HIV and care of people affected by the disease.

"Ending Dr. Arash Alaei's confinement will benefit public health in Iran and will have a positive impact on the international medical community and the efforts to prevent and treat HIV/AIDS.  With his release, Dr. Alaei can continue his life-saving work for the benefit of humanity.

"Please visit http://www.iranfreethedocs.org/  and sign the petition asking the Government of the Islamic Republic of Iran to release Dr. Arash Alaei immediately so that he can continue his important public health work."

Recent Astonishing Realizations

Has it really been over a month since I last posted an entry?  I guess it has been; for most of that intervening time, I have been traveling and, based on my travel experiences, thinking about what I discovered, experienced, and learned.  The world is changing rapidly it seems.

Just a couple of days after I returned from our Dominican Republic study tour, I repacked my suitcase for a trip that took me to partner organizations in China, Cambodia, and Vietnam, a trip of just over three weeks.  Because there were unique purposes for each country visit, I think I'll discuss my experiences and impressions in three separate entries, one for each country starting with China, the first stop on our journey.

I was joined on this leg of the trip by three fun and sophisticated fellow travelers:  Bonnie Nasca, Shao Lin, and Syni-An Hwang.  Our primary purpose was to visit Sun Yat-sen University's Medical and Public Health School in Guangzhou (formerly Canton).  Sun Yat-sen is one of China's leading universities and the alma mater of Dr. Shao Lin, a faculty member iin the Department of Epidemiology and Biostatistics at the UAlbany School of Public Health and a Research Scientist in the Center for Environmental Health at the New York State Department of Health, and her husbamd who is also a Department of Health employee.  We have had a partnership agreement with Sun Yat-sen since 2009 but this was the first opportunity to visit their universiy and meet a significant number of their faculty.  Shao is taking the lead on this partnership which will stimulate collaborative research on environmental health issues common to both our countries with a focus on those brought about by global climate change.

The last and only time I had previously visited China was about 10 years ago.  What a difference a decade can make!   We all know what an economic powerhouse China has become (and how much of our debt it owns!) but the pace of development there is mind-boggling.  Guangzhou is a city of 20 million (a bit more than the entire population of New York State!) and is spreading outward at a rapid pace with new roads and hundreds, if not thousands, of new high rise apartment buildings going up.  What you see from the highways are contruction cranes and new clusters of buildings rising in all directions. Of couse if you are a PBS listener and NY Times reader, you also know of the concerns this is raising among those landowners who have had their homes and lands conficated and leveled to make way for these massive construction projects . . . The new China is shiny and modern; the traditional China is disappearing fast.  But what is also remarkable is that things seem to run efficiently.  Ten years ago, you saw more bicyclists and small vehicles plus lots of public transportation.  Today there are lots of cars--new cars made by every manufacturer from Japanese and Korean to American models. But they have also built the roads and tunnels and bridges to accommodate the traffic and everything flows smoothly; there is no gridlock like you find in Moscow or some of our cities.  Another remarkable thing was the number of trees and the beautiful landscaping everywhere.  Even in the city, trees have been preserved or newly planted, highways are landscaped with colorful flowers and bushes, and hanging flower baskets adorn every major street.  Sometimes the glitz seemed excessive.  Guangzhou had recently played host to the Asian Games and may have spruced up their city for that but an evening boat trip along the Pearl River demonstrated the charm and glitz of neon in abmdance:  many of the buildings and all the bridges along the River have been turned into light shows!  We were wined and dined by colleagues at magnificent banquet houses and taken to a circus that was Cirque de Soliel on steroids.  For some reason, everything seemed out-sized  and a bit excessive but admirable in terms of ability to "get things done."  Maybe dictatorships are bad in many ways but when I see our Congress at an impasse and so little progress being made here on the major issues facing our nation, I can't help but think we'd be better off with a stronger Executive.

In addition to the visit to Sun Yat-sen University, we were able to meet with leaders of the Provincial Centers for Disease Control for Guangdong Provincial.  That province alone has a population of 100 million!  They are housed in a very modern building in Guangzhou with four floors of laboratory space fully equipped with the latest equipment.  However, they were pleased to show us plans for their new, expanded and even better equipped, facility which they will move into soon. 

We certainly have a lot to learn from our Chinese colleagues!

Next time I will write about our experience in Siem Reap, Cambodia where we visited an NGO, The Global Child, which was started by people from this area to help street children and orphans stay in school and off the streets. 

The "DR '11 Team" Returns Triumphant

The "DR '11 Team" has recently returned from an eleven day study tour of the Dominican Republic where we learned about the Dominican health care delivery system and built latrines in the city of Neyba close to the Haitian border.  This was an outstanding team of students with a wide range of experience and skills.  We ranged in age from 19 (Alexandra or "Alex" as she preferred) to 68 (guess who?) and we were a group of undergrads as well as Master's and Doctoral level public health students (and one international business major).  We spent the first few days in Santo Domingo where the principals of Community Service Alliance (one of whom, Elizabeth Conklin, is a graduate of our MPH program) provided a program that included the history and culture of Dominica as well as an overview of the health care system.  We also toured the capital's colonial zone and even had a Latin dance class (which came in handy later in the trip!).

Then we took a four hour journey to Neyba where we began working with a team from World Vision related to the latrine building and serving as mentors to a group of teens who are trained as peer educators in a number of important public health issues.  The focus of the training was on parasitic diseases and dengue (there has been a number of outbreaks in the DR lately and while we were there the local newspapers reported 100 new cases a day seen at city hospitals).  Our team, working along side the World Vision trainers, was responsible for coming up with new and engaging ways to educate members of the community on basic sanitation and disease prevention.  We also, of course, got our hands--and everything else--dirty on the latrine building project.  But what a team!  They were wonderful.  Without the benefit of any power tools, they were successful with saws, hammers, pick axes, and shovels--they are now experts in mixing cement and creating "throne rooms." 

We stayed at the World Vision's retreat center high in the mountains above the city of Neyba in a cloud forest where it was cool and very serene, much cooler and quieter than the city which was on the plain and very hot.  It was good to retreat to a cooler climate even if the showers were only cold water showers and we slept on bunkbeds under mosquito nets.  The food was delicious, all of it locally grown--free range chickens and an extensive garden which gave us the most delicious salads I think I've ever had.

One day early in our stay in Neyba we had the opportunity to visit a community of sugar cane workers where a women's cooperative is producing a nutritious mixture of grains and other ingredients that can be used to bake any number of items including breads and cakes (a nutritious form of Bisquick).  We left there expecting to visit a regional hospital only to be stopped by a strike among workers, primarily bus drivers, upset about the high price of gasoline.  The road was completely blocked and, although the police had been summoned, it was felt they had been paid off to let the strike continue.  When our colleagues grew concerned there might be violence, we took a wild ride over some unpaved and often flooded back roads to reach Neyba.  It was an excellent lesson in the local political situation.

We were treated especially well on our last day with a trip to a beautiful island, Isla Saona.  We travelled by catamaran  to reach the island (the dance lessons came in handy) and spent the day on the beach, returning to the mainland by power boat and stopping on the way to jump off the boat and into the "hole in the ocean," a fascinating geological oddity that has shallow waters four to five feet deep in the midst of the ocean.

This was an excellent learning and service experience and we'll look forward to returning to the Dominican Republic in March next year with another team of students.

Our Friends From Costa Rica Are Arriving Monday!

We have an excellent partnership between our School of Public Health at the University at Albany (SUNY) and the University of Costa Rica's School of Public Health.  For the past two years I have taken groups of our students (and alums and faculty members) to Costa Rica for short study abroad  and service learning experiences and a couple of times each year they send a small delegation of students to our School.  In a couple of days four MPH students accompanied by the director of that program will arrive from Costa Rica for a two week visit.

When we go there we learn about their model universal health care program which provides access to everyone at a reasonable cost (half of what we in the U.S. pay for our health care) and provides excellent results (their longevity is greater than ours!).  No wonder they are the happiest people on earth as measured by so many recent surveys and polls.  In the late 1940's they decided not to have a military and to spend instead on social programs and the environment--in addition to an excellent education, health care, and pension program, they have set aside a large percentage of their country in protected national parks and reserves.  They have beaches on three coasts, mountains that rival any in the world for beauty and recreational opportunities, and even some wonderful active volcanoes that are fun to visit. 

But you can imagine how difficult it is for us to describe to them how our health care delivery system works with all of the players, fragmented services and programs, and high costs for poor results.  Why, they wonder, do we do it this way when there are so many ways to provide better access to all at lower costs and with better outcomes?  Our value systems are so different from theirs.  Our profit-driven system of health care and inequalities leave them shaking their heads and we shake ours along with them as it is not a system that we as health policy professionals can in any way justify.

But we will show them some of the best we do have to offer:  they will visit the Albany County Health Department; the Hudson Headwaters Health Network that serves a very rural population in the Adirondacks; the Albany Free Clinic; and they will undertake mini-preceptorships through the Pediatric Infectious Diseases Program at Albany Medical Center and visit the Pediatric Ambulatory Practice Program there as well as make visits to Centro Civico in Amsterdam and Equinox, a program serving at risk young people in Albany.  They will spend a weekend in Lake Placid and take a tour of the NYS Capitol led by Assemblyperson Jack McEneny, our local representative.  They will go salsa dancing and spend two nights at festive galas, one as guests of Equinox and one to help us celebrate our School's 25th anniversary.  They will be here during Albany's Tulip Festival so they will tiptoe through the tulips in Washington Park, dance the light fantastic on a number of evenings, and even do some hiking in an Olympic setting.  So what if our health care system hasn't yet been reformed sufficiently to match theirs--we can still show them a good time!  Sounds like fun to me--I can't wait!

The Panic Virus

Earlier this week we at the School of Public Health, in partnership with the New York State Writers Institute, had the privilege of hosting Seth Mnookin, author of The Panic Virus:  A True Story of Medicine, Science, and Fear published in January, 2011 by Simon and Schuster.  Two years ago, before Seth was even a father (he now has a 16-month old child), he heard his friends talk about their concerns related to childhood vaccinations and the dangers they thought were associated with them.  He was curious and began to look into the topic; the result is this excellent study which not only champions what public health professionals have been saying all along but also explores a very important issue in today's internet environment:  how people decide what is true.

A Simon and Schuster piece on Mnookin's book says:  "Despite overwhelming evidence to the contrary, the myth that vaccines cause developmental disorders [including autism] lives on.  It has been popularized by media personalities and legitimized by journalists who claim that they are just being fair to 'both sides' of an issue about which there is no real debate . . .

"Mnookin explains how dishonest researchers and snake-oil salesmen have taken advantage of desperate parents, and how the media--by ignoring facts and pretending that all points of view are equally valid--has through its irresponsible coverage fueled a controversy that never should have arisen in the first place.  He explores how cultural relativism and insular online communities have blurred the distinction between facts and feelings to the point that the traditional American ethos of individualism has been transformed into one in which individualized notions of reality, no matter how bizarre or irrational, are repeatedly validated.  In addition, he gives readers fresh and fascinating insights into the scientific process, the nature of knowledge, and the subconscious forces that drive much of our daily lives."

Mr. Mnookin, who has an undergraduate degree in the History of Science from Harvard, was right at home speaking to a small group of journalism students and faculty members during an afternoon seminar and an outstanding presenter at the evening event we held on our campus which attracted public health professionals, students, parents, and others from the community interested in this topic.  Seth spared no one:  he was articulate about public health's failures in combating this myth and urged us to become much more skilled and capable of working with the media to get our side of the story out to the public.  Hear!  Hear!

I think every public health student and professional should read this book!

100 Years and Counting

Last weekend I attended Alice O'Brien's 100th birthday party, an extraordinary event.  I suppose it's not so unusual now to reach the age of 100 but Alice is among the most remarkable older individuals I know.  She was born March 5, 1911 in Buffalo's First Ward.  I first met Alice when several years ago her neice, my good friend Mary Lou Woelfel, invited me to have dinner at her home with Alice and Alice's younger sister, Jean, who were visiting Albany from their home in Westchester County.  The sisters, both at that time women "of a certain age," were remarkable even then.  I loved their stories of growing up in Buffalo which was ethnically diverse and an industrial powerhouse at that time.  The two women pursued education and began a life of travel and interesting adventures, attending Columbia University for graduate degrees and living in Berlin after the Second World War.  Alice, a teacher in Westchester County schools even lived for a period of time in Kenya to learn about African culture to be better prepared for integration of the that school system.  When asked about her current interests she recently cited happy hour (a glass of white wine), reading the local newspaper every morning, and gathering with her new friends at the Daughters of Sarah Nursing Center for bingo and TV watching on the big screen.  She's also looking for a boyfriend, a woman after my own heart.  Among her secrets of longevity are Godiva truffles eaten daily.  As I said . . .

One of the things that struck me is Alice's memories of the 1918-19 flu epidemic.  She would have been about 7 years old. She recalls that every neighboring family was impacted including her own immediate family of nine children, her parents, and many relatives.  Her sister Margaret suffered the greatest and they feared she would die but she began to slowly rally and, after a prolonged period, recovered.  When one considers all the childhood diseases that individuals of that generation had to survive to make it through childhood:  measles, mumps, rubella, pertussis, polio, diphtheria, tetanus, and on and on, you realize the power of public health advances and immunizations.  Alice had good genes but she also survived all those childhood diseases as well as the most major influzenza epidemic ever known. 

Way to go, Alice!  Continue to enjoy the chocolate and happy hour (although red wine is supposed to be better than white for increasing longevity--something to think about!)