The Global Engagement Summit: Inspiration and Innovation in a Community of Global Leaders

Vivienne Walz

From April 3-10, I attended the Global Engagement Summit at Northwestern University in Evanston, Illinois. The annual Summit connects and empowers young leaders from across the US and around the world to inspire and nurture social innovation. In a mix of workshops, seminars and speakers, the Summit deeply inspired me, allowed me to build my networks, connected me with mentors and gave me opportunities to build specific skills important for working in global health.

The GES is not an academic conference. Rather, young innovators bring projects to share, workshop and improve with the help of GES staff, guests and peers. The project I have been working on is called Skátne Ionkwatehiahróntie’ (“Our families grow together”).

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Vivienne (centre) with fellow attendees at the Global Engagement Summit.

The Summit was an opportunity to find solutions to project-related challenges, especially through our small group sessions. In groups of 4-5 Delegates and 2 Facilitators, we each presented our projects, answered others’ questions, and received feedback on project strengths and weaknesses. On another level, the GES was also an opportunity for personal and professional development. In particular, I developed my public health skill-set by learning about social impact assessment and practicing my public speaking and grant-writing skills.

For the first few days of the Summit, the International Delegates toured Chicago in a pre-conference session called Engage. We toured the underground Pedway, visited the Shedd Aquarium, appreciated the modern art collection at the Art Institute of Chicago, and learned about past activists at the Hull House. I took this opportunity to get acquainted with my fellow Delegates before the rush of the conference started and to reflect on my intentions for the GES.

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Vivienne gets the chance to tour Chicago, snapping this shot at the famous “Cloud Gate” sculpture at Millennium Park.

After three days of Engage, we kicked off the Summit by getting to know each other through theatre exercises. This set the stage for the rest of the Summit: we all came from different places, with different experiences, and at different points in our projects. I soon realized that despite all these differences, what we all had in common was our willingness to make a positive change in our communities.

For the next three days, I attended many workshops, seminars and talks. In our session on Asset-Based Community Development (ABCD) with Seva Gandhi, we learned how to look for solutions by focusing on community strengths rather than deficits. In my reflections on this workshop, humility and respect were central values in this approach. It’s easy to perceive a problem when we are looking from our particular perspective – especially when we are trained to assess the social determinants of health. When we take the time and make the effort to question our own position and put the preferences and needs of those we wish to serve first, we can arrive at more sustainable and ethical collaborations. Asset-Based Community Development is one tool we can use to engage with communities. More tools like ABCD can be found at the University of Kansas’ Community Tool Box.

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Vivienne (second from left) with her small group at the Global Engagement Summit.

I also took away valuable lessons for global health work in a seminar on Social Impact Assessment, led by Joanna Cohen. Here we learned about how to build measurement mechanisms into the design of our innovations in three steps: by understanding our issue, by determining our approach to solving the issue, and by identifying our intended results through a results framework. Here my biggest take-aways were not to impose my own beliefs on other people, to redefine my own concepts of success, and to always hold respect at the centre of my work.

A highlight of the GES was my mentorship session with Erica Colangelo. The Summit staff match each Delegate to a Mentor with relevant experiences and passions. Erica connected me to excellent resources, and helped me develop ideas to generate sustainable funding for my project. Another memorable part of the Summit was the Pitch Competition. The GES staff selected three outstanding project pitches to compete for a $500 prize before a panel of judges and Delegates.

There are so many more moments from the GES that I could write about. If you would like to read more about this year’s facilitators and speakers, you can check out the GES blog.

I am grateful to have been able to attend the GES, with the generous support of Global Health Programs and the Office of the Dean of Students. I connected with incredible young change-makers who share my values, I got thoughtful feedback on my project, and I deepened my understanding of global issues affecting health. To top off an amazing week, I also returned to McGill having won the $700 Open Shutter award for Skátne Ionkwatehiahróntie’s engagement of media and arts. I encourage anyone with an idea or with an existing social change project to apply!

 

Vivienne Walz is a Masters in Public Health student at McGill University.

Elise in Haiti: Post-Travel Report

 
 
 
 
 
 
 
 
 
By: Elise Vuille-Lessard

Award won:

The Global Health Travel Award for Postgraduate Medical Residents

Bio:

I am a PYG-3 in internal medicine based at the Royal Victoria Hospital. What made me want to participate in the McGill Internal Medicine Global Health Initiative in Haiti was the idea of a long-term partnership between McGill and Haitian doctors and of capacity building, rather than a one-time intervention.

Project Overview:

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Elise in Haiti

This project is a one-month elective rotation where a team composed of internal medicine senior residents and staff from McGill works at Hopital St-Nicolas (HSN) in St-Marc, Haiti. This involves collaborating with local residents and staff as well as Zanmi Lasante/Partners in Health (ZL/PIH), the largest non-government health care provider in Haiti. The goal of this project is to maintain a partnership with ZL and the family medicine program at HSN (including exchanging knowledge, teaching, mentoring), while developing competencies for McGill residents in global health.

Lessons learned:

Change is so difficult to implement. Last year’s team had tried to implement the concept of a patient list on the ward, using whiteboards where you put the patient age, sex, diagnosis and plan. Unfortunately, the first day we arrived to the hospital, the whiteboards were empty. We re-emphasised this concept and did some positive reinforcement throughout the month, and finally the boards were being used when we left. Our fear was that residents would stop using them after we left, but 1 month later we were excited to learn that they were still in use. Change IS possible! I was sometimes discouraged thinking what we were doing was a wasted effort, that those interventions we were making would not stay. But when I learned that the whiteboards were still in use after we were gone, I suddenly felt like I had done something good and valuable.

Advice:

Students looking for a global health experience need to find a project that involves a long-term relationship with the local workers and try to avoid sporadic interventions. The main reason for that is that the time spent on-site is limited and maintaining the change afterwards becomes the most difficult challenge. One of the terms I learned with this project is “capacity building”, which includes finding ways of making an intervention sustainable.

 

This experience influenced my future career plans in many ways. I don’t know when I will participate again in a global health initiative, maybe not in the near future, but possibly later in my professional life. One thing this experience did reinforce is my desire to be a teacher. I certainly want to work in an academic setting and teach young people how to become better doctors, in regards to the medicine itself but also the human side of it.

 

Mental Health Recovery in Different Contexts: Lessons Learned from the Field

Jessica Maria-Violanda Spagnolo

The mental health recovery movement emerged in order to counter the overly biomedical view of mental illness that littered the era before deinstitutionalization (Anthony, 1993). After this era, community-based services for people living with mental illness were strongly encouraged, as illness is not merely the absence of disease, but a state of holistic well-being that goes beyond physicality (WHO, 1948). Therefore, mental health recovery includes ways of “living a satisfying, hopeful, and contributing life even with limitations caused by illness”; as well as finding “new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness” (Anthony, 1993, p. 527).

I have always been interested in understanding how this concept is seen and understood around the world. This post will report on examples of the cultural representation of mental health recovery in local communities where I worked.

Picture 1 (McGill Blog)

Photo 1

At a shelter in a small village in the Caribbean, mental health recovery meant developing new skills by learning how to plant vegetables, pineapple, and flowers, as well as care for chickens. This manual labor encouraged the presence of a daily routine, which can easily falter when one is affected by illness; learning through trial and error, which promotes patience and perseverance; as well as interacting with others, which can often be a limitation caused by illness. Photo 1 shows the chickens that the residents took care of until they were either sold to local community members or were used to feed the residents at the shelter. These same residents highlighted the importance of religion in their lives, which helped them find new meaning after illness. For example, when asked what inspired them, the majority of the residents said “God.” This reality is also apparent when visiting the shelter, as the walls are painted with religious images and symbols by local artists (Photo 2).

Picture 2 (McGill Blog)

Photo 2

In a small village in Central America, where many refugees sought protection after experiencing hardships in another country, often showing signs of post-traumatic stress, mental health recovery was seen through the development of new social ties. Arriving as strangers, women leaned on each other for support as well as hope for the future. Their children, through play, would do the same (Picture 3).

Picture 3 (McGill Blog)

Photo 3

The beauty of the mental health recovery movement is that it ensures the focus is not solely on mental disorders or symptoms. Not once during my work in these 2 communities did the residents mention the word “sick” or “ill,” but spoke about what was important in their own, unique, personal recovery journey from illness: developing new skills; generating hope for the future, creating social support and networks. These things are what innately make us human, and are anchored in what can help people living with any type of illness enjoy a satisfying and fulfilling life, despite symptoms.

 

Jessica Spagnolo is a Doctorate Candidate at the School of Public Health at the University of Montreal. Her research focuses on building system capacity for the integration of mental health at the level of primary care in Tunisia. Jessica is funded by les Fonds de recherche du Québec – Santé (FRQS) and MITACS Globalink. Jessica holds a Bachelor and a Masters of Social Work from McGill University.

Julie in India: Post-Travel Report

Julie Vanderperre

Award:

AID India (Magasool) Internship, through the McGill Faculty of Arts Internship Office

Project Overview:

Last summer, I traveled to Tamil Nadu, India, where I conducted a research project with Magasool, a non-profit organization based in Chennai. My research was focused on the negative socioeconomic and health effects of alcoholism, an illness which plagues many low-income men within the state.

Vanderperre_photo_editWith the help of another intern, I created a survey and administered it to over 700 people throughout the state to gain insight on rates of alcoholism, and the ways in which addiction affected low-income families. The aim of the study was to quantify the many and varied medical costs attributed to alcohol addiction, including: hospitalizations for illnesses related to drinking, accidents that took place under the influence, domestic abuse related to alcohol consumption, productivity losses, and costs of rehabilitation. We also investigated the determinants of drinking, such as distance from a state-run liquor store, correlation between father and son drinking, and the correlation between income and drinking. Our data revealed startlingly high rates of alcohol addiction among men, especially in slums of Chennai, where 75% of men reported consuming liquor on a daily basis. A lack of awareness of the health risks of alcoholism, as well as inadequate access to health facilities and rehabilitation centers has led to a serious drinking problem in Tamil Nadu. Education and improved access to healthcare, in combination with restrictions on the availability of alcohol, are required to combat alcoholism within the state and mitigate the negative social and financial impact that alcohol addiction has on many low-income families throughout the state.

Impact:

My experience working with Magasool allowed me to expand my data analysis skills, which I hope to further develop in the future. I was also able to conduct a follow-up research project, under the supervision of McGill’s Professor Kuhonta, which allowed me to conduct in-depth research and provide policy prescriptions. Most importantly, my internship experience allowed me to visit and speak with people throughout the state of Tamil Nadu who feel the effects of alcoholism, and to hopefully improve their situations through my research.

 

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Julie is a recent graduate in Political Science from McGill. She is interested in international politics, economics, and policy, and is currently working in the field of journalism.

Why The World Needs An Essential Diagnostics List

Lee Schroeder, Timothy Amukele and Madhukar Pai

This article was originally posted on Forbes website. See the original post here.

Without diagnostics, medicine is blind. And yet, diagnostics receive much less attention than vaccines and drugs. Imagine a sick infant with bacterial sepsis in sub-Saharan Africa. Without diagnostics, they will likely get incorrectly treated for malaria. Every year, 1 million patients with TB in India are either not diagnosed or not reported. Pregnant women with anemia, syphilis and diabetes are often missed in low-income countries where laboratory capacity is severely lacking. And where there is testing, it is often of low quality.

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Hepatitis and HIV diagnostic tool. Photo by Dr. Nitika Pai.

recent NEJM article proposes a simple way to improve access to critical diagnostics: make a list. In 1977, the World Health Organization started (and has since maintained) a Model List of Essential Medicines (EML). The EML, a global health success, has improved access to medicines. Sadly, there is no equivalent Model List of Essential Diagnostics (EDL). Such a list would be impactful for these reasons:

1.  Improve patient care and clinical outcomes

Patients will get consistent access to quality essential diagnostics that will be affordable and always available. When a diagnostic is added to an EDL, governments, funders and manufacturers will work to ensure availability and access.

2. Help detect emerging infectious threats

The Ebola and Zika epidemics have underscored the need for surveillance. While many countries have reference laboratories, laboratory capacity at lower health system tiers is often weak. By increasing laboratory capacity at all tiers, an EDL could help countries better prepare for epidemics and implement international health regulations.

3. Increase affordability

Bulk and advanced purchasing, volume discounts and pooling mechanisms are widely used for vaccines and drugs. Without such mechanisms, quality diagnostics can be unaffordable. Xpert MTB/RIF is a good TB test, but affordability is limited. An EDL could promote group purchasing by international organizations (e.g., Global Fund). With larger, predictable volumes, manufacturers can lower prices. Countries can use EDL to impose price controls and waive import duties to ensure affordability.

4. Reduce antimicrobial resistance (AMR)

Indiscriminate antimicrobial use drives AMR. Without adequate diagnosis,antimicrobials get widely abused. In half of malaria-endemic African countries over 80% of malaria treatments are applied without diagnostic testing, leading to legitimate concern for the emergence of drug resistance.

5. Improve regulation and quality of diagnostics

Unlike developed countries, regulatory agencies that approve the accuracy of diagnostic devices either do not exist or are weak in resource-poor settings. An EDL could focus such agencies on priority tests and help to harmonize regulation at the regional level. An EDL could aid in the identification of sub-standard diagnostics, as is already occurring formalaria rapid tests.

6. Facilitate laboratory accreditation and training

Even if a diagnostic test is of high quality, its impact can be crippled by improper use. In Kampala, Uganda, 95% of all laboratories failed to get the lowest score on the WHO laboratory quality checklist. Country-level laboratory accreditation groups could use the EDL to establish targeted and appropriate quality assurance programs. An EDL could also help shape in-country training of laboratorians.

7. Improve supply chain and laboratory infrastructure

As is too often the case in low-income settings, poor infrastructure and inconsistent supply chains render laboratory devices unusable. An EDL could encourage ministries of health to strengthen necessary infrastructures and develop targeted supply chains for the essential tests.

8. Facilitate change in healthcare provider behavior

Healthcare professionals trained in countries where laboratory testing is either unavailable or of low quality are likely to treat based on clinical suspicion. The impact of the Xpert MTB/RIF TB test has been blunted because of such issues. Likewise, in several settings, providers continue to give anti-malarial therapies, despite negative rapid test results. An EDL could improve providers’ confidence in test results and strengthen thediagnostic-treatment cascade.

9. Inform new technology development

Several teams are now developing point-of-care diagnostics for global health. An EDL could help develop target product profiles that can inform new product development. In fact, such initiatives already exist for several key diagnostics.

10. Facilitate epidemiological surveys, program evaluation and disease elimination

Policy makers need data on disease burden. An EDL could support national surveys and help track changes in disease burden and efficacy of interventions (e.g., diagnostics to support polio elimination).

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TB diagnostic tools. Photo by Dr. Madhukar Pai.

In summary, essential medicines require essential diagnostics. The NEJM article has proposed an EDL to set the ball rolling. While many agencies could establish an EDL, WHO is the obvious choice, since they maintain the EML, make health policies, run prequalification programs and oversee international health regulations. So, we call upon WHO to take the lead in creating a List of Essential Diagnostics. We also call on key stakeholders (e.g., FINDPATHTDRCHAIASLMGHTCStop TB PartnershipRoll Back MalariaUNAIDS), civil society (e.g., MSFTAGACTION) and donors (e.g., Global FundBill & Melinda Gates FoundationUNITAIDUSAID) to support WHO to make this happen.

 

Dr. Lee Schroeder is assistant professor at the University of Michigan,  where he is director of Point-of-Care Testing and associate director of Chemical Pathology. Dr. Timothy Amukele is an assistant professor at the Johns Hopkins University School of Medicine, where he is the director of the Bayview Medical Center Clinical Laboratories. Dr. Madhukar Pai is a Canada Research Chair in Epidemiology & Global Health at McGill University, Montreal, Canada. He serves as the director of McGill Global Health Programs and associate director of the McGill International TB Centre.

 

This article was originally posted on Forbes website. See the original post here.

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