Month: March 2013

GlobeMed Scavenger Hunt

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At our Sunday night staff meeting, the Community Building team surprised the Tufts Globemedders with a scavenger hunt. Items on the list included pictures re-enacting the iconic Titanic scene on the top of the Tisch Library roof, posing in front of something maroon and white, playing ping-pong in the Campus Center, and of course, each group had to make the GlobeMed sign!

The teams we worked in for the scavenger hunt were also our groups for our ghU research project. We’re focusing on specific pressing health concerns in Achham, Tufts, and the Medford/Somerville area, and have split up our research into five sub-topics: infant mortality, nutrition, transportation/heath service access, sexual health, and alcoholism.

Our Community Building team comes up with fun bonding activities like the scavenger hunt to help us get to know the rest of the GlobeMed team better so that we can be more comfortable creating and sharing new ideas and projects. Take a look below at some of the pictures that resulted.

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A Dialog with Data

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From January 2012 to June 2012, 54% of the patients seen in Bayalplata Hospital came from village development communities (VDCs) within the Community Health Program’s “catchment area.” The graph below depicts the frequency of ER cases based on VDC. Note that the VDCs in red are ones that are not part of the current catchment area.

Data can tell a story. It can tell you about people’s lives, about your own life. It can tell you about a country, or a community or a business. It can tell you a great deal about how to best serve a population, and about the factors that impact a person’s health. At Globemed at Tufts, we believe that data has the power to make a difference, you just need to step back and take a look.

This post is the first part in a series called “Dialogue with Data” on what the data that Nyaya Health collects is telling us. The series is written by the Globemed at Tufts data team which has the privilege to review some of the data that Nyaya collects in order to find any patterns or trends that might exist. Each week another post will be published that will attempt to tell a story about Nyaya and their patients.

We’ve learned something from looking at this data, we hope you will too.

The End of an Age-Old Action?

The chhaupadi goth in which girl died two weeks ago.

Last Tuesday, three wards in Ridikot VDC were declared “Chhaupadi Free,” marking the beginning of a movement that is hoped to gain recognition throughout Achham.  This declaration marked a moment of triumph for the residents of the wards, and they were certainly proud of it.  But the announcement came at a price; it came at the expense of a young girl’s life.  A 14 year-old girl suffocated to death in a chhaupadi goth (shed) two weeks ago.  Chhaupadi is a centuries-old tradition that is practiced in the Western and Far Western regions of Nepal.  In this tradition, females are banished to a chhaupadi goth during the days of their menses.  The goth is generally made out of stones, straw and mud, with no windows, and can barely fit a person. This practice arose from the belief that women are impure while menstruating, and hence are not supposed to touch anyone.  They are not allowed any dairy products during menstruation, and are only given a thin blanket (little thicker than a sheet), which is not sufficiently warm during the winter months.  The practice also requires women to bathe and wash daily.  This may seem normal, but in these circumstances the woman has to travel miles early in the morning to reach one specific tap that is reserved only for menstruating women.  During their monthly cycles, women are not allowed to touch communal water taps, due to the belief that they will tarnish the water source.  Every year there are stories in the news of women and young girls dying in chhaupadi goths because of snake bites, animal attacks, or the cold, as in this case.  The girl had lit a small fire in her chhaupadi goth to keep herself warm, and had stuffed the cracks around the doorway with her clothes to prevent the cold from entering in.  Due to the small area and the smoke, the young girl was found dead by her mother the next morning, due to asphyxia.  Having realized the harmful effects of chhaupadi, the community decided to banish the age-old tradition.

The Bayalpata Hospital Community Health Department (CHD) joined in their efforts, and together went around the wards tearing down the goths.  The first house visited was the home of the recently deceased girl.  Her family members were very supportive of the campaign.  The goth was right by their house, but one had to crawl to get inside and there were cracks in the doors.  It was evident why the girl had felt the need to light a fire.  The ashes from the fire lit by the girl were still there; a painful reminder of a young promising girl whose life had been cut short by this practice.  As we moved from house to house, the women of the respective houses took part in the process.  I still remember one woman who was actually dancing and saying “O! We don’t have to live in goths anymore, and my family members will never have to.”  The same emotion was echoed at every house we went to, and there was a feeling of liberation in their voices.  This was followed by repeated meetings within the community, during which wards 1-3 were successfully declared “Chhaupadi Free,” and the commitment was made to work on the remaining wards of Ridikot as well.  Our CHD prepared a lesson plan on carbon monoxide poisoning for our Community Health Worker Leaders the following week, and decided to include carbon monoxide poisoning in the monthly menstrual hygiene workshop that we give at the high school in Bayalpata as well.

This course of events made me think about a conversation I had with Dr. Aruna Uprety recently.  Dr. Uprety serves on our Board of Advisors and works extensively in the field of women’s health.  She has long been an advocate for the uprooting of this practice, and since we intend to work in the remaining wards of Ridikot VDC, her input and suggestions at this stage are crucial for planning our strategy.  During our meeting, she suggested that the first step was to involve the Jhakris.  The health-seeking behavior of the people of Achham is to first seek help from local Jhakris, and then to sometimes pursue further treatment at health posts or hospitals.  Hence, it was immediately clear why she emphasized the involvement of Jhakris as the first step if one plans to work in the field of chhaupadi or any other health-related issue in Nepal.

As our Country Director, Stephen Petersen says, “Bringing about a change is difficult, and any amount of awareness is not really going to help the cause unless it comes from the people within.”  I had thought that true change had happened in this case, since the community had self-motivated and taken the first step forward.  Upon hearing the news about the family going to the Jhakris to learn the cause of their daughter’s death, I have to wonder whether this decision was made out of true understanding or merely emotional outrage?  Is the community going to follow through on their decision and give up age-old superstitions and beliefs, or is “Chhaupadi Free” going to be a phrase that exists in paper only?  If, despite all of our efforts, this young girl’s family still believes her death to be of unknown origin, it may only be a matter of days or weeks before they return to the old practice.

Only time will tell.

Written by Ashma Baruwal, February 27, 2013, Nyaya Health Blog. Original article here

What does every human deserve?

It’s a simple question with some very complex answers. Our mission is to inspire people to turn these answers into solutions. Come to our advocacy event co-sponsored by Tufts Engineers without Borders for a panel of global health experts who have worked with organizations like GlobeMed, Partners in Health, The Millennium Campus Network, and Nyaya Health.

Join us this Friday at 4:30pm in Robinson 253 to learn about how to turn our ideas about the basic and not so basic things every human deserves into action.

2013 EPIIC Symposium Inspires Tufts

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Jason Clay Addresses Food Security. Credit: EPIIC

The Tufts EPIIC 2013 Symposium on Global Health and Human Rights was held last weekend and was a great success. The EPIIC students prepare throughout the year various panels and discussions with experts in the field and they themselves present research of their own. The four day event examined issues in global health from a variety of disciplines and featured Peter Piot, the founder of UNAIDS as the keynote speaker. Panels ranged in topics from food security, sexual violence, and mental health to bioterrorism and health systems.  Audience members were given the opportunity to question the panelists at the end of each session, stimulating some provoking and challenging debate on some of the most important issues facing our planet today.

A particularly engaging lecture pertained to water, sanitation, and disease. Three Tufts professors, David Gute, Jeffery Griffiths, and Daniel Langtagne, were joined by Janine Selendy, author and Yale professor, and Junaid Ahmad, Director of Sustainable Development for the World Bank in the Middle East and North Africa. The panelists spoke of health problems stemming from inadequate and unsanitary water and current programs to provide people with better water. 884 million people in the world do not have access to clean water and 2 million children under the age of five die every year form diarrheal disease; a result of consuming infected water. The relationship between water and sanitation was discussed, as many diseases are caused by bacteria spread via the fecal-oral route. Additionally, environmental factors were discussed and their connections to disease and malnutrition. The experts explained viable programs to deliver improved water to communities across the world. The main emphasis was the importance of community. What to target and how are successfully derived from the communities’ needs and abilities, exemplifying a founding principle of public health.  Through involved leadership and ownership from the community, behaviors can change to provide countless people with clean water and a better chance to prevent disease.

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Panelists Discuss Bioterrorism. Credit: EPIIC

EPIIC has a long tradition of engaged, interdisciplinary, and provoking themes and this year proved no different. Tufts and Tufts students are constantly looking outward at global issues and sustainable progress in issues affecting the world. The Symposium provided the community with the chance to learn about pressing topics and possible ways to mitigate problems.