Stakeholders Meeting on Palliative Care and Treatment of Cervical Cancer

Stakeholders Meeting on Palliative Care and Treatment of Cervical Cancer

By: Jacob B. Stocks & Sandra Yvonne Oketch - June 18th, 2019 On May 23rd, 2019, a stakeholders meeting on palliative care and treatment of cervical cancer for partners in Kisumu County was hosted at the KMET Complex in Kisumu. The main objectives of the meeting were 1) to share experiences on palliative care and cervical cancer services in Kisumu County and 2) to identify opportunities for networking and collaboration among partners. The 7-hour meeting began with a discussion of structural barriers to effective referral and treatment of cervical cancer in Kisumu County. The presenter, Brenda Otieno, discussed barriers such as the complexity of intra-facility referrals and client tracking, the lack of centrally located data on cancer patients (i.e. lack of a county-level cancer registry), and the lack of financial protection for clients seeking treatment. Following this session, Dr. Chemtai Mungo, an OB/GYN from UCSF, presented the evidence for cervical cancer screening via HPV testing by citing multiple studies discussing the cost-effectiveness...
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Pelvic Health Physical Therapy

Pelvic Health Physical Therapy

Part 3: Mama, LLC In Part 2 of this Pelvic Health Physical Therapy, we were introduced to Dr. Laura Keyser, a physical therapist who specializes in maternal and child health. She also is the co-founder of Mama, LLC. Dr. Keyser was able to share some aspects of her work at Mama, LLC and to inform us of some projects the firm is working on. Mama, LLC is a physical therapy and public health consulting firm that specializes in domestic and international women’s and girl’s health. Mama, LLC partners with humanitarian organizations, professional organizations, educational institutions, and for-profit groups to meet maternal and women’s health needs around the world. The firm’s work includes but is not limited to education efforts, promotion and advocacy, research, and rehabilitation capacity building. When asked about her work at Mama, LLC, Dr. Keyser reports: “We see the health concerns of women and girls around the world as experiences on the same continuum. While women in low income, low resource settings...
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New State Abortion Bans

  Photo Credits: John Benson After the recent passage of restrictive abortion legislation in Georgia and Alabama, abortion continues to be under attack across the country. The abortion bans signal continued attempts by states to undermine a woman’s right to access an abortion. Last week, Louisiana Democratic governor, John Bel Edwards, signed into law a restrictive “heartbeat” bill. The law, like other recent abortion legislation, would prohibit an abortion after an ultrasound detects electric pulsing of what will become a fetus’ heart—which can occur before most women know they are pregnant. Moreover, the Louisiana law does not include exceptions for rape or incest. Although the law will not go into effect immediately, it is likely to be stalled in the courts. In Missouri, only one abortion clinic remains open. If it closes, it would be the first time a state does not have an abortion clinic since 1974—when the Supreme Court ruled on Roe v. Wade. A judge is expected to a settle...
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Missing and Murdered Indigenous Women in Canada and United States

In 2014, Tina Fontaine, a member of the Sagkeeng First Nation in Canada was murdered. Her death garnered national attention as it highlighted the alarmingly high rate of violence against indigenous women in Canada. Such violence prompted the creation of the National Inquiry into Missing and Murdered Indigenous Women and Girls. After nearly three years of investigation, a report was published earlier this week that calls the treatment of indigenous women “a genocide.” The report included policy recommendations that seek to mitigate the violence and address its causes. As in Canada, native women in the United States disproportionately experience violence. A report conducted by the Department of Justice (DOJ) found that some counties in the U.S. have murder rates against indigenous women that are more than ten times the national average. Moreover, limited data and reporting on crimes against indigenous women and girls in the United States make it more difficult to understand the extent of the violence. According to a...
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International Pelvic Health Physical Therapy

International Pelvic Health Physical Therapy

Part 2: How Physical Therapists Are Helping Women’s Health on the Global Stage In January, I attended a presentation by Dr. Laura Keyser, a prominent figure in world of pelvic and global health. Keyser has been a physical therapist for 12 years and has developed public health expertise in maternal and child health. She also is the co-founder of Mama, LLC, which is a physical therapy and public health consulting firm that specializes in women’s and girl’s health. I had the wonderful opportunity to pick Dr. Keyser’s brain about global women’s health issues and how she sees physical therapy helping solve those problems. For the past ten years, Dr. Keyser has acted as a consultant to local and international organizations such as Global Strategies, EngenderHealth, the Harvard Humanitarian Initiative, Panzi Hospital and Foundations and HEAL Africa DRC. Through this role she has developed rehabilitation programs and community outreach initiatives in many parts of Africa and south Asia. When asked about her first...
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OMEGA FOUNDATION MEETING WITH HARUN KODIAGA – HEAD OF PROGRAMS

OMEGA FOUNDATION MEETING WITH HARUN KODIAGA – HEAD OF PROGRAMS

I had the opportunity to meet with Harun, the Head of Programs at the Omega Foundation (OF) at the Kisumu Office. The OF mission is, “to strengthen the capacity of communities to live meaningful lives through integrated health and innovative livelihood solutions” across 12 counties in Kenya: Kisumu, Siaya, Migori, Homa Bay, Busia, Bungoma, Nandi, Uasin-Gishu, Kakamega, Vihiga, and Bomet. OF undertakes various projects including Sexual and Reproductive Health Service Delivery and Advocacy projects funded by Planned Parenthood Global. The projects are being implemented in Kisumu, Siaya, and Homa Bay counties respectively with an objective to increase awareness of, access to, and use of quality family planning (FP) and Post Abortion Care (PAC) services. Twenty facilities in Kisumu are supported in delivery of the services and focus on strengthening the capacity of partners to provide facility-based FP and PAC services and advocate for expansion of Sexual and Reproductive Health (SRH) rights and services. To achieve their goals, the OF supports provision of...
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Alabama and Georgia Pass Restrictive Abortion Laws

  On Wednesday, Alabama Governor Kay Ivey signed into law the most restrictive anti-abortion legislation in the country. The bill not only bans abortion at nearly every stage of pregnancy, it also criminalizes the procedure for doctors who perform abortions. Although women who receive an abortion will not be prosecuted, the new law targets doctors who could face up to 99 years in prison for performing an abortion. The bill includes protections when a mother’s life is endangered, but it does not include exceptions for rape or incest. While the courts have continued to reaffirm a woman’s constitutional right to an abortion since the decision in Roe v. Wade, the Alabama law is most recent attempt to challenge the 1973 precedent. Since the beginning of 2019, nearly 300 restrictive abortion laws have been introduced in state legislatures across the country. Earlier this month, Georgia governor Brian Kemp signed into law a fetal heartbeat bill that prohibits abortion after a doctor can detect...
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South Korea Poses Amendment for Anti-Abortion Law

South Korea has fostered an anti-abortion law for 66 years which names abortion a crime with repercussions of heavy fines and women facing up to a year in jail and doctors facing up to two years. Last Thursday, South Korea’s Constitutional Court ruled this law unconstitutional and concluded that Parliament must revise the law by 2020 or else it will become invalid. There are a few exceptions to the law which allow for abortions under the situations of pregnancy from rape or incest, pregnancy which poses great risk to the mother’s health, or pregnancy that will result in a child with a serious deformity. However, a study does prove that since the law has been enacted, there have been huge amounts of illegal abortions—49,7000 abortions took place in 2017 and an estimated 94% of those were performed illegally. There also seems to be a general shift in trends of what South Koreans think of abortion because a poll shows that...
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Continuous Medical Education at Migosi Sub-County Hospital in Kisumu, Kenya

Continuous Medical Education at Migosi Sub-County Hospital in Kisumu, Kenya

Migosi Sub-County Hospital is a government level 4 hospital situated in Migosi sub-location of Kisumu County. The hospital is staffed with a Medical Officer Superintendent, Nursing Officer, Lab Technologists, Clinical Officers, Pharmacy Technologist, Support Staff, HTS Service Providers, Peer Counselors, and a Nutritionist. The facility has a catchment population of over 20,000 and is expected to provide services to over 5,000 women of reproductive age per year. Some of the services offered include Antenatal, MCH services, Anti-Retroviral Therapy, Family Planning, Home-based Care, Basic Emergency Obstetric Care, and Inpatient care. The Hospital has strengthened its cervical cancer department and has been in the forefront of beating cervical cancer. The department embraces a “see and treat” slogan and uses the Visual Inspection with Acetic (VIA) method and treatment by means of cryotherapy. The Hospital has intensively engaged Community Health Volunteers (CHVs) who take advantage of any chance to urge women to come for cervical cancer screening. On 14/02/2019 Dr. Phil Gorrindo visited the facility to...
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Professor Spotlight: Dr. Nunn

Dr. Nunn is a professor of Evolutionary Anthropology and Global Health and is currently teaching the course “Human Health in Evolutionary Perspective” here at Duke. The following is the transcript of an in-person interview conducted with Dr. Nunn. What inspired you to teach “Human Health in Evolutionary Perspective” at Duke? In particular, what long-term perspectives do you hope students will gain from this course? “I came to Duke in 2013 from Harvard where I taught this course and it was called Evolutionary Medicine. I was really excited to teach it there because it was in the General Education Curriculum and a colleague of mine, Peter Ellison, and I developed a course that was aimed at people without any background in evolution or background in pre-med. It was meant to be a course that attracted any student and it was amazing. It allowed me to engage with the material in a more basic level and I came to realize the material is something...
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