Category Archives: global health

Medicine and Sustainability

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Two important stories that will make sense to all of you, but specifically to those “I wanna be a doctor” folks among us.  As you’ll learn in the California story, doctors get paid by the task — office visit, exam, surgery, etc.  This is not sustainable given where health care may be headed; it’s certainly not beneficial to the consumer.   Also as you’ll hear, given the cost of medical school and the loans MD’s have to pay back after graduation, specialization in the system drives doctors away from where they are indeed needed — primary care.

In California, Facing Down a Family Physician Shortage

In another story that shows us how wonderful we are, this is concerns Global Health.  In fact, this link will take you to several stories concerning Global Health — cholera perhaps spreading to the DR and Miami, organ trafficking, and a global food crisis.

As you ponder your last “mini” essays, think about some of these challenges.

Geoengineering: People vs. Planet?

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A new method of potentially earth-saving technology has come about, but its consequences may outweigh its benefits. Geoengineering is the process of changing the earth’s climate in order to counteract global warming. Scientists have adapted this idea and a large part of their evidence has come from the Mt. Pinatubo eruption in 1991.

This massive eruption in the Philippines released 20 million tons of Sulfur Dioxide into the atmosphere. These particles of Sulfur reflected the suns rays back into space and lowered the earth’s average temperature by half a degree. Scientists are looking to utilize the same earth-cooling process without erupting any more volcanoes.

One plan to use Geoengineering was introduced to the U.N. Convention on Biological Diversity. This plan entails releasing sulfur dioxide into the stratosphere in order to cool the earth’s temperature. In addition to its effective results, this process would also be very cheap.

On the other side of the argument, some people are worried about the affects that these changes could have on our life. Is global cooling worth the potential for drastic rain changes that could cause massive issues in areas of the world that depend on constant rainfall? As of now, Geoengineering is halted until the scientific research has been concluded and regulations have been set up.

Understanding Social Determinants of Health

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Understanding the Social Determinants of Health: Breaking the Link between Poverty and Health

Brown graduates working with Project Health (program where college students work in local health clinics) based in Providence, Rhode Island. Samantha Murder (Program Manager) and Hanna Nichols (National Talent and Technology Coordinator)

Cycle of Poverty

  • MONEY is needed for healthy food, healthy housing, childcare (so you can go to work), education and school, clothing (job interviews), health care, utilities, medicine
  • in order to get money you need a JOB
  • in order to have a job, you need EDUCATION

Need education and a good job for money, but need money for education and chance for a job! Not a linear path and a difficult cycle to enter.

Project Health works to provide resources and knowledge.

Social Determinants of Health- “economic and social conditions under which people live which determine their health”

  • The Big Five: Food, housing, energy, education, and employment/insufficient income.
  • Shaped by the distribution of money, power, and resources (influenced by policy choices)
  • Social determinants are mostly responsible for health inequities

What do we mean by Poor?

Mentioned that the federal poverty line has been used a lot throughout the symposium as a measure of poverty. They stressed that people are struggling for money well above the federal poverty line. The federal poverty line for a family of 4 is $22,050, but, in suburban Illinois for instance, a family needs at least $58,000 for necessities (study done by NCCP -see budget calculator)

FOOD

Food insecurity greatly increases likelihood for poor health (ex. low birth weight for mothers)

Compared nationally, Vermont is doing well, subsidized lunches and breakfasts at school are critical (50% of kids in Essex county use this) Essex also has high levels of low birth weight.

What’s out there? Resources to combat food insecurity

ENERGY

Heat or eat?

Energy insecure households- 22% increased chance of being hospitalized since birth

What’s out there?

  • LIHEAP (covers a large amount of monthly winter heating bill, if you can’t meet cutoff your utilities will be shut off- difficult to pay back. Grants are getting smaller)
  • local neighborhood funds
  • Special protections for disabilities
  • Payment plans (utilites prefer some money)

HOUSING

Related to health. Household mold (makes you 2.2 times more likely to experience asthma!), cockroaches, cold, lead poisoning, unsafe housing conditions, stress from not being able to pay rent contribute to asthma and low nutrition, hospitalizations, poor health

Housing is considered not affordable when it costs more than 30% of income.

Housing in context- Vermont. Top 10 occupations in Vermont include retail salespeople, cashiers, janitors and cleaners- none of whom have a salary high enough to pay for housing. Not a livable salary! Poverty is “not just about getting a job”

What’s out there

  • public subsidized housing (projects)
  • private subsidized housing (contracted out)
  • housing choice voucher Program (Section 8)- pay up to 30% of income and government pays rest- HARD TO GET, 5 to 8 year wait for voucher in Rhode Island
  • shelters
  • transitional housing
  • rental assistance
  • legal action- something unsafe in house- legal pressure on landlord (less expensive than moving)

EDUCATION

They highly suggested the film “Waiting for Superman”! (check out the trailer)

What’s out there

  • GED classes
  • ESOL classes (English is 2nd language)
  • Adult basic education
  • Computer literacy
  • Child enrichment
  • Head start and early head start (includes literacy classes for parents, checkup for kids, losing seats right now)

INSUFFICIENT INCOME/ EMPLOYMENT

Related to obesity and other health issues. Not knowing what will happen raises stress and sickness- lack of locus of control.

People below the poverty line live an average of 9.6 health adjusted years less than Americans above the poverty line!

What’s out there

  • Child care subsidies
  • Food stamps

PROJECT HEALTH

Founder noticed underlying health problems involved with evictions

Doctors could do nothing for patients suffering from unemployment, poor housing.

Student in project health connect families to resources/volunteers. For example, they often connect families to food pantries or call utilities to arrange payment plans.

HOW THEY WORK

  • guided referrals
  • resource knowledge
  • identification of barriers
  • creative solutions
  • education
  • advocacy
  • connections

Conversations about food security and housing are important to both doctors and patients, but those conversations weren’t happening. Health services often don’t have the time or the knowledge to refer people, which is where Project Health steps in. Project Health also works to collect data that can be used in advocacy movements and campaigns.

Located in 6 cities, with 600 volunteers, and has helped over 5,000 families.

If you’re interested, check them out here!

The New Biopolitics of Race and Health

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“The New Biopolitics of Race and Health” by Dorothy Roberts of Northwestern University School of Law

Disparity and Health Inequities- Introduction

In Chicago

  • 1/3 of blacks would not have died if rates of black and white deaths were equal
  • black women are 2X more likely to die of breast cancer than white women (even though whites are more likely to get it)
  • black women are not more susceptible, white women just had more access to new technologies from 1996-2004

Globally

  • 50% of black woman wouldn’t have died of breast cancer if rates were equal
  • Rates of child mortality (before the age of 5) is 6/1000 in high-income countries, 88/1000 in developing countries, 120/1000 in poor countries
  • In the U.S, there were  83,570 excess black deaths (the number of deaths that could be prevented in the U.S if the black-white mortality gap were eliminated)

New Biopolitics of Race

  • Different approaches to the WHY behind health inequalities
  • One explanation is to treat race as a biological category, which attributes disparate health outcomes to racial differences
  • Roberts says this approach is denying the impact of race on society and reinforces racial inequality
  • Human Genome Project showed no evidence of racial divisions (Bill Clinton, Francis Collins, Craig Ventor all noted this at the conclusion of the project)
  • For some reason, the results of the Human Genome Project are now being geared towards research involving the differences of race (on a genetic level) and health. Nicholas Wade of the New York Times said researchers are now being “forced to confront a treacherous issue: the genetic differences between human races”. Roberts says this is ridiculous, and that none of the results of the project suggest this line of research.
  • Somehow, she says, the reasoning is that the 0.1% genetic difference in people’s genomes accounts for race which accounts for unequal health outcomes. Roberts says this argument is ridiculous.

Research

  • Flawed studies about genetic differences, race, and health have gained lots of media attention
  1. Study done that supposedly proved that genetics were the cause of blacks having more preterm babies. The researchers said the experiment was independent of social constraints, but they only controlled a few things. Without proof, or any scientific backing, they leapt to the conclusion and created a theory that genetics were the cause of the difference in the number of preterm babies between black and whites. This highly flawed study made it to a New York Times headline.
  • Millions of dollars are being invested into genetics and race research (especially from the U.S and U.K). Roberts mentioned this article

Drugs

If genes are the cause of health inequities, there are 3 ways to address this

  1. nothing we can do, blame nature
  2. gene therapy
  3. drugs

This last option has gained a lot of attention. Roberts described the history of  BiDil, which is a heart disease prevention drug that is specifically made for blacks. The drug is actually just two generic drugs put together, and was originally patented for anyone. The FDA only patented the drug once it was specifically marketed for blacks. The FDA said this was a “step towards personalized medicine”. The original goal of the Human Genome Project was to provide personalized medicine, but the FDA is now using race as a proxy for genetic difference, while waiting for legitimate drug treatment differences based on people’s individualized genotypes. Dr. Steve Nissen, of the FDA, said himself, “We’re using self-identified race as a surrogate for genetic markers”. Roberts says this is unfounded and inappropriate. Obviously, the FDA is using race and health concerns for it’s own commercial advantage.

New Race Based Genomics – where is this new ideology being implemented (already mentioned drugs and research)
  • race as a category in biomedical and human gentic varation research
  • race specific pharmaceuticals
  • genetic ancestry testing
  • DNA forensic and biobanks
  • reproduction-assisting technologies (eggs and sperm grouped by race)

What “They’re” Saying

This new theory says that racial differences are real at the molecular level, but constructed at the social level. Treating race as an ideology, rather than a scientific truth, is what causes social tensions (the example of political correctness). People are starting to believe that social justice is actually working against improving health through genetics!

What Dorothy Roberts is Saying

  • Why would we ever divide cell lines by race? The idea that we should divide people by race as a biological category is engrained. But we are seperated by society, not by genetics. “Race is a political category, not a biological one”.
  • Inequity is a product of the social and political situation, and is not a “natural” difference.  Inequity is unjust and calls for social change, not solutions involving individual choice (like race-based drugs).
  • Social justice is a way of achieving better health, and genetics and social justice should not be pitted against each other.
  • “A More just World would be a Healthier One”

Corporate Captilism vs. Intrinsic Nature of Race

What is causing this change in thinking? Roberts’ says it is a combination of both corporate capitilism (whatever sells, example of BiDil) and the perputuating defintion of racial order. Ever since race was invented, the idea that some people are naturally inferior has persisted. The very function of race was to create political division.  The evidence of  natural divisions is now manifesting in genetics. This sort of manifestation has been happening for years (ex. Tuskiki experiments in the 1970’s) and just because it’s said to be based in science doesn’t mean it is unbiased or justified. The two components are working together to spread this ideology, one has “a hand in the pharmaceutical industry” and one is based on “the usefulness of race in America”.

Zoe and Dorrie

Targeting the Youth

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This Saturday, I attended the workshop on AIDS in Africa that was lead by Lisa Adams, who is an assistant professor at Dartmouth College, and coordinator of Dartmouth’s Global Health Initiative.

As a group of about 10, we discussed how to spread knowledge and information about HIV/AIDS to younger generations and address problems facing health-care providers in Africa.

-Lisa introduced herself and gave us a brief background of the progress of AIDS relief in Africa. Because of the work of programs  initiated during the Clinton and Bush administration (i.e, PEPFAR, CHAI), most areas of Africa have access to necessary drugs and care. The problem has become more of a social one, and the focus has now moved to the prevention of AIDS as well as the treatment.

-Lisa emphasized the importance of teaching youth AIDS prevention and awareness. WHAT AGE, she asks, should this education begin? As a group we discussed…

  • starting when kids leave for home for a boarding school (very common in Africa)- around age 12.  (free from parental disapproval, with peers)
  • maybe starting at an even younger age, because so many have been exposed to the disease with deaths in their areas.
  • When do we first learn of AIDS? Around 6th grade for most American schools.
  • We finally decided that the age range of 12-19 seemed best.

Then she asked us to discuss WHO should be involved in teaching kids? As a group we came up with the following list..

  • via School teachers, have AIDS education incorporated into the standard curriculum (especially at the boarding schools). We thought it would be especially important that this be part of the regular school day and not an afterschool activity
  • community health workers going to schools
  • parents (if they support it)
  • community/ religious leaders (depends on religion and community values)
  • peers/friends (we discussed the possibility of training older kids to be peer educators for younger grades. Peers are probably more effective than parents in transmitting information)
  • siblings
  • health care workers (ex. when visiting the doctor)
  • coaches (we talked about this program called Grassroot Soccer, which mixes soccer training and concepts with HIV/AIDS education)
  • media- pampthlets, billboards (very succesful strategy in Ghana- see pics)
  • HIV+ person

We spent most of our time talking about the power of both peers and mentors. At a certain point, kids stop listening to their parents, and for many of them, something that a peer (especially an older one) or a coach says is much more respected. We also mentioned the importance of having someone confidential to talk to, and whether the person teaching the kids should be taught by someone close to them (a sibling, parent) or a stranger, but from the community (older peer), or a complete stranger (health workers).  One girl, who had actually seen an AIDS information session given to kids in Jamaica, said that the kids were not as willing to listen to a stranger.

Content of the AIDS/HIV awareness education

We all agreed that it had be a uniform message, given without bias or judgement, and that, in most cases, some sort of training should be required. (Who provides training? We didn’t discuss that…). Lisa talked about the ABC’s, Abstinence, Be faithful, and Condoms. When PEPFAR was initiated, a certain percentage of the funds had to go towards Abstinence information. One girl, who had traveled to Russia and worked with prostitutes, STD’s, and drug use there, said that a large part of PEPFAR proved to be a waste of money in the area she was in because of this stipulation (it wasn’t that effective to lecture sex workers on being abstinent). We discussed putting more focus on teaching abstinence as a way to delay having sex, rather than 100% avoiding it. We also thought that the ABC’s method should be modified depending on who the audience is (when talking to older teens, put more emphasis on prevention techniques than “Being Faithful” which is more appropriate for married couples).

Factors affecting HIV/AIDS education and prevention

  • Religion- some prohibit the use of birth control
  • Culture- often taboo to discuss sex and AIDS in areas of Africa, especially to children
  • Stigma- people with HIV face prejudice (we discussed how an HIV+ person would be treated on Middlebury campus)
  • Opportunity Costs- even though treatment is free in most areas, costs of transportation, lab tests, etc. sometimes make treatment impossible

Disclosing Status: At what age do you tell HIV+ kids (who had it passed on through their mother’s  of their status? In general, we thought the younger the kid, the better. Then they could have more time to accept their situation and learn about the consequences of spreading the disease. But, in many areas of Africa, parents do not tell their children until pretty late. Many kids take treatment drugs, but are never told what they are taking them for. Parents are often racked with guilt and fear about telling the child, and they put it off until the kid is already sexual active or thinking seriously about it. This is one of the biggest problems facing health care officials. Do they have the authority to inform kids without full parental consent? How do they convince parents/relatives of the importance of informing the kid as soon as possible? In the ideal situation, we thought it would be best if the medical worker talks with the parent privately (in an effort to convince them that sooner is better) and then both the parent and health care worker, together, inform the child. Still, this is a very messy issue in Africa, and one that is causing considerable tension between health care workers and parents/members of the communities.  Uninformed HIV+ kids are becoming a large part of the continuing spread of the disease.

Lisa wrapped up by reminding us of the multifaceted and complex issue that is AIDS/HIV awareness and prevention in Africa. She reminded us, too, that many of the issues are no longer medical ones, but cultural ones. These, she said, are the hardest to fix.

Zoe

Communicating Health Lisa Russell:”A Filmmaker’s Perspective: Utilizing Media and the Arts for Global Health Advocacy”

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Before Lisa Russell became an Emmy-award winning filmmaker she was interested in medicine. She describes hearing Jonathan Mann, former head of the World Health Organization’s global AIDS program, speaking about AIDS as a social issue, from a gender, race, and economic perspective, as the day she changed her views. With a masters in Public Health, she set off on a career as a documentary filmmaker showcasing health issues in countries like the Congo, Niger, Ethiopia, Lebanon and many more.

During the talk she spoke about Not Yet Rain, a film she made in 2008 with Ipas about unsafe abortions in Ethiopia. Although Ethiopia decriminalized abortions in 2006, which the government believed would allow women access to safe abortions, many women still resort to unsafe abortions. The documentary follows two young women who are denied abortions because they are too far along in their terms. Russell describes her film as “putting a human face” to a human rights issue. She got a lot of feedback from people, even on Face Book, where a 19 year old girl from Dubai, sought help from Russell to get her to Ethiopia for an abortion. This shows the magnitude of power of media, that people from all over the world were made aware of this issue.

Another project Lisa Russell works with is Urban Word NYC. The program works with teenagers on areas such as creative writing, journalism, etc. It is based on the principle that “teenagers can and must speak for themselves.” This I thought was especially powerful because it gives young people an outlet to express themselves, and to raise awareness about certain issues.

This leads into her Emmy-award winning piece. Her close ties to NYC and the overall flexibility in her film topics are displayed in the next video she presents. She informs us of her close work with young students in the Bronx, New York on issues regarding race, gender and economics. She brings to life in her film, the inspiring poem of a young 13-year-old girl from New York, which she calls ”Biracial Hair”. The poem commences with light and humorous approach of a young girl fussing over her hair, but then both the poem beautifully creates a parallel between the pride holds for both her hair type and how she views herself in society.

Russell is heavily involved in promoting UN MDG Summit #5, one of the few goals the United Nations have prepared, in which the nations engaged plan to decrease and hopefully eliminate maternal mortality. She administers a site, www.MDGfive.com that provides a network and trafficking of situations, ideas, and news that will stimulate awareness and engagement on the said issue. Although the site is relatively new, we found it very well organized and took light into one very cool feature, which would be the clip remixer. In which there are tons of powerful quotes, photos and clips, which you can assemble together for your own custom slide show.

We decided to make one for Class and the Environment: (Please comment) (Fred picked the song)

http://mdgfive.realitydigital.net/Media.aspx?key=DDAC5AFF450B7832

Lisa Russell described her projects as more spontaneous than pre-decided, and we think this illustrates her unique and well-organized way in developing them more than anything. She is meticulous in almost every step of her project and makes sure that she is not offending the people that she films. She also analyzes every position of the issue; by making sure even the “bad guys” that are performing the abortions get their voice. At times she stated she feels in a paradox in terms of films being documented about Africa due to the overall negativity a the films, and she explained that she makes sure her films shed light to the positives, so that there is no inferiority.

Overall her presentation was insightful, informative, and an endearing pleasure to be a part of.

Fred and Sonam

The End of Nature, FEMA Trailers, and Bed Bugs

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There’s an uncanny relationship between climate change and man’s infringement on nature, the national bed bug plague , and what is likely to be the metaphor of our times, FEMA trailers…more

Before correcting papers, today, and after falling off a horse, I set out and tried to put together some of the material we’ve read in the course with the Clifford Symposium. I asked myself, “what does global health mean to me?”  And, “what are some relationships between class and the environment and global health. If you select “more,” you see what I’m thinking — and what we’ll discuss Tuesday.

Roundtable:Teaching at the Intersection (9/24, 4pm)

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Middlebury professors discussed the new interdisciplinary minor that Middlebury is offering in Global Health.

1. Svea Closser, Department of Sociology-Anthropology, Middlebury College

Discussed the creation of the minor

-Outlined some of the courses she teaches for the minor (Core course is SOAN 267 Global Health)

-Growing interest in global health led to creation of minor (Supply and demand)

2.Sarah Stroup, Department of Political Science, Middlebury College

Discussed goals of program: To teach humanitarian and charitable action at home and abroad

-“The causes and solutions to disease are political and economic”

This connects to the theme of the keynote speech given by Dorothy Roberts who claimed that social inequalities created by race lead to higher mortality rates for African-Americans.

-Teaches class on international humanitarian action

-Difference between humanitarian relief on a global scale and community scale

a. Global- Developed countries like the US see disasters as oppurtunities for change, but this is impossible because of pre-existing political problems (Rwanda)

b. Community- Easier to take action because easier to understand social/political dynamics of a smaller group.

3. Steve Viner, Department of Philosophy, Middlebury College

Discussed moral responsibilities we have as wealthy citizens of a developed country and moral dilemmas of global health

-Who should get what in terms of relief

-What moral responsibilities do we have to the global poor

Example: 18 million children die prematurely worldwide due to diseases like malaria.

–Unicef has a program where you can donate 25 dollars to pay for all the vaccinations for a child in a poor country

-It should be our moral duty to donate this money, yet some don’t

-Those who do donate feel like they did something above and beyond the scope of their duties when in reality just did what they should do

-In the case of natural disasters more people likely to give because no one is to blame for situation

-We need to see global poor as our equals

-Thinks that liberal arts leads to better understanding of global health issues because more in tune with social and political issues

4. Robert Cluss, Department of Chemistry and Biochemistry, Dean of Curriculum, Middlebury College

-Discussed the role of liberal arts in minor (side note, this minor perfectly exemplifies an interdisciplinary program, if you look at the professors who spoke they come from chem, religion,soan, poli sci, and philosophy departments)

–Study Abroad plays big role in program

5. Q and A session led by James Davis, Department of religion

  1. [Senior student who started globomed at mid] How do you see the future for Middlebury and the study of global health? Are there any limitations?

-We are lucky to have J-term, allows for lots of innovative and creative classes

-No plans to create major out of minor

2. [Linda White Japanese/WAGS] How much is gender a topic in these courses?

-Courses stress that women’s rights are just natural human rights but applied to women.

3. [Sophomore student] What are we not doing as developed countries to help the underdeveloped countries?

-People aren’t doing the easy things like donating 25 dollars.  Many people can do this but don’t

-We need to realize it’s our duty to help, not optional

4. [Jeremy Greene prof. at Harvard]

How does the combination of all these fields lead to a comprehensive minor?

-The beauty of liberal arts is that everything doesn’t have to make sense.  If you pull knowledge from many different fields and it doesn’t all add up to something understandable, you’ve still learned.

Best,

Cooper and Nick

Roundtable: Local/Global (9:30-11)

In this session, we learned of both local (Middlebury) and global (Bangladesh and NE Brazil) health and sustainability projects.

Abul Hussam, Center for Clear Water and Sustainability Technologies, Dept of Chemistry and Biochemistry, George Mason University.

Dr. Hussam’s project originated because his family has been drinking water laced with arsenic, a huge problem in Bangladesh.  His talk emphasized sustainable technologies (SONO arsenic filter) and the social implications, though he dealt less with this aspect.

He highlighted 3 UN Millennium Goals that his project is tackling:

  1. MG1: eradication of extreme poverty and hunger
  2. MG7: ensuring environmental sustainability (water <>sanitation<>hygiene)
  3. MG8: develop a global partnership for development

Water is interconnected with sanitation and hygiene — the problem of sanitation has to be solved simultaneously.  In Bangladesh, people get their water from 5 sources:

  1. surface water, the most popular and dangerous
  2. groundwater (tube- wells) — where we find a lot of arsenic
  3. deep tube wells
  4. dug wells
  5. rainwater harvesting (very difficult to do  because if it sits it develops bacteria and other organic “things” and it has to be filtered quickly, which is difficult and expensive)

People who drink water with arsenic for long periods develop Arsenicosis, which can look like this.  Thus, from arsenicosis multiple problems arise: marginalization, lack of opportunity, and the labeling “poor.”  Arsenicosis is a disease of poverty.

So Dr. Hussam and colleagues developed the Sono arsenic filtration system.  They’ve been able to get this filter to thousands, but new technologies have to be developed and the commercial segment has to enter into the picture thus lowering costs.  It took 2 years to get people to buy into the filters because once the water is cleaned it tastes different and people were used to drinking their polluted water and saw this as the “right” water.

Maria Carmen Lemos, School of Natural Resources and Environment, University of Michigan

Professor Lemos’ work concerns how people use information, particularly climate change, to make informed decisions about development.  She said that all issues of development are linked to — or have to be linked to climate change since it affects everything we do.  The affects of climate are not distributed evenly. For instance, those who have affect climate change the most, will be least affected by these changes; those that have affected climate change the least, the poor,for instance, will be most affected.

She gave us a vulnerability function, which makes a lot of sense: Vf(E,S, AC) = Vulnerability is a function of exposure, sensitivity and adaptive capacity.

The rest of her talk focused on Adaptive Capacity:

  • the ability of a system to adjust to climate change, to moderate potential damages, to take advantage of opportunities, or to cope w/ consequences
  • set of resources, and the ability to employ these resources, that are prerequisites to adaptation

Thus, Adaptive Capacity is a positive (+). But we’ve lived with the notion that more is better — more knowledge, more spaces, more of everything is better (sounds like McKibben, here, in our reading/syllabus).  More, says the professor, has failed so we have to change this idea.

How do we reframe adaptive capacity in climate change since the following characteristics [of adaptive capacity] make it difficult? :

  • latent nature
  • dynamic
  • lack of baseline date
  • difficult to measure
  • what scale?
  • there are many unknowns (such as how do we measure social capital?)

She advocates a 2 tier approach: Generic (income, education, health, safety, political access) and Specific (drought response, disaster relief, climate information)

You have to build adaptive capacity before the disaster, before the risk becomes manifest.

Dr.  Brian Saltzman, Dentist, Middlebury, Vermont, Open Door Clinic, Addison County

Most prevalent childhood disease in childhood is dental decay.  Dr. Saltzman is therefore tackling this issue through his Open Door Clinic and through education, focusing on the marginalized, particularly the migrant worker.

He spoke about “Dental IQ,” which is the knowledge  of diets and foods, which really comes into play with socio-economics.

Dr. Saltsman sees EDUCATION as the primary problem and the solution — we need more people and more bodies to help in this.

Panel: Finding Meaning

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The main idea of the panel was to discuss the complicated issue of global health. The first speaker was Katherine Ott, a curator at the Smithsonian Institution in Washington DC.  She argued how culture relates to the issue of public health. Ott says, “We live in a world surrounded by stuff,” referring to the material objects that control and manipulate our society. She discusses the fact that medicine has extended its purpose into mainstream society. It is no longer just a remedial drug, something used to help people recover, but it is now a part of everyday life. With this progression, society has also developed a fear of medicine such as date rape drugs and workout pills.  This transformation from a drug used strictly to help people to something that assists and enhances many facets of someone’s life shows how society has become just as concerned if not more concerned with profit and material wealth as the well being of humans.

The other speaker was Richard Keller, a professor of medical history and bioethics at the University of Wisconsin at Madison.  He suggested that medicine was essential in building strong empires which is a concept taken directly from Dr. Paul Chatinieres.  Throughout history, powerful nations such as the United States and France have offered medicine to people in underdeveloped countries.  Keller questions why these institutions would provide such help. To most it may seem as if these powerful nations are providing help to be moral and helpful but in reality, some countries are simply trying to gain more resources and expand their nation. There seems to be a linked distrust in two areas you might not necessarily expect- warfare and medicine. In both cases, less fortunate countries are concerned about the help that “wealthier” or more advanced countries are providing. For example, in Morocco, a French based country, Hubert Lyautey stresses the necessity and power of physicians due to their ability to assist and save the lives of those who are suffering. In addition, in recent time, Colin Powell talks about the importance of NGOs  and how they are an important part of our combat team. Obviously the military is the most significant facet, but Powell considers the NGOs almost as important due to their daily interaction with the people in these struggling nations. Due to the language barrier and the dissimilarities of their culture, citizens of impoverished countries do not believe the intentions of countries such as America to be honorable. For instance, David Brooks talks about how many countries such as Haiti resist assistance of different cultures which is often the cause of their problems. There is an existence of a voodoo religion which some believe causes Haitian people to reject and resist outside help. As a result, they are are unable to deal with problems such as the earthquake.

-AJ and Joey