Section Connection An insider's view of the APHA International Health Section

“The idea that some lives matter less is the root of all that is wrong in the world.”

- Paul Farmer

Issue 10 - January 2019

Section Connection

In this issue:

  • Letter from the new IH Section Chair
  • The Scrutinizer Challenge Initiative
  • Meet Your Leadership
  • Book Review: Can you hear me? How to connect with people in the virtual world.
  • IH Section's Instagram Pilot Project summary


  • Theresa Majeski - Editor-in-Chief
  • Chandra Sekar - Associate Editor

letter from the New ih section chair

Dear Colleagues,

Thanks for your vote of confidence in my ability to serve as your in-coming Chair of the International Health Section.

We are facing unprecedented challenges to people’s health and the health of our planet, with the undermining and reversal of policies in many spheres that were designed to protect and promote health for all. It is incumbent on us as the American Public Health Association to speak out and to act to defend the public’s health. The International Health Section has taken a leadership role with other sections and with APHA leaders and staff to generate analysis and commentary on governmental policy and practices. We can expect that events in the next few years will demand even more activism and advocacy from all of us.

Our working groups are doing a great job involving the IH Section in important conversations about APHA policies and public health practices. In partnership with our Policy and Advocacy Committee, I hope to see even greater levels of engagement by our members to create critical policy statements and then, importantly, to use those statements to work to improve health. We are the largest and most important public health organization in the country, so these statements can carry that authority into our teaching, our lobbying, and our public education. But only if we, and the APHA as a whole, use them.

The IH Section brings together people with expertise working in low-resource settings on an incredibly diverse array of issues – aging, environmental health, mental health, maternal-child health, early childhood development, health care systems strengthening, reproductive health and rights, to just scratch the surface. Our diverse expertise is a resource for the professional and academic efforts of our own membership, and collectively we are a huge resource to the rest of the interest-area sections within APHA. Our members have a great deal to offer; I hope to facilitate greater collaboration with other sections within APHA.

Collaboration with other interest-areas within APHA is also a great way to increase the visibility of the IH Section and to reach and engage new members. I invite each of you to think creatively how you can build connections between the IH Section and the other APHA groups you are active with.

Building community among our section members by bolstering communication and activity in between annual meetings is an important way for all of us to stay connected and to feel collective strength and solidarity. Towards that end, I hope to see our excellent mentoring program grow and flourish, to expand the number of local gatherings in different parts of the country, to support our active working groups and committees, and support our excellent e-newsletter and communications.

Like many of you in the IH Section, I travel internationally and speak with people involved with health; in almost every conversation someone expresses incredulity and shock that our government can act so consistently and irrationally against people’s health, as if that was their goal. I find myself explaining again and again that most of us are working to restore science, sanity and solidarity as the basis of our international health policy. And I’m glad to have you all as my colleagues in doing just that. Let’s hope we have a really good year, and work hard to make that happen.

Sarah Shannon

The Scrutinizer Challenge Initiative

Doing the Research Needed to Analyze New Stories and Research Articles of Public Health Significance

By Sophia Anyatonwu

It can be difficult to distinguish between truth, fiction, half-truth, and misinformation as we watch the news, read headlines, and scroll through various social media feeds. Fortunately, epidemiologists and public health practitioners have the tools needed to serve as a practical resource for colleagues, partners, and communities. The Scrutinizer Challenge initiative is an opportunity for epidemiologists and public health practitioners to tackle at least one headline or news story a month that is relevant to public health. The goal is for all of us to understand how we can serve as a practical resource by doing the research needed to examine data sources and implications of news stories and research articles. This process can help us deliver consistent and reliable messages to share with colleagues, partners, and communities. It also provides an opportunity for public health practitioners to consolidate resources and develop working relationships between practice and academia.

The outline below provides guidance on how to approach The Scrutinizer Challenge initiative after identifying a headline/news story or research article of interest:

Scrutinizer Challenge initiative end products include a list of sources and a short explanation about how each source truly contributes to a research article/news story and its implications, as well as one of the following: 1) an actionable summary that could be shared with colleagues or 2) a summary that could be shared with a local partner/the general public. The Scrutinizer Challenge initiative can be applied within an organizational framework for action or simply be used as an educational resource for action. The end goal is for Scrutinizer Challenge analyses to be disseminated in appropriate formats through social media feeds, local news media sources, community forums and professional circles so that there is an effective feedback loop of communication. Visit my website to learn more and join the movement!

Introduction https://scrutinizernetwork.com/2018/11/18/the-journey-begins/

Current Submissions https://scrutinizernetwork.com/

“A hero is someone who has given his or her life to something bigger than oneself.”

- Joseph Cambell

Meet your leadership

Featuring: Elizabeth holguin

By Shazie Senen

Elizabeth Holguin, MSN, MPH, FNP-BC, is a recent graduate from University of New Mexico's College of Nursing PhD program. She is a Robert Wood Johnson Nursing & Health Policy Collaborative Fellow. She received her Master’s of Public Health from Tulane University as a Master’s International student and served in the Peace Corps in Ethiopia. During her graduate studies, she also implemented an Infection Control Program in a government hospital in Kenema, Sierra Leone, West Africa. She then went on to receive a Master’s of Science in Nursing degree from Duke University and became certified as a Family Nurse Practitioner.

Elizabeth Holguin

She was able to combine her passion for Neurosurgery and Public Health by managing a research program dedicated to reducing transport to a level one trauma center and increasing access to specialty care with telemedicine with a focus on mild traumatic brain injuries for Indian Health Service hospitals. Elizabeth was also a delegate for the International Council of Nurses at the 69th World Health Assembly and attended the 70th UN General Assembly to assist with the rollout of the high-level commission on Health Employment and Economic Growth 2030.

Her current research interests include increasing access to care, sustainability of care and resources, vulnerable and marginalized populations both locally and internationally, and implementation science-particularly adaptations that may increase program sustainability.

How did you get into global health? What is your background?

I have had an interest in global health since childhood and was able to spend a summer in Merida, Yucatan, Mexico with a medical doctor on a dispensary. That experience further ignited my passion for health equity and led me to pursue an MPH with a concentration in International Health and Development after graduating nursing school.

I see that you and your group are busy each Annual Meeting (AM). What do you all work on before and during the AM and what does this mean for the greater APHA/IH section membership?

Editor's note: Elizabeth is the co-chair of the Policy and Advocacy Committee within the IH Section

We attempt to hold section meetings and ensure that we have representatives at all policy events in order to voice our approval for policy proposals brought forth by other sections. We also discuss frameworks to better process policy proposals/statements throughout our section and APHA as a whole.

What are your goals for the next 5 years?

My goals include continuing to take on additional leadership roles within APHA and to obtain a position that allows me to use research to influence policy beyond the individual or clinical level.

Elizabeth Holguin

What is your favorite part about working in the public health field?

I enjoy experiencing the shared passion that allows for collaboration with public health practitioners from around the world as well as getting to meet and work with such a diverse group of people with unique experiences.

Any words of wisdom for future global health leaders?

Think global, act local

book review

"Can You Hear Me? How to Connect with People in the Virtual World"

By Jeanie Holt

The virtual world—email, conference calls, webinars—the thing we love to hate and know we can’t live without! These days we maintain our relationships and conduct so much of our work in the virtual world. Because this reality is new, we are only now beginning to research and understand how to work effectively in this space. A new book by Nick Morgan (Can you hear me? How to connect with people in the virtual world (Boston: Harvard Business Review Press, 2018)), a top communications theorist, details our current state of understanding about the many forms virtual communications, the problems and pitfalls we encounter when using them, and some possible solutions for working more effectively in our virtual world.

The central premise of the book boils down to this: “Every form of virtual communication strips out the emotional subtext of our communications.”

Dr. Morgan reviews research and discusses implications of this simple but profound statement. He demonstrates that we are hardwired to pay attention to our emotions and those of others. Our brains learn and remember patterns of stimuli. We arrange these into a hierarchy based on their emotional content—those that evoke the strongest emotions are the most memorable. In addition, we observe, process, and recall much of this emotional content unconsciously. We also observe, process, and, to some extent, absorb the emotions of others. We use this understanding, this empathy, to adjust our own understanding of the situation. As Morgan puts it, “emotional truth is as important in communications as intellectual truth.”

A related issue is that without emotional cues and content to work with, a significant part of our brain is idle and bored. So, the brain fills in the void with assumptions, memories, daydreams, or other tasks—likely we are all guilty of checking email during conference calls, multi-tasking during webinars, and carrying on conversations while on “mute”.

Building on this basic premise, Morgan outlines five problems with virtual communications and suggests some techniques for beginning to address these issues.

  1. Lack of feedback: When Morgan discusses feedback, he speaks specifically of implicit forms: the feedback we receive from another person’s eyes, facial expressions, and body language. He also mentions explicit feedback—the words we use to give feedback. He points out, however, that face-to-face explicit feedback is accompanied by tone and body language that modifies the words. In the virtual world, lacking the implicit cues, misunderstanding of the explicit feedback can damage trust and openness in relationships.
  2. Lack of emotion: The loss of emotional communication goes beyond the feedback problem. When we take emotion out of the equation, the conversation “no longer engages our deep connections with other people.” For our brains, the virtual conversation, lacking feedback and emotion is not as engaging or important to our unconscious minds.
  3. Lack of empathy: We all know that distance makes it easier to objectify others, to separate people into us and them. The virtual world adds distance even as it shrinks the world. As Morgan puts it, in every virtual communication mode, “less of us gets through…we are a little blind, a little deaf, and a little less human…” As a result, we more easily jump to “confusions”; we judge more harshly; we don’t forgive as readily.
  4. Lack of connection and commitment: Without feedback, emotion, and empathy, making connections between folks becomes more difficult. It is also more challenging for people to commit: to the goal, to the process, to each other.
  5. Lack of control: Morgan points out that we no longer have “the right to be forgotten”. The virtual world “remembers” everything we post and you can bet that others look at the person the internet thinks we are.

Since we must continue to work in the virtual world, we must take steps to make our interactions in this world as effective as possible. Dr. Morgan repeatedly emphasizes two fundamental steps toward this end. First, “if you can possibly begin a relationship of any importance in person, you should do so. Period, full stop, end of discussion.” When this isn’t possible, we must be very aware that the relationship is fragile; trust will be harder to achieve and more easily broken.

Second, consciously and explicitly add the emotional content back into the virtual conversation. Dr. Morgan fills many pages with (sometimes repetitive) suggestions for doing this. Here are a few:

  1. Express your emotions verbally—“This idea excites me!”; “I feel worried about that.”; “I am so confused.”; “Your comment really upset me!” The leader should especially work to model this.
  2. Make space in your meetings for emotions. For example, the leader can say, “I am going summarize the discussion so far and then we will go round robin to hear how everyone feels at this point.” Then the leader should first model what is needed by using emotion words and then call on each person in turn (with the caveat that people can pass but push a little to try to get everyone to weigh in).
  3. Make space in your meetings for “water cooler chatting”. Personal “trivia” humanizes us, facilitates connections, and oils/lubricates the teamwork needed to accomplish the work.
  4. Check in with everyone at the beginning of the meeting. Morgan suggest using a color to make it a quick check-in: green = “I’m in a good space, awake, energetic, ready to work.”; yellow = “I’m a bit distracted by stuff outside this meeting but I’ll do my best to be present.”; red = “I’m having a week from hell!”. The leader can take these into account as the discussion proceeds, possibly excusing the person in a “red” space from the meeting entirely.
  5. Check in with folks at the end of the meeting as well.

Finally, for effective meetings, Morgan encourages the use of some ground rules that everyone commits to following:

  • Meetings start on time—start dialing in (or getting on-line) 5-7 minutes before the actual start time;
  • No email/side conversations during the meeting. Morgan cites research that suggests doodling helps people pay attention because it occupies that unconscious mind that gets bored in virtual meetings;
  • Read the materials in advance—and the corollary: send the materials far enough in advance that people can get them read;
  • Use a head set to ensure confidentiality for all participants;
  • State your name at the beginning of every comment—phone technology cuts out a lot of the overtones of voices which makes it hard for some people to recognize who is speaking.

The book has chapters devoted to email and texting, conference calls, webinars, and chat sessions. Some of this gets repetitive; the book could have been shorter but it is rich in details and ideas making it worthwhile for those of us who conduct much of our work in the ever-growing virtual world.

"Every second, every day, every year, we fail to address demand for reproductive health and family planning services. Lives are lost, and girls' opportunities to thrive and contribute to their country's development shrink. These are real people."

- Jenny Shipley, former Prime Minister of New Zealand and first female Prime Minister of New Zealand

Instagram Pilot Project


By Christa Cook, IH Section Communications Committee - Social Media Manager

This year, the APHA IH Section’s Social Media Subcommittee brainstormed ways to better engage members that are students and early-career professionals. Although the Section has various social media accounts, the team ultimately decided to launch an Instagram pilot project due to students and early-career professional members not using Facebook as regularly as before- Instagram and Snapchat have emerged as the new favorites for younger generations. The APHA IH Section Social Media Subcommittee committed to piloting the Instagram account for the period between July 2018 and December 2018.

The IH Section's Instagram account

From August 7th to December 31st, 2018, we actively utilized Instagram in combination with our Facebook and Twitter accounts. Starting in August, content shared on the Instagram page was simultaneously shared on Twitter and Facebook. The content on these preexisting pages were mainly focused on bringing awareness to global and national health days as well as professional development opportunities. In September, posts were focused on slowly introducing members of the broader APHA IH Section Communications Committee as well as highlighting the blog and health awareness activities. In October, we coordinated a daily countdown to the APHA National Conference in San Diego on our Instagram, Facebook, and Twitter pages. The countdown to the conference ended in mid-November. In December, we transitioned back to original posts about health awareness activities as well as posts about registration for meetings and webinars of public health significance.

In total, we shared 58 posts during the Instagram Pilot Project and 126 followers were gained. Most followers were gained during the month of October with a jump from 66 to 104, we associate this jump with an increase in the frequency of posts shared (daily for the countdown) and interest in the content that was distributed in anticipation of the APHA Annual Meeting. All 58 posts were liked by at least one user. Stories and polls were also used during the pilot project period. Although there wasn’t much activity associated with these specific social media features, we are interested in further exploring them in 2019.

Photos from the IH Section's Instagram account

During our December Social Media Subcommittee Meeting, the decision was made to continue utilizing Instagram in 2019. The pilot was seen as a success because of the great gain in followers and increased engagements with posts. We will continue to brainstorm new ways to engage Instagram followers in 2019. This includes finding creative ways to portray public health messages through images, polls and stories.

Editor's note: Professional social media management is an in-demand skill for many organizations, both domestically and globally. Social media is driving engagement with and awareness of many public health organizations, not to mention the impact of social media on fundraising efforts. Having personal social media accounts does not mean you're qualified to run an organization's social media accounts. The IH Section can help you develop professional social media skills. To find out how you can improve your own professional social media skills by volunteering for the IH Section, email the Communications Committee at ihsection.communications@gmail.com

Connect with us:

IH Connect blog, Facebook, Twitter, Instagram, Google+

Background photo credits, in order:

2017 Md. Zakirul Mazed Konok, Courtesy of Photoshare; 2014 Amelie Sow-Dia, Courtesy of Photoshare; 2017 LINKAGES_MALAWI_FHI360, Courtesy of Photoshare; 2017 Shahab Naseri, Courtesy of Photoshare; 2017 Haydee Lemus/Save the Children International, Courtesy of Photoshare; 2018 Dennis Ssesanga/Marie Stopes Uganda, Courtesy of Photoshare

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