Posts Tagged ‘TB’

Tuesday Talks: Beyond the Numbers with Director of “They Go To Die” Film

Tuesday, October 11th, 2011

An inspiring endeavor that will undoubtedly change the face of epidemiological research  is being completed by a student. Jonathan Smith is an epidemiology student at Yale University who recently completed his thesis research on the HIV/TB epidemic in South Africa. He not only collected quantitative research, but also took the time to learn and understand the community. He is putting his work into a documentary film, but needs more support in order to make it a reality. The stories that he has to share are deeply moving and have the potential to make a big impact beyond the communities where he completed his research.

Support the film’s production here on KickStarter >>

I interviewed Jonathan this past week over email:

1. As a student from a Western country, why do you feel it is your place to tell the stories
of South Africans?

I really like this question – I don’t feel like it is my place at all. I am showing these stories, not necessarily telling them. My role in this project is to be a vector for their stories to unravel by themselves – then to stay out of the way! I think often times people do not appreciate the contextual differences in disease – any disease – and think what solutions work for ‘us’ will work for ‘them.’

This became real to me when I was living with Mr. Mkoko. I struggled to make headway in HIV education, prevention, and testing, at first, but eventually broke through with some success. Not by imposing what I was learning from school on them, but by working together, understanding the cultural beliefs of the community, and taking those beliefs seriously (not casting them aside as ‘stupid’ or ‘wrong,’ although they were indeed dangerously misleading). Because of this, I was formally accepted as a ‘brother’ into their community – even given the tribal name Masheshay’nike. This meant I was no longer an ‘umlungu’ (‘white person/outsider’) and that they now would respect my views and thoughts as one of their own – I worked with their traditional healer in a pseudo-scientific, quazi-clinic capacity that promoted proper prevention strategies and testing without undermining their traditional practices. This was an intense amount of work,
but if I were to just go in there and say “this is right, you are wrong,” I would have been shut out immediately.

2. Since there have been many fully funded large scale studies completed by international organizations, how has your work been received coming from a student?

For the film, I think being a student really helped me. People were really willing to help since I was just a student. I think it made the industry executives and government officials a little bit more relaxed – i.e. this was ‘just a student project,’ as opposed to a mainstream film, if that makes sense. Several production companies let me use their studios for interviews for free, international universities accommodated me, and people favorably responded to interview requests all because, honestly, I think they remembered what it was like being a struggling student.

3. How has your work been received in the epidemiological community since you
are using a mixed methods approach as opposed to sticking with traditional
quantitative research?

So it’s a little tricky – there are two things occurring simultaneously, but independently: a research project and a film. I am simultaneously working on a mixed-method research study at Yale that incorporates both qualitative and quantitative measures to indicate contextual factors that lead to increased TB and HIV vulnerability among this population. In other words, what other forces are at work that increase disease vulnerability and allow this cycle of disease to perpetuate. The film itself, while technically independent from the research, further investigates the lives of people caught up in the very cycle that I am researching. So puts a face to this and hopes to shift the conversation away from the data and more towards the person. Hopefully combined, they will really demonstrate a need for change – the data will explain that this is a widespread and serious problem (i.e. not some crazy activist film), and the film will demonstrate that for each ‘number’ that we quantify in the research, the impact goes well beyond just the statistics. So one does not negate or undermine the other, they actually go hand in hand to augment each other.

As far as reception from the academic community, people have been very receptive to the idea. I work with a number of professors at the University, and we are currently trying to figure out how we can expand on this idea, how to replicate it in other issues, as well as metrics to gauge its effectiveness.

4. What impact do you hope to achieve with the completion of the documentary?
What will your research and documentary be able to do that “million dollar” studies have failed to do?

What I think any research project on this issue has yet to do is place accountability. I’m in no way against the million dollar studies – we need them to highlight the problem. But over the past few decades, we have used this research to define the problem now with surgical precision – we know what it is. We know why. We know what needs to be done. We know how to do it. We know certain methods will work. But nothing is being done. Why? Because there is no accountability. Its not just ‘big mining’ dropping the ball – its everyone. Governments, the industry, and the unions could do more.

Even researchers. Because rates of TB and HIV are so high, researchers now use the mining
population for cohort studies that have nothing to do with the population itself, they just know they will get the disease so it would be an easy cohort study. They are literally human guinea pigs for epidemiological research. We are dancing a fine line of ethics when we treat a population int his manner.

I hope the film will educate and empower civil society to place accountability on the decision makers to actually get things done – to make the appropriate policy changes or actually enforce existing ones. I hope to string together motivated individuals and organizations to say, “Now we are watching.”

The Week of Health in Africa

Friday, November 12th, 2010

This week in the African health world the conclusion of the m-Health Summit in Washington D.C. garnered a lot of attention concerning the future of African health efforts. With the highly publicized polio and cholera outbreaks throughout the world and the African continent, the UN and aid agencies are asking for support from the developed world to contain and eradicate the outbreaks and diseases.

As the m-Health craze comes to a close in Washington D.C. there were two main headlines attached to the summit. One number thrown around the summit was 500 million. That’s the number of mobile health applications expected to be in use by 2015, according to the Global Mobile Health Market Report released after the close of the summit. Bill Gates even made a comment about the issues associated with the next highlight of this post, recent outbreaks of preventable diseases.  During his keynote address at the summit Gates said, “Diagnosis of malaria and TB will likely be the first ones you can assign a number to and say without this mobile phone app these people would have died.” Whether or not m-Health really is the savior everyone says it will be is to be determined. However, the m-Health movement and its supporters are definitely trying to make a mark on health in the developing world.

This week big agencies like the United Nations have called for an increase in support of containing and thus eradicating these diseases. It has been reported that Tuberculosis (TB) killed almost 2 million people in Africa and Asia in the last year.  UNICEF and WHO are trying to contain the Polio outbreak in the Democratic Republic of Congo. In three different provinces in the DRC there have been approximately 30 cases of Polio in the last year. Hopefully, the United Nations (including UNICEF) and WHO along with local support within the countries can tame the sudden outbreak of multiple preventable diseases.

The Week of Health in Africa

Sunday, October 17th, 2010

(Photo credit: Dominic Chavez/ WHO)

This week comes with controversy and numerous calls for the eradication of various diseases by the WHO. Health workers in go on strike in another African country after South Africa’s months long strike. Liberian doctors said they would only treat “critical” patients. Tuberculosis is becoming more resistant among young people and HIV positive individuals, but more effort is being put into research.

WHO sees end to TB

Last week TB was discussed as a “forgotten disease for forgotten people,” but now it seems that the WHO has released a plan that identifies gaps in research to create faster treatment regimes. “There is an urgent need to scale up action against TB – 10 million people, including 4 million women and children, will lose their lives unnecessarily between now and 2015 if we fail,” Dr. Margaret Chan, the WHO director-general, said.

Its Time to End the Double-Standard of Food Aid

Tido von Schoen-Angerer, Executive Director of Doctors Without Border’s “Access to Essential Medicines Campaign” wrote on Huffington Post about how the US government continues to send sub-standard food supplies to areas in need. The United States, the world’s biggest food aid donor, continues to send the corn-soy flours that do not address childhood malnutrition. You would be hard pressed to find these foods in American grocery stores, because it’s food we would never feed our own children.

More: Can the story on US food aid get any worse from Aid Watch posting Financial Times

“Paradigm” Shift Needed in Health Care, Experts Say

In Africa there needs to be a greater focus on prevention and treatment of noncommunicable diseases like diabetes and hypertension and not just infectious diseases like HIV/AIDS, health experts told the 2010 U.S.-Africa Private Sector Health Conference October 6. “Health is as critical as institutions, infrastructure and education for Africa’s economic competitiveness and growth. It is a prerequisite for human energy, entrepreneurship, dynamic markets and a productive society,” said Haskell Ward, vice-president of Seacom Corporation and chairman of the Global Health Strategic and Advisory Committee of the American Cancer Society.

Ending Africa’s Hunger Means Listening to Farmers

Africa is hungry – 240 million people are undernourished. Now, for the first-time, small African farmers have been properly consulted on how to solve the problem of feeding sub-Saharan Africa. Their answers appear to directly repudiate a massive international effort to launch an African Green Revolution funded in large part by the Bill and Melinda Gates Foundation. “Food and agriculture policy and research tend to ignore the values, needs, knowledge and concerns of the very people who provide the food we all eat – and often serve instead powerful commercial interests such as multinational seed and food retailing companies,” said Michel Pimbert of the International Institute for Environment and Development (IIED), a non-profit research institute based in London.

African cholera outbreak kills 2000

A preventable disease that is linked to the need for clean water sources has continued to kill people in a number of countries. WHO officials report that, as of October 3, there have been 40,468 reported cases of cholera and 1,879 reported cholera deaths in four countries, including Cameroon, Chad, Niger and Nigeria. The outbreaks started a few months ago, officials said.

Obesity: an underestimated “silent killer”

There is a new “silent killer” in town. It joins the ranks of malnutrition, malaria, hypertension, diabetes, HIV/AIDS, etc. It is obesity. “We are eating our way to the grave’’ and “obesity is rising in rural areas.’’ Adults are overweight or obese, while children are malnourished – a paradox. In the men still look at a potbelly as a badge of pride and success.” The World Health Organization reports that more than one-third of African women and a quarter of African men are estimated to be overweight, and predicted that it will rise to 41 percent and 30 percent respectively in by 2016. Once considered a problem only in high income countries, overweight and obesity are now dramatically on the rise in low- and middle-income countries, particularly in urban settings.

The Week of Health in Africa

Friday, October 8th, 2010

The Mo Ibrahim Prize for African Leadership hasn’t been given out since 2008, but the Mo Ibrahim Foundation has launched the Ibrahim Index as a measure for African countries and their progress. This is an interesting and important development as a number of the indicators for the index focus on health. Check out other interesting news from across the continent. Check it out for yourself!

Reducing poverty with water!

“Water is more valuable than oil, more precious than gold,” said Amy LoPresti, co-founder of Africa Water is Life. “It is the essential ingredient of our life, our culture, our history, and our future. Yet, 1.2 billion people in the world do not have access to clean, consumable water.” Unsafe water and a lack of basic sanitation cause an estimated 80 percent of all diseases in the developing world and together kill more people than all forms of violence, including war.

Modified bananas to fight child and maternal mortality

This is a story that really invokes our organization’s name. High rates of chronic malnutrition and micronutrient deficiencies of Vitamin A and iron among women and children remain Uganda’s most common malnutrition problems. However, an edible banana could solve this problem.

How fight against Guinea Worm was won

Africa Water News highlights a CNN article that suggests we are close to eradicating the disease. Once called the “forgotten disease for a forgotten people” the Carter Center believes that every country in Africa except Sudan will be rid of the disease.

Healthcare is a Moral Obligation

The ANC’s National Health Insurance scheme has yet again opened up the deep economic divisions in South Africa. The economic divisions are best represented by access and quality of health care. Doctors are very difficult to find in poor, crowded townships and settlements, but major towns with many wealth have centers for plastic surgery. 60% of funds for health services are directed at the 15% of the population which is covered by private health insurance. Only 40% of the funds are used to pay for the public sector that serves 85% of the population.

Medical Education in Africa to receive $1.3million in American Grants

Over the next five years and in partnership with the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the department is awarding grants to African institutions in a dozen countries under its Medical Education Partnership Initiative (MEPI), which works with U.S. medical schools and universities to form a network that includes about 30 regional partners, country health and education ministries, and more than 20 U.S. collaborators.

Ghanaian belief and Healthcare

This article is being featured because of the subject matter. Voice of America (VOA) has a habit of generalizing, especially in Africa and about African people. I suggest reading the interview transcript on how traditional beliefs guide health practices in Ghana, something that I studied during a 6 week study abroad covering disparities in health care. The US health care system could learn a thing or two from the Ghanaian health system.

Hope Expanded Protection Against TB

With a vaccine and drugs available to treat tuberculosis (TB), you would think that it should no longer be a problem. 1.3 million people worldwide died from TB in 2008, according to the World Health Organization most lived in Africa and Southeast Asia. Is this becoming another “forgotten disease for a forgotten people?”

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