Roundtable Discussion – Equity, Rights and Progress toward the MDGs
This discussion started off with a conversation on data collection and analysis. Fortunately, my epi and biostats classes provided me enough background to not follow the discussion but also see the value and limitations of such research. Thank you USC faculty.
The major themes addressed here were again community ownership of the data. Justin Narayan, an Aboriginal representative, mentions it is important to ask the community what measures indicate the outcomes of interest, to train the community to collect the often times difficult to obtain data due to cultural barriers and geography, and to make sure the analysis is benefiting the community. I understand the purpose of data analysis and research is to verify a program’s success or usefulness. However, the data itself must also be useful in the community. I was surprised to hear opponents of data collection. Their argument was that numbers are meaningless to vulnerable communities and that limited resources must all go to the community. I understand the frustration of wanting to help the most people possible but I think it’s more cost effective to evaluate a NGOs efforts.
Dr. Claudio Shuftan, member of PHM and an adjunct professor at Tulane University, spoke about the MDGs as quick fixes that do not address the root of the problem, which is human rights violations. He boldly continued by saying that achieving the MDGs will not result in global health. In fact, he seemed to condemn NGOs for only aiming to advance the MDGs. He stated that human rights should not be woven into programs aimed at the MDGs but they should be the ultimate aim themselves. I think he’s probably correct about human rights violations being the root cause of deficits needing to be overcome by the goals. However, I’m not sure pragmatically how one addresses these violations without restructuring societies as a whole. I hope someone smarter and more experienced than I can offer tangible suggestions.
The second workshop I attended was titled “Primary Health Care Prioritizing Women and Children Delivers MDGs”. Speakers in this workshop represented a few organizations including the Burkett Institute and Save the Children.
What struck me about this workshop was Jilda Shem’s work in Vanuatu. She detailed a program sponsored by Save the Children that trained village health workers (VHW). From what I can gather, Save the Children has developed a program that trains rural community leaders to provide basic health care needs and dispense basic medicines. The VHW tasks include delivering babies to malaria testing and treatment. For example, they are so successful at reaching, diagnosing and treating malaria patients that the community is on track to eradicate malaria in by 2015. The VHW are community volunteers that do not receive financial remuneration. The NGO additionally works with the community leaders to support the VHW by providing their families with food, for example. I think that this builds community ownership of the health concerns and builds sustainable community resources.
The third workshop I attended was “Slipping Through the Crack: Women and Infectious Disease (TB & TB/HIV)”. The NGO presenting this workshop was Result.
I learned that women are more prone to TB infection and complications. Women’s traditional role as caregivers in the home puts them at greater risk for acquisition. Additionally, I am aware that HIV transmission rate is greater for women and therefore the complications from TB/HIV are more prominent in women. Shockingly, the TB test most often used was designed over 120 years ago and the most common drug prescribed was identified in the 1960s. Their message was that TB is detrimentally overlooked. Additionally, 70% of the funding for TB comes from a single source, the Global Fund. Governments are apparently debating right now on how much to refinance the Global Fund due to recession demands. Therefore, Result was asking the audience to appeal to their governments for aid.
Lucy Chseire, a member of Kenyan AIDS NGO Consortium (KANCO) and a HIV+ public health worker, spoke eloquently about her experience being diagnosed with HIV and the stigma she faced as well as her complications for TB infection.
To be honest, the second day was a bit disillusioning. From the perspective of a student trying to forge ahead in this field, I feel there was a lot of rhetoric about the problems and theoretical solutions but few practical options were offered. The lack of publicized and dramatic change is often a criticism of the UN. I don’t necessarily prescribe to that perspective because I think the issues they face are challenging. There was a need for the formation of the UN and NGOs because other governmental organizations and individuals were not accomplishing this task either. The challenges they face are difficult to accomplish for a number of reasons. Additionally, some NGOs at this conference have an agenda to only promote their work and get more funding. This gives the impression that they are not open to hearing new experiences or even on collaborating. While individual NGOs are accomplishing great strides locally I believe grand scale collaboration and organization is required to make significant changes in global health.