Being Thankful

Today is Thanksgiving in the U.S. and I’m finding myself far away from home. I’ve been in this position before – sometimes by choice and sometimes by circumstance – and its always an odd feeling to be away from your family and many of your friends on a holiday.

For those of you who pay any attention to this blog, you’ll remember (and see below) that I said I would be back at it in late September/early October… It is now late November, funny how life goes. I’m afraid I don’t have anything witty or insightful or even interesting to say today, but I needed a nudge to get back to writing and Thanksgiving was it.

There are certainly things to talk about, however! New country, new job (prevention, NCDs, the built environment, HiAPs…), continued work with OHR, World AIDS Day coming-up next week, and new thoughts on community prevention and well-being. Looks like maybe its time to get writing..!

I am thankful for many, many things this year, not in the least my brilliant, interesting and supportive family and friends. I am also thankful for the opportunities I have to travel, and try new things, and read interesting stories. I am thankful I have the means to enjoy a large Thanksgiving meal this weekend. And I am thankful for the chance, in my small ways, to help those in our communities who can not.

Summer Mash-up

Summer always seems to be busy and fly by in a flash, but the last few weeks (and the couple forthcoming) seem to be zooming..! In lieu of a full post or an “In the News” update, here are a few “mini” posts to keep things rolling…

10 Years of Medical Anthropology at Oxford: Last week I was in England to attend a reunion conference commemorating 1o years of medical anthropology at the University of Oxford. The conference brought together alumni, faculty past and present, current students, and others somehow linked or interested in the medical anthropology program at Oxford. I was fortunate enough to have been asked to speak on the opening panel designated to alumni in “the real world” – a very ambiguous phrase – where I discussed my work in public health policy, improving cultural competency in public health, and the impact medical anthropology has had on my career thus far.

The remainder of the conference was filled with fascinating presentations on current research both outside of and at Oxford – all linked to the program – along with several bottles of wine at dinner and multiple trips to the pub, of course. The holistic and broad spectrum nature of medical anthropology was clearly present with topics such as ethnobotany and ethno-heritage in Belize; “eating” dirt in Ethiopia; moving beyond the political ecology of obesity on Nauru; bridging the sociocultural and the biological with dance science; and “sick lit”.The conference concluded with an open discussion on the future and role of this medical anthropology program. While there was a clear tension regarding the place of medical anthropology in both the anthropology and health worlds; at the core of the discussion was how medical anthropology can and should be both academically “pure” and “real world” relevant. Myself and others spoke of being “translators” (albeit not always competent ones!) – infusing medical anthropology theory, methods and discourses into public health, global health, biomedicine and beyond. With so much to offer, my personal belief is that medical anthropology needs to do a better job of getting out there and being annoying. Something that can be done without losing the discipline of ethnography or theory. Here’s to many more years of medical anthropology at Oxford!

Stepping Up Part 2: In early May I posted on the pedometer steps challenge that my office was undertaking, well…the results are in! After three months, I walked (and swam and stretched and lifted) my way to 1,447,444 steps. I think this is a lot, but sadly it only got me 4th place overall.

When I discussed this challenge the first time, I talked about how acutely aware it had made me of how much I was and wasn’t moving in a given day and that still holds true today. I’ll happily admit I don’t think I’ll have any long-lasting behavior changes as a result of this competition, but I do appreciate how attuned it has made to the structures and activities in my life that both facilitate and limit physical activity – in many circumstances, it’s much easier said than done.

A Year Ago: About this time last year I was prepping for my first visit to the island of Mfangano, Lake Victoria, Kenya. Not only was this field visit crucial for my ongoing work with the Organic Health Response, but it set a foundation for my ongoing thinking on community prevention. As a concept, community prevention can take on many realities wherever it is and as a public health intervention mechanism, it has the potential to play a crucial role in the growing challenge of non-communicable and chronic diseases. These efforts will only be effective however, if realized on a community-by-community basis and appropriately integrated into larger health systems. Amazing how fast a year can go!

Happy 4th of July to all!

Image is author’s own – Exeter College, University of Oxford, morning of June 24, 2011.

Preventing as a Community

This week I am attending a meeting in Oakland, California focused on community prevention (and some grant opportunities for community prevention programs that are mandated in the new health care law). The aim of the meeting is not simply to acknowledge that community focused prevention programs and initiatives can work (which most of us know to be the case), but how we in health define “community”; what prevention means; and how our cultures (American) can move towards creating healthier communities rather than just focusing on specific diseases?

These are all interesting and dynamic questions which need to be explored in full, and the focus of the meeting will be what structural and social changes can be made. However, simply making “structural” changes – adding sidewalks, taxing tobacco, or making neighborhoods safer – will not necessarily engage communities. Community prevention has to come from within. Not just communities having the will or desire to make their communities healthier (in their eyes or ours), but they have to embody prevention. Healthier lives and “communities” are a lived experience. There are day-to-day realities that penetrate deeper than whether or not you have access to fresh produce or quality, affordable health care services.

Evidence-based methods and tactics are what get funding for communities to implement prevention programs. Hopefully this gathering will acknowledge that the internal experience is evidence and should be part of any comprehensive community prevention campaign.

As an interesting counter to this meeting, beginning next week I will be spending several weeks on Mfangano Island, Kenya. The Organic Health Response (OHR) is attempting to revolutionize disease prevention by fostering community from within – as an organization which has taken a truly diverse group of volunteers and has them supporting community members on Mfangano, rather than make changes for them. OHR has a sustainable ethos (which started with an organic farm), has harnessed IT, and thrives off of and builds social solidarity, not external structural changes. With one of the highest concentrated rates of HIV infection in Africa (and the World) – over 30% of adults are HIV + – the Lake Victoria region must make community prevention work. AIDS is a cornerstone of OHR, but holistic, community drive, community prevention is the aim.

Two very different perspectives on making communities healthier – a world apart? Or maybe not. It could be wishful thinking on my part to imagine that there is tangible give and take between the two, but I think not.

*Image is author’s own: Protests (which later turned violent) in Oakland, CA. Unsafe neighborhoods – violent environments – are unhealthy communities.

Stay tuned for notes from the island upon my return from Kenya!