HESO 449: Ecohealth SDS

Name of event:
Speaker Series on HIV & AIDS, held by AIESEC UBC (Wed Mar 2nd)

Summary:
Overall, this event aimed to inform us about the topic of HIV/AIDS from three very different perspectives. We heard from 3 speakers, Dr. Dan Small, who spoke about his work with Insite, the safe injection site in the downtown east side; Sonja Babovic, who informed us about the work of a UBC club she co-leads, UAEM (Universities Allied Against Essential Medicines); and Paul, who is a counselor with the BC Persons With AIDS Society (BCPWA).

Most interesting revelations:
I found each speaker to be engaging and informative, while presenting very unique perspectives. I learned a lot from Dan Small about the obstacles he and his team had gone through (and still do) to establish and run the safe injection site. It was also refreshing to hear from Sonja, and how other UBC students like herself advocate fair access to medicines that help treat HIV/AIDS in developing countries. I was particularly struck by the final speaker’s comments on being a person living with HIV. One message I took away from the final speaker’s talk was one that I found very touching and powerful, regarding his experience with the compassion of others. Paul showed a painting by Sir Luke Fildes (1887) that illustrates the compassion that his doctors had shown him, and that has helped console him by giving him hope that there is kindness in humanity despite the darkness he has faced as a result of his diagnosis:

http://www.artmagick.com/pictures/picture.aspx?id=7284&name=the-doctor

One audience member asked how we can help with the BCPWA, or in any way at all. Paul’s answer was meaningful and tangible: he said to become educated about HIV/AIDS (not only its causes, but also its spread, what individuals living with HIV go through, etc), to be a volunteer with organizations like his if we can, and, most importantly, to show compassion.

I went to the same event as Natasha the Speaker Series on HIV & AIDS, held by AIESEC UBC on March 2nd.

Most interesting revelation, I would say, is the talk that Dr. Dan Small gave since I didn’t know much about the work he has done. He is a medical anthropologist and one of the founders of Insite, the safe injection site in the Downtown Eastside. His presentation was really interesting and brought up a lot of issues surrounding the people living in the Downtown Eastside. He believes that people with addictions are treated as lepers and have a huge amount of barriers when it comes to housing, having a bank, health care, and dental for example. Many of the projects he’s involved in remove barriers and allow people living in the Downtown Eastside to have homes without worrying about eviction and bank accounts even though they are living off of very little money and have no form of ID. Also, Insite along with their community transitional care team provide low barrier care and create a place where people can go if they need medical attention and if they need a clean needle to use drugs. This prevents syringe sharing so decreases HIV/AIDS, prevents overdose deaths, and decreases skin infections. Other goals of the program are the direct referral of people to detox and treatment programs.

Overall, I think Insite is a great program and the removal of barriers is a key solution in providing some sense of humanity to the people living in the Downtown Eastside.

I attended the same AISEC discussion “Reaching people in the Shadows of Life”, and the 3 speakers shared insights that I found very impactful. Paul, the speaker who works for PWA that Natasha and Alcina mentioned, told us about not only what he does in promoting outreach for the PWA organization, but also the challenges and discrimination he faces as a person coping with AIDS. He gave a very moving talk about the time when he was diagnosed with AIDS, the reaction of his doctor (which floored me; he described how his doctor’s compassion changed the way he viewed his own disease and how it was one of the most touching moments of his life). As someone who plans to work in healthcare, I was reminded of the importance of stepping back from the objectivity that medicine can trap us in, to open our hearts to all those we mentor. I took away much from what he had to say because I found it very ‘real’, open and uplifting. He also clearly described the science behind HIV, the undesirable side-effects of the medication that labels him as ‘an AIDS patient’, and how he chooses to keep taking the medication that gives him these symptoms, despite there being alternate ones that would not show visible side-effects. That defines conviction to break stereotypes lingering in society, to not only bravely face them, but also hold them in the light with determination.

A representative from the UAEM (Universities Allied for Essential Medicines) came to speak as well. She described the complexities of the pharmaceutical industry, the detrimental impacts of it on developing nations, and also, most interestingly, the role UBC plays to alleviate that detrimental impact. Once drugs make reach the stage to be made for the community, UBC is involved in collaborating with both larger pharmaceutical companies (who sell for an incredible profit; UBC, in turn, benefits from that profit) and smaller pharmaceuticals that provide to the developing world; these, as predicted, provide to many more people and make much less of a profit…in terms of wealth, that is, which is worth much less than our significant role in alleviating global discrepancies in access to essential medicines.

More about the organization and the unique position that universities take on:
http://essentialmedicine.org/issues/access-gap

I attended the same event as my classmate above which was presented by AIESEC UBC. The name of the event was Speakers Series on HIV & AIDS and it was held on March 2 in global lounge.
As Natasha has described, we had 3 speakers during the presentation. Medical anthropologist Dr. Small, Sonja who was the presenter from Universities Allied for Essential Medicines UBC chapter and Paul from BC Person?s with Aids society. All of these speakers were very knowledgeable and they covered interesting perspectives regarding the work they are involved with. Overall, I really like this speaker?s series as a whole because it covered different angles through the unique perspective of each individual speaker.
Dr. Small gave a powerful speech describing his work and his involvement with the Safe injection site program. He described that the main purpose of the injection facility is harm reduction. Safe injection site was introduced in 2003. He further talked about the complexity and the barriers that people with addiction face and how their access to many things are denied in the society. The program is designed to help them overcome or reduce these barriers. To name a few, providing a place to live, free dental service in their dental clinic and an ID to be able to have bank account through their life skill classes are some aspects of the program. Furthermore Dr. Small explained preventing overdose death, preventing sharing of syringe and unclean equipment and deceasing incidence of HIV/AIDS/HCV (Hepatitis C virus) are the primary biomedical goals of the Vancouver?s Safe Injection Facility. Furthermore, reducing skin injection and increasing detoxification and treatment referrals are the secondary biomedical goal. Lastly, the cultural goal as Dr. Small mentioned is to ?validate Humanity? and bring the ?marginalized population? into healthcare. I thought this statement was very powerful. I think more people need to be educated about the safe injection site program in order to appreciate its benefits.
For more information on InSite you can visit:
http://supervisedinjection.vch.ca/home/
Sonja was the Universities Allied for Essential Medicines (UAEM) presenter. What I found interesting about her talk was that she pointed out the reason behind the high cost antiretroviral drugs. Surprisingly ~57% of the cost is allocated to marketing, administration and profit!!! University students can play an important role in helping reduce the cost of essential medicine in developing countries. Sonja gave an example that the result of negotiations of university students activists for developing countries, the cost of Stavudine which used to be the first line of drug treatment for HIV, reduced from 15,000$/person/year to ~89$.
Lastly, Paul from BCPWA talk was very heartfelt and touching as he described his experiences and work involvements.
Overall, Great and very informative Speaker Series!

I am sorry again for some reason my apostrophe and quotation marks come up as question marks! Sorry about confusion!

I attended a talk by Donna Barry, a nurse practitioner working with Partners In Health (PIH) in Haiti. Her talk in Vancouver on March 22nd was about post-earthquake Haiti and how different issues are being dealt with by PIH.

PIH has been serving 3 of the largest camps for internally-displaced people in Haiti since the earthquake. Their goal is to increase capacity, enhance clinical operations, and implement public health infrastructure. Their values lie in ensuring that in addition to medical and financial aid, social support, community development, and poverty alleviation are also incorporated into the reconstruction plan.

Some of my most interesting revelations included the consideration of the role of NGOs and the incorporation of mental health programs.
Donna Barry made an interesting comment about the contract-based nature of NGOs and how these short-term contracts lead to unsustainable reconstruction plans and unmaintained infrastructure.

The inclusion of mental health care in PIH’s public health infrastructure plans is particularly interesting; post traumatic stress and depression are important considerations following disasters, and it would be interesting to look at how well these programs are working. They claim to be very participatory and based on local knowledge. If these programs are effective, they would be good models to pursue.

I went to a portion of the Global Indigenous Conference last Friday, April 1st. The conference was held at the First Nations Longhouse at UBC. The conference highlighted Aboriginal realities in Canada and also raised the issue of Canadian mining in Peru. A group of indigenous Peruvians made up one of the panels and from what I gather, they shared their stories and struggles regarding the mining exploitation on their land. The two panels I was present for focused on self-determination and Aboriginal health in Canada.

From listening to the panels, I got a better sense of how these two topics are quite linked actually, as Aboriginal people’s health and their ability to provide their own healthcare and healing requires self-determination. However, gaining self-determination requires not only the cultivation of it within Aboriginal communities but also the Canadian government’s support, which is a challenge. A positive move in the direction of self-determination is the number of healing centers that have been built in certain Aboriginal communities across Canada. Ideally these enable Aboriginal people to receive quality care and healing that embraces the Aboriginal perspective on holistic health, in centers near their home communities. Issues of funding may arise and could pose a challenge to these health centers.

Another two key elements of Aboriginal self-determination that come to mind are Aboriginal-based education and maintaining a healthy natural environment.

Name of event: Camp2Campus

Summary: Friends of MSF along with a coalition of other UBC clubs banded together to create an education exihibit on the living conditions, issues, and aid involved in refugee camps around the world. Seen through the eyes of MSF, the day portion consisted of displays such as a) Food & Malnutrition b) Health & Clinics c) Water & Sanitation d) Human Rights e) Shelter
f) Connections to Canada. I was apart of the planning committee for the Clinics display and had my hand in acting as a logistician, explaining the state of health and clinics of refugee camps to visitors.

There was also a nighttime portion where a number of presentations given by a nurse who spoke about her experiences with MSF in refugee camps abroad, a panel of refugee lawyers, and a seminar led by STAND discussing the situation in Darfur, Sudan.

Most interesting revelations:
I found the evening portion of the event to be quite informative as well as interesting. The presentation given by the MSF nurse reiterated what I already knew about Doctors Without Borders (MSF) but it also revealed to me specifically the routine operations that MSF underwent during emergency situations. The nurse explained the Top 10 List of Things to Accomplish in any given operation, with an overview of each given scenario being number one and Measles vaccinations as number two in order of importance. It was enlightening to hear about her personal experiences in Liberia, Somalia, and Darfur as well. I feel that I have a better sense of what MSF stands for after watching her presentation.

The Darfur seminar presented by STAND taught me a lot about the situation in Darfur in terms of politics and history. Before the seminar, I had very little knowledge about Darfur and I felt that STAND did a wonderful job in summarizing the important points. The thing that moved me the most about the seminar was the second portion which dealt with the personal perspective of humanitarian aid works working in Darfur. One of the STAND members presented ‘Six Months in Sudan’ by Dr. James Masalyk, oftenquoting from the book itself to emphasize the hardships experienced and rewards reaped through Dr. Masalyk’s MSF experience in Sudan. The segment really struck a chord in me about why I want to go into aid work. Masalyk’s reasoning to go into aid work was that he wanted to see who he was when everything was taken from him – when there was no insulation between himself and the world. I found that specific quote very meaningful to me and I know it is something that will stay with me forever.

I am currently in the process of looking to buy my own copy of ‘Six Months in Sudan’. 🙂

Name of event: Environmental Change in Darfur
The event was a short presentation and discussion of the environmental factors that are affecting the people of Darfur today. We discussed the impact of climate change as force which is increasing food insecurity in the nation as well as deforestation. People in the North are being continually pushed southward as arable land is disappearing. Food aid is very prevalent as a means of approaching malnutrition. There are also efforts now to replant forests to improve the regional climate.

I didn’t know much about the geography of Darfur before. It was interesting to get some historical geographic information, and very scary to think of the changes that are happening and the rate at which desertification is occuring (1km every ten years I believe). It also was sad to realize how much our actions effect vulnerable populations. Warming will actually increase arable land in Canada while Darfur becomes a desert.

I guess my main frustration with the session was the limited amount of time but also the lack of overview of the situation in Darfur. I don’t actually know that much about the history there and was hoping to learn quite a lot from this event. I was a bit underwhelmed. There was some interesting discussion amongst my group but often I felt like everyone was on a different page but trying to debate.. it’s not very productive.

I attended The Global Health Symposium on March 22 held by the Friends of MSF. It was more of a club meeting but it was an interesting and informative night. We started the night with our very own Dena’s presentation on the Shinyanga region of Tanzania. She spoke about her experience and hardships that she faced during her stay there. Some of which include becoming accepted into the community due to her race, communicating skills due to language barriers and so on. After her presentation, the MSF announced the winner of the 2011 essay competition. I do not remember her name but her essay was on female circumcision in some parts of the world.She gave us a brief over view of her essay which led to interesting discussions. One of the cases she gave was about a doctor who was working in a small community in Africa I believe. She was stuck between 2 decisions of providing clean, sanitized utensils to those who do the circumcision or not to provide anything so that she would not be promoting the activity. As a little over view of the issue, female circumcision is very common in some places in the world. Once a girl reaches puberty, they tend to circumcise her and most often, the utensils used are very dull and dirty as there are no resources of clean materials. It must also be added that most girls actually want to get the surgery and this is in part due to the categorization of sexuality as something awful and unacceptable.

I kept thinking about what I would do if I were in that doctor’s position with having to choose a path to go on. The first thought that came to mind was the similar situation of our safe injection sites. The doctor who was working for an organization ended up not giving the sanitized materials. If it were me, although it would be an extremely difficult decision, I would have gave it. Even though it is very unethical and unacceptable in nature, it is a process that is so deeply embedded in their cultures that it would be very difficult to stop. Thus, no matter what our decision is, the community members would continue their practice so why not provide safer method for them instead of allowing them to continue using dull blades and other materials that are cleaned with only dry wipes. After all, it is what we are doing in BC with our safe injection sites. Just because it is morally and culturally unacceptable to us, should we refuse to help individuals and allow them to continue causing health problems from being unsanitary?

Name of event: Gallery Dinner with Dr. Helen Caldicott

A physician, an author, and a Nobel Peace Prize nominee, Dr. Helen Caldicott has devoted the last 38 years to an international campaign to eradicate the use of nuclear weapons and nuclear power.

Summary:
Dr. Nuclear power is commonly perceived as the ?clean and green? energy source. Dr. Caldicott, in her 38 years of work on anti-nuclear activism, uncovers that nuclear energy creates significant greenhouse gases and pollution, and is ?on a trajectory to produce as much as conventional sources of energy within the next one or two decades.? She mentions that nuclear power plants are invitation targets for terrorists and attacks. The subsequent meltdown can induce large scaled death and long term diseases from the radiation exposures.

Most interesting revelations:
When we hear about nuclear energy, we are only told of how green it is when power plants are used to generate energy. The part of how power reactors run is entirely wiped out of public knowledge. In order to run nuclear power reactors, we need to mine and refine uranium. This process is done by using traditional fossil fuels which emits CO2 into the atmosphere. The uranium, when it is enriched, needs large amounts of chloroflurocarbon (CFC). CFC destroys the ozone layer and is 10,000-20,000 times more deadly than CO2.

Points made that I disagree with (if applicable):
I find it a little extreme to claim that nuclear power plants are invitation targets for foreign attacks. While the risks exist, most nuclear power plants are built to withstand bombs and air attacks. Some new ones are even protected against hurricanes, earthquakes, and other extreme natural disasters. Some people might use Fukushima to argue this point, but the power plants at Fukushima are 40 years old. The time span of 40 years can have quite a drastic impact to the development of our technology.