"If you don't have a dream, you can't have a dream come true."

After a whirlwind of a first day of the assembly, our second day at the WHA began with a Committee A meeting which addressed WHO Reform and the agenda item: Programme and Budget. It was interesting to hear individual countries voice their approvals and concerns regarding the proposed documents. A common consensus among many of the nations who spoke is that there is a definite need for coordination and communication between the 3 levels of WHO.

The highlight of the day for some of the USC MPH students was the opportunity to speak with the United States Secretary of Health & Human Services, Kathleen Sebelius. During our brief conversation with her, Secretary Sebelius mentioned that some top priorities of the WHA were noncommunicable diseases (NCD's), obesity, LGBT issues, violence against women, and new and emerging viruses, such as H7N9. It truly was an honor to meet and interview such an influential leader in the field of health and human services.

After speaking with Secretary Sebelius, we also had the opportunity to interview Dr. Howard Koh, the United States Assistant Secretary for Health and Human Services. Dr. Koh shared his story of volunteering for the American Cancer Society for twenty years, completing medical school and working as a physician, and finally pursuing and completing his Master of Public Health degree at age 40.  Dr. Koh provided us with the words of wisdom of, "Follow your passion."  He emphasized that you can make a difference at any age, as the anecdote of his career highlighted, and encourage us to passionately pursue our goals as we work to better the health of the global population.

We also were able to find some time to interview Sir George Alleyne, who is the United Nations Secretary-General's Special Envoy for HIV/AIDS in the Caribbean region.  Sir Alleyne's conversation with the MPH students was very informative and thought-provoking.  He left us with many points to consider as we continue to contemplate global health issues for the remainder of the week.  He stressed the importance of initiating negotiations between governmental health organizations and private sector health organizations on the basis of common interest--that interest being the ultimate desire to improve the health of the population. Sir Alleyne left us with an important item to consider throughout the remainder of the assembly, as well as throughout our public health careers: global health should be viewed as a field of practice and research directed at reducing inequities of health. He explained that equal access to healthcare for all people may be a dream, but it is a good dream. In Sir Alleyne's words: "If you don't have a dream, you can't have a dream come true." These words will certainly stick with me, as I'm sure they will with my fellow MPH peers, this week, as well as for years to come, as I strive to create positive change and influence as a public health professional throughout my career.

66th World Health Assembly - Day 1

Hi Everyone!

I'm excited to be in Geneva for this year's World Health Assembly for my practicum and want to thank Dr. Wipfli and the USC Institute for Global Health for this opportunity.

Today is the first day of the 66th World Health Assembly and everyone was very excited! This year's topic is on non-communicable diseases (NCDs) and plans in the post-2015 agenda. Dr. Shigenu Omi was elected President and spoke on adoption of the agenda and allocation of items to the main committees. Some topics touched on were the coordination of national and international strategies in addressing NCDs, utilizing a multi-sectoral approach in addressing these issues, and moving towards health equality with universal health coverage. At the third plenary meeting, Director-General Dr. Margaret Chan, gave an inspiring opening address. She talked about tackling NCDs as not being easy, especially being amplified by products of economical forces, which translates to political forces. Industries contribute to NCDs, and when there is economic interest, there will be opposition. In this, she reinforced the importance of multi-sectoral approach, on not excluding the role of other industries to reduce NCDs. She gave the example of there is not one country that turn around obesity level in all age groups, reflecting a need to address NCDs. Addressing NCDs depends on prevention and cost-effective clinical care. She stated that: "good health can be achieve at low cost if good policies are in place."

I also attended Committee A on the opening committee agenda items 10 and 13 on NCDs and a side event on "The role of private sector in countering NCDs. Committee A was a discussion on the draft of action plan for prevention and control of NCDs. It was extremely interesting to hear the member states' views on the plan. The discussion was not finished and will continue later in the week. In the private sector side event, food labeling and other innovative instruments for involving the private sector in helping consumer to make healthy choices easier was discussed. Dr. Lynn James of Singapore gave a case-study of the Healthier Hawker Program in engaging the private, public, and the people in reducing the rising trend in obesity in Singaporeans. The Netherlands representatives discussed on Choices Programme, the logo they made to put on products in their program to help consumers make healthier choices received recognition among consumers, encouraged brands to develop healthier options, and encouraged retailers to present healthier options. The important message I got from this side event is again to have a multi-sectoral approach and that countries should learn from other countries by using the examples of other countries to tailor interventions to their own cultural and economic situations.

Overall, it was full first day with lots of information and an eye-opening learning experience for me. I am looking forward to the rest of the week!

Alice Ting

Akwaaba- Welcome

It has been one jam packed day! Jenn, Austin, and I arrived in Accra last night and were greeted by the CareNet Ghana crew. The airport itself was definitely an experience. We got off the plane onto the runway and the air was comparable to a sauna. Inside, where we were checked by military personnel, was not much better in terms of heat and humidity. Once having our passports and visas checked, we walked into a large room that was termed 'baggage reclaim.' However, it was more like a bunch of people moving around not knowing what to do and instead following the person in front of them, who equally did not know what to do. We claimed our bags and continued to what we thought would be customs, except for we were waived straight through.

Since we arrived late, and Patrick (the director of CareNet) has work to do in Accra, we are staying at the Ecstacy Royal Hotel for two nights. Today, some of the people who work for CareNet were nice enough to take us around the city of Accra! We started our day by driving to the center of the city. On the way we saw a four car pile up at an intersection. Pretty rough traffic accident! The intersections in Accra have traffic lights, but it appears that very few people acknowledge them. When they are used, people stand at the intersections selling snacks and gum or beg for money. Another interesting thing I noticed on the side of the road was the Ghanaian flag painted on walls, everywhere! Even in just my one day in Accra, I have found Ghanaian people to be extremely proud of their country and heritage. Not only was the flag posted and painted all over the city, but so was the picture of the current president. I saw sights such as the Independence Square and the National Museum-- all which celebrated Ghana as an independent country. 

The first stop on our tour of Accra was the art center, which was really more of a tourist market. We were brought into many stalls with beautiful carvings, beads, masks, and textiles. In the market, we met a Ghanaian man who could name every capital of every state in America, and he could even name state mottos and other random towns and cities in the states. Impressive! We then walked through the national museum and saw the tomb of Ghana's first president. After lunch we checked out the national soccer stadium and the beach. Let me tell you, the beach in Accra is quite the popular place! Everyone was dancing and swimming and having an all around great time! Accra was definitely a cool place to see and compare to what we, as Americans, think of when we think 'city.' I don't believe I have ever seen a woman balancing a basket of fruit on her head along the roadside in Los Angeles. But, the traffic was at least comparable!

Tomorrow, we will be heading to Akatsi, a village outside of Hohoe in the Volta Region. I am excited to begin my research and immerse myself in Ghanaian village life! I am unsure if I will have any access to internet while in Akatsi, but I will try my best to post any updates on my research as well as life in Ghana!

Some new words that we’ve learned…

Good morning- Undi’i

How are you?- eff’wei

Responding to ‘how are you?’- ehh

Welcome- Akwaaba

Stay tuned!

A Look Back: My Experience at the Emory Global Health Case Competition

The Emory Competition Participants (Credit: Tony Benner/Emory Global Health Institute)

How many opportunities do you have to interact with students from various parts of the country as well as the world on a global health platform? How many opportunities do you have to present a business proposal in front of prominent international health policy officials? I’m not sure, but I know that the 2013 International Emory Global Health Case Competition was incredible.

After my team won the USC Global Health Case Competition in February, the five of us worked with the USC Institute for Global Health to prepare for the international competition at Emory University in Atlanta, Georgia, on March 23, 2013.

Downtown Atlanta

My team and I woke up at 4:30 am on Thursday, March 21, to catch a flight to Emory. We got off the plane looking a little haggard from lack of sleep, but the welcome we got was amazing; Emory greeted us with welcome signs and open arms. Throughout our time there, they fed us great Southern food (I ate grits for the first time!) and actually made sure we didn’t forget to eat each meal on the day before our competition.

Our presentation was judged by two very well-respected officials—Lincoln Chen, president of the China Medical Board, and Jaehyang So, the Manager of the Water and Sanitation Program at the World Bank. I walked into that room terrified, but I knew that this was a rare and amazing experience. I was proud of how we performed in such a setting, and we waited until all of the teams had competed.

While we didn’t make it to the finalist round, my teammates and I greatly enjoyed the feedback that the judges had to offer. But perhaps the most amazing experience was watching the finalist presentations. It was incredible to see the parallels that could be drawn between presentations that made it to the final round, and those that didn’t. Many elements of our presentation aligned with one school, and as I later found out, other finalist presentations were very similar to additional non-finalist competitors. I realized that so many of us came up with such similar ideas. It was inspiring to know that my ideas were comparable to the ideas of people who were five, or even 10 years older than me—and consequently had more life and health experience than me.

CDC across the street from our hotel 

Following the competition, we were able to meet Dr. Sara Mirza, all thanks to Dr. Wipfli. Dr. Mirza is an epidemiologist at the CDC and also served as a judge for USC’s internal competition. Over dinner, we discussed her work as well as our own professional aspirations. She offered me great advice that has since encouraged me to seek out my interests more often and take more chances.

Dinner with Dr. Sara Mirza

The amount of energy at this conference was indescribable and unlike anything I had experienced before, but I enjoyed it immensely. There was so much passion and drive in everyone I met, and though we were all competitors, we were also all friends. I met some amazing people that I truly hope I keep in touch with. I would definitely say that this spring break was definitely like no other. I never thought I would say that I would choose to and enjoy spending my week off poring over research and data, but the Emory competition definitely made it a worthwhile experience.

USC Global Health Film & Photo Contest 2013

Thank you to everyone who submitted to this year's USC Global Health Film & Photo Contest! The judges had a tough time picking the top submissions, but we are happy to congratulate the following for winning first place:

1st Place Photo:

"Brushing Teeth"by Natalia Sejbuk

September, 2008
Kolkata, India
An Indian girl living in the slums of Kolkata, India brushes her teeth with her fingers in the public sinks of Sealdah Railway Station. The organization I volunteered for that year provided welfare to children living under precarious conditions. I was the one that gave this little girl a tube of toothpaste and showed her how she should brush her teeth. She had so much fun doing it, that she asked if she could do it again. (1 in 6 Indian city dwellers live in unsanitary conditions unfit for human habitation, according to the 2011 India Census).

1st Place Video:

"Who is Responsible for the Obesity Epidemic?" by Hadley Greswold

Interviews at Hermosa Beach reveal who people believe should take responsibility for the obesity epidemic in the US - the individual, government, or industry.

Other Submissions:

	"On Aging" by Bianca Hernandez The importance of wellness and implications into late-adulthood.
	"Ambulance Boat" by Otana Jakpor January 8, 2013 Lagos, Nigeria While going with my cousin to look at potential sources of scrap metal, I came across a couple broken down "ambulance boats" like this one. I don't know the full story behind these particular boats, and I can't presume to know why they are out of service and falling apart. That said, they reminded me of the importance of sustainability in global health interventions. Even when global health projects are innovative and effective in the short-term, their impacts are likely to be extremely limited unless they are sustainable.
	"Who Pays The Price for 'Development'" by Caroline Jensen October 2011 Pokotane, Senegal While dam development was intended to provide benefits for agriculture in Africa and the Middle East, it has caused an unprecedented explosion of schistosomiasis over the past several decades. The snail-vector for the disease is provided with the perfect freshwater environment with dam development. Those most at risk are the women and children who spend the most time in the water - washing their clothing, collecting water, or for many of the children, cooling off with a swim. 200 million people are newly infected each year, with over 700 million more at risk for infection. Lack of universal access to treatment and failure to establish effective sanitation allow this problem to persist and compromise the quality of life for millions. This photo illustrates how women and children put themselves at risk everyday by going into the water.
	"Mask" by Jane Chung June 2011 Seoul, South Korea My grandmother the day she was diagnosed with gastric cancer. To some, the mask is a symbol of poor air quality or poor health, and can exacerbate stigmas against the ill. But whatever the perception, the mask can act as a tool to heighten awareness of global health issues. (Urban outdoor air pollution is estimated to cause 1.3 million deaths worldwide per year. - WHO)
	"The Power of Tradition" by Trisa Taro June 2010 KwaZulu-Natal, South Africa In rural South Africa, over 60% of people seek health advice and treatment from local traditional healers before visiting a medical doctor. Many initiatives have sought to train traditional healers and utilize them as a resource and point-of-contact for rural communities, however, concerns remain that these initiatives will only work to further "legitimize" the role of traditional healers in the eyes of the community and deter formal medical treatment even more, as has been seen with the use of traditional birth attendants in other parts of Africa.
	"Community Meeting" by Ruby Langeslay March 2011 Cuje, Nicaragua For seven years, the student organization MANOS (http://www.wmmanos.org/) has been working in rural northwestern Nicaragua providing a free clinic while building a partnership with the residents of Cuje to address underlying health problems. Because all of Cuje extends over a vast set of mountains, the group decided to begin with a pilot project in the sub-sector of Chaguite. After years of social network and GIS research as well as resident interviews about their health concerns, the students presented the community with a map of the Chaguite sector outlining not just residences, but locations of resources, particularly water. Today, MANOS students and Chaguite residents are working on larger projects to address water, nutrition, and the environment, among other concerns.
	"I am Not a Statistic" by Sasha Horn July 28, 2010 Qujing, China  Our Operation Smile medical team repaired the cleft lips, palates, and immobile scar tissue of 98 patients that week. He was number 99. He arrived the morning our equipment was packed up--too late to receive surgery. Statistics don't always tell the full story of a success; they don't measure the love of a mother for a child.
	"I'd Like to Buy the World A Coke" by Isabella Kim February 2012 Karatu, Tanzania  “I’d Like to Buy the World a Coke” is the popular 1971 slogan that kept its’ promise as Coca-Cola is an easily accessible food product in even rural areas of developing countries with high food insecurity. Global dietary changes that are rich in salt, saturated fats, and bad carbohydrates, like fast food and Coca-Cola, contribute to the one-quarter of the world's adult population that currently have hypertension while future projections indicate an increase to 1.15 billion hypertensive patients by 2025 in developing countries.

Moms United

On my recent trip to Uganda I joined members of the Twezimbe Development Foundation to visit a number of health clinics in Mawokota North District west of Kampala. I don’t know what I expected to see – I had seen pictures of the drab wards and knew there were challenges with lighting, drug supply, and lack of equipment  – and yes, all of these challenges were strikingly obvious and frustrating.

What I wasn’t expecting was the emotional impact I would feel as a woman and mom. Each clinic was overriding with pregnant women and small children – maternity care is, of course, a core function of these rural clinics. At the large clinic that offers C-sections I witnessed four women going through stages of delivery. The first woman I came across lay in a rustic bed in the post-operative corner of the maternity ward with a thin cloth wrapped over her. She had a small bundle cradled to her breast. When I made eye contact she lifted her sheet, beckoning me over to gaze on her precious child – her first. Beautiful, perfect, healthy.  She was lucky – she had been able to get to the clinic and received sufficient emergency care. She smiled at me, already a proud mom.

The second woman I met was in the opposite corner of the room in the midst of active labor - only minutes from delivery. A couple of midwives stood by as she heroically bore the pain of childbirth. A few minutes later as I walked the grounds of the clinics I watched as a third woman tried to walk to facilitate labor – aided by her husband.

The fourth woman I did not actually see - she was in the operating room have a C-section and as I passed by I heard low moans and she bore through the process. As a survivor of three C-sections I compared the rustic environment to my deluxe remodeled maternity wing at my hospital with the fancy beds, televisions, and drugs. If I was scared there, what would I feel facing the procedure here where drugs and supplies had run out two months ago?

A bit later as we were leaving the clinic the doctor ran out to our car, his face beaming. He had successfully delivered the baby – a girl – the mother’s first. His joy was infectious and reminded all of us that this was what progress looks like – moms seeking out care in facilities that have the capacity to safely steer them through the most wondrous experience known to many women – becoming a mom.

 The next clinic we visited provided maternity care as well, including checkups and normal deliveries. The maternity ward was packed when we arrived. Mothers of all stages of pregnancy crowded on the beds chatting happily, excited. I smiled and congratulated them and asked how many weeks along they were. They replied and some eagerly shared the sex of their babies. They knew the sex because of a recent donation of ultrasound machines to the maternity clinics throughout the area. The women were all there waiting for their turn to see their babies.

It is often struggle to get rural women to seek out care in medical facilities and not rely on trusted traditional birth attendants in their village.  Clearly in this clinic the ultrasound machine was inspiring dozens of women to come in for care – and providing them with the special joy of seeing their babies for the first time.  The challenge in this clinic is that they do not perform C-sections so if a delivery becomes complicated the mother must be transported more than 10 miles on a rustic dirt road to the first clinic we visited. The women rarely have access to transport and are most often loaded onto the back of a motorcycle. Those that do deliver naturally at the site leave about an hour after delivery – by foot – with their babies in hand.

During our visit to the large regional clinic we also visited the maternal-child health ward that offers wellness checkups and vaccinations. There were dozens of young mothers there with children ranging from small babies to toddlers. As I was walking out of the building I was stopped by one of the mothers – she handed me her small baby girl – 6 weeks old. There are few things in this world I like better than holding small babies and I happy whisked the baby in to my arms. It was then that she turned to another woman and took a second baby – the twin brother – and placed him in a hanging sack to weigh. After finishing she turned back to me and we swapped babies so she could weigh her (noticeably smaller and skinnier) baby girl. The process was a three-person job. I can’t imagine the challenge of having twins in her environment – but I was touched by the fact that as a woman walking by she naturally enrolled me in the care process. Women in these communities stand together and help each other and, of course, I was expected to as well. The question becomes – how do I best contribute? 

Can't Help Being a Mom

The past week has been the most whirlwind experience of my life – and I have had a number! In the past 6 days I have been on 4 continents and slept a total of about 6 hours. By missing a connection in Istanbul my planned 6-day stay in Kampala turned into 4 packed days that left no time for visits to the restroom, much less for eating. Amidst the chaos, there is one story that has left me contemplating myself and my role in global health.

My story came on the last day of our visit. We had gone to the National Referral Hospital to meet with a doctor about his recent research. As is common in Uganda, he was running late so I was hanging out in the breezeway in the HIV ward outside his office suite. I quickly realized a small girl was watching me. I smiled and waved – she smiled and waved back. She came closer, eyeing my phone. I asked her if she wanted to get her picture taken and she eagerly agreed. So I held the phone up and, instead of standing there with a straight face as most of the Ugandan children do, she suddenly struck a pose. I smiled and showed her the picture – she beamed with joy. She was ready for a fashion shoot. Over the next few minutes she struck pose after pose and we pretended to be in Paris or Milan. I then showed her how to take the pictures herself and she became the photographer, clicking off shots like a pro. After a few more minutes she was happy and said bye and ran off down the hall. I went into the waiting area laughing at having met such a cute kid.

A few minutes later I see her head pop up around the corner. She had gone to get a bag of bananas and was back. I smiled and she came over and crouched next to me. I asked her her name – Winnie. How old? 6. She liked school and fashion. Why she was at the hospital? Her mom was sick. How long had she been there? 2 months. Was anyone else with her? No, her brothers and sisters were back in the village and she, the youngest, was sent to care for the mom. I welcomed Winnie into my lap and after looking through all the pictures on my phone together I opened Subway Surfer – my 6-year-old son loves it, as did Winnie. I tried to show her how it worked – failing miserably time after time – frustrated with my ineptitude, she grabbed the phone and within a minute was well on her way to expert level. Eventually my host came to round us up and I said goodbye to Winnie. I held her in my arms and I told her that I hoped her mom got better and to tell her I said hello. I told her she was beautiful and we hugged. I don’t know what Winnie thought of me – if she will remember me as a strange white woman that showed up at the hospital – but I will never forget her. Kids all over the world are the same – they love taking pictures, playing video games, and shoes that light up. They also need hugs, preferably from their moms. Winnie found me and helped me find myself. Even at work, I am a mom.

(my boys happy to have mom home)