Post Trip Reflection Questions

What’s an example (or story) of something you’ve seen in Belize that connects with something we discussed in class?

Westernization is a real life issue and it is progressing more and more throughout the years. Even in some of the very underdeveloped towns in Belize that we visited there were so many signs of westernization that was impacting their culture. In an example as simple as Coca-Cola, these signs were everywhere! I mean everywhere. No matter if the town was big or small, developed or underdeveloped, people could not escape from these American companies intruding on their own country and culture. I do not believe in Westernization of all countries and that just because there are ways that work for us does not mean they need to work for all countries throughout the world. I think a big problem with westernization is that these developed countries always think that they are right, about everything. Because of this, we think that everybody would want to and should be like us. When I visited Belize, the things I enjoyed the most of Belizean culture was how they were not like us. I truly cherished the things I learned and the experiences I had that I would never be able to have in America.

How has this experience influenced your future career goals?  (Confirmed, shifted, clarified, etc.)

This experience definitely confirmed my future career goals. Almost all of my life I have wanted to be a doctor, specifically a pediatric doctor. The time I spent in Belize and at the clinics helped me to confirm that this is what I wanted to do for the rest of my life. I have always loved being around kids and to have them around me and in the clinics was such a joyful experience to have. It was like when a kid entered the clinic or was there during a house visit, my whole body lit up and I was so excited to play with them. It was also very confirming for me to have other people come up to me to tell me that they thought I was really good with kids and that is was so obvious that I was passionate about medicine and children together. Every day we spent on this trip just made me more excited for the future to come and that I too one day could be a doctor like the ones we worked with in Belize.

What are the global health initiatives or priorities of Belize that you’ve witnessed while here?

Maternal Health was a health initiative that I saw Belize took a lot of priority in trying to improve. When we went to the hospital, there were so many posters about how to properly breastfeed your child as well as the importance of breastfeeding after birth. It was apparent that Belize saw this initiative as high priority. Dr. Overman was telling us that there is a beautiful statue in Corozal, Belize of a woman breastfeeding her child. ALthough we were not able to see it because we never went to Corozal, it confirmed our ideas that maternal health is something they take very seriously in Belize. Although there were not any statues in Orange Walk that I saw, there were still so many posters and paintings that were all throughout the district. I was really happy to see how much effort the country had been putting into this movement and how much the statistics in maternal health were improving because of it!

Another priority I witnessed in Belize was drinking clean and purified water. Like the breastfeeding posters, there was a lot of advertising of drinking the “Crystal” purified water. When we went to the house visits, almost all of the houses we went to said that they buy the purified water jugs and use that as their water source. I was also really happy to see that so many of these families were avoiding the drinking water that could be contaminated with worms and sticking to the purified water regimen. There were hardly any people that came through the clinics that got diagnosed with worms so it is apparent that drinking the purified water is really improving their overall health.

What level of impact to do feel you are making in your service communities?  

When I arrived to Belize, I really thought that we are going to be making a big difference by coming in, setting up these free clinics, and trying to help the people. Throughout the trip and especially on clinic days, I sometimes felt hopeless that we were not making as much of an impact in these communities as I originally thought we were going to be. It was really hard for me to see patients that were in so much chronic pain and the doctors only give them a 15 day supply of Ibuprofen or give a woman with anemia a 30 day supply of iron pills. It was hard for me to comprehend how it was okay to only be helping these people for 15 or 30 days max. Were they just supposed to be going back to how it was before when the 30 days were up? How was that helpful? Another difficult thing about this trip was when a patient would come in and the doctor could not definitively diagnose the patient and would suggest for them to go to the hospital to get blood work done, get an X-ray, etc. It was upsetting to me that I would not be able to know that when that patient left the clinic whether he or she would go to the hospital to get the additional tests done or if they even had a way to get there? The unknown of some of those patients was really hard for me. After expressing some of these frustrations, my roommate during the trip showed me the importance and value to us being there. She helped me to understand that even if we only gave someone vitamins or we even just made them laugh or smile, we were making a difference. That was a really helpful aspect of the trip that I held onto. Overall, I don’t think that our two-week trip to Belize was life changing, but I do believe that what we did when we were there mattered, and for that, I am happy and grateful that we went.

What challenges did you observe in Belize that can/may hamper global health efforts?  How, why?

One thing I noticed during my trip was the lack of infrastructure when it came to the roads you had to travel in Belize. At no point during my entire trip did I see one stop light or stop sign or anything. The only thing I observed were speed bumps you would go over in the roads periodically to try to prevent people from speeding. Overall, the driving situation felt more like a “free for all” then it felt safe. There were many giant potholes we had to go over and sugar cane debris filled the roads at all times, no matter where we went. This made me question whether or not Belize had many deaths or hospitalizations due to driving accidents. We talked about how driving accidents are a major contributor to deaths in a lot of developing countries in our class, and I could not help but think about it the entire time we were on the trip.

Another challenge I noticed during this trip was lack of speciality doctors or higher trained doctors than the ones we worked with. The doctors we worked with on our trip went straight to medical school from high school and spent 6 years there to become a general practitioner. One of the doctors was telling me that majority of the people who become doctors do not do anymore specific training after that to have a speciality because they usually want to start practicing medicine immediately. I found this to be a good thing in the sense that there were many doctors who had a well-rounded knowledge of many things, but I also found it to be a challenge. Since there were not many doctors that are highly trained in one specific speciality, if a patient presented with symptoms that were “out of the normal range” for the general practitioners, how would they be properly diagnosed? This is an issue I see slowly diminishing throughout the next 20 years since Belize’s health care system is really starting to improve but as of right now, there is a huge lack in speciality doctors and a dire need for them.

What has been challenging for you in this experience?  How did you handle this experience?

The most challenging part of this experience for me was enduring the heat. Although it may be obvious to all that it was of course “hot” and a silly thing to have as such a challenge, for me, being in the heat becomes debilitating for me. I am extremely sensitive to hot temperatures and have suffered from many heat strokes before. So for me, being in such a hot environment was the part of the trip that I was worried about the most. Nevertheless, I did not want to let that stop me from being in this amazing program and experiencing all that I came to learn. Every morning I would drink an entire water bottle during breakfast along with taking some electrolyte replenishers.  Throughout the day I would drink multiple water bottles as well as bring some gatorades. My goal was to stay as hydrated and cool as possible. The house visit days were much harder to accomplish these goals due to us being outside in the sun and heat majority of the day. There were a few days where I got really bad headaches and felt nauseous from the dehydration and heat. Although I had a low grade headache for the majority of the trip, the pros of this trip made it easy to ignore the headache and just continue to take it all in and learn everything that I could.

If you could steal a part of culture to bring home, what would it be?

I would steal everyone’s positive attitudes and love for everything. The people that I met in Belize had this radiant energy about themselves that made me wish people in America were like. It was crazy to me that some of these families had gone through the toughest of times and barely had a roof over their heads but still they smiled and acted as if they still had the world. I think many people in the US take for granted what we have and the luxuries we get without even noticing. During community day, we fed all of the children there lunch but we had been given a prepackaged lunch. We all got a few cucumbers and carrots in our boxes and I asked the little girl I was playing with if she wanted mine. You would have thought I had just given the little girl a brand new barbie doll the way she lit up with excitement. It was an amazing and eye-opening experience to be able to interact with people who are gracious and appreciative with anything that they are given, even if it’s just a smile and a wave hello.

Guided Reflection #8- Maternal and Neonatal Health

What are the challenges to treating obstetric fistula in the developing world?  After looking at the Hamlin hospital and study presented in class, what do you think is the first step to implementing positive change?

One challenge of treating obstetric fistulas in a developing world is that it requires a surgery to fix it. Although it is a simple procedure, it still means that women need to be able to travel to a hospital to have this procedure done by a trained surgeon. This is difficult in a developing world when hospitals might not be very close by to people and they don’t have the means to get there. It is also difficult because most of the time these fistulas develop during childbirth and these women give birth in their home or another place besides a hospital. It is not the same circumstances like in a developed world where everybody goes to the hospital to have a baby and if anything goes wrong, a team of doctors are on board ready to tackle the complication. With that being said, a lot of fistulas go untreated because of traveling to the hospital to get it fixed after the birth of the baby or they don’t go to the hospital to have the baby in the first place. Since most of these mothers are so young most of time, this is an extremely common problem that could easily be prevented. Also C-sections are not an option that are readily available like in developed worlds so that further increases the rate of obstetric fistulas. IF they are able to treat the fistula, most of these women are malnourished which further complicates the procedure and increases the risk factor. In some cases, the husband may not allow the treatment of the fistula to happen in the first place, which is allowed in some cultures for the men to be able to choose what happens to his wife. Cultural practices could disencourage women from seeking medical attention due to religious beliefs. Genital mutilation that may have occurred in the past could make for more complications during the procedure. In addition to all of these potential challenges, lack of medical supplies and inadequate doctors to perform the procedure could potentially cause more harm than good and make other women not want to get their problems fixed. I think the first step into implementing positive change is by having women who have had a successful experience be able to share their experience and tell their story to other women in the villages and communities and show them that their livelihood, their family, and their health was saved because of this procedure and that these other women can be saved too. Success stories are the best way to bring attention to things and show people that is isn’t something they just have to “live with” and that nothing can be done to fix it. Although this is a small action in the grand scheme of things, I think it will make a big impact and really get things to go in the right direction to fight this simple condition.

I think the article’s plan of training putting midwives everywhere along with both men and women community leaders was a great idea to start implementing into these developing countries. I think using the midwives as a middle ground is a perfect leeway into stopping this problem altogether. Culturally, the women will feel comfortable with the midwives, and in turn they will be able to distinguish whether or not the woman needs to go to the hospital and could avoid the fistula forming altogether. I see this strategy as a great prevention method and hopefully it will continue to be implemented and grow from here.
Seim, A., Alassoum, Z., Bronzan, R., Mainassara, A., Jacobsen, J. and Gali, Y. (2014). Pilot community-mobilization program reduces maternal and perinatal mortality and prevents obstetric fistula in Niger. International Journal of Gynecology & Obstetrics, 127(3), pp.269-274.

Guided Reflection #7-Gastrointestinal

“No single intervention is sufficient to eliminate the global burden of enteric and diarrheal disease.”  We’ve explored many different solutions to diarrheal disease, and there are many options for moving forward…..so, what should we do?  How do we approach diarrheal disease?

Diarrheal disease is a multi-combination disease, meaning that there are many factors that go into having acute, persistent, or chronic diarrhea. Therefore, we should approach diarrheal diseases using a multi-combination strategy. Implementing probiotics into the community is a great way to start. It helps balance out the good bacteria and the bad with people who have to deal with diarrhea on a daily basis. It is easy and cheap to manufacture and give out, which is a huge plus in a developing world where expensive treatments do not have a life-long sustainability and are not a “fix it once and leave it solution”. Although it is beneficial for people to take probiotics everyday for the rest of their lives and that would use a lot of resources, since it is cheap and can be manufactured by the masses, it helps that problem. I think that probiotics is a great solution that people should not ignore. Although I do not believe it would solve the solution entirely, I do think that it could help tremendously. A few other  main issues with diarrheal diseases is sanitation, water, and hygiene. If even one of those parts is bad off then this disease will prevail. We need to be able to tackle all three of those aspects to be able to fight diarrheal diseases completely. There are obviously many aspects of sanitation and water that need help with, but I think an easy one that we could start working on is hygiene. I think that educating people about proper hygiene could help a lot when it comes to diarrheal diseases. Teaching people about safe hygiene practices is an easy and cheap way to help the economy by hiring people from the community and help the people themselves by showing them a better way to avoid parasites and harmful bacteria just by simply wearing shoes. I think that the ability to the fight diarrheal diseases is in our reach, we just need to take the proper steps to combat it altogether.
Strunz, E., Addiss, D., Stocks, M., Ogden, S., Utzinger, J. and Freeman, M. (2014). Water, Sanitation, Hygiene, and Soil-Transmitted Helminth Infection: A Systematic Review and Meta-Analysis. PLoS Medicine, 11(3), p.e1001620.

Preidis, G., Hill, C., Guerrant, R., Ramakrishna, B., Tannock, G. and Versalovic, J. (2011). Probiotics, Enteric and Diarrheal Diseases, and Global Health. Gastroenterology, [online] 140(1), pp.8-14.e9. Available at: https://www-sciencedirect-com.prox.lib.ncsu.edu/science/article/pii/S0016508510016148 [Accessed 31 May 2018].

 How do we close the sanitation gap?  Should we?

I believe that when it comes to closing the sanitation gap, there is a line that should not be crossed. Improving sanitation to the extent of helping people suffer from diarrheal diseases, parasites, and more, I think that it is important to improve their overall sanitation. When it comes to trying to make everyone across the world use our toilets and sanitation system no matter cost or how it may impede on their daily living, we should not impose. So overall, yes the gap in sanitation between developing and developed countries should close some, but we could easily cross the line of westernizing these countries to our way of living, which is not what our main goal should be. To help close the sanitation gap, I believe that a company like LifeStraw is a great example. The fact that the people that they hire are from the local community and come in for an hour to teach these families how to use the product and why the product is so important is a perfect example that shows educating these people is a great way to improve sanitation. To avoid gut-eating parasites that live in the ground, teaching people just to simply wear shoes could help them extremely. Teaching WASH practices around local communities is an easy and safe way to help people try to be as cautious as they can. I think that the more people know how to stay safe and proper sanitation practices in their environment, the more we can decrease all these types of infections that are easily avoidable. Strunz notes that WASH practices showed a 33% decrease in STH infections. That is a huge statistic for just practicing clean and safe hygiene, water, and sanitation. Statistics like that make me believe that closing this huge gap is possible, but education is the key to success. We need for-profit companies to hire local people in the community, which in turn will help the local economy, and get them to teach surrounding communities about safe sanitation practices in all kinds of ways and prove to them that it is efficient. When the LifeStraw guy went through the whole process of cleaning the water and then at the end drank the water, that was proof that it was safe and that anyone can drink it. That is going to be more successful in showing these people how to do things than any other way.

Strunz, E., Addiss, D., Stocks, M., Ogden, S., Utzinger, J. and Freeman, M. (2014). Water, Sanitation, Hygiene, and Soil-Transmitted Helminth Infection: A Systematic Review and Meta-Analysis. PLoS Medicine, 11(3), p.e1001620.

 Are probiotics a realistic solution for diarrheal disease in the developing world?

I believe that probiotics are a great step in the right direction for fighting diarrheal diseases in a developing country. I do not believe that it is a “fix it all” solution to this massive problem because there are so many different problems associated with this disease. With that being said, probiotics are cheap, easy, and do not have any harmful effects associated with them. People in a developed world take them regularly for a healthy gut so why can’t it be beneficial to those in a developing world too? As long as the way probiotics are manufactured are kept in a safe and sterile environment and then given to those in the community who need it, there should be no problems. They could potentially help people from devastating diseases by fighting off infections such as Listeria and many other infections that could be potentially fatal if not treated. I believe this solution to be better than broad spectrum antibiotics because it is adding good bacteria to your body rather than wiping out all bacteria in your body altogether. The overuse of antibiotics have their own conflicts and problems associated with them but probiotics do not. People could take probiotics everyday for 10 years and not have harmful side effects associated with that, which is huge in a developing world. Why not provide something to the people that can only help them? Studies have shown that it has helped with children’s growth, immunity, and vaccine efficacy. I don’t believe you can fix diarrheal diseases without fixing the water and sanitation problem, I do believe that you can help it significantly. Probiotics are a great way to start helping reduce diarrheal diseases in a developing world.

Preidis, G., Hill, C., Guerrant, R., Ramakrishna, B., Tannock, G. and Versalovic, J. (2011). Probiotics, Enteric and Diarrheal Diseases, and Global Health. Gastroenterology, [online] 140(1), pp.8-14.e9. Available at: https://www-sciencedirect-com.prox.lib.ncsu.edu/science/article/pii/S0016508510016148 [Accessed 31 May 2018].

Guided Reflection #6- Mr. Tate Rogers

How can we work to decrease the stigma of sanitation?  

The stigma of sanitation is a serious issue in our society and around the world. This topic is not highly discussed because in many cultures it is not appropriate to talk about and considered a private matter. Although I can completely understand how people might not want to talk about this issue, I being one of them, it is a major concern in our world on how we handle it to avoid these crisis situations. I believe to decrease the stigma about sanitation we need to get everybody talking about it. Education about this topic is vital for decreasing the stigma about it. This issue is huge around the world but nobody knows about it because nobody wants to talk about it. That is a major problem. If we can get people talking about it like they do about other issues around the world, people can start to see the major impact it has on health around the globe. Another way to decrease the stigma about it is to connect this issue with other issues that people are willing to talk about. Like Tate mentioned, talking about clean water around the around is an issue that is widely talked about in our society and people around the world discuss this to try to solve the problem. What people do not realize is without proper sanitation, we will never have clean water. If we can get these two issues to go hand in hand with each other when discussing them, it will help people realize that to fix one of these issues, you have to fix the other as well. We all know that talking about going to the bathroom is not a commonly brought up topic, but when talking about health issues globally, we cannot ignore it. I also think it is important to start at the source and talk about it with people in the community that are directly affected by this sanitation issue. If we can reward and encourage people to use proper hygiene methods when it comes to sanitation, we can impact their efforts directly to help this problem. Diarrhea is a direct result from improper sanitation and dirty water which is a problem that affects almost every person in developing countries. If we can teach people that proper sanitation could help to relieve these diarrheal issues, we could get people on board with talking about it and helping others to follow proper sanitation.

Citation: stigma, S. (2018). Sanitation must go beyond shame and stigma. [online] YourStory.com. Available at: https://yourstory.com/2017/06/sanitation-shame-stigma/ [Accessed 29 May 2018].

Take a look at Dr. Frances de los Reyes’ Ted Talk.  If governments do as he wishes them to, what are some of the global impacts of investment in sanitation?  

Some of the global impacts in sanitation if the government were to invest in proper sanitation would be the significant decrease in diarrheal diseases and unclean water. If we are able to improve sanitation across the world, those efforts directly impact the health of communities across the globe. There is an investment return if money is put into these sanitation projects. As much as $34 can be returned for every dollar invested by the government, says Dr. Frances de los Reyes. Another global impact this might have is the stigma regarding proper sanitation in general. If the government is spending money to help improve sanitation efforts, this will increase the education and “talk” of it, reducing the stigma of sanitation being a “taboo” topic to discuss. People might be more willing to discuss proper sanitation if the government is able to talk about it with them. Another impact is that communities can benefit all over the world from proper sanitation by using these waste products to create high value products that are desperately needed in villages with inadequate fertilizer and other products that can be made from this waste. One government following this plan and idea could impact over governments all over the world to follow the same path once they see how the country could benefit from these investments. Not only will it help improve the overall health of the country, it could improve the agriculture and the economy in the country. With all of this areas improving and benefitting from this, the country could eventually go from a developing country to a developed country, which is the goal for almost all countries these days.

Citation: Reyes, F. (2018). Sanitation is a basic human right. [online] Ted.com. Available at: https://www.ted.com/talks/francis_de_los_reyes_sanitation_is_a_basic_human_right#t-487854 [Accessed 29 May 2018].

What are some of the successes and challenges of the SOIL project in Haiti?

Some successes of the SOIL project in Haiti is that it not only benefits the sanitation issue but also helps the agricultural issue that is in Haiti, which is that the soil in haiti is not adequate enough to have proper farming. This SOIL project is kind of a “kill two birds with one stone” kind of deal which is a good thing for developing countries like Haiti who have multiple problems to tackle. Another success of this project is that everything they use is local. This helps avoid the use of importation and helps the longevity of the project. If they had to continue to import goods and resources to help maintain the project, it could not be as effective long term, so by using Haiti’s own local resources for this project, it remains sustainable in helping the local people continue these efforts. Another success of this project is that is creates jobs for the local people which aids their economy in addition to the sanitation issue. By hiring Haitians to carry out the project, it also enforces the idea of proper sanitation within the community and promotes ways they can spread information to the whole community.  

Some challenges they face with this project is adherence. It has to be managed by the people of the community so if they do not keep up with cleaning it and putting in the sawdust, the project is useless. That could be a major issue if the people in the local community do not clean it regularly and could still spread diseases if not kept up with. Another challenge that this project does not explicitly prove yet that the soil is helping the farmers, agriculturally speaking. Further research needs to be done to make sure that it is working or improvements need to be made to the soil to fix this issue if it is not helping as much as they need. If the soil does not help the farmers, then one of the main goals of the project has failed them.

Citation: SOIL Haiti. (2018). SOIL Haiti. [online] Available at: https://www.oursoil.org/how-were-different/ [Accessed 29 May 2018].

If you had the resources, which of the reinvented toilets would you choose to fund – and why?  

I would choose to fund the E-toilet for multiple reasons. My first reason is that many people in developing countries would find public toilets better and more useful for them because they would not be able to supply their home with their own toilet for many reasons. Since it is a public toilet, everybody could have access to this no matter the home conditions they currently are in. Another reason I would choose to fund this project is that it not only helps the sanitation issue but it also helps the economy by allowing companies to pay to have ads on the outside of the bathroom. That is a great way to promote businesses as well as contribute to the local economy in that village or city. Another reason I like the E-toilet is the cleaning process. I like that the entire room is made of stainless steel and the entire room flushes itself after use, which is important in preventing the spread of disease in these places. Privacy is another issue for people in developing countries and since these doors lock, people can feel safe when they are using the bathroom which can also help the overall attitude of sanitation in general. Overall, I believe that the E-toilet can benefit the greatest amount of people in all types of situations while also contributing to the economy at the same time.

Citation: Pareek, S. (2018). This eToilet Is Changing The Way Public Sanitation Works In India. [online] The Better India. Available at: https://www.thebetterindia.com/13940/etoilet-changing-way-public-sanitation-works-india-eram-marico/ [Accessed 29 May 2018].

Guided Reflection #5-HIV/AIDS & Mosquito-borne Illnesses

Though the article revealed that there isn’t a synergistic connection between malaria and malnutrition causing lower birth weight, there is a high percentage (and vulnerability) of pregnant women contracting malaria.  How can we protect them from malaria in developing countries?

We can protect pregnant women from contracting malaria in developing countries by providing them with malaria medication when they go to the clinic to find out if they are pregnant. We can also can provide them bed nets to sleep under so they are protected from mosquitoes at dawn and dusk. We also can advise them to wear long sleeve clothing to help protect them from getting bitten from a mosquito while they are outside. Using preventative measures to avoid letting these pregnant women contract malaria and potentially give it to their child will be the best strategy. Using insecticides and insect repellents could potentially to be harmful to the baby as it is developing so it would be best to avoid those strategies to avoid being bitten and focus on ways that will block contact from vector to human without using chemical methods.

Citation: Unger, H. W., Briand, V., Fievet, N., & Valea, I. (n.d.). Malaria, malnutrition, and birthweight: A meta-analysis using individual participant data. Retrieved from http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002373

Is mosquito eradication a viable option to prevent mosquito-borne illnesses?  Why or why not?

I do not believe that mosquito eradication is a viable option to prevent mosquito borne illnesses because there are far too many other scientific methods of control that are easier and less damaging to the environment than mosquito genocide. Eradication of any species is not a good idea for a multitude of reasons such as eliminating itself from the food chain and costing other animals to lose a food group. Mosquitoes are also pollinators which helps out the environment so we would be losing that too. There are alot of harmful ways that people could go about killing off all these mosquitoes that could potentially be worse for us if the way they were trying to be killed was not monitored properly. Overall, I think solutions such as using CRISPR are in turn going to be more effective in preventing these illnesses rather than just trying to kill off the vector entirely. If mosquitoes were eradicated, the disease could potentially travel through another vector and all that work would have been useless.

 What are challenges to the 90/90/90 goals for HIV/AIDS?

It is extremely apparent that the biggest challenge this 90/90/90 goal will face will be finding and supplying people with all the resources they need to have this goal be a success. They need so many tests and medications to be able to give to so many people across the world and that could turn out to be very expensive and more money than they originally intended on paying.  Another issue is the sheer quantity of people that will be coming to clinics from all over to get these tests done and be given the medication they need. Some clinics might not be adequately supplied enough to be able to enough a large sum of people flooding in like that so it is important that they set up times for different groups of people coming in so they all can have a chance to get tested and treated if needed.

Citation: Jamieson, David, and Scott E Kellerman. “The 90 90 90 Strategy to End the HIV Pandemic by 2030: Can the Supply Chain Handle It?” Freshwater Biology, Wiley/Blackwell (10.1111), 30 June 2016, onlinelibrary.wiley.com/doi/full/10.7448/IAS.19.1.20917.

What can be done to encourage PrEP administration globally?  Should it be encouraged?

I think it would be important to provide incentives for people to encourage them to take this medication on a regular basis. If we were able to provide them with something they need in exchange for taking this pill, we would be able to help out people in a multi-beneficial way because we would be giving something they need as well as preventing the spread of HIV. If this was successful, it could help us dramatically decrease the rate of HIV spreading. I think that PrEP should be encouraged because I do not see the harm in taking it if it can only help you in the long run. People that could be exposed to HIV on a regular basis should be extremely encouraged to take this preventative medicine because it could truly help save their life. A 90% success rate is amazing and would be able to save millions from contracting the disease if taken properly.

Guided Reflection #4- Dr. Kristin Schroeder

Describe some challenges that Dr. Schroeder has met in her global health journey.  How are they similar with challenges we’ve seen in the developing world (so far)? How has she worked to overcome them?

Some challenges that Dr. Schroder has faced during her global health journey is a stigma about oncology treatment in underdeveloped parts of the world. She mentioned that a lot of people do not believe in seeking treatment for cancer or going to the doctor to see what they have because they think that cancer is untreatable, and once you have it, nothing can be done. I think this could relate to the developing world in a way because there are alot of people who think cancer is a death sentence, which in some cases now, it is not. It is so important to change the stigma and attitude about medical issues in the developing world. Another issue she has faced is dealing with other doctors in the area who are not as trained as she is and sometimes she has a hard time dealing with other opinions that conflict hers and coming to an agreement. This also could be similar with other issues we have seen because many health care providers coming from all over the world could have differing opinions that cause arguments among the doctors and could take away from solving the issue. She has overcome these issues by taking a deep breath to not get too frustrated and try explaining things in a different way so they could come to a compromise.  

 What is your global health goal, long term?  

My long term global health goal would to be able to say that everybody in a developing country would be able to have access to health care. I would want people to be able to just be able to get examined from wherever they are coming from. To do that, I would need to set up clinics throughout the area so that people from far away would still be able to come to a smaller clinic to be seen and then if there is something wrong, they could be sent to the hospital.

 After exploring the Guinea Worm neglected tropical disease, what are the successes and challenges still facing the eradication of guinea worm in the developing world?  

Some successes of the eradication are that they have decreased the number of cases from the millions to just several in the year. That is an extreme success story that should be glorified because they are really making strides with eradicating the disease. Some challenges they still face seem to remain in Chad, where there are still cases popping up throughout the year in that area. They need to have zero cases for over a year to completely eradicate the disease there. They seem to be making significant progress though and reducing the number of cases each year.

Guided Reflection #3-Musculoskeletal Disorders

How would you modify the Ponseti Method to be better suited for global health?

I would try to come up with a way that could shorten the amount of time it takes to go through this process and find a better way to make it more accessible to everyone around the world. Adherence is an important aspect to avoid relapse and that can be difficult to do to after months and months to continue to come back to get treatment. If they are to shorten the amount of time, more people might be able to to finish the treatment. Another important aspect of adherence is the shoes. First of all, the shoes need to also become accessible to all the people who go through the treatment because otherwise it was a waste of time due to the relapse that would occur. We need to make sure that everyone can get the boots and is properly educated on how important they are and how often to the wear for the next few years. The last thing we need to do is early detection. Finding children as early as possible is the best way to nip the problem immediately. If there was a way to has screenings for pregnant mothers around the world it could be a great way to fix the problem early.

https://www.namibian.com.na/index.php?id=138454&page=archive-read

 How can we (actually) fight stigma in clubfoot?  

I think the most important thing to fight the stigma of clubfoot is to raise awareness about the issue and make it public knowledge that this is an extremely treatable condition and it is not a repercussion of a “curse”. I think that if we are able to let large groups of people know about it and bringing people in to be treated we can fight the problem starting at the source and that is fixing all of these people’s feet. We also can improve the education of it in the school systems to start to help people in villages that don’t have start to understand it and hopefully decrease the attitude towards it.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3940756/

If you were the CEO if Jaipur Foot & Knee, how could you improve/resolve the challenges they face?

 I would try to come up with ways that they could use parts that were cheaper to use than the ones they are using now. Although still significantly cheaper than some other options, making it the least expensive they can would be the most ideal situation for the people who need it. I would reach out to other universities besides stanford to try to get some other opinions on ways they could use different materials that would be less expensive but still not cause the other complications like the clicking noise.

Click to access cios-6-245.pdf

Guided Reflection #2- Westernization and Cardiovascular System

There is no denying that westernization is happening – everywhere.  How can we prevent the westernizing of developing societies? Do we want to?

I want to prevent the westernization of developing societies because I truly love and cherish the different cultures around the world and how unique they are compared to others. To see a McDonalds in a town in China is so disheartening to me because it makes me think that that town is losing its cultural values by allowing their customs and traditions on food to be overruled by a popular fast food chain that is wanting to place their business there. If everywhere looks the same and acts the same, who is to say we are different from one another? Being different with cultural traditions is something that I love and when you travel you want to see the differences with places and how it is unlike where you are from rather than just being the same everywhere you go. I think we can prevent the westernization of developing societies by creating stricter laws that prevent development of unnecessary businesses that disgrace and ruin the culture of the city that they are trying to develop their business in. I think that restaurants and business such as that should not be allowed in other countries because it takes away from original culture of the country.  Westernization should be held to developments like education and medicine and economics that could actually prove to be helpful for that country and it should also only be offered as a suggestion rather than a demand and forced upon them because some countries might want to stick to their herbal medicinal techniques for some things.

 What do you see as the major ‘pros’ and ‘cons’ of the polypill?  

Some major pros I see of the polypill is that it is all one pill and that makes it very easy and convenient for everyone to take and keep up with. Sometimes, I think it is hard for people to keep up with all of their medications, especially when they are taking more than a couple a day, so that would be an extreme ‘pro’ in my opinion. Another ‘pro’ I see is that it would actually work to lower your risk if proper dosage is given and it is taken when directed. Since cardiovascular disease has the ability to affect everyone and Americans in particular are extremely susceptible to this disease, why not try to implement a drug that could lower this risk significantly. A ‘con’ I see about this drug is something that I see definitely being an issue is people continuing to live a lifestyle that is not healthy and got them into this situation in the first place. If this pill can fix their health problems, why do they need to change how their eating or exercising? This is certainly not the case and I can 100% see this happening with many people who would take this pill.

https://www.bmj.com/content/326/7404/1419

What should be considered to make the polypill a more viable option for practical use and application in global health?

I think that this pill should be in the form of some sort of supplement rather than a prescription pill. I think that if if the dosages were lowered of each of the parts of the pill and could be taken more as a preventative measure rather than a “fix-it pill” that would help people not take advantage of its effect and continue to live a bad lifestyle. This also could make it cheaper and more easily attainable to people all across the world who don’t have the ability to go to the doctor and get a prescription. If these could be mass produced for people like vitamins then more people could have access to it, and it could help so many more people.

https://www.bmj.com/content/326/7404/1419

Guided Reflection #1-Global Health

What is Global Health?

The article’s definition defines global health as “Global health is collaborative trans-national research and action for promoting health for all.” My own definition of global health would be defined as All countries, of high and low incomes, coming together to provide resources and research to help obtain the overall goal of health and health equality.

What is my role in Global Health?

My role is to participate in activities like this class, where we go to other countries in need to help them in whatever we can. Mission trips are a vital activity for me to feel like I am contributing to the cause. When I am older, I want to join the peace core or if I become a doctor do the “doctors without borders” trips to help as many people as I possibly can.   

  What makes a successful Global Health Initiative?

 A successful global health initiative involves a variety of factors that can come together to achieve the overall goal. This should first involve a set goal that they have along with a timeline that could coincide with their efforts. It also should have aspects from all types of categories that could be helped rather than just the health aspect. So many low income countries that need help with their “health” have other issues like their economy, resources, and infrastructure to deal with natural disasters that severely impact their ability to improve their overall health. If we can help with the other aspects they need help on, it could help their overall health at the same time. You also need a way to monitor your efforts to see if anything is improving and the hard work and money going into this initiative is actually beneficial.