Winter 2019 Director’s Message

The end of the semester and calendar lend themselves to reflections on the progress and challenges of the past year, and global health is no exception. In fact, last year we highlighted some of the year’s ups and downs in reproductive health. Both myself and Konyin Adewumi, DGHI MSc ’17, concluded that despite some setbacks, 2018 left us optimistic about progress toward reproductive and sexual health, reflected in a global call toward cervical cancer elimination, a historic decision on abortion rights in Ireland and a record number of women seeking (and achieving) government office in the United States and around the world. This year, the 25th anniversary of the International Conference on Population and Development (ICPD) facilitates reflections on not just the past year, but the past 25 years of achievements in global reproductive health. The momentous discussion at the ICPD in Cairo, Egypt and the resultant 20-year Programme of Action were pivotal in shaping the agenda in women’s health around...
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Sandra Oketch: The Voice of Cervical Cancer Prevention in Kisumu County

Sandra Oketch, the Kisumu Research Director for the Center has been making the rounds of the radio talk shows to share information about human papillomavirus testing in anticipation of this week’s cancer awareness activities. During this media blitz, Oketch has been speaking on radio shows in Luo, Kiswahili and English, she is working with key members of the Ministry of Health to raise awareness of cervical cancer, educate women on their risk and how to get screened. Activities will include in-person education, screening and a cancer awareness walk on the second and third of October. Key stakeholders will take advantage of the momentum to convene of meeting of partners actively engaged in cancer prevention and treatment to help develop a cancer prevention alliance that works synergistically, without duplication of activities. The First Lady of Kisumu, Dorothy Nyong’o, long a supporter of cancer control activities in the region, has promised to serve as a patron for the Kisumu County Cancer Alliance....
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Welcome Back!

Welcome Back!

With classes back in session, the halls are flowing with students talking about the trials and triumphs of their summers—whether they were in the field, interning in DC, trying out consulting work or just had an amazing vacation. The new school year brings with it a sense of new beginning and purpose—and sometimes an overwhelming feeling of everything needing to get “scheduled” during these first weeks of September.  A colleague recently started an email with the greeting: “did you have a relaxing or productive summer?  I feel like it’s either one or the other.”  It made me reflect on how we take advantage of being out of the classroom, trying to fit in various opportunities for travel, fieldwork and writing time that become harder during the semester, while also taking time to regroup and relax with family and friends. I hope everyone was able to have a little balance this summer, and come into the new school year with renewed...
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Summer SRT team joins Kisumu office

This summer the Center office in Kisumu will be hosting three students through a Student Research Training (SRT) summer program. They will be joined by a Masters in Global Health student, an ob/gyn resident and a post-doctoral fellow, all researching various aspects of cervical cancer prevention and health systems strengthening for reproductive health.  They've just arrived in Kenya, and I've asked them to share some of their plans and expectations for the summer.  Follow this page to see updates on their projects and reflections throughout the summer. Emma Mehlhop, T'21 Since this summer will be my first experience in field work of any kind, I have much to anticipate. First, I am looking forward to reflecting on not just why I am passionate about Global Health, but what I am personally able to contribute to the field. During the Global Health Ethics course, we spent time reflecting on the work of Boniface Mwangi, a Kenyan photojournalist, who asks Global Health workers and...
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Expect the Unexpected

Expect the Unexpected

As students and faculty start lifting their heads from the end of semester rush and head off to Summer adventures, we have a chance to reflect on all we have accomplished this past year and to celebrate our graduating students. I had the opportunity to think more about this as I prepared my remarks for DGHI's undergraduate commencement on May 10. The opportunity to speak to graduates and their families was one of the most meaningful experiences I’ve had since joining the Duke faculty in 2016. Asked to talk about my journey from Duke student to a career in medicine and global health, I told the students that they need to expect the unexpected, be prepared for— and maybe even proud of— the inevitable failures, and to take chances on new adventures and challenges. As we embark on new and exciting projects with learners across the university and medical school this summer, I am encouraged to see a new generation of researchers and...
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Director’s Blog, Spring 2019

Director’s Blog, Spring 2019

On March 8, we celebrated International Women’s Day, which coincided with the one year anniversary of the Center’s launch in 2018. We took this opportunity to celebrate the activities and achievements of the past year with a tweetstorm celebrating the amazing women who have worked with the Center—from our team in the field, to the team of Duke undergraduates running our communications strategy, and a lot in between! Check out our twitter feed (@RHatDGHI) to keep up to date on all of students, faculty, residents and fellows who have contributed to the Center this year. This’s year’s IWD theme, “think equal, build smart and innovate change,” was a call to address the need for truly transformative solutions to advance gender equality and empowerment for women and girls. There is increased recognition that the growing gender divide in STEM fields will continue to hinder innovation and development of the disruptive solutions necessary to address disparities in reproductive health outcomes in the US...
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California Right to Access Act Revisited

California Right to Access Act Revisited

Story by Karina Moreno Bueno, T'21 There was a recent attempt in September to require California to provide medical abortion in public colleges and universities. Medical abortion is otherwise known as the abortion pill. Unfortunately, this bill was not signed by by Governor Jerry Brown. California’s governor announced that he vetoed the bill because “the services required by this bill are widely available off-campus” within five to seven miles off California state university campuses, meaning that he found it an unnecessary government expenditure. The problem with going off-campus to seek these services is that half of students in the California state university school-system are low-income students, meaning that they are likely to struggle to pay for abortions off-campus. Furthermore, the majority of these students do not have a car, making transportation very difficult and not accessible to everyone. Reproductive health rights activists have not given up, as there has been an introduction of updated version of the bill into the state’s legislature...
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Intake of caffeine during pregnancy and neonatal outcomes

Intake of caffeine during pregnancy and neonatal outcomes

Story by Karina Moreno Bueno, T'21 Experts are beginning to warn pregnant mothers who drink coffee on the daily in heavy loads about potential impacts on their pregnancy. Researchers at the University College Dublin have found results that have correlated increased consumption in caffeine during pregnancy to premature births. The National Health Service (NHS) of the UK suggests to that the safe caffeine intake for pregnant women should be kept at around 200 mg, or about 2 regular cups of coffee. Their data suggests that even drinking the below what is considered the “safe” cutoff for caffeine during pregnancy, it may still lead to giving birth to a small baby. The study consisted of 941 mother-baby pairs born in Ireland. Tea was the source of caffeine to 48% of mothers, and coffee was the source of caffeine for 38% of mothers. Results at the end of the study indicated that for the first trimester for every additional 100 mg of caffeine consumed...
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Nesterone, a birth control gel for men, could come to the market soon

Nesterone, a birth control gel for men, could come to the market soon

Story by Karina Moreno Bueno, T'21 A new form of contraceptive for men might be out on the market soon, in the form of a birth control gel. This gel is called NES/T and is rubbed on the back and shoulders on a daily basis to be absorbed by the skin. This gel is supposed to reversibly lower sperm count to a very they cannot get a woman pregnant. It contains segesterone acetate — which contains progestin — and a dose of testosterone and is made under the brand name Nestorone. Testosterone production in the testes is hindered by progestin, which results in very low sperm production. This gel is very similar to a vaginal ring used as a female contraceptive, which contains Nestorone combined with a hormone called estradiol. The hormone mimics pregnancy in women, which causes women to stop releasing eggs. If there aren’t any eggs released, she can’t get pregnant. In men, the hormone makes the body think it...
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New Drugs for Resistant Strains for Gonorrhea

New Drugs for Resistant Strains for Gonorrhea

Story by Karina Moreno Bueno, T'21 About 78 million people around the world are infected with gonorrhea according to the World Health Organization (WHO). In 2017, the Center for Disease Control and Prevention (CDC) reported gonorrhea as the most common sexually transmitted disease in the United States. According to WHO, two-thirds of the world’s countries have reported antibiotic-resistant gonorrhea to all antibiotics. This may result in not being able to treat gonorrhea at all. Although a gonorrhea infection is not life-threatening, it can lead to many health problems such as pelvic inflammatory disease which can lead to ectopic pregnancy and infertility in women. In men, untreated gonorrhea can lead to epididymitis which can also lead to infertility. The problem with the bacteria is that rather than losing resistance after not being exposed to an antibiotic, they instead retain their resistance genes. This allows for gonorrhea strains to become more resistant and transfer their genes to other strains, thus, allowing for gonorrhea...
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