Issue 3 - April 2017
In This Issue:
- Letter from the IH Section Chair and Section Happenings
- Meet Your Leadership
- Student Spotlight
- Getting to Know APHA
- IH Conversations
- Connecting to Global Health Trends
- Call to Action: Global Health Photo Submissions and National Public Health Week
- Theresa Majeski - Editor-in-Chief
- Erick Amick - Associate Editor
- William Rosa - Associate Editor
- Meghan Huff - Meet Your Leadership Section Editor
"2017 not only brings a new president to the White House, but also a new Director-General to the World Health Organization and a new United Nations Secretary General... As a result, there is tremendous uncertainty about the future practice and policies of global and domestic public health."
Dr. Michael Osterholm
This section profiles various members of the IH Section to highlight their global health careers and learn about how they got into global health.
Featuring: Caroline Kingori
By Katrina McCandless
What originally drew you to the general field of public health?
I was drawn to the field of public health after witnessing the devastating impact of HIV infection globally about 3 decades ago, particularly in Africa. Open discussions about the infection were not common at the interpersonal or the national platform, given its attachment to sex. It was a taboo topic. There were many misconceptions and misperceptions surrounding HIV transmission, which fueled stigma and discrimination against those infected. This culture of silence and shame motivated my participation in prevention efforts, particularly working in affected communities while engaging in research to find ways to enhance HIV prevention.
Have you worked in any other fields that have informed your approach to life and/or work?
Before my interest in public health, I pursued banking and finance after high school but shifted focus to psychology for my undergraduate studies. Psychology was my gateway to public health after exposure to prevention science through a competitive honors program at Morgan State University. I was selected to participate in the program during my junior year and that experience solidified my interest in public health. I pursued psychology because I wanted to understand individual behavior. That desire to understand behavior motivated me to want to focus on not only the individual but also different influences of behavior at other levels e.g. interpersonal, and societal levels. That led to my pursuing an MPH and PhD in Health Behavior.
What spurred you to pursue global health in addition to your domestic work?
I was interested in global health primarily to give back to my community in Kenya after gaining the necessary skills in the US. I realized that I could continue gaining further education and skills in the US and go back and forth to Kenya to conduct community based participatory research to improve health outcomes. My domestic work in the US was motivated by the need participate in the elimination of health disparities in communities of color, including immigrants and refugees.
Do you have any recommendations to other researchers or students on finding the health issues or populations they wish to focus on in their career?
There are so many health issues that need attention. The secret is passion. Find something that excites you and that will ultimately make a difference in another person’s life, including society in general.
Could you share a triumphant moment in your career? What factors do you feel led to this moment?
There are many of them. But, one that is poignant is when I conducted HIV stigma research in the rural central province of Kenya. My late grandfather and other ancestors hail from one of the towns where I collected data. When people asked me where I was from and I told them about my family, it was great to hear people talk about the great things that my grandfather, a former Senior Chief, had accomplished that benefited the whole community. I realized that my innate desire to enhance the well being of communities, was akin to what my grandfather had done as a community leader.
What do you see as being the greatest challenge for international health during the next four years?
Relevant to Africa, funding for HIV/AIDS prevention and treatment continues to decline in favor of other communicable diseases, e.g. malaria and tuberculosis in Africa. Regarding HIV treatment for people who are HIV positive, there are only about 40% in Africa and 32% in Asia who have access to antiretroviral therapy. Such information is disconcerting. Also, the co-morbidity of HIV and other chronic diseases (e.g. diabetes, tuberculosis, malaria) is alarming in Africa and other resource limited regions. Such issues present great challenges in the effective treatment of HIV/AIDS. Decline in HIV funding will have a greater impact on the already broken health systems in countries disproportionately affected by HIV infection.
Do you have any talents or hobbies you would like to share-perhaps one that has intersected with your work?
I enjoy traveling, dancing, listening to music, singing, cooking, etc. Pursuing global health and conducting research across different countries has complemented my traveling hobby. I have enjoyed interacting with people from different cultures, tasting different types of foods, and listening to varying perspectives about health issues affecting communities.
Featuring: Laura Chanchien Parajón
Putting the Community First
By Laura Chanchien Parajón, MD, MPH, Intro by Temitayo Ifafore-Calfee, MPH
Programs that support and train community health workers (CHW) started in China in the 1930s. The model quickly spread to other countries. By the 1960s and 1970s, CHW programs were widespread throughout Latin America.
Community health programs provide curative and preventive services in areas that are not easily served by the existing health system. Perhaps equally, if not more important, community health programs, serve a transformational role. These programs empower and engage community members to serve as change agents for the well-being of their communities.
What’s a good model for a U.S-registered organization to support community health programs? How can cultural humility be used to put the community first?
I asked Dr. Laura Chanchien Parajón to share her experience because she and her husband co-founded AMOS Health and Hope to serve 25 remote, rural and urban communities across Nicaragua. Below are her reflections on why she and her team do the work they do.
Dr. Laura Parajón: Many of my physician friends say they are inspired that my husband and I took a 75% pay cut to live and work in Nicaragua for the past 15 years. However, we both acutely recognize that our "choice" to go to Nicaragua is one of privilege. At any moment we can leave and return to suburbia and a well-paid medical job in the U.S. This is why for me, living and working in a low resource setting towards the dream of "health for all" is not any kind of sacrifice -- it is my calling.
I have a passion for community empowerment and taking action for social justice, and ultimately choose to live in Nicaragua as a medical missionary because I am also a mom, medical doctor, and public health practioner fighting for a world where everyone has the opportunity to make a choice.
In the remote mountain community of San Onofre, Nicaragua, women like Timothea --my inspiration, friend and co-worker-- make much more difficult choices everyday than I have ever made in my life. She is a community health worker (CHW) with only a fourth grade education. When she decided to follow her dream of becoming a CHW to help prevent infant deaths in her community, her husband, a product of Nicaragua's highly machisto society, left her because "a woman should stay home to take care of her family." As a CHW she has saved countless lives of children and mothers in her community at a high personal cost.
My husband and I co-founded the non-profit organization AMOS Health and Hope. We lead our community-based health work with a public health team that implements health programs; an inspiration team that fundraises for donations and provides service opportunities for mission teams, an operations team that runs a guesthouse to finance community-led projects, and an innovation team that provides global health education opportunities for students and volunteers, writes and implements foundation grants, and uses community based participatory research (CBPR) methods to innovate for improved health in low resource settings.
AMOS uses the strategy of Community Based Primary Health Care (CBPHC). It is a comprehensive approach which promotes community empowerment, equity, evidence-based methods and partnership. Our AMOS team has been working for the past ten years to evaluate, reflect and improve our practice of trying to reach the most vulnerable populations. As an organization, we constantly challenge ourselves to recognize our own power and privilege in an effort to authentically and humbly contribute to the well-being of poor and marginalized populations. We have developed as a learning organization to use data to continuously improve our health interventions, and through AMOS we have helped to decrease health inequities by providing access to health care for over 23 communities, influenced health policy through research and advocacy, and contributed to over a 50% reduction in child and neonatal mortality in the communities we serve through community based participatory methodologies and evidence-based interventions.
This is what global health is all about – each of us sharing our strengths to make things better to decrease health inequities as part of our call for social justice to transform this world to be a better place.