July 26, 2012

Global Health Corps’ 2012 Fellows Training at Yale


Nina Gumkowski, GHLI staff

This July, 90 young adults began their work as Global Health Corps (GHC) fellows fellows with two weeks of training at Yale where they attended sessions to build “professional and intellectual development in the training’s leadership framework.” Fellows prepared for their year-long placements around the globe, in Burundi, Malawi, Rwanda, Uganda, the U.S. and Zambia, where they will assist in programs that focus on an array of health care issues. During the two week program, fellows listened to presentations and participated in discussions examining different viewpoints on a variety of issues, including the AIDS epidemic.

AIDS activist Gregg Gonsalves discussed how grass roots campaigns in the 80s and 90s were fundamental to getting the government to address the effect of AIDS in the United States. He stressed the importance of community activism and that small voices in a group can make a lot of noise. Next, Ambassador Mark Dybul, who led PEPFAR under President George W. Bush, presented the fellows with a case study based on the events that occurred right before President Bush announced PEPFAR at the state of the union and asked the fellows “What would you have done?” This approach led to a vibrant discussion in which the fellows spoke about all the details involved in influencing policy.

This is the second year that the training was held at Yale. GHC has an educational partnership with GHLI to support the fellowship training. Mike Skonieczny, executive director of GHLI, welcomed the fellows and emphasized the progress being made to internationalize Yale -- in the past four years global health concentrations and certificates have become part of the Yale School of Public Health, the Yale School of Medicine, and the Yale University Graduate School of Arts & Sciences. “The work that GHC is doing felt in sync with the mantra of Yale, to groom future leaders,” said Mike when asked about GHC. “We hope that there will be possibilities to expand this partnership in the future.”


UPDATE:

During the GHC training at Yale co-founder, Barbara Bush was interviewed by iVillage about the work being done by the fellows and some future plans for Global Health Corps.

July 16, 2012

A Hectic Pace in South Africa

Heather Fosburgh,
2012 GHLI Fellow

After much searching and staying at seven different places in my first two weeks in South Africa, I found a little cottage to rent on the same land as the owners – who have kindly helped me out with rides to work or the store, site seeing and inviting me to their beach house.

I am living in the city of Pietermaritzburg in the KwaZulu-Natal (KZN) province and working with the KZN Department of Health and the Office of the Premier (similar to a governor). Pietermaritzburg is about an hour west of Durban and the province borders Lesotho, Mozambique and Swaziland. The area boasts of a number of historic events from the train station where Gandhi was inspired to start his passive resistance movement to the capture site of Nelson Mandela.

The Premier’s office coordinates all activities, projects and programs related to HIV/AIDS while the Department of Health focuses on treating the disease and the medical side of it. Given my interest in health promotion and community health workers, it is the perfect location for me -- when I hear about something that is really interesting, like the work with the integrated wellness centers at truck stops, I have the opportunity to work on these projects as well. And, thanks to some interns here from the University of Natal I am also learning what streets I shouldn’t use as short cuts on my walk home to where to find the best pizza.

South Africa is currently piloting a National Health Insurance plan that is based on re-engineering the primary health care system to focus on community health care and preventative medicine. Three provinces in KZN are piloting the program. My role is to document the process in the Umgungundlovu district through interviewing key stakeholders and accompanying clinicians and health care workers in the field. This project ties in to the delegation’s work in improving maternal and child health indicators as well management leadership training.

The Road Ahead in Ethiopia

Lexy Adams,
2012 GHLI Fellow

I am nearly halfway through my time here in Ethiopia and I can’t believe it has gone by so fast. The weeks have been filled with hospital visits, designing a training for site visitors and preparation for a visioning committee for the future of Ethiopia’s health status in 2035. In addition to the work, exploring Addis has been fascinating, including venturing to the top of Entoto Mountain to explore Emperor Menelik’s Palace and navigating the crazy minibus system. We have met so many fascinating people in the hospitals and NGOs and even just other travelers staying in our guest house. And the food is delicious!

We are now in Nekemte to visit the hospital and kick off the best practice documentation that we have been planning and perfecting for so long. With this new Ethiopian Hospital Alliance for Quality, we hope to create a platform for sharing ideas and best practices between all public hospitals in the country. Now, our job is to travel to the LEAD hospitals scattered throughout the country, already high performers in patient satisfaction, and unearth the practices that set them apart. Ideally, after compiling a list of practices that are effective, sustainable and low cost, hospitals across Ethiopia can adopt these simple practices that will lead to quality improvement, independently changing themselves for the better.

These weeks have been full of eye-opening experiences, from witnessing the poverty and debilitation on the streets to the extreme lack of resources in the hospitals. More than anything, this last month has reinforced my desire to become a doctor and to work in developing countries. Driving through the countryside it is evident how many people lack quality health care but have no means to attain necessary care. get it. With visionaries such as the Ministry committee and GHLI team in Ethiopia, hopefully in 20 years we can revolutionize the system in Ethiopia, and provide millions more people with the primary health care they deserve.

Arriving in Ghana

Micah Johnson,
2012 GHLI Fellow

My time in Ghana has been great so far, in terms of both working and living. A major portion of my work has dealt with the newly passed Mental Health Act, as well as its Legislative Instrument (the framework that defines how the law will be implemented). The morning after I arrived I traveled to Pantang Psychiatric Hospital (about an hour outside of Accra) for a meeting of the Mental Health Technical Committee regarding the drafting of the Legislative Instrument. What struck me most about the meeting was the diversity of people around the table all working together on this crucial project—not just professional policymakers, but also clinicians, researchers, hospital administrators, heads of NGOs, professors, and politicians. It was a clear reminder of just how many stakeholders it takes to effect system-wide changes. I also found the scene very relevant to my own aspirations—in my career I hope to combine clinical practice with involvement in health policy. I couldn’t help but think that these were the types of efforts I could see myself contributing to throughout my career.

One important lesson I have learned at the GHLI conference, through my involvement with the drafting of the Legislative Instrument and other experiences in-country, is that even when a law is on the books, a tremendous amount of work remains in order to translate the words on the page into reality on the ground.

There’s so much more I could say about mental health in Ghana and the work I’ve been doing, but I should also briefly mention some of my other adventures. After a visit to Ankaful Psychiatric Hospital I had time to do some exploring in the Central Region of the country. Among other things, I had a chance to see some of Ghana’s natural beauty at Kakum National Park. I went on the famous canopy walk, which gives a spectacular view of the rainforest from walkways over 130 feet high. Needless to say, I’m looking forward to the rest of my time here!

The People of Ethiopia

Sudhakar Nuti (far left) with the 2012 Ethiopian delegation.
Sudhakar Nuti,
2012 GHLI Fellow

During the ride from the airport to my guesthouse, my hostess spoke about how the Ethiopian people are “nice.” I had heard about the unique physical beauty of Ethiopians, but having been here for only a week, I can confirm that this beauty extends to and permeates throughout the character of the people. They are not just nice, but are helpful, friendly and considerate, even to a ferengi (foreigner) like me. While it may help that I am on crutches, their warm smiles and genuine concern have made me feel quite welcome.

On my first day, as I walked the dusty streets of Debre Zeit Road, an elderly man with a cane stopped me and said, “Hello! Are you okay?” I gave a smile and a nod, but I was surprised by the concern of this stranger. Both Lexy – my fellow intern from Yale – and I experienced this kindness on our ride to Entoto Hill today. First, a minibus driver drove an extra five minutes to take us to our next stop for free, and then an elderly woman volunteered to serve as our escort and found us a ride to the top of the hill. While we were afraid at first of a scam, it turned out that she was a great guide and a nice woman – although she did seem to trick the driver out of his payment at the end. Even the children have been welcoming, often gathering around us and offering a hand to shake, a big smile, and a friendly Selam greeting.

Our coworkers at the Medical Services Directorate in the Ministry of Health have been taking great care of us as well -- continuously giving us food, transportation, and aid in correcting our faulty Amharic pronunciation. Whenever pursuing a large-scale effort, as we are with trying to improve hospital quality here in Ethiopia, it is always helpful to put a face to the issue, and all of the people I have met have provided me extra inspiration in pursuing our work. I just hope that we can make a difference in the short time we are here.







Arriving in Liberia

Janeen Drakes (far left) with the 2012 Liberian delegation.
Janeen Drakes,
2012 GHLI fellow

I arrived in Liberia at the beginning of the rainy season. It began with the occasional downpour and has quickly escalated, becoming a nearly constant feature from morning to night. Despite the gloom you would expect it to cast over the city, Monrovia is still lively, upbeat and thriving. People may be a bit delayed but they just seem to take it all in stride. This sort of perseverance seems to permeate Liberia’s culture and its people.

It is evident in everyone I have met so far: the Ministry’s staff working tirelessly to rebuild the country’s health system; the nationals who have returned in recent years with a desire to help rebuild their country; the Lebanese store owner who left a war in his country and chose not to rebuild for a second time; the diligent staff from the various NGOs working in the country; vendors in the market and children who are always dancing in the rain. Despite the numerous setbacks they encounter, they all seem to possess a relentless drive.

Their attitude is inspiring and infectious and one I wish to adopt in my work here and take with me when I leave. My work this summer will focus on the implementation of a pilot project of maternal waiting homes. These homes are designed to give pregnant women who are at high risk and those who live far away a place to stay near health care facilities in the weeks prior to their delivery. Currently, 41% of people live more than 5km from a health facility and the majority of women deliver at home without the help of a skilled attendant.

In a country with few obstetricians, the goal of increasing access to quality care and reducing maternal mortality seems challenging. However, Liberia has learned to leverage the resources it does have to make a difference. Certified midwives, trained traditional midwives and community health volunteers are on the forefront delivering quality care. The maternal waiting homes give pregnant women access to this care and alleviate the burden posed by poor infrastructure. This project is yet another example of how Liberians persevere.