Changing Seasons

To those of you who might be regular readers and those who have just stumbled onto this blog, I apologize for the lack of posts as summer winds down and we move into fall. I am in the process of making some big changes myself, so unfortunately the lack of posts will continue into late September/early October.

A new country, new city and new job (along with all the other changes that come with any one of these events) will inevitably lead to lots more to talk about, when time permits. In the meantime, please take a look at my colleagues on the blogroll and watch for coverage of the up-coming UN high level meeting on NCDs prevention and control.

Be well!

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.

Don’t Let the Bed Bugs Bite..?!

It’s all fun and games until someone get’s hurt – or bitten!

Yes, I had bed bugs. Well, ONE bed bug… And as this goes up, I’m wrapping-up 2 weeks of homelessness (many thanks to parents and friends for your hospitality!) and over a month of headache. The bites have gone, the chemical smell is dissipating, and clean sheets are back on my bed.

I’ve learned a lot about bed bugs in the last few weeks. They are tiny; they like warm (but not hot or cold) “fabric-y” places; their reproductive abilities make bunnies look prudish; they don’t carry human diseases (or so we all thought until about a week ago – seriously!); and they seem to make lots of people squirm – but not me.

Besides the large, tremendously itchy bites, the bug never really bothered me. I certainly wasn’t losing sleep over it. The reactions I got from just about everyone else I told however, implied I should have been having a different reaction…my “eeew” factor was missing.

Our societal reaction to bed bugs seems to equate them with dust, dirt and general un-cleanliness. If you ask anyone who has lived with me or been to my apartment, they will tell you that I’m pretty much the opposite of “un-clean” (or at least I’d like to think so). Perhaps this personal knowledge, that there was nothing I did that welcomed the bugs into my space, took away the “ick” factor – they were just bugs who happened to make their way into my apartment. And if nothing else, they made me acutely aware that even in our modern lives, we are co-habitating with much more than we realize. They are gone now and I’m back, happy to have this little saga behind me.

Image: New Hampshire Pests and Termites (Not my bed!)

When in Rome…

It’s been a while since we’ve talked about anything obesity related, but that doesn’t mean there isn’t anything to talk about! Every day there is something new about what to eat, how many steps to take (more on this another day) and what the personal “causes” of obesity are, but frustratingly still little in the general media about the impact our environments have on our weight and health.  I’ve been thinking a lot about this the last few weeks since a quick trip to Rome where, not surprisingly, the environment for food was just right.

In town for the marathon (don’t worry, I wasn’t running!) this was my first time to Rome and in 2 1/2 days I was soaking up as much as I could as fast as I could – mainly in the form of carbohydrates.  With good friends gathered to cheer on one of our own, the atmosphere was perfect for long dinners and gelato breaks.  As the weekend passed along it never once occurred to me (or my companions no doubt) to maybe have a salad or find some fresh fruit (both available if we’d wanted). After all, when in Rome…

It did occur to me however, while sipping cafe between miles 18 and 23, that I wasn’t seeing many people around who visually could be considered obese.  Even the Americans* (and British) flooding the Spanish Steps on spring break were of the more average variety. While I say this with a tone of humor, I was genuinely curious about what I was seeing (or not seeing). Economic explanation for the foreigners aside – in developed countries, the wealthier you are the less likely you are to be obese and the more likely you are to be able to afford a trip to Rome – what was it about this ancient place which was keeping people so not-fat?

Even with the freshest ingredients “traditional” Italian fare is carb, sodium and dairy heavy. Delicious. But portions are reasonable; the pace is relaxed; and, like with many (old) urban centers, walking is the best way to get around (or a Vespa!) Italians may be blessed with a food friendly environment and culture – much like the French – which until very recently have kept their obesity rates some of the lowest in the developed world. As a point of reference, OECD statistics put Italy’s obesity rate under 10% of the population while England and the U.S. are over 20 and 30% respectively.  Italy, like the rest of us, has seen a rise in these rates in recent decades and will have to start thinking about the long-term effects of obesity (if they aren’t already).

For now, I hope the Romans continue to enjoy their food and the historic environment they get to eat it in – and acknowledge those factors which have kept them skinny. Here at home, more needs to be done on acknowledging the impact of our total environment (built, natural, social, economic…) on our weight and on actually translating this information to the general public in effective and appropriate ways.  I’ve gotten back on track post-Rome, but might go find myself some pizza for lunch!

*Side note: Playing “spot the American” has become one of my favorite games while traveling. It’s anthropological!

Images: Author’s own. Start of the Martona di Roma; the Spanish Steps; and friends enjoying post-marathon pizza (Rome, Italy).

Dirt

Last week in London I returned to one of the more interesting museums off the beaten path — the Wellcome Collection.  If you haven’t been there, I would highly recommend stopping by the next time you find yourself in London. It’s small, but jam packed with all sorts of things of the healthy persuasion.  It just so happens that on the day an Oxford classmate and I decided to take a new look, a new exhibit was opening!

Based on the work of Mary Douglas (an anthropologist!), Dirt examines human relationships with the thing, the concept, the word, and the symbolism of dirt.  Through six different cultural perspectives, the exhibit highlights concepts such as cleanliness, filth, disease, deprivation and renewal.  While I’ve come to embrace the social norms of working in public health (i.e. I have and use a giant pump of hand sanitizer on my desk), a little dirt never hurt!