Talking Health Out Loud: How volunteering led to life-saving strategies for teens

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Nurse Susan Gold, RN, BSN, ACRN, who works in the UW Health HIV Clinic and Pediatric Infectious Disease Clinic, has volunteered as a nurse in East Africa since 2003. She discusses her journey of hope, learning and teaching, from volunteer to establishing her Talking Health Out Loud project at the March 2017 Global Health Tuesday seminar. Listen here.

Gold received a Fulbright Grant in 2007 to evaluate a curriculum on reproductive health for HIV-positive adolescents. Since 2011, she has led global health field courses to Africa, in which students help teach the HIV curriculum. She talks straight with Kenyan teens about sexuality and HIV/AIDS. Her Talking Health Out Loud mobile platform gives them reliable information about HIV and a safe place to talk about the disease and sexuality.

This year, Gold was awarded a Mandela Washington Fellowship Reciprocal Exchange Award to collaborate with Sicily Mburu, a Kenyan physician who co-founded AIDS No More. The women met during a GHI-hosted conversation in Madison that brought together health care workers from the Young African Leadership Initiative and UW-Madison to discuss their work with HIV/AIDS patients.

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Nursing student brings fresh perspective to UW-Madison

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Ummu Drammeh is on a journey. A mother of five (her oldest is 22), she is originally from Gambia in West Africa. Now, she’s a student in the School of Nursing. And that’s not all: She’s a Badger parent, too, with two of her daughters also enrolled here. Drammeh says waiting until later in life to go to college was a good decision. “I think I’m more focused now than I would have been. I have a mission and I know what I want to do.”

 

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Slow Change

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Steve Carpenter, a member of the GHI advisory, director of the UW-Madison Center for Limnology and a principal investigator of the UW-Madison Water Sustainability and Climate Project, was recently awarded a Wisconsin Academy Fellowship. During his April 17th acceptance speech, he remarked on creating good legacies by embracing our planet’s slow-moving processes – something rather hard to do in today’s fast-paced society.

“The rebound of Earth’s surface from the weight of the glaciers has gone on for 10-15 thousand years and is still happening today at a rate of a few millimeters per year… Slow changes, like melting glaciers and terrestrial rebound, create legacies. By dictionary definition, a legacy is property or money left to someone in a will. But we also create legacies on our planet…

Higher sea level will become one of our most important legacies. Sea level is rising because global warming is melting glaciers, adding their water to the sea…

To create good legacies, we must learn to Respect the Slow. This might be the most fundamental challenge to humanity.”

Read the full essay here on Yahara in situ, the blog of the Water Sustainability and Climate project at the University of Wisconsin-Madison.

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Third Thursday Global Health Seminar: The UniverCity of Monona: Better. Places. Together

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Monona Mayor Bob Miller and Jason Vargo, an assistant scientist at GHI and the Nelson Institute for Environmental Studies, discuss the first UniverCity Year project with Monona, Wisconsin.

UniverCity Year is a program through the UniverCity Alliance, which is co-convened by the Global Health Institute. The collaboration among partners across UW-Madison aims to make the resources of the university available to address cities’ challenges in a changing world.

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Remembrances and Reflections: Global Health, Local Needs, and One Very Special Patient

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This paper is originally published through Society of Teachers of Family Medicine (STFM) here.

Penina. I will never forget her. She was a beautiful 3-year-old girl with sparkly brown eyes, smooth dark skin, and a captivating smile. She lived in a village near Kasangati, Uganda, with her parents and five siblings. We met in 1986, toward the end of my family medicine residency, during a 3-month-long experience that would alter the course of my life.

Uganda at the time was emerging from a brutal civil war that had ravaged the country almost since independence from British rule in 1962. Its weak health system was in complete shambles. Malaria, tuberculosis, vaccine-preventable diseases, and HIV were rampant. One out of three Ugandan children died before the age of five.

My job, according to the description I received prior to my departure from the United States, was to train village health workers to prevent and manage common health problems. Once on the ground in Africa, reality took hold: I was the only doctor caring for a dispersed rural population of about half a million people.

The Kasangati Health Center, my professional home base in Uganda, had not had a full-time physician for well over a decade. It consisted of bombed out shells of buildings with no electricity or running water, supplied with scant medical equipment and very few drugs. We were surrounded by grim reminders of the recent war, including stacks of bullet-ridden skulls and piles of human remains. The locals were busy resuming their lives and were reluctant to bury partial bodies until they could be identified. Josiah, the administrator of the health center, sat me down on the first day and provided this sage advice: “I know you’re a doctor, and you’re trained to treat patients. But our needs are so great that you could see patients here 24 hours a day for the rest of your life and not make much difference. Yet, if every time you see a patient you also teach one of our staff, you will make a long-lasting difference. We need you to teach.”

I spent most mornings working at the health center alongside a courageous and dedicated group of nurses, medical officers, and midwives who had continued working at the health center through the war and despite lack of pay. I taught them examination and diagnostic skills, and they taught me about tropical diseases, local resources, and creative problem solving. In the afternoons I trained village health workers in the basics of child survival based on World Health Organization standards; the health workers shared stories and taught me their values, culture, and language. Along the way, my family and I settled into routines of daily work, community life, and sleeping under mosquito nets. My husband joined locals in gardening and rehabilitation projects. Our three young children joined new friends in chasing chickens, feeding goats, and climbing mango trees.

About a month after our arrival in Kasangati, one of the health workers asked if I could examine and treat his daughter, Penina. She had a fever, rash, runny nose, and harsh cough, all telltale signs of measles pneumonia, a condition rarely seen in the United States, where most children had been immunized. Immediately upon seeing her I knew she might require more intensive therapy than was available at our center. I urged Penina’s father to take her to the hospital in Kampala. He declined: there were five other children at home; the cost of the journey was too great; he could not afford to spend time away from the family and farm. Reluctantly, I treated Penina with amoxicillin, supportive therapy, and daily visits.

Two days later, I woke to a gentle knock on my door. Penina had died during the night, her father calmly explained. I was devastated, filled with remorse. I felt responsible for Penina’s death.

The following day my husband and I visited Penina’s family to pay our respects. Her family thanked us for doing the best we could to help. They forgave me for not being able to save Penina. They were not angry, as I was expecting. They were grateful for our presence.

I know I should have done more and could have done better. I also know that Penina died due to a complex web of harmful conditions: inequity born of a long history of colonialization, two decades of violent internecine strife, and the utter collapse of a poorly developed infrastructure, not to mention insufficient human capacity and the lack of basic health resources.

Fast forward 10 years. I had settled into a teaching practice in beautiful rural Wisconsin, caring for patients from womb to tomb, delivering babies, watching children grow strong, caring for parents, grandparents, and patients at the end of life. My practice partners and I joined local leaders to promote community health through programs with teachers, farmers, and seniors. We set up walking trails, developed safety programs, and offered “doc talks” about sex, drugs, and guns.

I loved patient care. I still do. And yet I have remembered this, as Josiah advised me in Uganda years ago: medical care is a necessary but not sufficient component of promoting health for those in greatest need. If I wanted to make a difference, I needed to look beyond individual patients to design and lead educational programs; to cultivate skills to influence systems of medical education; to recruit, train, and retain motivated, well-trained family physicians and other health professionals where they are needed most; and to raise my voice as an advocate for justice in health care. I needed to find others with similar goals, to build teams to strengthen medical education and health systems and to target efforts where they had a chance to make long-lasting impacts.

Reflecting back on almost 30 years ago, I had no idea how my experience in Uganda would influence my career as a family physician educator in Wisconsin and launch my career in global health. This seminal experience heightened my awareness of the social determinants of health, the power of community, and the resilience of the human spirit. It galvanized my commitment to work with medically underserved people, to promote health equity and humanism in medicine, and to develop my skills as a health advocate for individuals and communities at home and around the world. It strengthened my resolve to work for health system improvement and expand access to high-quality, primary health care for all.

In doing this work, I have often considered the words of the poet Mary Oliver: “What is it you plan to do with your one, wild and precious life?” I remember Penina, and how her precious life was cut so very, very short. I am deeply grateful for the lessons I learned long ago in Uganda. I continue to honor Penina’s memory through my work today.

Acknowledgement: This paper is based on remarks shared with medical students on the occasion of receiving the national Gold Humanism Award at the annual meeting of the American Association of Medical Colleges in Chicago, IL, November 2014. Thank you to William Ventres and Mindy Smith for their input on the manuscript.

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Climate and Health: Where We Stand

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GHI Director Jonathan Patz addressed the Physicians for Social Responsibility’s Climate Health Summit in September 2015. The two-day summit informed participants about the health implications of climate change and the health benefits of climate solutions. The slides and handout are available here. 

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Impacts of agricultural development on human health and nutrition in Ethiopia

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Henok Kurabachew Mulat, associate professor of plant pathology and director of the School of Nutrition, Food Science, and Technology at Hawassa University, promotes multidisciplinary academic and research programs to improve nutrition in Ethiopia. He is working with UW-Madison on an orange-fleshed sweet potato nutrition and health project in collaboration with the International Potato Center. He is also interested in the impacts of climate change on agricultural productivity and nutrition in his country.

He visited UW-Madison in August to expand collaboration between the universities, create new partnerships to improve nutrition and health for small farmers and rural communities, and improve agriculture-nutrition-health programs in both countries. The Global Health Institute hosted an event titled “Agriculture 4 Health: Impacts of agricultural development on human health and nutrition in Ethiopia where Henok Mulat discussed his work with sweet potatoes and nutrition in Ethiopia. You can watch his lecture here.

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Improving Heat Health Resilience through Urban Infrastructure Planning and Design

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GHI Assistant Scientist Jason Vargo discusses improving heat resistance through a webinar with the Environmental Protection Agency (EPA). Vargo discusses results from the COOL Study, which looked at three metropolitan areas, Atlanta, Philadelphia, and Phoenix, and evaluated how landscape policies affect health. Specifically the study looked at how heat wave days and the impact of warmer summer temperatures impact the health of urban areas. Reflective coatings, planting trees and green roofs are all design policies that cities can use to mitigate heat related deaths.

Listen to his webinar and learn more about how heat islands influence health

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Watch Dr. Frantz Large’s discussion on eye health care in Haiti and around the world.

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Dr. Frantz Large gave a discussion on eye health care in Haiti and around the world on July 15. Large conducts mobile clinics in Haiti and shared his insights and strategies for eye health care, focusing on S.E. Haiti and how partnership efforts improve vision in remote global regions.

Large graduated from the Faculty of Medicine, Universite d’Etat d’Haiti with internships at Lincoln Hospital, NY; Georgetown Hospital, Washington, D.C.; and Hilton Roche Hospital, Bello Horizonte, Brazil.

Watch video: Eye Care for the Arrondissment of Belle Anse, Haiti: A Proposal, here.

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Mittenthal considers course that looks at some of Wisconsin’s invisible environmental hazards

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Robin Mittenthal, the administrative program manager for the Undergraduate Certificate in Global Health, leads a one-week field experience every summer called “lead, algae and trash, oh my!” This course explores environmental health and allows students to learn more about some of Wisconsin’s invisible environmental hazards.

“Many of the students are from Milwaukee or surrounding counties and they say afterward to me, ‘I grew up here, but I had no idea that this program is here, that this problem is here, or that this effort to address it is here.” And this changes their perception of the place that they are from,” Mittenthal says.

Throughout the week, students study lead contamination, specifically in the Milwaukee area ,as well as visit with a number of different environmentally focused organizations around the state. Mittenthal talks more about the course in this video.

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Global Health Seminar Series: Education, Ebola and Empowering Girls in The Gambia

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When 20 Gambian girls learned about teaching female reproductive health, they planned to share their knowledge in their communities as peer health educators. Faced with an Ebola outbreak, they realized they were prepared, proactive and ready to serve – and used their education and cultural knowledge to fight the disease. As a part of the Global Health Seminar Series here at UW-Madison, Mam-Yassin Sarr held two discussions on topics of health and the importance of educating girls to advance global health. Listen to her lectures here.

Girls-in-The-Gambia-2

Education is key to helping girls in The Gambia face social and health challenges.Adrienne White from University Health Services, left, helped train girls to become health advocates.

Starr founded Starfish International with the goal of providing education for Gambian girls from pre-school through graduate school. Teen-age girls in The Gambia face a host of social and health issues and challenges, including early marriage, teen pregnancy, violence against women and building their confidence and financial independence.

 

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#UWVoices

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Events in Madison, Ferguson and New York City have brought UW-Madison voices together in #UWVoices. Students have come together to demonstrate commitment to addressing issues of racial disparity and marginalized groups in our community.

This video explores some of the challenges of race that students experience on campus at the University of Wisconsin-Madison. It was produced by UW-Madison senior Christian Inouye with assistance from senior Christian Wilson.

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