health

World Day of Social Justice

“Social justice is an underlying principle for peaceful and prosperous coexistence within and among nations. We uphold the principles of social justice when we promote gender equality or the rights of indigenous peoples and migrants. We advance social justice when we remove barriers that people face because of gender, age, race, ethnicity, religion, culture or disability.” -United Nations, WDSJ webpage (1)

In 2007, the United Nations General Assembly declared that February 20th be celebrated annually as World Day of Social Justice. A product of rising globalization, World Day of Social Justice encourages nations to devote the day towards the eradication of poverty, inequity, exclusion, and unemployment. While we know these goals cannot be achieved in a day, World Day of Social Justice provides us with a chance to look around our community, locally and globally, with extra purpose and passion. GlobeMed at Tufts and PHASE Nepal share a drive to collaborate and eliminate global health inequity, and we find inspiration in the action taken by the international community in support of global health equity. February 20th has become a day to rally, to dream, to energize, to learn, to grow, and to come together. Especially in the current national climate, it is increasingly important every single day to take action and to create hope.

This February 23rd, GlobeMed at Tufts will be hosting a film screening of Vessel, an award-winning documentary following the work of Rebecca Gomperts, founder of Women on Waves. Dr. Gomperts, a Dutch physician, activist, and artist, made it her life’s work to end the health risks associated with illegal abortions. Dr. Gomperts and her organization work on a ship-turned-clinic that sails to areas where women cannot access legal and safe abortion. Once in international waters, Dr. Gomperts and her crew are trained and authorized to administer abortions and provide contraceptives. They also train local women to administer safe abortions using non-surgical WHO-researched protocols. Through a network of empowerment, Women on Waves has given countless women access to safe abortions, birth control, and invaluable knowledge.

We find this documentary especially relevant after the reenactment of the U.S. Mexico City Policy, also known as the Global Gag. First enacted by President Reagan and most recently reenacted by President Trump, this policy blocks federal funding to NGOs that provide abortion services or counseling as well as those that advocate for the decriminalization or expansion of abortion services.

GlobeMed at Tufts is devoted to social justice, nationally and abroad, and aims to emphasize the importance of self-education and community discussion. Please join us on February 23rd at 6 PM in Tisch 304 for a free screening of Vessel with snacks, discussion, and good company! We hope to foster an open dialogue about the film and World Day of Social Justice, so all thoughts, feelings, and opinions are welcome.

Vessel trailer: https://vimeo.com/106489346

Women on Waves website: http://www.womenonwaves.org/


(1) http://www.un.org/en/events/socialjusticeday/

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 http://phasenepal.org/

To donate to our project, please visit https://www.globalgiving.org/projects/child-health-education-program-in-nepal/

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

Samantha Nutt: Global Health Icon

In high school, I first heard about Dr. Samantha Nutt when she came to speak to my school about global health in war torn regions, the talk she gave was one of the most inspiring and eloquent speeches I have ever heard and since then I have been inspired by her career and her work around the world. I thought I would share a bit of what she has done to the GlobeMed community!

Dr. Nutt is the founder and president of War Child Canada, a charity that works in regions that have been torn apart by conflict. She focuses on helping women and children in these regions, providing health care, education and vocational training in order to get their lives back on track. She has worked in regions such as Afghanistan, Sierra Leone, Uganda, and The Democratic Republic of the Congo to name a few. In addition to her work with War Child she is a physician at the Women’s College Hospital in Toronto and is a Professor at the University of Toronto. In 2011, she was appointed the Order of Canada – the most prestigious honor bestowed by the Canadian Federal government for “for her contributions to improving the plight of young people in the world’s worst conflict zones, notably as a founder of War Child Canada.” How she ever has time to sleep, I am not sure!

Her recent book “Damned Nations: Greed, Guns, Armies and Aid”- a national bestseller – is a comprehensive look back on her career and her experience in the foreign aid industry. An excellent read that I highly recommend everyone check out as it mixes her personal narrative and experiences with facts about foreign aid, and its failures and successes.

She is someone who has inspired me and taught me a lot about foreign aid, and the challenges of effective distribution of health throughout war-torn regions. I find that her methods and philosophies about global health are very similar to GlobeMed’s! Everyone should check out her book, or even go on youtube and check out a couple speeches she has made to learn a bit more about her and War Child Canada!

Here are some I have found really interesting:

Future of Aid – Dr. Samantha Nutt Keynote

https://www.youtube.com/watch?v=ALCScV_CoA0 (starting at 5 minutes)

CBC News Our World: Africa’s Killing Field

https://www.youtube.com/watch?v=YCbdfMWZL54

Adrienne Caldwell is a sophomore majoring in Biology and Psychology.  She is a member of the Communications team.