Friday, January 20, 2017

A Sense of Urgency

I haven't posted anything in a while, simply because the last few months have been occupied with self-reflection and constructing a plan of action for 2017. After the US Presidential election results were released, it seemed like a waste of time and energy to write about some disease that most people in the US will never even learn about, let alone be exposed to.

I was caught in an ambiguous fog of wondering whether the work that I do (my research, not necessarily this blog) is truly worth it, or if I'm just contributing to the unsustainable aspects of "global health". It can be frustrating when your subjects are on another continent, in another time zone, and will never interact with you face-to-face. Its also frustrating when you realize that you are just another white lady that claims a passion for global health/"wanting to make a difference". What does that mean, really? And frankly, what does that mean now that our government is lead by someone who believes in business over, well, everything else?

Community health workers in Madagascar (photo from K4Health)
How do you cope with being a person of the scientific community who wants to help initiate positive change, such as expanding the development and access to treatment and vaccinations for neglected diseases, improving access to clean water and sanitation technologies, or expanding educational and economic opportunities for young women in developing countries (just to name a few popular and reoccurring themes in global health), but also realizing that you may be forcing a very biased view on communities that are rarely empowered, but instead labeled has victims? (example: Many journalists claimed the cause for the last, explosive ebola outbreak was initially due to "ignorance" of the affected communities). Similarly, how do you prioritize issues abroad when there is so much happening in your local communities?

I recently finished reading Sometimes Brilliant, by Dr. Larry Brilliant, which details his journey through being a hippy MD with a passion for social justice and civil rights, and how he managed to find a spiritual connection to India while working to eradicate smallpox. On a number of occasions in this story, Dr. Brilliant (lovingly nicknamed "Dr. America" by his guru) questions his actions and whether his efforts are actually helping people in the long term, or if he's contributing to immediate yet unsustainable aid. This obviously spoke to me on a number of levels, but didn't help guide me to a solution (the answer isn't always broad and right in front of you, I guess).

Here's a great interview with Dr. Brilliant on Marketplace.

Dr. Larry Brilliant (center) in India in the 1970s, working to educate communities and eradicate smallpox.
The beginning of the year coincides with my birthday, and instead of setting resolutions, I try to revisit the actions I've taken in the last year, and reflect on whether I'm having enough of an impact, giving enough of myself (energy, time, money, values, etc.) to others. This year, I wasn't feeling great about it, because I feel like there isn't enough time in one day, or even one year, to give enough of oneself to a cause (or causes) that will result in a true impact, a change, an improvement.

This dilemma is amplified by the fact that I spend a majority of my time and effort working in a lab at one of the most well known, private universities in the world, wherein I primarily interact with other white people, and everything sparkles with privilege and ongoing gifts from wealthy donors. Despite being in such an environment where low-income students get to attend for free, or where new and extensively valuable discoveries are made regularly, I'm not working in the hospital directly, where I could leave my workday feeling like I had a direct impact on someone's quality of life, or interacting with the students, who will go on to spread their expert educational experiences to many parts of the world with their future careers. When you work in such an environment, it is not clear who is "on your side" politically, or who is there to make a difference versus for the prestige of working with such a well known university. Its easy to feel isolated in a well-off environment when you are aware of inequalities.


Earlier this week, I attended a Global Health Symposium. It was a great event last year, but I wasn't expecting anyone to speak about the real issue at hand: How can we navigate global health issues with the new switch in government? It is typically not talked about, because you never know who voted for which party, or who actually believes the wall should be built. But without discussing such issues, it can make you feel like you are a part of the problem just by going to work.

The opening keynote address was given by Diana Chapman Walsh. Dr. Walsh was president of Wellesley College until 2007, and currently serves on the board of the Broad Institute of MIT and Harvard. She is also on the board of directors for the Mind and Life Institute, where she gets to work with the Dalai Lama. At first look, admittedly, I stereotyped and judged her. I thought, "she appears to be another 'rich white lady' who will talk about working together and doing good things for people of the world, but her talk will be empty and uninspired", because that's how jaded I've been feeling about everything lately. I was clearly desperate for inspiration and guidance.

Diana Chapman Walsh. Image borrowed from GoldLab
She proceeded to talk about the urgency of collaboration and navigating our resources while we still have access to them. Stating "they told me I could be political", she spoke outwardly about how white supremacy has put us in our current position, and how it is a danger for the future of global health. Frankly, white supremacists do not value the health and wellness of other, non-white/non-(North) Americans. How does that view impact the health of our nation, and the health of people around the world? Negatively. This new administration is not going to value the federal organizations that perform research and provide aid that benefits people worldwide, as 'they should be able to take care of themselves'. Statements like these do not acknowledge that there is a monopoly on resources that are a fundamental human right. Instead, these resources are traded strategically, doled out as bribes for economic advantage (example: mining natural resources in Africa, trading access to such resources strategically for money and power). Don't even get me started on the white supremacist view of developing countries through the narrow lens of tourism and hospitality industries (Dr. Walsh didn't touch on this, but I bet she has thoughts about it).

Dr. Walsh spoke of climate change as a vital component of global health, which is not a view you hear regularly. You hear of polar bears losing their habitat, and small island villages being swallowed by rising sea levels, but with the polarized nature of climate change, no one likes to talk about the increased spread of disease, how it is affecting animal populations, or how it is going to get extremely difficult for some regions to access basic resources, like clean water and food. Why would you allocate funds for research and innovation to combat these problems if you don't believe in climate change? Also, why would you believe in climate change when you cant see past your own bubble?

A bad photo of an inspiring talk.
What especially surprised me was how Dr. Walsh openly expressed her support for Black Lives Matter. I have never heard anyone at our university (outside of my immediate lab group) express such views openly. It hit me like a punch in the face, because I thought she was going to be someone who wouldn't take a stand, and who would most likely be an expert at straddling the fence. But, no, I was wrong! What a refreshing surprise! She used her position of power to say that we need to consider our local communities as a part of our global health initiatives. What that showed me is that we can be an example, and we shouldn't keep quiet. Also, maybe if we start listening more, we can learn how to get things done? Here's an article that details "8 Black Panther Party programs that were more empowering than federal government programs", just as one example.

Amazing photo from the Atlanta Black Star
A few people referenced the latest Oxfam report on inequality that states "62 people own the same as half of the world", and 53 of them are men (surprised?). Only until the end of the day was the concept of engaging these powerful few for philanthropic endeavors. I mean, look at what a tremendous impact Bill and Melinda Gates have had on research, innovation, and impacting global health. It just has to be seen as a priority.

So where do we go from here? Which causes are you passionate about? How do we harness these ideas for fuel for our activist fire? I hesitated to use the word "activist", but then realized that standing up for global health means being an activist for social justice, no matter where your efforts are targeted.

In a specifically memorable moment of Dr. Brilliant's book, he tells a story about being caught in the middle of a dilemma: to play the game of corruption that may lead to long-term support for their smallpox eradication mission, or to stand up for noble action and do what is immediately right for the cause. He sought guidance from another spiritual leader and was told to consider the question "how are my actions affecting the children who are sick and dying from smallpox?" with every move. Truly how do you navigate these situations when there is a business side to global health? We cannot always only lead with our hearts, because funding will run out in a flash.

Global Goals taken from One.org

I'll still cover infectious diseases, but the tone of my blog may change. There will be more calls to action, for sure. Global health is not only up to the righteously motivated or the extensively educated, especially when we consider global health as all encompassing.

Thanks for the much needed inspiration, Diana Chapman Walsh and Larry Brilliant. I'll see you on the front lines.



This one's for you, Trump:




Note: I've received a number of requests to do a series of posts about vaccinations: how they are developed and manufactured, how they work, etc., so I will be dedicating my next few updates to that subject.

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