Stay tuned to Global Pulse Blog for more views on this monumental speech and its implications.

Yesterday, Secretary of State Hillary Rodham Clinton declared the U.S. government’s intent to create an “AIDS-free generation.” Secretary Clinton outlined a bold plan to reduce new HIV-infections, globally, including the eradication of pediatric HIV by 2015. This new strategy builds upon the success of the President’s Emergency Plan for AIDS Relief (PEPFAR), the U.S. program that addresses HIV/AIDS in resource-limited settings.

A notable feature of Secretary Clinton’s “AIDS-free generation” initiative is to strengthen healthcare systems in sub-Saharan Africa. Clinton stated:

“We know we can’t create an AIDS-free generation by dictating solutions from Washington. Our in-country partners — including governments, NGOs, and faith-based organizations — need to own and lead their nation’s response. So we are working with ministries of health and local organizations to strengthen their health systems so they can take on an even broader range of health problems.”

Strengthening African healthcare systems is a view echoed by many eminent voices in the global health community. Last year, the Institute of Medicine (IOM) of the National Academy of Sciences authored a report entitled: “Preparing for the Future of HIV/AIDS in Africa: A Shared Responsibility.” The IOM report recommended the urgent need to increase African healthcare workforce capacity to address the HIV epidemic.

I offer Secretary Clinton a solution to assist African healthcare workforces and ensure the success of the “AIDS-free generation” initiative. Last year, in an editorial in The New England Journal of Medicine, Vanessa Kerry, Sara Auld, and Paul Farmer reintroduced the idea of enacting a Global Health Service Corp (GHSC). The GHSC, compromised of U.S. healthcare professionals, would provide medical education and technical assistance to enhance the healthcare workforces in low-income countries. The GHSC’s goal would “go beyond that of filling a human resource void to focus on infrastructure development, knowledge transfer, and capacity building.” The GHSC could also offer partial student loan forgiveness for U.S. corps members who engage in service abroad for a specified time period similar to the loan forgiveness offered by the National Health Service Corp.

To address the African healthcare workforce shortage, I encourage Secretary Clinton to adopt the principles of the GHSC. The success of the “AIDS-free generation” initiative depends on the availability of skilled healthcare workers in African resource limited settings. Additionally, the eventual transition from a U.S. to African led HIV/AIDS response requires the U.S. to teach and train healthcare personnel in recipient countries through collaborative partnerships that eventually lead to African ownership of their domestic healthcare needs.

Some may argue that enacting the GHSC, especially in the era of U.S. government austerity measures, is not prudent. However, the funding for the GHSC already exists. In addition to HIV/AIDS prevention and treatment, PEPFAR’s congressional mandate requires the program to “strengthen partner government [healthcare] capacity to lead the response to this epidemic and other health demands.” Last year alone, PEPFAR committed over $734 million in healthcare capacity building initiatives.

Global health is the moral litmus test of our time. As Secretary Clinton asserted: “An AIDS-free generation would be one of the greatest gifts the United States could give to our collective future.” The U.S. should enact the GHSC to ensure the success and sustainability of the “AIDS-free generation” initiative.

-Anand Reddi, The Huffington Post

If you are interested in supporting the Global Health Service Corp please sign the petition to show your support. http://www.globalhealthservicecorps.org/index.php/petition/

Additionally, the Medical Student Section of the American Medical Association is considering a resolution endorsing the GHSC at its 2011 Interim Meeting in New Orleans, Louisiana.

Kaiser Family Foundation recently held a webcast on “The Future of US Multilateral Engagement on Global Health“ as part of the Foundation’s US Global Health Policy: In Focus live webcast series. This question and answer format webcast featured an expert panel including Mark Abdoo the director for Global Health and Food Security, Natasha Bilimoria the president of Friends of the Global Fight Against AIDS, Tuberculosis, and Malaria, and Jennifer Kates the vice president and director of Global Health Policy & HIV for the Kaiser Family Foundation, moderated by senior analyst Josh Michaud.

This discussion explores the approach taken by the United States to address Global Health funding historically and looking into the future. Discussions on global health funding often involve a division between bilateral approaches to funding versus multilateral funding engagement. Bilateral funding involves the provision of direct assistance from one government to, or for the benefit of, one or more other countries, with the donor having significant control over the target, approach and content of assistance. On the other hand, multilateral organizations such as the World Health Organization, the United Nations and the Global Fund, bring together global stakeholders to develop and collaborate on global health targets.

Historically, the US has commonly supported global health priorities via bilateral funding and programs but the focus on promoting multilateral organizations is growing. For example, the US was the first and is currently the largest donor to the Global Fund to Fight AIDS, Tuberculosis and Malaria, and a key component of the Obama Administration’s Global Health Initiative includes a renewed and increased commitment to multilateral engagement. The shifting approach has led to questions regarding the appropriate focus for US global health engagement, the proper balance between multilateral and bilateral funding efforts and the appropriate role of the US government and other organizations in international treaties and other collaborative agreements.

Check out this and more global health-related webcasts and other valuable resources on global health policy at the http://www.kff.org/ website. A more detailed discussion on the US Government’s Global Health Policy Architecture is also available.

• End Poverty and Hunger
• Universal Education
• Gender Equality
• Child Health
• Maternal Health
• Combat HIV/AIDS
• Environmental Sustainability
• Global Partnership

The Millennium Development Goals Report 2010 summarizes the progress which has been made thus far while striving to meet these goals as well as potential actions, strategies and policies which could be implemented to continue positive progress.

As I have written previously, medical professionals, students, and human rights groups in New York State are teaming up for action to pass the nation’s first law holding medical professionals accountable for assisting torture and abuse of prisoners.  AMSA is proud to join the list of organizations putting their support behind the proposed legislation:

• National Physicians Alliance
• Committee for Interns and Residents
• American College of Physicians-NY
• NY State Nurses Association
• NY Civil Liberties Union
• Center for Constitutional Rights
• Human Rights Watch
• Amnesty International
• Physicians for Human Rights
• I Have A Dream Foundation
• Metro NY Religious Campaign Against Torture
• (full list and statements at whenhealersharm.org/)

ANTI-TORTURE LOBBY DAY in Albany: Join AMSA and PHR with medical students from across the state in our first Anti-Torture Lobby Day in Albany on May 18th!  This is our chance to meet with our local lawmakers and tell them that ending torture is important to us as ethical medical professionals and Americans.  We will meet at 9AM for a white-coat press conference and advocacy training with experts from the Bellevue/NYU Program for Survivors of Torture, and follow up with advocacy meetings.  If you are a NY State resident and a medical or pre-medical student, don’t miss this chance for real-time local action for human rights!

Don’t forget to sign the petition: Stop Torture NY.org

Read AMSA’s statement of support after the cut:

From AMSA’s Letter of Support:

]]> http://www.globalpulsejournal.com/blog/index.php/2010/05/11/action-alert-amsa-anti-torture-ny-may-18th/feed/ 0 http://www.globalpulsejournal.com/blog/index.php/2010/05/05/action-alert-aids-funding-protestin-nyc/ http://www.globalpulsejournal.com/blog/index.php/2010/05/05/action-alert-aids-funding-protestin-nyc/#comments Wed, 05 May 2010 15:56:56 +0000 Hana Akselrod http://www.globalpulsejournal.com/blog/?p=875 Farheen Qurashi, AMSA’s Jack Rutledge Legislative Director 2009-2010, and Mary Carol Jennings, AIDS Advocacy Network Chair 2009-2010, contributed to this post.  To join this event in NYC on May 13th, please contact Farheen at jrld@amsa.org.

On the campaign trail, President Obama pledged “to provide at least $50 billion by 2013 for the global fight against HIV/AIDS, including our fair share of the Global Fund, in order to at least double the number of HIV-positive people on treatment and continue to provide treatments to one-third of all those who desperately need them.”  HIV/AIDS patients and their advocates, including AMSA members, were important in getting then-candidates Obama, Clinton, and Biden to commit to these figures.

However, since taking office, the Obama Administration’s budgets have flatlined funding for AIDS programs.  Our commitments to fighting AIDS have not even kept pace with inflation: PEPFAR funding increased by only 2%  in 2010, while annual  inflation in most African countries is 7%.  Now, clinics around the world are reporting turning away patients with clinical AIDS who would previously have been treated, due to funding cuts (ITPC, 2010).

On May 13th, AMSA will be gathering for a white-coat protest at a Democratic Party fundraiser at St. Regis Hotel in NYC, to remind President Obama of his promises.  We will be joining activists from ACT UP, Africa Action, African Services Committee, NYC AIDS Housing Network, VOCAL-NY Users Union, Housing Works, Health GAP, Philadelphia Global AIDS Watchdogs, and other allies.  Join us, and let the President know that extending AIDS funding to meet the global need is important to you!  Please contact Mary Carol Jennings (marycaroljennings@gmail.com) for more details.

UPDATED: [05.11.2010] More information and disclaimer after cut.

If you are coming from Philadelphia or Washington D.C., Health GAP is providing free buses. Contact Kaytee Riek, Health GAP’s Director of Organizing, at kaytee@healthgap.org.

Read more about the AIDS funding shortfall at the New York Times: Cutting AIDS Funds Risks “Death Sentence” (Apr. 26, 2010):

The International Treatment Preparedness Coalition (ITPC) found patients are being turned away from treatment programs and AIDS drug stocks are running out because of government budget cuts and flatlined funding from major donors like the U.S. President’s Emergency Plan for AIDS Relief (PEPAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria.

“Governments, North and South, cannot afford to put the clock back and return us to the days when HIV was a death sentence,” said Aditi Sharma, coordinator of the report.

The report said the Global Fund would need $20 billion over the next three years to help meet health-related U.N. Millennium Development Goals (MDGs), but said G8 nations and other donors were warning that raising $13 billion is a stretch. It also highlighted funding pledges that had never properly been met or were being cut because of the global downturn.

DISCLAIMER: Your safety and comfort are our top priorities. AMSA does not condone, endorse, or support any activity which could put you at risk or make you uncomfortable. AMSA is not asking, encouraging, or requiring you, its members, and/or its leaders to participate in any activities that would put you at risk or make you uncomfortable.

[Updated 05.11.2010]

U.S. student activists

Just a few days ago, we celebrated World Health Day – the progress we’ve made in providing aid to patients around the world, the diseases prevented and the treatments admitted. But, we still have a long way to go, and as we celebrated, we also remembered that there is much to accomplish and continue in global health aid.

Two weeks ago, Rep. Barbara Lee (CA-9^th) introduced HR 4933, the Global HEALTH Act of 2010. This is a key piece of legislation that makes bounds towards creating a comprehensive and integrated global health aid strategy, focusing on strengthening health systems of developing countries to provide comprehensive primary to tertiary care as well as expanding the vital health care workforce – including doctors, nurses, midwives and community health workers—in needy areas. There is a dire international shortage of all kinds of health workers, and this is a bottleneck to providing sustainable and adequate care to patient populations – strengthening the health workforce is a key part of strengthening an overall health system.

Importantly, the Global HEALTH Act:

• Creates the Global Health Workforce Initiative, which emphasizes training, retention, and support for needed health workers
• Mandates the creation of a multi-year, in-depth strategy for health systems strengthening, and authorizes necessary support for this strategy
• Ensures country-ownership and accountability to health strategies
• Authorizes support for health strategies to ensure the swift achievement of US global health goals
• Prioritizes the needs of marginalized and vulnerable populations like women and girls, sex workers, etc.

On the cusp of the US’s own health system reform movement, we must also remember our patients in need around the world. The Global HEALTH Act makes a much-needed and bold step forward for global health aid, and AMSA is proudly one of its original supporters, along with Physicians for Human Rights, Health Alliance International, Health GAP (Global AIDS Project), and other organizations.

The Global HEALTH Act, HR 4933, is currently awaiting discussion in the Foreign Affairs and Financial Services Committees of the House of Representatives. For the ideas within the bill to receive recognition, support, and success, we must ask our Congressmen to show their support by co-sponsoring the legislation.

To send your Congressman a message, click here.

To find out more about the Global HEALTH Act, click here.

To read the full text of the bill, click here.

This is the second in a series of posts for the American Public Health Association’s National Public Health Week.

Today, Wednesday April 7th marks World Health Day 2010. This year, the UN Secretary-General’s Message for World Health Day centers on the theme of urbanization and health with the campaign “1000 cities – 1000 lives.” The theme of Urban Health was chosen in the setting of a world in which the majority of the population is living in urban versus rural areas for the first time in history. At the same time, poverty is also shifting from sparsely-populated rural areas to urban areas especially in developing countries.

Disparities in people’s income, opportunities, living conditions and access to services along with numerous threats to public health including inadequate sanitation and refuse collection; industrial and traffic pollution; infectious diseases that thrive on squalor and crowded conditions; high rates of tobacco use; physical inactivity; unhealthy diets; crime, violence and the use of harmful substances are complex issues depending not only on public health measures but also social policy and governmental structures.

Source: Wikipedia

This is the first in a series of posts for the American Public Health Association’s National Public Health Week.

Most of us associate biodiversity with images of tropical rain forests and coral reefs. While these ecological hot-spots are an important source of medications and global ecosystem services, biodiversity also plays a key role in neighborhoods across the US through regulating the spread of diseases such as Lyme disease. But how is that possible, you might ask, and what can you do about it?

Lyme disease  affects hundreds of thousands of people across the US, with a greater concentration in the northeast. Recent decades have seen an explosion of urban sprawl across the northeast leading to decreased species diversity along with people living in close proximity to fragmented habitats.  But how are these related?

The connection is explained succinctly in Sustaining Life: How Human Health Depends on Biodiversity:

“The Blacklegged Tick (Ixodes scapularis) is the vector of Lyme disease, as well as of several other pathogens in the eastern U.S., and the primary reservoir for Lyme disease in this region is a common rodent, the White-Footed Mouse (Peromyscus leucopus)…Mice live in many different habitats, from pristine old-growth forest to degraded woodlots, garden sheds, and even kitchens. Several studies have demonstrated that populations of White-Footed Mice become very concentrated in small forest fragments, probably due to the absence of other vertebrate species that prey upon, or compete with them (forest fragmentation…affects predators over prey disproportionately). As a consequence, tick populations in small forest fragments have many White-Footed Mice, but few other mammalian hosts on which to feed, resulting in a high proportion of the ticks being infected and able to infect people. In contrast, in more extensively forested areas, the combination of fewer White-Footed Mice and more abundant, alternative, reservoir-incompetent hosts (an incompetent reservoir for Lyme does not pass on the Lyme bacteria to ticks that bite them, or does so poorly) results in a lower proportion of the tick population being infected.”

This phenomenon is known as the Dilution Effect: As species richness declines there is a subsequent decrease in the “dilution” of host-species making Lyme disease easier to spread. As the authors note, the dilution effect is not unique to Lyme, the same mechanism also operates in Hantavirus and West Nile Virus and possibly many others. As sprawl-based development patterns spread to more areas of the planet, we can only expect to see an increase in the number of dilution effect diseases unleashed upon populations worldwide.

So how can you increase biodiversity in your community and thereby help protect the health of your family and neighbors?

Get involved with your local conservation commission and bring these dangers to their attention. Find ways to support local parks and nature preserves. Also, if you have a yard or garden, try to plant local species that help support wildlife.  Most importantly: Education! If you are in college or school, talk to your professors about integrating awareness of biodiversity into curriculum.  Thanks to the UN and various donors, Sustaining Life is available at a very affordable price and can serve as a great textbook without placing a great financial burden on students. In addition, local schools can serve as great sources of biodiversity through gardens and planting of local species on grounds. Often these locals are less expensive to maintain, requiring less water and fertilizer.

These are just some ideas…we’d love to hear from GP readers with their experiences and success stories.

But long time advocacy is finally paying off as the WSJ reports that World Bank and the Indian government are set to spend $4 billion to “to ensure that by 2020 no untreated municipal sewage or industrial runoff enters the 1,560-mile river.”.  The methods proposed also have the benefit of being less carbon and electricity intensive than traditional wastewater treatment plants – key aspects for a country with chronic brownouts in a warming world.  In order to reach their goal, the government and partners will need to engage the most neglected slums which, if done right,  has the potential to create environmental justice at the same time as cleaning the river.

Of course, governments have a tendency of announcing lofty environmental goals which are then forgotten in the next election cycle. The Ganges also had a previous cleanup effort that failed to reach its goals, partly because of lacking public participation. Hopefully things will be different this time, but GP would love to hear from anyone with on the ground insight.

————–

Earthquake Crisis in Haiti

Original post by Wilnise Jasmin [01.14.2010 @ 6:53 AM EST]

As you may have already heard, a 7.0 magnitude earthquake struck about 10 miles southwest of Port-au- Prince, Haiti at about 5 pm Tuesday night. The quake ravaged the infrastructure of Haiti’s fragile government and destroyed some of its most important cultural symbols.

“Parliament has collapsed,” Mr. Préval told The Miami Herald. “The tax office has collapsed. Schools have collapsed. Hospitals have collapsed. There are a lot of schools that have a lot of dead people in them.” He added: “All of the hospitals are packed with people. It is a catastrophe.”

President Obama promised that Haiti would have the “unwavering support” of the United States.

Haitian authorities and humanitarian aid organizations are struggling to respond amid devastation.

A Red Cross field team of officials from several nations had to spend Wednesday night in Santo Domingo in the Dominican Republic to gather its staff before taking the six-hour drive in the morning across the border to the earthquake zone.

Here are some various ways to help with the recovery:

• American Red Cross
• Center for International Disaster Information
• On this website, there have been posts containing information about missing relatives. If anyone can possibly account for anyone please do.
• Partners In Health, and their partner organization in Haiti, Zanmi Lasante, are familiar to many of us from Tracy Kidder’s book Mountains Beyond Mountains.  They have been working in Haiti for over 20 years, in times of emergency as well as in a long-term commitment to improving the health infrastructure.  They are currently looking for qualified surgeons and nurses.
• More organizations
• Build a fundraising page with MercyCorps

————–

Updated [01.14.2010 @ 3 PM EST]: Key news items and op-eds:

• Barack Obama: “Unwavering support”
• U.S. grants temporary protection status to Haitians; sends troops
• Red Cross: 45,000-50,000 dead
• Tracy Kidder: Country Without a Net
• Bill Clinton: What we can do to help Haiti, now and beyond
• Nicolas Sarkozy: Time to end Haiti’s “curse”

Updated [01.14.2010 @ 11 PM EST]: US Military Plan of Action Established and Underway

Secretary of Defense, Robert Gates has shifted all of the resources of the US Department of Defense towards providing relief. General Douglas Fraser of the US Southern Command publically announced the Haiti relief plan on Thursday at a press conference held at the U.S. Southern Command Headquarters in  Doral, Florida. The main areas addressed by Douglas focused on improving life sustaining capabilities and to provide assistance  in the relief efforts in order  to mitigate the suffering as soon as humanly possible. Some of the areas discussed:

• An  initial Commander and  Control  has been set up until communication capability has been reestablished
• Opening the air field and making it operate on a  24/7 schedule
• 4 Coastguard cutters to provide helicopters and any additional support it can
• A navy destroyer will also be providing helicopter support as well as the fuel needed to keep all the helicopters running.
• A Threat and Disaster Relief assessment team has been organized in order to  get an accurate survey of the extent of the damage
• Paratroopers have been dispatched
• Carrier USS Carl Vinson is scheduled to arrive on the morning of the 15th to provide additional helicopters and serve as the platform that will alleviate the organization problems faced due to the poorly established infrastructure that currently exists in Haiti
• Marines are scheduled to bring the heavy equipment necessary to provide capacity and capability on the 19^th
• USNS Comfort hospital ship is is scheduled to arrive on the 22^nd

Updated [01.15.2010 @ 12:30 PM EST]: The Big Picture

Two days later, the extent of the damage is seen in these harrowing photographs at the Boston Globe.  Click on the image to see the photo-essay of devastation and rescue.

Updated [01.15.2010 @ 4 PM EST]:

• The U.S. military reopens the Port-au-Prince airport

Updated [01.15.2010 @ 8:30 PM EST]:

• Port-au- Prince is not the only area in Haiti that needs help.

Updated [01.16.2010 @ 10:30 AM EST]:

T-Mobile USA Waives Call Charges to and From Haiti

• T-Mobile USA is enabling phone calls for current customers to Haiti without charges for international long distance through January 31, 2010, and retroactive to the earthquake on January 12, 2010. Additionally, T-Mobile customers who may already be in Haiti will be able to roam on T-Mobile’s partner networks in Haiti (operated locally in Haiti under the names Voila and Digicel) free-of-charge through the end of the month.

• T- Mobile also pledge to assist in wireless restoration.

Updated [01.17.2010 @ 10:30 AM EST]: Prevention and Rebuilding

Many are asking if this tragedy that resulted from the earthquake could have been prevented. Back in 2008 two geophysicists who study fault lines in the Caribbean predicted that the fault line that Haiti sits upon called the Enriquillo fault could produce a 7.2 magnitude quake.  The plates of the fault had been slipping past each other at about 7 millimeters per year for the last 250 years and the geophysicists predicted that it was time to snap.

While the earthquake could not have been prevented, the scientists believe that there was enough forewarning to implement emergency plans for when the earthquake would occur.  While the limited resources of Haiti did not allow it to upgrade every single building standing, some buildings , such as hospitals and governmental buildings, could have been designated as critical and plans to strengthen these could been made.  These areas could have served as the base from which all rescue efforts could be organized.

Unfortunately these plans were not made and to dwell on the errors of the past will not resolve the current problems that exist today.   Once all rescue efforts have been exhausted, we can take learn from the errors that were made and not repeat them.  When the reconstruction phase begins, NGO’s like Architecture for Humanity can work to ensure that another tragedy like the one that occurred this week will not recur.

Updated [01.17.2010 @ 11:30 AM EST]: Earthquake on Ocean Floor

On Sunday morning, a 6.3 magnitude earthquake was detected by seismologists In the Drake Passage on Atlantic Ocean floor between South America and Antarctica.  The quake had no effect on nearby lands.

Updated [01.17.2010 @ 10:00 PM EST]

The CDC has deployed staff to Haiti to assist in the emergency response and guide the efforts to minimize public health impacts in the coming months.  It has also updated several relevant resources for health care providers and responders:

• Guidance for Relief Workers and Others Traveling to Haiti for Earthquake Response
• Emergency Wound Management for Healthcare Professionals
• After an Earthquake: Management of Crush Injuries & Crush Syndrome
• CDC’s Earthquake Webpage
• Health Recommendations for Relief Workers Responding to Disasters
• Public Health Issues and Priorities for the Haiti Earthquake
• Travel Health Warning
• CDC Emergency Twitter account
• Haiti Disaster Volunteering

Updated by Jennifer Weinberg [01.19.2010 @ 9:00 am EST]

Partners in Health (PIH) is one of many organizations from around the globe dedicating efforts to the earthquake victims in Haiti. As this organization has been working in Haiti for over 25 years, they are in a unique position to understand the multitude of factors contributing to this tragedy.

Watch a PIH Executive Director Ophelia Dahl discuss the importance of long term rebuilding efforts with CBS’s Katie Couric.

Read an op-ed by PIH co-founder Paul Farmer focusing on the importance of building back better.

Updated [01.20.2010 @ 2:20 PM]:

As inquiries about volunteering in Haiti keep pouring in, while after-shocks rattle the island and life-saving supplies are turned away for lack of logistics support, the World Journal of Surgery shares some thoughts on the “cardinal sins” of humanitarian medicine.

Updated [01.20.2010 @ 8:30 PM]: More ways you can help

• If you are a health professional interested in volunteering to help, the American Academy of Family Physicians can link you organizations that are in Haiti.

• The Pan American Health and Education Foundation’s is an independent philanthropic organization working to build public health expertise to be able to innovatively lead development of healthier generations of people in the Americas.  It has set up a  Disaster Relief Fund to help bring critically needed emergency supplies for affected families and to support recovery efforts in Haiti.

• Habitat for Humanity has worked with Haiti for over 26 years and will continue to serve the people there by helping to rebuild.

• Nine Medical Teams International volunteer physicians and nurses are hard at work at various hospitals in Port au Prince. At Kings Hospital, a 350 bed inpatient facility that survived the earthquake the physicians are providing  care to those who would have died without the help of the volunteers.

Updated [01.21.2010 @ 11:30 PM]: When Good Intentions Make Things Worse ;   Record Donations; and Mass Movements

Haitian government figures relayed by the European Commission put the death toll at 200,000, with 80,000 buried in mass graves. The commission now estimates 2 million homeless, up from 1.5 million, and says 250,000 are in need of urgent aid. The countless number of untreated injuries that many Haitians still have will continue to add to the earthquake’s death toll. Lack of food and water will also contribute to the death toll.  .”  Partners in Health, an organization that has been providing health care in Haiti for two decades, estimated that 20,000 Haitians were dying daily from lack of surgery.

In an effort to prevent the loss of more lives, health experts have arrived in Haiti from Israel, Cuba, Portugal and other countries, many with stocks of medicine and supplies as well as extensive experience in disaster conditions. And the United States Navy hospital ship Comfort pulled up off the Haitian coast to handle the worst-off patients.

One of the problems with the relief effort is that there is a lack of organization and communication between the various aid agencies. “Nobody knows how many doctors, how many nurses have come to Haiti,” said Dr. Henriette Chamouillet, head of the World Health Organization in Haiti. “No one is providing the government with the data it needs.

Disaster organizers say good intentions gone wrong are another hindrance to the recovery effort.” Some examples include volunteer medical teams who have gone to Haiti on their own, without the support of established organizations that have the prior experience in disaster relief and working in developing nations, may actually use up the resources that could have been used to help the victims of the earthquake.  Contacting one of the many organizations listed in the earlier updates of this post can help the individual healthcare worker allocate his or her skill sets in a way that will not take away from those that need aid.

For many organizations, donating money, rather than goods, is the better way to provide aid.  Jeff Nene, a spokesman for Convoy of Hope, a Springfield, Mo., agency that feeds 11,000 children a day in Haiti, urges cash donations that allow his group to buy in bulk from large suppliers and retailers. “When people give $1, it translates into $7 in the field,” he said. “If they spend $5 for bottled water, that’s nice and it makes them feel good, but probably it costs us more than $5 to send it. If they give us $5, we can get $35 worth of water.”

According to the Chronicle of Philanthropy’s recently released a survey, donations to relief groups working in Haiti are breaking fund-raising records. The survey was based on a tally on proceeds reported by the nation’s 22 largest charities and it showed that US charities raised more than $150 million in the four days after the quake. The Chronicle’s survey doesn’t include the sums raised by smaller charities, such as the $25 million by Partners in Health. Among the biggest recipients was the American Red Cross, which has raised $87 million for Haiti so far. Small texted donations account for $16 million of the $150 million raised so far.

Despite the slow progress in coordinating the communications between the organizations providing aid in Haiti, the Haitian government has been able to begin the process of moving 400,00 earthquake victims to new settlements outside of the haphazard camps in Port-au- prince that have been set up in the days following the earthquake. The United Nations supports this move because the consolidation of the nearly 450 homeless encampments in Port-au-Prince alone will help to streamline food distribution.

Updated [01.30.2010 @ 1:20 PM]:  Surveillance for Disease, and Advocacy for Investment

• Dr. James Wilson’s epidemiology surveillance of infectious disease outbreaks in Haiti: Operational Biosurveillance
• Dr. Paul Farmer’s testimony before the Senate Foreign Relations Committee: Video | Transcript

Updated [02. 18.2010 @ 9:30 AM]:In President Preval’s Own Words

The president of the Haiti talks about his initial response to the crisis.

Visit msnbc.com for breaking news, world news, and news about the economy

This New Year as you set down and make resolutions, we at AMSA urge you to make another one. Ghandi once said “Be the change you want to see in the world.” Imagine how much of a difference we could make in our practices, medical schools and in our communities if each of us 30,000 AMSA members made this resolution? Apply for AMSA’s inaugural International Women’s Leadership Institute and BE THE CHANGE.

Read on for details.

2010 does not mark a new beginning for many women and girls in this world that are suffering from gender-based violence and oppression:

1. For Mahabouba in Ethiopia it may be another year that she must live with the obstetric fistula she developed after 3 days of labor. Her 13 year old pelvis was far too narrow to pass the baby’s head and without emergency obstetric care her baby died and she was left with a hole between her rectum, bladder and vagina that constantly leaks feces and urine.
2. For Neth in Cambodia this may be the year that this 10 year old is forced into child prostitution. Her poor family can not afford to send her to school and the recent economic downturn they had no other options but to sell her to become a servant in the city. They thought she was just being sold to a wealthy family that could provide for her but instead she was sold into child prostitution. According to UNICEF, 2 million children are victims of child sex workers and 1.2 million children are victims of child sex trafficking, most of them are girls.
3. Sia arrived at the maternity hospital I interned in with severe hemorrhaging. She was bleeding as a complication of unsafe abortion. According to an article in the Lancet, 97% of all unsafe abortion occur in low-income nations yielding 68,000 deaths and millions more injured.
4. This may be the year that Dina in the Congo continues to waste away from her traumatic fistula. Dina was raped as another casualty for the long conflict in the Congo.
5. Prudence in Cameron died in childbirth last year. According to Word Health Organization data 1/47, 600 women have a lifetime risk of dying in childbirth compared to Niger where women have a 1/7 chance of death.
6. Edna Adan was a victim of FGM. According to the UNFPA, 3 million girls and young women undergo FGM each year.
7. Ethel was a Sioux women in South Dakoata who was murdered by her husband. According to the United States Department of Health and Human Services, rates of sexual and domestic violence are highest in Native American women versus any other group. More over Native women are have a 1 in 3 chance of being sexually assaulted or raped in their lifetime which is more than 2 times higher than that of non-Native women.

All these stories are true. Most of them came from the Nicholas Kristof and Sheryl WuDunn book Half the Sky about international women’s empowerment, the story about Ethel came from Marianne Perl (A Mighty Heart) and the story of Sia came from my own personal experience in Liberia (name changed). Are you willing to step in and say “NO” to this situation and make a difference in the lives of these women and girls?

JOIN US ON JAN 30 – FEB 1ST AS WE HOST AMSA’S FIRST INTERNATIONAL WOMEN’S HEALTH LEADERSHIP INSTITUTE. Training will be provided on clinical skills, advocacy and on the pressing topics of international health. We will also provide you with resources for global health mentoring, electives and how to hold great, interactive service or awareness building programs at your school. Let us use the privilege and power that we have in getting an education and having a response government to advocate on behalf of these women. They could be our patients one day.

The application deadline has been extended to January 9th. Please apply early so that you can write your Dean of Student Affairs to help pay for the $150 program fee. This institute is offered to ALL AMSA members. Please visit our website to enter your application! We will get back with you in 5 business days. We look forward to hearing from you!

Thanks,
Vanessa

Conceived as a “Bill of Rights for Women,” CEDAW sets a common international definition for gender-based discrimination, and establishes an agenda for ending it. States ratifying CEDAW are required to institutionalize gender equality through domestic legislation, repeal and replace all discriminatory provisions in their laws, and establish public institutions of recourse for women who require protection against discrimination.

Discrimination is bad. Women should have equal rights. Surely this is something we can agree on? Not so fast. Read further for the controversial stuff.

CEDAW sets a universal standard as the most comprehensive international treaty addressing women’s equal political, civil, economic, cultural and social rights. Its ratification in the United States would strengthen US laws that ensure women’s equal rights as well as illustrate the United States’ commitment to serve as a global leader of human rights (PHR). As Nora O’Connell and Ritu Sharma put it in the Human Rights Brief:

CEDAW, like any treaty, is not a silver bullet. Just as the 1964 Civil Rights Act did not end racism in the United States of America, this treaty will not end human rights abuses against women and girls around the world. But like that landmark legislation, it will provide a roadmap for those countries that want to improve the status of women as well as legal recourse for victims when needed. By setting an international standard that countries have voluntarily agreed to, CEDAW serves as a powerful self-help tool for supporters of women’s human rights to urge their governments to do better. We have seen this work with other treaties. The U.S. ratification of the UN Convention to Eliminate All Forms of Racial Discrimination in 1994, for example, amplified the U.S. voice in the successful international drive to end racial apartheid in South Africa.

After its adoption by the U.N. General Assembly in 1979, the convention was introduced in the U.S. in 1980 and signed by President Carter. It then proceeded to stall in the Senate multiple times, and despite support from individual state legislatures and major public bodies, has not been ratified to this day — leaving the United States in the company of Iran, Somalia, Sudan, and three small Pacific Island nations who have also held out on CEDAW ratification. I am not informed about Somalia’s and Tonga’s reasons for rejecting CEDAW, but in the U.S. reasons for its controversy have included the following:

• General opposition to U.S. participation in international agreements on human rights, similar to that encountered by the Convention on the Rights of the Child.

• Concern that CEDAW reduces the sovereignty of nations and leads to over-reliance on international law
• Concern that “discrimination” is defined too liberally and could be used in frivolous lawsuits
• Concern that CEDAW de-values marriage and motherhood, and will impose culturally inappropriate practices backed by radical Western feminism
• The belief that CEDAW would sanction abortion and legalize prostitution
• For why these objections are unfounded, see: overview and detailed analysis. Mostly it boils down to the fact that CEDAW cannot impose any specific laws originating from outside a member country, is self-imposed, and aims to reconcile a universal recognition of women’ rights with culturally appropriate implementation.
• Other critics argue that CEDAW is, if anything, too weak and voluntary. However, in the 20 years since its introduction, it has been used in numerous and concrete ways to establish and protect women’s rights around the world.

To date, the United States remains the only developed country to have failed to ratify the convention — while countries where women’s rights are severely bound under religious law (Islamic countries), abortion is against the law (Ireland; Latin American countries), and women are repressed as a matter of tradition (pretty much everywhere else) have at least made the gesture of ratification. With President Obama’s reintroduction of CEDAW to the U.S. international treaty agenda in 2009, we have another chance to put our support behind this key agreement, and to show America’s commitment to the rights of women worldwide and at home.

Assuming, that is, that “we”, as a nation, actually have such a commitment — something I am personally in the habit of doubting. Although Americans individually donate millions of dollars to philanthropic efforts helping women around the world, discrimination against the interests of women — especially those in developing countries, or in urban minority neighborhoods — has been deeply entrenched in U.S. practices and policy. The striking down of the Global Gag Rule in early 2009 was a bright departure from years of backwards policies that shackled the real reproductive needs of women living in desperate circumstances and far away to American internal cultural politics. The current strength of the Stupak and Nelson “anti-abortion” amendments in the domestic struggle over health care reform is more or less a domestic extension of Mexico City Policy. If implemented, these amendments will disproportionately impact the health of poor and minority women — women who are already at tremendous disadvantage in the realm of sexual and reproductive health, as evidenced by current racial disparities in HIV/AIDS infections and maternal mortality. My personal opinion is that both the former endurance of the Global Gag Rule, and the current efforts to institutionalize nation-wide religious limitations on reproductive health care, are expressions of a tacit understanding that somehow, the reproductive health needs of women have little importance beyond that of a political token — especially if the women in question are poor or dark-skinned or both — because after all, sexual victimization and maternity-related suffering have been the lot of women in the natural course of things. And the idea of suffering being “natural” for certain people is an attitude that that ought to make any doctor’s blood boil.

Whether you believe the U.S. is a global leader on women’s rights and should stand up and say so, or that it has always been sadly behind most developed countries in its conceptualization of gender relations and needs to work harder, I urge you to sign the petition in support of CEDAW ratification. Please share your thoughts on gender, policy, and U.S. influence on reproductive health around the world.

Dear AMSA,

This last March, a few of our Representatives and Senators stood up to decrease the educational debt burden for future physicians by introducing a bill that would reinstate a pathway to defer loan repayment until after residency for the majority of medical residents.

This May, Congress is writing a huge piece of legislation that will reform our health care system – and impact our chosen career field for decades to come.

Your Senators and Representative need to hear from you that the cost of medical education must be addressed in this legislation.

Click here to send an email to your Congressperson.

Sound pretty good to be able to defer your loans during residency if you’re having trouble paying them? Well, don’t get used to it – as your school’s financial offices should have told you, last summer, the passage of the College Cost Reduction Act terminated this pathway for loan deferment.

As AMSA members, we have a responsibility to do everything we can to make medicine a feasible field for students from all walks of life – we need to remove the burden of intimidating student debt from the equation. Congress needs to hear from you that reinstating the economic hardship deferral pathway is a good thing, and that including comprehensive measures to decrease the cost of medical education in this month’s health reform legislation will be even better.

Thanks – let’s see this through!

– Mary Carol

Click here to send an email to your Congressperson.

Do your part to include medical school debt in the upcoming health care reform.