The Women in Our Lives

Today is International Women’s Day – a day to celebrate the strength and uniqueness of women around the World, but also to acknowledge our daily challenges (yes, I’m a woman!)  I have been fortunate in my life to be surrounded by strong and diverse women – my mom, my grandmothers, aunts, cousins, sisters-in-law, friends, teachers and mentors.  They are mothers, students, scientists, doctors, swimmers, cooks, travelers, musicians, photographers, soldiers, volunteers… I could keep going, but you get my point.

Women in different cultures have varying opportunities, priorities, and worldviews.  Yet, in one of those fantastic twists of humanity, there is a thread of commonality among us.  As the world’s health systems evolve, this commonality among women must be a priority – effective and appropriate prevention and health care for all women.

In the US, this means a commitment to Health in All Policies that address transportation, food and health care access, education, and child care needs.  In Kenya, the establishment of sustainable food security for women affected by HIV.  And in many places in the world, the ability for women to make their own decisions about their bodies.  The health and education of women, as most of you already know, has an exponential impact on the well-being of children and communities.  A well-being, how ever you define it, that is a right.

I have stated before that being part of a given population should not be a negative determinant of health and I’m going to say it again – being a woman should not be a negative determinant of health.  In far too many places in the World, it is.  The women in our lives (“fascinating, if not a little bit scary”!) and their well-being are a cause worth our defense.

Images: Author’s own.  Matriculation day (University of Oxford, UK) and members of the EK Sisterhood Exchange Program (Mfangano Island, Lake Victoria, Kenya).

Being Part of the Change

This past week, ABC News launched its Be the Change: Save a Life initiative – “stories and solutions for a global health initiative”. The idea, the way I understand it, is to highlight and share real world solutions to the array of global health challenges. One of the components I find fascinating is how these solutions are coming from every sector, not just medicine and public health. There are portable and re-heatable (without electricity) baby incubators from a group of Stanford students; pumps to clean water from a former nightclub owner; and local solutions too, like horses to get HIV tests to labs in time in Lesotho.

Being local, which won’t be a surprise to my regular readers, is key. Nifty tech devises and creative fund-raising are important, we need both for innovative and sustainable solutions. However, to make innovations work a) the local needs, environment, and lives must not just be acknowledged, but understood and b) solutions need to be fostered from within communities and not just presented to them.

This year-long initiative will undoubtedly share with all of us some truly remarkable solutions…for determinants and disease. And hopefully, as with the piece on child nutrition in Guatemala (I know someone involved with this initiative!), medical anthropologists and other community thinkers will be engaged and highlighted. For when all of us are part of the change, practical, simple and human solutions become a reality and lives are saved.

In the News: Here Comes Summer

Summer is just around the corner and here are some healthy news items to get you thinking, as the days heat up!

*Last week it was announced that scientists had witnessed the first cell produced entirely from synthetic DNA. I am not even going to pretend to understand the science behind it, but I’m happy to ponder the implications for human health (waaaaay down the road). Encouraging progress in technologies that have the potential to improve human health is important (really important!), yet at the same time it is also important to examine the systems and cultures in which these improvements are made and what implications they may have beyond healing.

*I grew-up spending my summers swimming…in pools, in Lake Michigan, in the ocean. If you ask me, in the water is the best place to spend the summer. NPR reported last week that a shocking number of American pools are not up to snuff when it comes to water cleanliness. Pools can be an easy place to catch an infection, the kind that can ruin any kids summer. Let’s hope that pools around the U.S. clean-up their act – swimming and days at the pool are an essential element of the American summer and it would be a shame if kids started to miss out because their pools weren’t being kept clean!

*Summer is the best season (unless you live somewhere super hot!) to get outside. We all know that exercise, even a little bit, can do wonders for our health, right now and down the road. We also know that you can’t simply make people exercise. However, if you look at where people go, what they like to do to begin with, and why they may or may not be exercising, there are simple (and dare I say, culturally appropriate) solutions to getting people moving. Last week in London, an “adult playground” opened in Hyde Park. Designed for low impact exercises, the machines at this playground include stationary bikes and ellipticals, are free, and easy to use. Hopefully this idea will catch-on in the UK and other western countries, and more and more adults will get moving outside.

*Fresh fruits and veggies are abundant in many areas all summer long and this provides us with the perfect opportunity to try-out new recipes. The NYTimes’ Recipes for Health page is a great resource for finding new, tasty, and healthy recipes (check-out Court’s Kitchen for other great ideas). We should remember, though, that many around us are struggling just to put enough food on their tables. Maybe this summer we can all do a small part to help those in need of a meal!

Happy Summer!

*Image is author’s own: Duck, North Carolina, USA.

In the News: Growing Healthier Kids

* A report this week in the UK stated that preventable diseases in children are reaching epidemic proportions. Conditions related to second-hand smoke, environment, and diet – including tooth decay and, of course, obesity – are on the rise and in many cases completely preventable. This is not a growing issue just in the UK, but in other industrialized countries as well, including the U.S.

* An article in Tuesday’s Times discussed the history and development of the “5-a-day” mantra and movement. For those who may not know, “5-a-day” is a UK campaign aimed at encouraging individuals to strive to have 5 fruits and vegetables a day. While this is a concept not foreign to the U.S., it is a whole different beast in the UK. Read it for yourself and see what you think…as I mentioned earlier in the week, it is often hard to discern between simple market ploys and substantial health advice. I do think eating fruits and vegetables is good for you tho..!

* Back here in the U.S., you may have come across Jamie Oliver’s (a British culinary import) Food Revolution. Mainly being promoted through a TV program on ABC. Oliver’s goal is to start a food revolution by first changing what we feed our children in schools. It’s an intriguing concept and as we all know, something that desperately needs to be done. While I support the efforts to promote healthier and fresher foods in schools, I’m also curious to know how people feel about an “outsider” (from a country with their own obesity problem) coming into their communities and telling them what to do? It should be noted that Oliver has worked for several years to improve school lunches in the UK – before starting his endeavors in the U.S.

Whoa Baby

Bayar from Babies

Babies seem to be all the rage these days, so much so they are the stars of a new feature film out next month. Babies, which chronicles the first year of four babies born in four different countries, looks to me like it will be a pure pleasure to watch. Hopefully it will highlight the universal joys of human life, but also examine how unique and fantastic our cultural differences can be (if you haven’t yet, you really should watch the trailer – it will put a smile on your face). One of these differences is how we come into the world – in the United States, we are increasingly becoming a society where cesarean births are the norm. The CDC released a report yesterday on the new statistic that 1/3 of all women who give birth do so through cesarean section, the highest rate in American history.

These rates have risen in every age-group (groups ranging from 20 to 54 year-olds) and all of the racial-ethnic groups included in the study. The rate of women having cesarean births between the ages of 20-29 (the lowest risk age-group when pregnant) between 2000-2007 rose by roughly 8%. Cesarean births are major abdominal surgery, which often have serious complications requiring stays in the ICU and the mother to be re-admitted to the hospital. And while it shouldn’t be a decision maker, they are almost double the cost of vaginal births. What used to be a procedure saved for high-risk pregnancies/births, is now becoming common-place. The NYTimes had a nice article summarizing the report and talking about some of the reasons and effects of such a drastic shift in our birthing practices.

Rising numbers of multiple births (twins, triplets, etc.), larger babies, larger mothers, and older mothers, all represent our cultural shift towards using some of the amazing fertility technologies now available. And they are all more likely to have cesarean births. The CDC study did not specifically state, but there are no doubt stark socio-economic differences between vaginal and cesarean births as well. Women have been requesting the procedure even when it has been deemed not medically necessary, creating a culture of ‘pushers’ and ‘non-pushers’. Doctor’s fears of lawsuits have been tossed around as a reason for the rise too, but we are going to stick with this larger cultural shift as a whole. What does this mean for mothers and babies and how does the U.S. compare to the rest of the world?

The U.S. and other developed countries medicalized childbirth decades ago, but now it could be argued that if the rise in C-sections continues, women will literally have no control over the birth of their children. This rise is occurring in developing countries too, with China and countries in Latin America reaching nearly 50% of births through cesarean. Maternal Mortality Daily states that nearly 550,000 women die a year from complications from pregnancy – 99% of these occur in the developing world where simple aspects like clean water and sterilized equipment are scarce. The contrasts in birthing around the world are stark, and while women should have the right to choose the birth they feel is best for their child and themselves, we should recognize that the human universal of childbirth is far from a universal experience.

*Image from the upcoming feature film Babies.