Wishing you and yours a happy and healthy holiday season. Looking forward to 2013!
Archives for 2012
In our upcoming Skill Building Session for the Advocates in Global Health Program, we’ll be exploring the concepts of media, advocacy, and global health. We thought that it would be helpful to engage with one specific example of this theme and deconstruct some of the perspectives that are prevalent in the public sphere. For this example, we chose the HIV/AIDS action programme, due to its global applicability, the amount of research capacity and the funding it’s received since the 1980’s, and primarily because the push for the campaign was largely a result of ‘ordinary people doing extraordinary things’.
This is a particularly helpful example of looking at the stagnation of politics in addressing health concerns, as well as looking at the power of activism at changing the direction of public health interventions, especially in marginalized populations. This is also a timely topic due to our proximity to World AIDS Day on December 1st!
We are excited to introduce two particular short films, one directed by Lisa Russell called “STOP AIDS: WHAT WILL YOU DO?” This was filmed in 2006 at the International AIDS conference in Toronto, and looks at the promises that have been made by governments and international health organizations, and the gaps in action for Universal Access to anti-retrovirals. The second film is a promotional video for the Global Fund, called “The Global Fund: 10 years of impact”, this video shows clips of prominent political leaders and advocates, including Bill Gates, Bono, and Jeffery Sachs, describing the leaps in health and development that have been a result of the Global Fund.
These two films were chosen due to the contrasting views they present on the campaign to prevent and treat HIV/AIDS.
We hope that students will take away from this session that advocacy is such an important factor in achieving global health equity; one that is achievable by anyone who wishes to speak up.
To learn more about the Advocates in Global Health Program please visit our website or contact Taq Bhandal <firstname.lastname@example.org>
*For those of you who are unfamiliar with the depth of political inactivity towards the HIV/AIDS epidemic during the 1980’s, we would encourage you to watch a lecture given by Gregg Gonsalves, one of the founding members of the AIDS Coalition to Unleash Power (ACT UP), at Harvard University – http://bcove.me/7r3v2yws.
Co-authored by Shawna O’Hearn, Director, Global Health Office and Dr. John LeBlanc, Faculty Advisor, Global Health Office
Our team focused on two weeks of MicroResearch training with a diverse group of health professionals in Ifakara.
The two week MicroResearch training program focused on key skills in developing a research proposal. Some topics included
- grant proposal development and management
- avoid pitfalls in research
- research ethics
- research manuscript development
- avoid pitfalls in presentations including abstracts
- technical report writing
- knowledge translation and policy development
- time and resource management
- community engagement
- curriculum vitae development
The Workshop had two different groups of participants. Twelve students taking a Masters in Public Health at the Catholic University of Health and Allied Sciences (CUHAS) (Bugando – Mwanza, Tanzania) and one coach were sponsored by the University of Calgary to participate in the MicroResearch Training Workshop. These participants were far from their home campus and housed at TTCIH for the workshop and were able to work on their proposals full time. This is the first time for this type of opportunity. In contrast, the other 26 participants were local to Ifakara and came from TTCIH, Ifakara Health Institute (IHI), St Francis University College of Health and Allied Science (SFUCHAS), and Saint Francis Designated District Hospital.
The students came from from a wide range of disciplines including professionals from medicine (paediatrics, orthopedics, surgery, family medicine), nursing, social workers, psychology, public health, library sciences, health research, laboratory medicine, biostatistics, computer science and engineering
The students were divided into 6 groups, two from CUHAS and four from Ifakara. Each group had 5 to 7 participants that included a range of professional disciplines. Many members had not met or worked with each other previously. The collaboration started with discussion of the research questions put forward by each member of the group. The research questions were based on their own experience and guided by the lecture: “How to develop a research question”. The group discussed the merits of each question and selected one to work on as their team project. A spokesperson for each group then presented the list of topics to the entire class and noted the one selected by the group and the rationale for its selection.
A distinguished panel of judges participated in deciding on the best presentation: Prof Cassian Margori, Principal of St Francis University College of Health and Allied Sciences; Dr Senga Pemba, Director, Tanzanian Training Centre for International Health (Ifakara); and Dr Angelo Nyamtema, Medical Director, Saint Francis Designated District Hospital (Ifakara).
There were two awards: one for the two groups from CUHAS and one for the four groups from Ifakara.
Group Winner: CUHAS Group 1
Title: What should be done to increase male involvement in Reproductive and Child Heath Clinics in Kigoma Municipal?
Group Winner : Ifakara Group 5
Title: Can the use of mobile phones improve antenatal clinic attendance?
The judges were impressed by the accomplishments from all six groups in the two weeks and by the care taken in the presentations. They recommended that all six groups proceed to develop full proposals for submission for a MicroResearch grant. They recommended that all review their question to refine further and then ensure that the objectives well matched the question. They noted that all six studies were important, relevant and well chosen.
Are you interested in getting involved? Do you want to learn more about the partnership taking place in Tanzania? Contact the Global Health Office
Co-authored by Shawna O’Hearn, Director, Global Health Office and Dr. John LeBlanc, Faculty Advisor, Global Health Office
Today is our 8 hour road trip to Ifakara. Using rope made from old rubber tires, our minivan driver, Majuto, packed 10 pieces of luggage in the back, on the roof and under our feet :(. We were squished and traffic was intense. We started on the main road out of Dar that takes one west to a T-junction. To the north, the road proceeds to Moshi, Arusha and eventually, Kenya (have a look on Google Maps). To the south, one proceeds through the Mikumi National Park to our destination Ifakara and then south to Mozambique. We had to work our way through big truck convoys against oncoming traffic and vehicles trying to pass these truck. This is, after all, one of the main arteries to southern Africa. We drove through the Mikumi National Park; to the right and left of the highway we saw, in sequence, a wild turkey, a baboon, gazelles, elephants zebras, giraffes, buffalo and a herd of goats! They were within a hundred metres of the road. No predators except people with the most dangerous of weapons, the automobile.
The final 85km of a 420km journey was mostly a bumpy, dirt, narrow road. Cheers could be heard as we saw the sign for the Tanzania Training Centre for International Health (TTCIH) and 6 miles through town, we reached our destination. We had a warm welcome and were treated to a BBQ of chicken and beef.
1 October 2012
We awoke in Paradise!
I was expecting a clean but functional, even austere setting with few amenities. We were treated to a lovely institute with beautiful flora, clean white buildings surrounded by lush lawns and a small cafeteria. We each have a large room with a double bed, a mosquito net, air conditioning, a fridge, a kettle and a television! Pickings are a little slim for those of us who don’t speak Swahili. The people are lovely and since Dalhousie has partnered with the Ifakara Institute for 10 years, the staff were eager to see us and hear updates on their friends. We started the day with a tour of the facilities by Dr. Senga Pemba (Director of the Training Institute). There is a new clinical training centre which had models for demonstrating birth and newborn resuscitation as well as plastic models demonstrating human anatomy.
There are 4 Institutions here:
- Tanzania Training Centre for International Health (TTCIH)
- Ifakara Health Institute (IHI)
- St. Francis Referral Hospital
- St. Francis University College for Health & Allied Sciences (SFUCHAS)
By Dr John LeBlanc, September 2012
Final day in Dar-es-Salaam and what a day! Terrilyn and I went on a bicycle ride through Swahilitown (one of the poorest neighbourhoods in Dar). Our university-educated tour guide, Meja, started a company, Afri-Roots, to promote the use of bicycles in Dar. He also offers 3-hour tours for wazungo (foreigners) for $40 to see what life is like for most Tanzanians living in Dar.
We first visited a market with hundreds of shoes on display sorted by type but not by size; one needs a lot of time to find a pair that both fits and looks nice. There were also many shops selling second hand clothes that had been beautifully washed and restored. We then went to a local coffee vendor. The vendor obtains raw beans from the Arusha-Mosha area, roasts them in a simple pot over a charcoal fire, pounds them with a pestle in a large wooden mortar and then makes the coffee Turkish style. We had that accompanied by a delicious amalgam of wheat, sugar and nuts, a home-made peanut brittle refreshingly less sweet than the commercial type. We continued to ride our bikes through back alleys and visited a traditional healer. She grew her herbs in a nearby garden and if she didn’t have the right herb, she’d write a prescription and send you to a traditional pharmacist!
The tour continued with a short visit to a home built in the traditional style of six large rooms (one for each wife and their respective children). The houses are made with coral walls and roofs of mango struts. Mango trees are no longer allowed to be used for building. We learned that people didn’t own their own houses; they had 99-year leases, which the government could revoke at will, and did, when they wanted to build something. This created insecurity in people’s minds and some difficult dislocations.
This neighbourhood raised money locally to build a bridge when the various levels of government were unable to provide the necessary funds. We stopped for home-made chips in pilipili (chili) sauce in the local version of a fast food takeout. This consisted of five ladies chatting around a pot of boiling oil while one cut potatoes and put them in the pot.
Next stop was a local cinema with wooden benches, a 30” old-fashioned TV and a DVD player. They showed pirated Hollywood or Bollywood movies that were overdubbed by a Tanzanian who told the story while the scenes unfolded. This wasn’t true dubbing as, according to Meja, he didn’t speak Hindi and perhaps not even very good English. Nevertheless, he was an excellent story teller and his overdubs were now distributed even to other East African companies. People paid 200 shillings at these theatres rather than the 10,000 shillings one would pay in a regular theatre ($1 Can = 1500 shillings). We later passed a theatre with a satellite dish that was showing live football games. These live shows cost 500 shillings and you can hear the cheering throughout the neighborhood!
We continued our bike journey through another market area where clothes were 1/3 to 1/4 as costly as the first market. Clothes were in large unsorted unwashed piles. The vendors from the other market bought many of their clothes here that they then cleaned, repaired and sold at 3-4x the price.
Returning to the hotel after an afternoon of cycling and learning about urban life in Dar es Salaam, we were greeted by Bob and Michele Bortolussi who had arrived from Uganda. Cycling in Halifax will be hard to resist after this experience.
Has anyone else taken this bike ride in Dar? Or had a similar experience that they would like to share with us about their cycling and learning about the local communities?
Submitted by Shawna O’Hearn, Director the Global Health Office, Dalhousie University
As our team wraps up their two week session in Tanzania we offer the 3rd post in this series – photos as soon as everyone is back in Halifax.
With a packed vehicle, 6 Canadians and Majuto (our fabulous driver), we began our 8 hour journey to Ifakara which took us out of the traffic jams of Dar es Salaam, through many villages as we zoomed along a national park with elephants, zebras and giraffes lining the road, then to a dusty and bumpy road; with the Tanzanian Training Centre for International Health (TTCIH) at the end of the road! To see Dr Pemba and Joyce greeting us at the end of a long journey made us feel at home.
The training program started on Monday with 40 participants from Ifakara and Mwanza. The participants from Mwanza are taking their Masters in Public Health at the Catholic University of Health & Allied Sciences. Students started by learning how to identify a research question, refine it and then explored what methodologies they could consider for their projects. The participants were divided into 6 groups; two from Mwanza and four from Ifakara. Each group had 5 to 7 participants that included a range of professional disciplines and many members had not met or worked with each other. The collaboration started with discussion of the research questions put forward by each member of the group. The research questions were based on their own experience and guided by the lecture: “How to develop a research question”. The group then vigorously discussed the merits of each question and selected one to work on as their team project. A spokesperson for each group presented the list of topics to the entire class and noted the one selected by the group and the rationale for its selection.
Some questions that the groups explored:
- Why do women who go to antenatal clinics not return to the hospital for delivery?
- Will the use of mobile phones improve antenatal care?
- What should be done to increase male involvement in reproductive and child health clinics?
- What are the factors associated with late hospital consultation of sick children?
During the second week we focused on writing reports, developing a budget, preparing an abstract and finalizing presentations which happened on Friday. Students debated, discussed, refined and finalized their questions and methodology
Presentations in front of judges to determine the top two groups as well as graduation happened on Friday.
Submitted by Shawna O’Hearn, Director of Global Health Office, Dalhousie University
While Shawna doesn’t have lots of time to send emails we are thankful for this note on our long standing partnership and wanted to share it with you!
There are many objectives to this trip to Tanzania starting with renewal of partnerships and establishing next steps with some of our long term partners. Upon arrival in Dar es salaam, I met with PASADA which is an HIV/AIDS clinic. In future posts we will provide you with links to more information on PASADA (as it’s available).
The meeting with Simon Yohana (Executive Director), Dr Daniel Mazesa (Medical Director) and Leonard Mwakasege (Human Resources Manager) resulted in a renewal of our student summer program as well as an expansion for resident opportunities and the development of a certificate in HIV/AIDS. After 8 years of working with PASADA, Dalhousie’s partnership will expand to support their new priority areas in research as well as medical education. We will keep you posted on the growth of this partnership over the next few months.
If you are interested in getting involved in the work and partnership with PASADA, please contact me at email@example.com
Submitted by Shawna O’Hearn, Director, Global Health Office
While Shawna and our colleagues are in Tanzania we will be posting a series of “Blog posts from the road”. This first one presents Shawna’s initial thoughts upon returning to Tanzania. Photos will be added as soon as we are able to transfer them. Enjoy! more updates to come later this week.
With all great intentions, I had planned to blog each day upon arrival in Tanzania. While a daily journal was put together, the internet has reminded me that there are not always the same amenities when we travel outside our urban contained world.
I have to start with two personal reflections (actually observations) that have been growing over the last week. First, while everyone has a mobile phone in Tanzania (actually many people have more than one phone as they have multiple network providers so people will have a phone for each provider) the difference between Canadian mobile users and Tanzanian mobile users is……Tanzanians aren’t on them 24-7! They walk on the streets with their heads up and look at life, people and where they are walking. You don’t see anyone with their head and fingers buried on an iPhone or Blackberry. A lesson that we need to remember in Canada.
My second reflection relates to my personal life and my December marathon goal. I am in the key weeks of training for a marathon and was worried about being able to run during my time in Tanzania. My worries were not necessary. I have met people of all ages and level of running abilities as I ran in the rain and pollution of the city (Dar) and the dust and uneven roads in Ifakara. There are people who will cycle with me as they return home from their fields, others who will run for a few miles to keep me company and some of my team members joined me on their bikes for my 20 mile run on Saturday morning. I have always loved to run and the last year of injuries has been challenging to be out of my training routine. I must thank the running groups in Dar, the people of Ifakara and my colleagues for their support and encouragement over the last few weeks. You will be with me as I cross the finish line in Sacramento in December! Asanti Sana!
You may recall a blog entry from July 2012 where we introduced two interns, Meredith Evans and Fiona Guerra, as the 2012 International Youth Internship Program (IYIP) Interns. Both women are settling into their roles in South Africa so we wanted to provide an update on their experiences. Thanks to our partners at the Atlantic Centre of Excellence for Women’s Health (ACEWH) for providing further details.
Both women are hosted by the Human Sciences Research Council (HSRC)
Meredith, who has a MA in Gender Studies from Central European University and a BMus from Dalhousie has extensive experience in feminist research. Her project at HSRC will involve analyzing quantitative data from the HSRC’s South African Social Attitudes Survey and co-authoring a paper on gender differences in perceptions of National Health Insurance (NHI). NHI is a universal public health system that will be implemented in South Africa over the next 14 years and this project considers how NHI has the potential to reduce gender inequality in the health care system.
Fiona, earned an Honours degree in Microbiology & Immunology with a Minor in Gender Studies from McGill University. This lead to further research and an interest in communicable diseases, which inspired Fiona to enroll in the PhD program in Immunology at the University of Toronto. As a result she is now working toward a career with an interdisciplinary, population-level approach to health improvement. As “Program Assistant-Health Promotion.” At the HSRC, Fiona is situated in the HIV/AIDS, STIs, and TB (HAST) unit, which undertook the first ever South African national household survey in 2002, in order to gauge the health status of South Africa. The current 2012 survey will reach 15, 000 households and 40,000 individuals and she will be involved in three independent projects, each developing very different skill sets.
To read more about these inspiring women please see the full story from ACEWH.
Here we present the final piece in our three part series on Global Health Office Summer Programs. An interesting cultural and clinical perspective from our fabulous students!
Photo essay submitted by Hyehyun Paek – Dalhousie School of Medicine
The city of Bangkok on the street where our language lessons were held. It shows the tall buildings in the financial district and the large number of cars and traffic.
This is a money tree in the Psychiatric ward. The colourful bank notes depict images of King Rama IV and the current King. When I asked the staff what its purpose was, they told me that they collect money on the tree and then donate it to a charity. I guess money does grow on trees after all.
In the Paediatrics unit, this is a shrine/memorial of the Buddha. The 2 main religions in Thailand are Buddhism and Islam, with the overwhelming majority of people being Buddhists. Buddha images and tributes are present everywhere in Thailand from hospitals to taxis to people’s homes.
This is the nursing station in the Pediatrics department of KKU. At the station, there are 3 nurses and one medical student. In the back room, there are 3 medical students discussing cases. Hanging on the wall, you can see a picture of the king and queen of Thailand. Pictures of the king were present all over the hospital and the rest of Thailand. At the time of our elective, the king was ill and staying at the Sirirat Public Hospital in Bangkok.
This is the medical dormitory 3, where Jocelyn Stairs, Carolyn Reardon and I stayed during the month of our elective. In Thai, it is pronounced “huh pet saam” . The dormitory is co-ed but male and female medical students are divided by buildings. (A is for boys, B and C are for girls: more female medical students than male in all of KKU). We stayed in B. Every evening, the students gathered on the court to play basketball. You can also see the many motorcycles parked in the front of the building. This is the main mode of transportation for most medical students at KKU although, some had four-wheeled vehicles instead as their parents did not approve of the more dangerous motorcycles. From our dormitory, the KKU hospital was about 10 minutes on foot and 3 minutes by car.
These are the medical students at KKU that showed us around Khon Kaen. They are all in the 5th year of medicine out of 6 years. In Thailand, students enter directly into medical school from high school and the medical program is 6 years long. The students names’ are (from left to right): Ping, Bo and Judy. This picture was taken during our paddle-boat ride in Khon Kaen. In the background, you can see the temple grounds.
Wat Si Chum (Temple of bodhi Tree) in Sukhothai, Thailand. Sukhothai was the capital of Thailand during the 13th and the 14th centuries. It is about 6 hours away from Khon Kaen by bus. We visited Sukhothai on one of our weekends during the elective. The entire Sukhothai historical park was stunning but the most breathtaking sight was this giant buddha. During our visit, we met a Thai lady who came to pay tributes to the Buddha and she told us of a tradition of praying to the Buddha. She said that we can kneel in front of him, introduce ourselves to him and ask for one wish. Then, we were to promise that we would come back to thank him if this wish comes true. As we left, she told us not to look back at the Buddha. It was a very wonderful experience to take part in this piece of Thai culture.
This is a traditional Thai dance performed by Thai medical students at KKU. On our last day of elective, the International office put on an International fair which we all attended. We enjoyed Thai dance and food and also sang the Canadian national anthem for the Thai staff and students.
Carolyn Reardon and Jocelyn Stairs, two of my fellow Med 1 students who did the elective in Thailand. This was at the lookout point on Koh Phi Phi on our last night together in Thailand before returning to Canada. We finished our trip with a few weeks of traveling after the elective in Vietnam and Southern Thailand. As evident in this picture, Thailand has beautiful scenery and beaches, but also beautiful culture and people.