Mental Health Leadership Collaborative Begins at Yale

Sang Hee Park, Yale MPH,

Class of 2013

At the beginning of this year, Yale began a new endeavor to further collaborations with universities around the globe. The GHLI led these efforts with the newly created Yale GHLI-Fudan Mental Health Program. Faculty from Yale’s Schools of Medicine and Public Health and a cohort of physicians and professors from several universities in China, accompanied by student ambassadors from Yale colleges and graduate schools gathered on the Yale campus as part of the initiative to improve the Chinese mental health care system.

Despite the long travel time and the time difference, the Chinese participants were engaged and active starting from day one. It’s easy to assume that considering the participant’s careers as lecturers rather than students and the achievements they have already made, that they would have less willingness to be “trained” by other people – but not so. Their aspirations to learn ways to better their system were evident during lectures, site visits and individual work sessions, engaging in endless thought-provoking questions and proactive discussions. Throughout the program, the director and staff of the program continuously brainstormed on how to make the remaining days even more effective.

By the end of the third week, the participants had formed professional and lasting relationships among themselves as well as with the professors at Yale and directors of the healthcare settings visited. A director from one site visit even drove over an hour to attend the farewell dinner in New Haven and give each participant a CD with photos from the visit as a gift.

Because this was the program’s first year, there was much excitement and a bit of nervousness during the preparations, and I was not too sure what to expect. But now, after a successful three weeks, I am excited to see how the participants will be able to utilize what they have learned to improve leadership and management skills and challenges they face in the Chinese mental health care system would unfold in the next years!

*Site Visits included: Yale New Haven Psychiatric Hospital, Program for Recovery and Community Health, VA Connecticut Healthcare System West Haven Campus, Institute of Living, Connecticut Mental Health Center, and Connecticut Valley Hospital.

To read more about GHLI's partnerships in china, click here.

Why the U.S. needs to be Concerned About Female Genital Cutting and What is Needed to Stop this Practice

Heather Sipsma, Associate Research Scientist, GHLI

More than 100 million girls and women worldwide have undergone female genital cutting (FGC, also known as “female circumcision”), and more than 3 million female infants and children worldwide are at risk for this procedure annually. FGC is strongly rooted in tradition, culture and religion, and puts young girls and women at risk for extreme pain and infection, as well as other reproductive health and psychological consequences and even death.

In a recent study published in the Bulletin of the WHO, GHLI researchers examined the practice of FGC across 10 countries in West Africa. The prevalence of FGC was high overall but varied across countries -- ranging from 94% in Sierra Leone to less than 3% in Niger. Older age and being Muslim were associated with increased odds of FGC, and higher education was linked with lower odds of FGC. The association between FGC and wealth varied considerably.

Based on data from countries included in the study where the FGC is on the decline, we found four necessary components to effectively reduce FGC practice and support, including 1) community education and awareness, 2) the use of prominent groups to champion the cause, 3) the support of FGC practitioners such as nurses, midwives, and traditional healers, and 4) enforced legislation. Successful community strategies have been documented, including circumcision-free rite-of-passage ceremonies and collective declarations in which villages pledge not to circumcise their daughters. Furthermore, community education and awareness can enable and facilitate affected communities to promote positive attitudes towards discontinuing the practice. Concerted and multifaceted commitments allow for the preservation of a community’s cultural heritage and social values while sustaining attitude shifts away from FGC.

We believe our findings will benefit clinicians and researchers in the US in two important ways: 1) in light of significant migration to the US from West Africa, it is important for US-based physicians and researchers to recognize the potential prevalence of FGC among immigrant groups; and 2) increasing interest in global health means that growing numbers of US physicians travel abroad, therefore, awareness of the FGC practices across cultural contexts can enhance the physicians’ preparation for and effectiveness in international settings.

Future work includes continuing to promote the awareness of FGC both in the U. S. and abroad and providing data for advocacy groups working to prevent FGC in practicing communities.

Why We Do What We Do: Patrick Byam

Patrick Byam, program manager for GHLI, recognized his interest in health during his undergraduate years at McGill University. Initially majoring in biology, Patrick realized that he wanted a career outside of the lab. “I was tired of learning about flies,” he explained. “I wanted to work in health outside of the lab and the hospital.”

His first global health encounter was through the Canada World Youth Program, an experience that involved working in community health in rural Canada and China. “Through that program, I realized that I really needed technical skills, such as skills in statistics and epidemiology,” Patrick said.

After obtaining his M.P.H. in epidemiology of microbial diseases from Yale, Patrick joined GHLI in his current capacity, which includes examining the impact of the Ethiopian Millennium Rural Initiative. “One thing you hear a lot in the news is people saying that we poured all this money into Africa and we don’t see any results,” Patrick said. “My work involves making sure that these interventions meet the desired goals.” Through evaluating health interventions, Patrick’s work helps ensure the sustainability and social accountability of these programs.

One particular experience Patrick relays captures the importance of his work. “During an on-site visit to a health center in northern Ethiopia to corroborate data, myself and colleagues encountered a grandmother with her emaciated, malnourished grandchild. The child’s mother had died while giving birth, and the grandmother was feeding the baby cow’s milk, which is harmful to newborns. We were able to quickly enroll the child in a nutrition program, which helped to save the baby’s life. I realized the benefits and limitations of global health programs and just how much of a need there is for effective, sustainable health interventions,” he articulated. “Our work means making people healthier and transforming communities.”

Shatreen Masshoor, GHLI Intern
Yale College 2012