Rebuilding Nepal: Reflections from a GlobeMed Alumnus

Nick James Macaluso, an alumnus of GlobeMed at Tufts, is currently working with our partner organization, Practical Help Achieving Self-Empowerment (PHASE) Nepal at their headquarters in Bhaktapur. He answered some questions about his experience over email.

IMG_0120PHASE’s new office building

Nick James (NJ) Macaluso graduated from Tufts last year and was a GlobeMed member during his time as an undergraduate. He served as GlobeMed at Tufts’ Grassroots Onsite Work (GROW) Coordinator on our executive board. The GROW team organizes our summer internship projects; NJ was able to visit PHASE Nepal during the summer of 2014 as a GROW intern. He is currently working with PHASE Nepal at their headquarters in Bhaktapur. He works under the Communications Manager, and has been helping with PHASE’s website, including creating graphics and generating future website content, among other projects.

NJ’s biggest project with PHASE so far has been creating a summary sheet for each Village Development Committee (VDC) where PHASE works; he described a VDC as “kind of like the subgroup of each district—for example, Rayale is a VDC of Kavre.”  These summary sheets include project information, donors, and demographic information.

NJ is also helping plan the 2016 GROW trip. His history with GROW and previous role as GlobeMed at Tufts’ GROW Coordinator has informed his work with PHASE in this aspect. He wrote, “As coordinator last year, a big part of my job was figuring out how to make the trip unique from the previous year, and I’ll continue to do that here on the ground in Nepal.” NJ will be traveling to Rayale, where this year’s team will be placed, to evaluate their needs and help next year’s team develop a project that will benefit PHASE.

IMG_0275The view from where NJ is living in Nepal

Earthquake Damage

The massive earthquakes in Nepal on April 25th and May 12th of 2015 and their aftershocks left thousands of families without homes or livelihoods; the earthquake on April 25th was of 7.8 magnitude; the two major aftershocks on May 12th were of 7.3 and 6.8 magnitude. On NJ’s first night, there was another earthquake of 5.3 magnitude. He wrote, “It was absolutely terrifying, but such aftershocks have become the norm for most people in Nepal.” NJ was in Kathmandu at the time, relatively far from the epicenter in Sindhupalchowk, so he was unharmed.

NJ stated that since his arrival in Nepal, he has seen countless construction projects. However, Bhaktapur and Kathmandu, the two areas he has visited so far, were not among the areas that were severely damaged by the earthquake. According to NJ, many popular tourist sites were damaged; tourism is a large contributor to Nepal’s economy. For example, two of the sites he visited on his first trip to Nepal—Bhaktapur’s Durbar Square and Basantapur—have been significantly damaged by the earthquakes.

IMG_0152Damage in Bhaktapur from the earthquakes

PHASE Nepal’s Relief Efforts

Like the organization’s name suggests, self-empowerment is central to PHASE’s mission. As stated on their website, PHASE Nepal’s vision is “A self-empowered and self-sustained society, where all kinds of discrimination are absent.” PHASE Nepal is a non-profit, non-governmental, nonpolitical, social development organization founded in 2006. PHASE Nepal’s core programming includes health, education, and livelihood projects for disadvantaged populations in the Himalayan regions of Nepal. PHASE strives to break the cycle of poverty in these regions by helping communities achieve a self-sufficient future.  

In addition to these core projects, PHASE has implemented an Emergency Relief Program for VDCs of Gorkha, Sindhupalchowk, and other districts. NJ wrote, “These projects include distribution of shelter materials and other necessary items, construction of school TLCs (Temporary Learning Centers), roof reconstruction, winterization projects, and WASH [Water And Sanitation for Health] projects. PHASE attracted many new donors around the world after the earthquake who have been responsible for these projects.”

IMG_0272Students celebrating Saraswati, a school holiday devoted to the Goddess of Education/Knowledge

GlobeMed After College

NJ said, “My involvement in GlobeMed definitely made this all 100% possible!” He also stated that things our chapter discussed during our weekly Global Health University (ghU) lessons have informed his volunteer work. For example, one of his projects is updating PHASE’s donors on Nepal’s progress in the Millennium Development Goals, a topic we covered in ghU last semester. He added, “GlobeMed is definitely a great tool for those who would like to work with NGOs or have a career in public health. Even the structure of GlobeMed is similar to the office structure of PHASE, and it’s nice to feel comfortable in this setting, delegating work within teams and sub-committees.”

IMG_0233NJ with some students of Shankhadhar Memorial School, which is located right near the PHASE office, during their Parents Day program. The students did performances, such as dancing, singing, playing musical instruments, karate, gymnastics. 

Learn more about PHASE Nepal through their website and 2014-2015 Annual Report.

Learn more about GlobeMed at Tufts through our Facebook page.

Consider donating to PHASE through GlobeMed at Tufts’ current project to support the work that Nick James Macaluso and countless others are doing to help rebuild Nepal.

Please contact if you have further questions about GlobeMed at Tufts or about our partner organization, PHASE Nepal.


Taylor Kennedy is a senior majoring in Child Study & Human Development and Clinical Psychology. She served as GlobeMed at Tufts’ Director of Communications from 2013-2015.


Treatment in the Time of Cholera

Last summer I had the opportunity to conduct research with Tufts’ Civil and Environmental Engineering Department on cholera in drinking water in rural Haiti. Nearly six years ago, when the 7.0 magnitude earthquake struck the country, Haiti was on the front page of every news source. Once the crisis abated and the country lost the limelight, international aid and attention plummeted. Still, in the months after the earthquake, cholera– an infectious disease spread through water– appeared in the country for the first time in a hundred years, brought in by foreign aid workers trying to help. It remains, now endemic, in the country to this day.

The thing about cholera is that is entirely treatable. If, say, I had contracted the disease while I was there last May collecting samples, I would have been transported to a hospital either in Port-au-Prince or Miami, rehydrated and maybe given some antibiotics, and I would have been fine. Untreated, however, it can kill in a matter of days. Furthermore, because the disease works by flushing all liquid out of the body, any water contaminated by the excrement of the diseased will then spread the cholera even further.

This was the case in Haiti. Because of the lack of infrastructure, the idea of waste water treatment or a centralized water system of any sort is entirely unheard of in the country, especially in the aftermath of the earthquake. Instead, in the rural areas where my research was focused, communities get their water primarily from wells and open sources called canals that irrigate the fertile Artibonite Valley. Once the Artibonite River, the main artery of Haiti, was contaminated, so was every canal in the valley. The disease spread like wildfire.

While cholera has been a chronic issue in Haiti for the past six years, it has recently popped up in outbreaks around the world. The tragedy of this sickness continues: in a world with the medical knowledge and technology ours has today, people are still dying from something as treatable as cholera. All you need to survive is clean water, something that is incredibly easy to take for granted in this country. The importance of providing basic human necessities like clean water to protect the health of others is insurmountable. We need not have another Haiti.

Kellie Chin, sophomore
Communications Team

To learn more about cholera and Haiti, check out Water, Sanitation and Hygiene – Unicef and Ministère de la Santé Publique et de la Population.

Mental Health at Home and Abroad

Last week at our chapter meeting, two members of our ghU staff team did an important presentation on mental health, both at Tufts and in Nepal. An underlying theme of the presentation was how mental and physical health are treated so differently in our society, and yet how there is no way to have one without the other.

Screen Shot 2015-11-03 at 11.31.41 AM

Screen Shot 2015-11-03 at 11.31.59 AM

This stigma prevents everyone from college students to rural villagers in Nepal from receiving the help they need. For example, in the entire country of Nepal, there is only one mental hospital. Looking at mental health from a wider, whole-body health perspective is also in line with the greater mission of our partner organization, PHASE. They include education and livelihood as key elements in promoting health because they know that health is a combination of physical, emotional, and social factors.

Finally, we discussed an important but difficult question: How should mental health be treated in nations facing serious physical health problems? Should it have the same priority level as physical health? As a chapter, we were unable to determine a definitive answer. What do you think?

P.S. If you’re a Tufts student looking for any sort of help, please visit Tufts Counseling and Mental Health Services at the Sawyer House, or call Ears for Peers (617-627-3888) any night from 7pm to 7am. Stay healthy everyone!

Lack of Resources for Asylum-Seekers Exacerbates Health Conditions for All

Healthcare is a human right. This is a fact that, as Westerners, we are imbued with from a young age and that is evident in Article 25 of the declaration of human rights that states: “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of…circumstances beyond his control.” Under this international article, all human beings are endowed with protection of the right to health and wellbeing of personhood.

The protection of this inalienable right, though in place under international law, is undertaken by individual nation states who implement and regulate their own systems of healthcare. Because refugees and asylum-seekers are between borders, internally displaced, or stateless, their precarious statuses make them a population particularly vulnerable to a lack of guarantee to this right to health.  This right, however, should not be contingent on citizenship status of a state, but on the basis of being human. Multiple European nations are not upholding this belief in the current refugee crisis, but rather are acting directly contrary to it.

It is the deplorable truth that many countries, including more economically developed nations, do not employ a healthcare system that embodies the fundamental principle of healthcare as a human right. Myriad US citizens, disproportionately low-income people of color, suffer from this absence of universal healthcare daily in one of the richest and most powerful countries in the world; not to mention less-economically developed nations, or nations that are hot-beds of conflict, that do not have the means to provide advanced and equitable healthcare to their citizens.

Because even within many nation borders there is a dire need for improved quality of health care, the dearth of access to and quality of healthcare for those between borders demands to be called into question.

Not only are millions of Syrian refugees making the impossible decision to risk their lives to escape what has become one of the greatest humanitarian crises of our time, but, in doing so, they are sacrificing fundamental human rights that come with the protection of the state—one of the most vital of them being access to healthcare. These asylum-seekers, however, are not finding a regaining of those rights upon their various entrances into Europe. Rather, in the majority of cases they find themselves in heavily-burdened countries such as Hungary, Greece, Turkey, and Italy, that not only are adamant in their unwillingness to grant them asylum, but that are unwilling to treat them as human beings with fundamental rights in the holding period.

Refugee camps and processing facilities within these countries are under-resourced, inhumanely disorganized, and stigmatized by the local community. In the majority of cases these camps are run solely by NGO’s and international aid groups, guarded only by the local police to dissuade any violent activity. With countries such as Hungary pledging to grant asylum to not one refugee, where does that leave those without a home? Oftentimes in poor physical and mental health, and with no other option but to continue the journey north towards countries more willing to accept them.

In recent weeks, there has been a cessation in the Dublin Regulations in Germany that, under EU law stipulates that refugees only can be granted asylum in the country in which they first enter, permitting entryway countries such as Hungary to bus thousands of asylum seekers to northern Europe; however, conditions are still in need of significant improvement in the processing facilities within these gateway nations. The rights of these vulnerable human beings are being blatantly disregarded.

This neglect is not only deteriorating health, and, in turn, overall living conditions for refugees within these camps, but is exacerbating health conditions in all locations within the EU experiencing an influx of refugees. As health is embedded in all sectors of livelihood, the refugee crisis only continues to worsen.

There have been myriad complaints and expressions of fears from within the EU that this incursion of refugees from countries particularly in the Middle East and the Horn of Africa such as Syria, Afghanistan, and Somalia, are bringing with them an array of new diseases. These fears, though valid, are bolstered by increasing Islamophobia in Europe and contribute to the stigmatization of refugees as well as the lack of organized aid going to them.

The point these countries are missing, is that withholding resources from refugees won’t deter them from coming; conversely, it is degenerating health conditions of asylum seekers even further that affect the hosting European cities and feed a self-fulfilling prophecy. To put it succinctly, the situation is becoming more dangerous for everyone.

Many European seem to believe that by refusing to grant asylum to the hundreds of thousands of refugees seeking it, paired with withholding basic aid and support will deter refugees from coming; the truth, however, is that refugees are using any means to make the journey into Europe regardless of the cost, and it doesn’t look to be slowing down anytime soon. According to the UNHCR, 38 European countries have recorded at least a 24% increase in asylum applications since 2013. This number is only continuing to rise as the state of the Syrian wars continues to worsen, along with conflict and instability in other countries such as Afghanistan and Eritrea. Therefore, devising strategies to keep refugees out is not the answer to mitigating an influx of diseases—improving access to, and quality of healthcare within camps and adhering to the Declaration of Human Rights, is.

Jenna Sherman is a junior majoring in Community Health and Peace and Justice Studies.

Nepal Earthquake: PHASE Update and Emergency Appeal

Our thoughts are with our partner organization, PHASE Nepal, and the rest of the incredible and resilient people of Nepal.

We are working with SAPAC (South Asian Political Action Committee) and other on-campus organizations to organize a vigil this Thursday evening and other fundraising efforts. Check and our Facebook page ( for more updates on how you can get involved in relief efforts.

Spring Semester: What did we do again?

Finally! After a long winter (Boston’s snowiest yet), today really looks like spring. That means that the school year is almost over… and that another semester of GlobeMed at Tufts is coming to a close. Before we all get swept away with finals and thoughts of summer (and a GROW trip!), we wanted to reflect back on all the awesome events and fundraising with done since January.

We started off the semester with a LOT of snow days, but once we got on our feet, we got a lot done! In February, a bunch of Tufts GlobeMedders headed over to a Boston-area conference at MIT to meet with GlobeMed groups from other schools and discuss health as a human right. We also collaborated with other global health groups on campus this winter— we put together a Taste of Global Health dinner. The dining services at Tufts offered a meal with food from Nepal, Guatemala and India. Along with a delicious meal, all the groups had information tables set up in the dining hall so students could learn more about the great work each of these groups do. A few days later, we sponsored a workshop with a GreenPeace representative about effective activism. Finally, we sent a team to GlobeMed Headquarters in Evanston, IL for the Summit, a conference with representatives from all the chapters across the nation. In terms of educational opportunities, this semester was packed!

But there’s more! We’ve been lucky enough to have surpassed our fundraising goal or $10,000 and have raised $12,150 to date. After a very successful campaign on Global Giving in December, we were ready to continue working on campus this semester. We were lucky enough to receive a second Kaplan course that we then sold to the Tufts community. After that, we began to think about ways to reach out to the student body, and ended up hosting two major events, both of which were wildly successful. The first of these was Trivia Night, where we offered food, (global health related) trivia fun, and prizes. The second was Comedy Night. Five different Tufts’ comedy groups performed and we had a raffle, making it a fun night full of laughter.

All and all, this has been a great semester, and we’ve done a lot of good things. We’re looking forward to the GROW trip this summer and a great next semester. Meanwhile, enjoy spring!

The ACA and Teen Mental Health

aca blog

Mental health is a major issue in the United States, especially in high school teens. There are many stigmas associated with mental illnesses that, in some cases, lead to cases going untreated. One of the most common mental illnesses that teens face today is depression. Some symptoms of depression can often be misconceived as part of school stresses or being a teen. The “treatment” for depression can sometimes be antidepressants. Drugs never fix the problem, they just suppress the symptoms, thus in the long term, that needed care is being delayed and prolonged. For some teenagers, antidepressants often don’t get to the core of the problem or discuss the source of that depression. Sometimes talking to a professional does help. What if a family cannot afford the cost of “talking to someone”? Why the Affordable Care Act may be able to help…

In 2010, the ACA authorized $50 million towards the Substance Abuse and Mental Health Services Administration. This money is funneled towards providing “co-location grants” to provide behavioral treatment options in communities. Furthermore, in expanding Medicaid, the ACA is providing more funds to help states’ abilities to create these community-based homes and programs for people who are suffering from long term chronic mental illnesses. Now that the average person can stay under their parents’ health insurance, teenagers can have a more prolonged system of care and help to deal with depression and other mental illnesses. Other legal improvements to the Medicaid is improving health facilities,federally qualified, to have behavioral health programs and care.Does that mean that the ACA fixes everything? Is everything suddenly better and Americans have wiped out depression entirely? No. There are still teenagers depressed and millions of people suffer from various mental illnesses in America. But, there is a faint light at the end of the tunnel.

The ACA does not magically gets rid of depression or cures other mental health issues.  However, it does create programs about mental illnesses to educate against stereotypes and encourage teenagers to seek medical help that they need. Mental health is part of overall health, and the ACA is advocating to shed some lights on it.

Written by Stephane Alexandre


Crash Course on the UN Development Goals

As an organization deeply invested in the promotion of global health, Globemed at Tufts often discusses the United Nations and their involvement in global equity. Every time we do, I find myself realizing that I have only a hazy understanding of what exactly the UN does, so this time I looked into it a little. The United Nations can be broken down (as it is on the website) by its five broad purposes: Peace and Security; Development; Human Rights; Humanitarian Affairs; and International Law. Development is the area we most often discuss in Globemed — the mission is to maintain peace by promoting economic prosperity and well being as well as by protecting the planet. Within the UN, several bodies collaborate on the Development segment, including the General Assembly Second Committee (Economic and Financial), the General Assembly Third Committee (Social, Humanitarian, and Cultural), Economic and Social Council (ECOSOC) and the ECOSOC Commissions and Expert Bodies.

Up until this year, the focus of UN development has been their Millennium Development Goals, which, in 2000, political leaders across the globe committed to support. The eight goals were: eradicate extreme hunger and poverty; achieve universal education; promote gender equality and empower women; reduce child mortality; improve maternal health; combat HIV/AIDS, malaria, and other diseases; ensure environmental sustainability; and global partnership for development.

Frankly I’ve always found these kinds of goals both too ambitious and too vague to be brought to fruition. Being as cynical as I am, I always thought of the goals as nice ideas with little substance or force behind them. The bold phrases like “eradicate” and “ensure” and “universal” seemed to be asking too much. Since the UN is not an authoritative governmental body, I wasn’t sure how they would achieve such ambitious goals in the face of greedy and corrupt governments around the world, many of whom who cared little about their peoples’ suffering. However, upon further research, I’ve realized that some progress has been made towards achieving the goals.

Some of the MDGs are split up into more specific targets. For example, the first goal is broken down as follows: Target 1.A: Halve, between 1990 and 2015, the proportion of people whose income is less than $1 a day; 1.B: achieve full and productive employment and decent work for all, including women and young people; and 1.C: Halve, between 1990 and 2015, the proportion of people who suffer from hunger.

Stipulations like “halving” rather than complete eradication do seem more manageable, and, according to the UN statistics, extreme poverty was in fact halved before 2015. However, about one in five people in developing regions still lives on less than $1.25 a day. Another salient issue found in the data is the disparities between different regions of the world – while some have made steady gains, others, like southern Asia and sub-Saharan Africa, have not met any targets.

If you’re interested in finding out more about the progress of the MDGs, this 2014 report summarizes the successes and shortcomings of each of them.

Featured image

As the target for completion – September of this year – drew closer, the UN set out to keep moving forward, regardless of the success or failure of the MDGs. In 2012, several countries met up in Rio de Janiero (Rio 20+) to discuss the post-2015 plan of action. There, they laid the groundwork for the Sustainable Development Goals, (SDG), a new framework for UN development, which will be managed by an intergovernmental body of the UN called The High Level Political Forum.

These new goals are designed to be “action-oriented, concise, and easy to communicate, limited in number, aspirational, global in nature, and universally applicable to all countries, while taking into account different national realities, capacities and levels of development and respecting national policies and priorities.” The MDGs are not to be scrapped entirely, but the new SDGs will attempt to focus more on the gains that need to be met in poverty, taking into special account its uneven distribution. To facilitate implementation of the goals, the UN is working with governments at all levels from local to national, as well as a variety of other stakeholder organizations, hailing from all sectors of society, including NGOs, businesses, and a variety of interest groups representing the voices of certain demographics such as women, children, indigenous people, and farmers.

The specific goals and targets are still in the making, but will be announced in late March of this year. Information on the means of implementation for post-2015 development should be available in late April. Whether this new set of goals will have more success than its predecessor is yet to be determined. Nevertheless, I’ll take it as a sign of hope that people all over are still fighting to keep all humans, as well as the planet, in good health.

To stay informed on the progress of the Sustainable Development Goals and all of the UNs post-2015 development agenda, visit the Sustainable Development Knowledge Platform here.

Leah Cubanski is a sophomore possibly majoring in Political Science.  She is a member of the Communications team.


Framing the Health Disparities Problem

This past week, I had the opportunity to attend the National Institute on Minority Health and Health Disparities Grantees Conference. Over 1,000 people attended, all representing different parts of academia and the non-profit world, all coming together to collaborate and present research regarding health disparities. The National Institute on Minority Health and Health Disparities is a branch of the National Institutes of Health. It’s mission is “to lead scientific research to improve minority health and eliminate health disparities.”

What are health disparities, exactly? The Healthy People 2020 initiative defines it in the following terms: “If a health outcome is seen in a greater or lesser extent between populations, there is disparity. Race or ethnicity, sex, sexual identity, age, disability, socioeconomic status, and geographic location all contribute to an individual’s ability to achieve good health.” Health disparities can be seen, for example if we look at something like infant mortality.

Infant mortality rates in the US by race

Infant mortality rates in the US by race

Since 1980, the US infant mortality rate has dropped from 12.6 deaths/1,000 live births to 6.17. This is okay (though it should be noted that we rank as having the 55th lowest rate for the wealthiest country on the planet). This rate takes on a new life when we break it down by race. For Non-Hispanic Whites, the infant mortality rate is 5.5 deaths/1,000 live births. For Non-Hispanic Blacks, the rate is 12.8 deaths/1,000 live births. We can see disparities again when we look at childhood obesity rates. At the conference I learned that for the first time, the national child obesity rate seems to be plateauing; yet for white, upper class children, this rate is actually declining, and for Hispanic and Black children, this rate continues to climb rapidly.

It is probably not surprising that health disparities are closely linked to what is termed, “the social determinants of health,” which can include everything from one’s education level to how close one lives to a landfill. It is important to remember that long histories of power inequality have led to many of these social determinants, and therefore, the increased health status of some groups over others.

In the United States, health disparities are certainly a reality. What struck me most at the conference, though, was a question posed at one of the panel discussions. The facilitator asked, “How can we combat health disparities, when the work requires that we give more to those at the bottom, while giving less to those at the top?” Though it caught me a bit off guard, this idea makes sense. Have-nots need more resources and support so that they can “catch up” so to speak, to the Haves. Though similar, this is not exactly Robin Hood logic. The rich wont necessarily be loosing out so that the poor can gain. The way the question was framed insinuated this, and it made me realize that this is exactly how some people think of health equity work. Potential supporters can be turned off to a cause when it seems like they will be deprived of something. We have seen this argument come up again and again with the Affordable Care Act. Saying things like “they’re going to make us ration health care if everyone is covered” or “we will have to wait longer to get appointments” fosters this exact type of thinking. The problem is that we’re framing it all wrong.

We need to highlight that it is important to give those at the bottom more support than we give those at the top, not even because they deserve it, but because they need it and the people at the top do not. A salient example is one from Chile, where everybody is covered for health insurance. Their public insurance option is tailored towards equity as opposed to equality—those who need more support get more support and those who need less support, well, they wont be missing out on any free services, because simply put, they don’t need them. New mothers in the lowest income bracket receive, among other things, free baby carriages. If the health sector were to view patients as equal, they’d give these to the wealthiest mothers, too. The majority of mothers in higher income brackets would probably not take the low-cost baby carriage, if they can and want to buy one of their choosing. Equity, on the other hand, still means that all mothers can and will have baby carriages, but that we should be intentional with how resources are delivered, targeting those most in need.

So, how can we in GlobeMed at Tufts use this idea of framing to combat health disparities with our partner organization, PHASE Nepal? Right now, we are fundraising through our individual giving campaign. So far we have raised almost $4500 for, our project right now, which is hitting an important determinant of health: that of childhood education. PHASE Nepal will take the funds we raise this year and hire a teacher trainer, who will work with currently employed teachers in elementary schools in the communities that PHASE serves. This trainer will help teachers utilize methods to foster creative thinking and problem solving among students of Nepal. He/she will also support child clubs, which operate as extracurricular forums for the children to play, learn, do local development projects such as planting gardens, and talk about child rights. Additionally, we envision the formation of a health curriculum to be taught as supplementary material in the Child Clubs, so that these children can begin to learn about the importance of having a healthy body and mind.

When we think about how to bolster our fundraising efforts, we need to be able to discuss how the situation in Nepal came to exist, and about the power structures that perpetuate such inequalities. When we talk about this stuff, we have to know how to frame it in a way that will help us build support for our chapter, PHASE, and the global health movement at large.

To learn more about PHASE’s work, please visit

To donate to our project, please visit

Rachel Weinstock is a senior majoring in Anthropology and Community Health. She is a member of the policy team.