Learning about Global Mental Health, and Teamwork, in Haiti

Blogpost by Alex Lichtl, T'19 During the summer of 2017 I traveled to Léogane, Haiti where I, and a team of student researchers, spent two months collecting data on women’s stressors in the community through a Duke SRT program. As a team, we had very little global health research experience, but after one week of orientation we were left on our own to recruit community leaders for interviews and organize focus groups for a project entitled "Mental and Reproductive Health Interventions for Haitian Women: Adapting strategies from community input on coping with stress." At first we were extremely lost, but with the help of our translator team and a lot of perseverance, we managed to reach our data collection goal. We were also fortunate because the women and men we worked with in the community were incredibly welcoming and open to sharing their life experiences regarding reproductive health. Overall, we asked women and men in the community about women’s stressors and coping...
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Progress Period: An Introduction to Menstrual Activism

Progress Period: An Introduction to Menstrual Activism

October 28, 2018 was not merely a day of yellow sunlight and cool fall air, but rather, the origin of a radical transformation of my being facilitated by Progress Period, a menstrual activism club at Duke University. The screen of my phone reported “12:27pm,” lighting anew a sense of urgency beneath my already frantic feet. The event was set to begin at 12:30pm and with the panicked realization that I was indeed going to be late, I barreled down the stairs towards Schiciano Auditorium. At 12:29pm, just as I allowed myself a breath of assured relief that I would make the event on time, I was stopped dead in my tracks. “Outside the (tampon) box: menstruating isn’t just for women,” declared a flyer taped to the glass door. Confusion clouded my awareness and my mind raced with questions, relegating my aspirational punctuality to a non-possibility. Among this maelstrom of questions, the loudest bubbled to the surface: Is menstruation not a qualifier of womanhood?...
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HIV Patients Sue Government Over Lack of Septrin

HIV Patients Sue Government Over Lack of Septrin

Co-trimoxazole preventive therapy is a feasible intervention for people living with HIV. It works to reduce HIV-related morbidity and mortality through an off-patent drug, which is widely available in resource-limited settings. The World Health Organization (WHO) conditionally recommends the use of co-trimoxazole as treatment for opportunistic infections in people living with HIV/AIDS. In Uganda, previous reports by the State Minister for Health stated that there was a funding shortage for the drug. The Global Fund, with headquarters in Geneva, Switzerland has since stepped in to provide all funds for the drugs available from July 2018 onwards. This is good news, as daily intake of co-trimoxazole relieves symptoms and prolongs life for people living with HIV/AIDS. However, a human rights organization and two people living with HIV have sued the Ugandan Government and the National Medical Stores (NMS) for alleged failure to supply public health centers with septrin as one of the essential drugs for treatment of AIDS for the months of March...
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The KCHSSIP 2018-2022 Validation Meeting

The KCHSSIP 2018-2022 Validation Meeting

The KCHSSIP (Kisumu County Health Sector Strategic and Investment Plan) 2018-2022 validation meeting held at the Acacia Hotel on 9th Nov 2018 saw the Kisumu County Health Department and a consortium of partners come together to finalize a plan, which is based on data from county health services over the last 5 years, as well as experiences and lessons learned during implementation of the first strategic plan from 2013 to 2017. The plan attempts to effectively position the County Health Department in the correct contexts of the health system pillars: human resources for health, health technology and infrastructure, pharmaceutical and medical supplies, health governance and leadership, health service delivery, health financing, health information system, health sector policies and context and health sector social outcomes. It also examines county health burdens such as malaria, HIV/AIDS, diarrheal diseases, skin diseases, pneumonia, tuberculosis and other respiratory diseases and non-communicable diseases. The document has gone through a process of stakeholder’s participation and input and is now...
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Community Impacts of Maternal Child Health Care in Kigali, Rwanda

Community Impacts of Maternal Child Health Care in Kigali, Rwanda

Guest Blog by Suzanna Larkin, T21 The Iranzi Clinic is a pioneering medical clinic in Kigali, Rwanda that focuses entirely on maternal and child health services. As an intern through DukeEngage-Rwanda this past summer, I worked directly alongside the midwives, doctors, and administrative staff that have made Iranzi Clinic their home. Only opened one year ago, the clinic is situated on the edge of the impoverished Nyabisindu neighborhood. Many of the women who visit the clinic are unable to pay for their services, and thus the clinic relies primarily on support from the Christian Life Assembly Church and donors. The commitment that the midwives and staff hold for their patients and clinic is clear. Every Monday, the clinic has a devotions session followed by a tea time, and the scene is joyous­–any observer can notice the deep and genuine friendships that grew between the staff members as they built the clinic from the ground up. Their anecdotes about the clinic’s history, from...
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Small Fish, Big Conference: Lessons from an early career researcher on navigating your first international conference

Small Fish, Big Conference: Lessons from an early career researcher on navigating your first international conference

Guest Blog by Konyin Adewumi, MSc-GH '17 Last month, I was given the opportunity to present my research work at the International Papillomarvirus Conference in Sydney, Australia. I submitted an abstract entitled, “Female perspectives on male involvement in a human papillomavirus-based cervical cancer screening program in western Kenya”; a qualitative analysis that was part of an ongoing study at Duke’s Center for Global Reproductive Health. After taking the time to reflect on my experiences navigating such a great opportunity, I found that I had learned a few lessons that may be beneficial to others who are in my shoes – anyone that is early in their research career, unsure where the path is headed, but eager to make the most of the opportunities presented to you.     So here are my five lessons: One. Similar to your fieldwork, what can go wrong will go wrong. Plan accordingly—and when all else fails, learn to pivot. From arriving to the airport to find out that I...
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A Frightening Global Truth: Domestic Violence Within Social Normativity

A Frightening Global Truth: Domestic Violence Within Social Normativity

In reviewing data from Demographic and Health Surveys administered in low and middle-income countries between 2005 and 2017, researchers at the University of Bristol have come to an unsettling conclusion; domestic violence against women often exists within the bounds of social normativity. These surveys evaluated the social acceptability of domestic violence when provoked by certain situations, such as when a woman goes out without telling her partner, argues with her partner, neglects her children, is suspected of being unfaithful, refuses to have sex or burns a meal. It was found that approximately 36% of survey participants considered domestic violence justifiable in at least one of these instances. Furthermore, in 36 out of the 49 countries studied, women were more likely to justify this abusive behavior than men, speaking volumes to the deep entrenchment of female subordination, even amongst women. The data regarding the social acceptance of domestic violence is highly variable, ranging anywhere from 3% of the population accepting this...
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The Devastation of Congenital Syphilis Amongst California’s Most Vulnerable

The Devastation of Congenital Syphilis Amongst California’s Most Vulnerable

As of twenty years ago, incredibly low prevalence rates made concern for congenital syphilis in California obsolete. However, in the past six years, the number of syphilis cases in California has augmented exponentially, jumping from 33 to 283 cases and wreaking havoc upon California’s most vulnerable: at risk mothers and their newborn children. Due to syphilis's ability to pass through the placental wall during pregnancy, an ever-increasing number of children are suffering from meningitis, anemia, organ deformation, pneumonia and neurological deficits. Approximately thirty stillborn babies in the past year were found to be infected with syphilis-- the highest number of infant mortalities attributed to syphilis since 1995.  Such statistics are incongruent with California's extensive health care system, especially since the horrific consequences of syphilis can be prevented by a single antibiotic shot. High levels of poverty, homelessness and substance abuse have been reliably linked to increased reports of syphilis cases. Although California law mandates that pregnant women receive mandatory screening...
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Ensuring Health Care for All in Kenya

According to the World Health Organization (WHO), Universal Health Care (UHC) is aimed at ensuring that all people are able to receive medicine and treatment without suffering financial hardships. Kenya is working to implement this healthcare strategy, with the goal of allowing more Kenyans access to healthcare in public health facilities. Additionally, Kenyans will be able to access the same services in private hospitals without digging very deep into their pockets. Despite this bold move by the Kenyan President to create affordable healthcare for all, human resources, finance, essential medical products, technologies and service delivery remain challenges. The story of a woman under the alias of “Dorothy” exemplifies the financial challenge in assessing care at treatment sites. Dorothy was enrolled in a study looking at integrating HPV testing into community health campaigns, and was ultimately referred to a selected health facility in Kisumu where she was booked for treatment. After she received treatment, she further was referred for biopsy testing. But,...
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Oregon, a champion of women’s health, is one of states with abortion challenge on ballot

Oregon, a champion of women’s health, is one of states with abortion challenge on ballot

Guest Blog by Suzanna Larkin, T '21 Oregon, my home state, is a unique champion in women’s right to abortion. While more than 400 abortion restrictions have passed in 33 states in the past 7 years, Oregon remains a key state in support for reproductive health rights. It was the first state to allow pharmacists to prescribe birth control directly to women in 2015. More recently, Governor Kate Brown signed the Reproductive Health Equity Act in August 2017, which expands coverage of abortion and other reproductive health services to thousands of Oregonians by allocating nearly $500,000 of Oregon’s general fund to expand cost-free reproductive and abortion services for those who are ineligible for Medicaid. It also requires all private insurance companies to cover abortions for free. There is one caveat to this legislation: Providence Health Plan, a large health insurance provider in Oregon, is insurer exempt from providing abortion services—the only insurance provider in the state with an exemption. This is because...
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