Heels in the Field
A Global Health Discussion Series
The curriculum in Global Studies is pleased to report another successful semester of Heels in the Field, a global health discussion series that explores the critical issues, current controversies and innovative solutions in global health research by UNC faculty. Last Fall, the brown-bag lunch-time program featured experts in maternal and child healthcare delivery, HIV preventions and interventions, and global injury prevention. The talks engaged students, faculty and healthcare professionals in a conversation on the possibilities of improving healthcare both locally and across the globe.
“The Heels in the Field Global Health discussion series has gained tremendous traction in the Fall semester with great attendance. Although varied schools and programs offer brown bag lecture discussions, ‘Heels in the field’ provides the unique opportunity for undergraduate and graduate students, faculty and staff from various schools across campus to come together and share in the current global health work at UNC, thereby fostering the interdisciplinary discussions that generate transdisciplinary ideas and research,” Mamie Harris, co-organizer of the series, said.
The program is sponsored by the curriculum in Global Studies and the UNC Institute for Global Health & Infectious Diseases.
“Why Are Women Still Dying?” With Dr. Martha Carlough
On September 22nd, the Fall 2011 Heels in the Field launched with Dr. Martha Carlough, MPH, MD, who discussed the state of maternal and child healthcare delivery throughout the world and the possible actions healthcare professionals can take to improve these conditions.
Dr. Carlough is an Assistant Professor of Family Medicine and the Director of International Affairs in the School of Medicine at UNC. Engaged in comprehensive outpatient family medicine domestically, Carlough’s research focuses on maternal and child health within a global context. Her articles on global perspectives of post-partum depression, the role of mission hospitals and the efficacy of maternal and child health workers in Nepal have been published in leading medical journals. Carlough has also worked in clinics across the globe, from South Asia to Latin America, and regularly supervises student practice overseas.
Dr. Carlough explained the high risks involved in giving birth in developing countries, such as being unable to reach a hospital, or being unwilling to receive care for fear of reprisal or a preference for traditional practices. Emphasizing the cultural stigmas attached to childbirth, she illustrated the difficulty healthcare workers have in their struggle to reduce mortality, and the importance of working within the local systems to be effective.
Dr. Carlough then showed the packed audience some measures healthcare professionals are taking to combat these issues, including providing pregnant women with home birthing training and a kit containing the necessary drugs to improve the safety of their decision. She further highlighted how doctors are working with local midwives to ensure that those women with complicated births can quickly and easily be integrated into the hospital system.
The results of Dr. Carlough’s efforts have been promising. Not only have these approaches increased the rates of survival, cultural norms regarding childbirth are changing in the areas in which she operates. The local community is beginning to trust healthcare workers, and seek care when they are in need.
An energetic conversation on the ethical hurdles the extension of healthcare delivery presents and other possible practical means of improving maternal and child health followed Dr. Carlough’s talk.
“HIV Prevention Intervention” With Dr. Audrey Pettifor
Audrey Pettifor, MPH, PhD, is an assistant professor in the department of Epidemiology at UNC. With standing-room only, she spoke on HIV preventions and interventions taking place in southern Africa on October 28th.
Pettifor articulated the struggle researchers have had in combating the HIV/AIDS epidemic. She showed how many of the hopes scientists had for containing the disease were never realized after repeated trials. What successes scientists have had, she argued, have existed on a biological level. Structurally and behaviorally, few practices have proven to be effective in controlling the virus.
The relatively recent policy of cash transfers has changed this situation, however. Pettifor displayed how cash transfer programs to those in need have correlated with a reduced risk in the population of developing HIV/AIDs. In her own research, she has found that often these cash transfers allow girls to stay in school longer, altering the girls’ network of relationships so that they acquire safer sexual partners.
Pettifor indicated the variety of implementations of cash transfer programs, and raised questions as to the practicality and efficacy of each system. Some states, for instance, provide transfers on the condition that children attend school a certain number of days a year, although monitoring students’ actual attendance is near impossible. Others offer cash on the condition that individuals test negative for HIV/AIDs, limiting the number of people who can claim help. Still others hope that in disbursing money without qualifications, the economic situation amongst poverty-stricken communities will improve, and by association, rates of HIV/AIDs will decrease. This sparked discussion on the value of the various structural methods of containing the disease.
Pettifor is an Assistant Professor in the Department of Epidemiology at UNC. She has conducted HIV prevention research in South Africa since 1996, with a particular focus on social and behavioral factors. Since joining UNC in 2005, she has expanded her research to other sub-Saharan countries, including the Democratic Republic of the Congo, Madagascar and Malawi. Her research concentrates on HIV prevention in young women, but she has also studied HIV prevention interventions for couples, positive preventions and acute HIV infection in the region. She brings to the series insight into new approaches to control the spread of HIV and AIDS.
“Global Injury Prevention” With Dr. Andres Villaveces
The final speaker of the semester, Dr. Andres Villaveces, MPH, PhD, spoke on the role of the environment in injury prevention on November 11th. The discussion centered on how one relates to one’s built surroundings.
Villaveces showed students and faculty the importance of adequate rules and regulations, offering numerous examples of the reduced mortality rates arising from motorcycle helmet and vehicle speeding laws. He recognized, however, the difficulties in often implementing these policies, citing cultural reasons such as fashion and bravado as reasons for resistance to helmets in particular.
Villaveces emphasized, as a result, how essential knowing the needs of a population is to effectively reducing injury. To portray how necessary this understanding is, Villaveces indicated the differences by method of transportation in what makes a road safe. He explored in the process how researchers can approach current planning issues, and argued that in attempting to make structural improvements compromises must be made. Small changes, however, can have long-term results, including shifting the discourse on an issue so that greater projects can be undertaken in the future.
Villaveces is a Research Assistant Professor in the Department of Epidemiology at UNC, co-leader of the UNC Injury Epidemiology Program and faculty member of t he Biostatistical Core Unit at the UNC Injury Prevention Research Center. His research focuses on injury and violence, and the characteristics of the built environment in relation to injuries among pedestrians. Villaveces studies global injury prevention activities and the history of injury prevention and control. He has taught courses on injury prevention in numerous countries, including Mexico, Vietnam, Uganda, Ghana, and Bahia in Brazil. He has also served as a consultant for the Unite dNational Developmnet Fund, World Health Organization, Transport Research Lab, UK and the Center for Humanitarian Dialogue. Villaveces graduated from the University of Washington’s School of Public Health with a PhD in Epidemiology.