Life in Chapel Thrill

I'm in the midst of a very good book - although rather public health oriented called, "The White Man's Burden" by William Easterly. (I will also say that I am in the middle of 4 books right now - outside of class, that I flip among as the interest suits me...all having to do with public health, social justice, and inequality so get ready for a flurry of ideas as I find myself agreeing with certain books and completely disagreeing with others)

"The White Man's Burden" gives quite a good analogy about what is going on in the world when it comes to foreign aid and ending the plight of the poor. Those who are often involved in the idea of ending poverty are called the "planners". They often figure out what needs to be done in order to get mosquito nets to families in malaria infested areas, get kids into school where they could not previously afford it, etc while creating aid agencies to do the job. Unfortunately, the mosquito nets never make it to the families and those kids never get to school because the planners "plan" and don't follow through past planning. We end up with grandiose ideas and no feasible implementation for sustainability. Then there are, as Easterly calls them, the "searchers" who are able to market their product and get it out to the masses with great success. These are the J.K. Rowlings of the world who find a niche in selling books about wizardry and remove themselves from poverty...completely. The problem is that the poor don't typically spend $30 in the same way that a parent would pay $30 for a book about muggles and wizards. We haven't been very good at marketing ourselves and following through. According to the Chancellor of the UK, malaria medication to prevent half of the deaths around the world would cost about 12 cents per dose and bed nets cost about $4 per net. Not that much money when you think about it although there's always the issue of getting it out to the masses by traveling through areas that resemble where I lived in Kenya...not easy terrain.

The analogy that i enjoyed is quoted as this: "Setting a prefixed (and gradiose) goal is irrational because there is no reason to assume that the goal is attainable at a reasonable cost with the available means. It doesn't make sense to have the goal that your cow will win the Kentucky Derby. No amount of expert training will create a Derby-winning race cow. It makes more sense to ask, "What useful things can a cow do?" A cow can nicely feed a family with a steady supply of milk, butter, cheese, and (unfortunately for the cow) beef." The aid agencies right now are referred to as our "cows" in the world where we are racing to find cures and sustainable projects that are "feasible" in the setting and don't just look good on paper.

The problem is implementation within the system that the necessary item is being applied...not in the US system. We get so lost in setting goals that we think are necessary that we often look past feasibility within a rural setting such as where we worked in Neiba, Dominican Republic. Goals would be a great idea to have. Let's think about what we want to do and how we are going to get it out there. What happens then, when your goals fall through and the community is requiring you to change the goals of your program? Do you continue with the goals because that is what you started out to achieve or do you re-evaluate based on customer satisfaction and actual need? There is the difference, as the author states, between the planners and the searchers. I like the taglines, I must admit.

I also love what the Malawians are doing to combat malaria through bed nets. Instead of handing them out to people who often don't want them or see the need for them (turning them into fishing nets, etc - something I definitely saw on Lake Victoria in Kenya), they have implemented a program whereby those citizens who want them come to the clinic and get them for 3 or 4 cents. Mothers often will come get nets for themselves and for their kids - a market where there is need AND want. Also, the clinic workers get paid 9 cents for every net they sell, so they are always stocked full. Then the richer part of society pays a bit more, thereby subsidizing the cost of the other nets making the program sustainable without outside funding. I must say, as a side note, that bed nets do quite well in catching fish from a lake. (I'm not advocating this though...)

The point I have taken from my reading so far, and from the title, is the idea that since we were "given prosperity and peace", we should find ways for other countries to have the same ideas even when we have no idea how that would be implemented in those other countries. Let's take for example, just for understanding purpose, an upper class retired lawyer who decides he wants to implement programs in Harlem to combat drug use. This is his "goal". He has never lived in or anywhere near Harlem but has decided that is his location of choice and his fight - drugs in Harlem. Do you honestly think that he is going to be able to implement and pursue a successful anti-drug campaign in an area where he has no idea how things are run or the dynamic of the community? Of course not. The same holds true for certain aid agencies, never having set foot in the prospective country, deciding that they want to combat malaria on a "grand scale" with specific goals that would work here and (postulate time - thank you trigonometry) THEREFORE, these programs will work in another country as well. Right.....

I will leave you all with two questions...because I have been rambling too long for a blog that you wish to take only a few minutes out of your day to read...or today - a while longer.

By the way in which we approach the idea of aiding other countries, do we think of ourselves as the "parents" who feel they need to save their children or do we genuinely want to become one in solidarity to improve living conditions? Are we approaching this idea of foreign aid by being a bit patronizing?

Great quote from my Comparative Global Health Systems professor:

"There are two things in this world that you don't want to see made: sausage and legislation"

(In reference to healthcare legislation after it has gone through processing in committee, the house and senate. It often looks quite different once it has been disputed and changed due to differing opinions and the possibility of getting bills passed.)

But isn't that a GREAT quote?!

Well...not only do I have resources at my fingertips when it comes to public health but I also have tons of programs directly targeting the hispanic population in the area. Perfecto! Today I met up with some other students from the medical school here at Carolina to staff a table at the "La Fiesta Del Pueblo" where we took glucose tests and blood pressure as well as had information about local clinics who cater to the hispanic community. The festival itself is quite fun and lasts the entire weekend. There are musicians playing most of the weekend and there are tons of activities for the kids as well as free stuff everywhere. There are sections on education, public safety, health etc that offer various services and information about area projects and businesses. I have included a picture of our booth...at the end of a very very long day.

The students who I was working with today usually help staff a local clinic in Carrboro specifically aimed at the underserved hispanic population. The program they work for is called SHAC: Student Health Action Coalition which brings in medical, graduate, and undergraduate students as well as other professionals who want to volunteer at the clinic. It is run on Wednesday evenings and a variety of services are available. Needless to say, I'm going to be a volunteer. Haha.

The really fun part about today was being able to use my spanish and talk to people about possible risk for diabetes, high blood pressure, BMI as well as just have normal conversations about life in general. I get that feeling again of wanting to go to medical school after public health...here we go again. Haha. I must admit I am still timid but even when I screwed up sentences, they still understood me. I met a guy from Cuba who actually lives in Veradero Beach...the same place that I stayed in whenever I went to Cuba. He knows all the people we stayed with (small world!) and so we talked a little bit about the town and the healthcare system there as compared to here. All would not be possible without my Spanish - yay Community Service Alliance!

I also joined the Student Global Health Committee here which focuses on issues around the United States as well as other countries on issues that affect all of us. We go around to area schools and do talks in their health classes about STDS and HIV and try and open these kids up to a new understanding of their bodies. Unfortunately, Yay Bush! (SARCASM), we cannot talk about anything other than abstinence in the school systems here because...again Yay Bush (SARCASM), someone pushed through that legislation. So we are going to pretend in these talks that these kids are not having sex, nor will they have sex, nor should we talk about protection measures outside of abstinence in case they are having sex. I'm thrilled. Again - note the sarcasm. Oh Politics...

We are also having speakers come in from their respective fields to do campus wide debates about pressing issues throughout our communities, our country, and our world and try and really get the campus involved in major public health issues. In addition, the Catholic Student Center here is having discussions on Fair Trade, closing the School of the Americas, and Latino Advocacy in the United States in the upcoming months. Did I ever mention that I love the University of North Carolina? Yeah - cause I do.