Global Health Ideas

Finding global health solutions through innovation and technology

Archive for the ‘Food for thought’ Category

Of Pandemics, Fear, the Facts and You

It seems that an influenza virus can survive on money for up to 10 days, and the New York Times has an interesting article on modeling virus spread on dollar bills.

But one thing remains true: “People have a very weird perception of large numbers,” [Dr. Brockmann] said. “If you have 2,000 cases of flu in a country of 300 million, most people think they’re going to be one of the 2,000, not one of the 299,998,000.”

I think people have a wierd perception of risk, and that is often influenced by media attention. Which reminds me of a memorable article from the New York Times Op-Ed page in 2003 – remember West Nile Virus? “Never Bitten, Twice Shy – The Real Dangers of Summer” by Ropeik and Holmes.

Never Bitten, Twice Shy - The Real Dangers of Summer (2003)

Never Bitten, Twice Shy - The Real Dangers of Summer (2003)

Yes, the graphic is not perfect (see this critique at Edward Tufte’s blog), but does get across the idea that risk perception is not always influenced by the facts. And is expanded in this article in Health Affairs “Dealing with the Dangers of Fear: The Role of Risk Communication” by Gray and Ropeik.

Ok, but what about the facts? The fast moving breaking news often plays fast and loose with the truth, and can spread alarming information. Early reports of the swine flu in Mexico seemed to have extremely high mortality reports, especially among young adults. Now, with new evidence of confirmed cases, the virus is looking alot milder. When I first read that influenza virus could survive for 10 days on money, I thought it was another casualty of the truth, as the avian-human-swine flu reported in a press briefing by the CDC. However, in this case, the facts seem to check out (Survival of Influenza Virus on Banknotes, Thomas et al), unlike the potluck origins of the swine flu which ProMED reported to be, upon closer examination – just swine flu.

More on risk perception:

Here’s a conversation with David Ropeik in the New York Times, and he wrote a book with George Gray – Risk: A Practical Guide for Deciding What’s Really Safe and What’s Really Dangerous in the World Around You

Reckoning with Risk: Learning to Live with Uncertainty – Gerd Gigerenzer

Can’t get enough of risk? Check out the Risk-0-meters and calculate your own health risk at the Harvard Center for Risk Analysis

Written by farzaneh

May 4, 2009 at 10:44 am

Graphic Stats: How to (Mis)Tell a Story

How one communicates a message is critical to what you are trying to accomplish. It amazes me how little upfront investment some organizations/campaigns put into this kind of thing. This recently came to mind when I saw the work of Toby Ng, who has “used information graphics to re-tell the story in another creative way” with the commonly used theme – if the world was 100 people then…Some examples below:
badstatsq1
HT (The Atlantic)

Cautionary Note and Counterpoint
The comment thread at Flowing Data suggests an alternate critical argument about using this  technique  because it is not a “serious attempt to convey information” and it is easy to distort data when you manipulate in such a manner. I am not a graphic design expert and I haven’t read Tufte but this is certainly a fundamental principle (don’t distort the data). Given this warning, this specific style is attractive and can be useful depending on the audience and the goals you have. There is a lot more that can be said on this theme and it would be great to have global health folks brainstorming different ways of communicating messages beyond doom and gloom.

For some inspiration and ideas check out sites like Flowing Data and Jaspal’s previously related post on “Why Bad Presentations Happen to Good Causes“. For audio visual storytelling the talk by Hans Rosling at TED 2006 is a global health classic that pushes us to be more creative story tellers. This has to be one of the best global health videos I have ever seen (which we posted 2 years ago):

Written by Aman

April 21, 2009 at 9:37 pm

Internet: Revolutionizing the Detection of Disease Outbreaks

First, a bit of housekeeping – we are tinkering with the look of the blog and considering moving it to another platform, if you have any feedback about what you like and don’t like, let us know.

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Published today in the CMAJ, Early detection of disease outbreaks using the Internet, is worth skimming:

“The Internet…is revolutionizing how epidemic intelligence is gathered, and it offers solutions to some of these challenges. Freely available Web-based sources of information may allow us to detect disease outbreaks earlier with reduced cost and increased reporting transparency. Because Web-based data sources exist outside traditional reporting channels, they are invaluable to public health agencies that depend on timely information flow across national and subnational borders. These information sources, which can be identified through Internet-based tools, are often capable of detecting the first evidence of an outbreak, especially in areas with a limited capacity for public health surveillance.”

The limitations section includes the below list, but I wish they went into much more detail about what the internet is not good for (probably detecting trends among the elderly for example) and more examples of misinterpreting the data. On a related note to using ICTs for surveillance, Jaspal wrote a fairly detail post on Google Flu Trends that you should also check out.

disadvantages

Written by Aman

April 14, 2009 at 9:48 pm

Art for Global Health

art_condom-dressesI recently discovered the UCLA Art|Global Health Center, the mission of which is to “unleash the transformative power of the arts to advance global health“. The arts have the ability to capture issues and tell a story in a way that can make a profound impact on our (social) consciousness and is not something we talk about enough as a tool. One of the more famous examples of this is the AIDS quilt which was conceived of in 1985 by an AIDS activist in memory of Harvey Milk. That quilt has had over 14 million visitors and is the largest community arts project in the world.

The UCLA center has some ongoing projects and last year opened “Make Art | Stop AIDS” that featured traditional art as well as things like condom dresses. Make Art/Stop AIDS “is organized around a series of seven interconnected and at times overlapping concerns expressed in the form of open-ended questions, some of which include direct art historical references to the epidemic: What is AIDS?; Who lives, who dies?; Condoms: what’s the issue?; Is it safe to touch?; When is the last time you cried?; What good does a red ribbon do?; Are you angry enough to do something about AIDS?; and, finally, Art is not enough. Now it’s in your hands.”

Creative art projects have the ability to move the human mind unlike the constant barrage of issues, numbers and headlines that desensitize us over time. If you have seen or heard of any interesting arts based global health projects let us know.

More Sources
Adriana Bertinin’s condom dresses

Addressing HIV/AIDS-Related Grief and Healing Through Art

History of the AIDS Memorial Quilt

Condom fashion show, China

Written by Aman

April 13, 2009 at 9:49 pm

Vote for mHealth Project: ClaimsMobile in Uganda

Please vote for Ben’s mobile payment for health systems project. Voting closes Friday.

VOTE – NETSQUARED: By introducing a smartphone and web-application system for submitting and reviewing claims, we hope to reduce the delays and errors, increase clinics’ profitability and improve communication. Below is a related post by Melissa Ho who is working with Ben on this project which fills a critical gap. Cross posted from ICTDCHICK:

First HealthyBaby Birth

The mother receives the baby from the nurses at the clinic.

The mother receives the baby from the nurses at the clinic.

As I have been pre-occupied with writing lectures for my class, and setting up my research, my collaborating partners at Marie Stopes International Uganda have been busy launching a new phase of the output-based aid voucher program, financing in-hospital delivery of babies, in addition to the in-clinic treatment of sexually-transmitted infections (STIs). The new program, called HealthyBaby is eligible to mothers who qualify under a specific poverty baseline and covers four antenatal visits, the delivery, and a postnatal visit. Last week they just started distributing vouchers, and this past weekend was the delivery of the first baby whose birth was covered by the program.

Like the HealthyLife program, the mother purchases a voucher for 3000 USh (approximately 1.50 USD, the HealthyLife program charges 3000USh for a pair of vouchers treating both sexual partners). The voucher then can be broken into several sticker stubs, one of which is submitted with a claim form on each visit.

The first mother puts her thumb print on the HealthyBaby claim form

The first mother puts her thumb print on the HealthyBaby claim form

The hospital then submits the claim form with the voucher to the funding agency (my collaborating organization), who then pays the hospital for the cost of the visit – labs, any prescriptions given, the consultation fee, etc. You can see in the picture to the right the nurse filling out the paper form and the mother putting her thumbprint on it. Filling out the forms can be tedious and error prone – this particular clinic had almost 18% of their STI claims rejected for errors last October. In the same month another clinics had 38.6% of their claims rejected. I am trying to work on digital systems that can help improve communications between the clinics and the funding agency, and also decrease the cost and burden of claims administration.

The Claim Mobile project actually focuses on the HealthyLife program – the STI treatment program, rather than the HealthyBaby program, but I hope to demonstrate the sustainability and replicability of the system that I’m developing by training the engineers here to retool my system for HealthyBaby – so by the time I leave, I am hoping it will be in place for both programs.

By coincidence, this first birth occurred in one of the two clinics where I’m running the pre-pilot of the Claim Mobile system.

Written by Aman

April 8, 2009 at 10:07 pm

World Health Day: The Future of Global Health

The WHO has decided to focus this World Health Day on hospital infrastructure during times of emergency. The folks over at Global Health Progress have a good round of what some bloggers are saying and include health journalism folks as well as thoughts from the AvianFlu diary. I thought I would go off theme and briefly throw out some thoughts on the bigger picture and encourage you to use this day to think about what is the future of global health? In this context of thinking about the future in 10, 20 or 30 years, the world is in turmoil and we are questioning the fundamental nature of market driven economies, why not use this as an opportunity to do the same for global health in a forward looking way? Think about where we are and whether we are prioritizing the right things and moving in the right directions?

Approximately 10 (only TEN!) years ago there was no Google, Kiva, Gates Foundation or knowledge about the cost differences between generic and brand name drugs (see this great talk on the Future of Global Health by Jim Yong Kim and his discussion of how they reduced the price of treating MDR TB patients by 80-90% in 1999) amongst major care organizations (absolutely stunning). Mobile phone penetration was less than 1% in developing countries and social entrepreneurship wasn’t hot, the vast majority of us probably hadn’t even heard of that term.

Where we were ten years ago is arguably a profoundly different world from where we are today and per the video below “we are living in exponential times“. To give you further inspiration to think differently today definitely watch the below (via 2173):

The acceleration of technology for social change and global health is going to increase, in this decade alone the convergence of movements in philanthropy, entrepreneurship and technology all enabled by the internet and mobile phone revolution have allowed people to collaborate, innovate and communicate on an entirely different level. I don’t know what the future of global health is – but I wonder how open source collaborations will contribute to solutions and whether twittering for global health will be around in five years and for whom and what purpose? Or will we just be doing more of the same. I wonder if we will be doing entire marketing and health education campaigns via mobile phones and how this will evolve. Will there be convergence of people and ideas working on global and domestic health? Will the flow of innovation and products from “South” to “North” become the next hot topic? I wonder if we will have a TED just for Global Health?

We might face a global crisis in 2030 but we will also be better equipped to face that crisis.Today is a day we should be thinking about what all the possibilities are and how we can get there in the fastest way possible.  The last idea I will throw out as food for thought is to think about what have been the top 10 biggest developments in global health in the last decade and how will these shape the future?

Other thoughts on World Health Day:
UN Dispatch, link
Human Rights Watch, link
The Lancet Student, link
Global Institute Blog, link
Charity Navigator, link

Written by Aman

April 7, 2009 at 9:05 pm

Quote of the Day – g20 in perspective

“In London, Washington and Paris, people talk of bonuses or no bonuses…in parts of Africa, South Asia and Latin America, the struggle is for food or no food…the greatest price for incompetence at the summit will be borne by the poorest people in the world.

Oxfam has calculated that financial firms around the world have already received or been promised $8.4 trillion in bailouts. Just a week’s worth of interest on that sum while it’s waiting to be deployed would be enough to save most of the half-million women who die in childbirth each year in poor countries.”

Nicholas Kristoff, NY Times, At Stake are More than the Banks, April 1, 2009

A different more pro-active spin on the above comes from Lynne Twist:
“This is a time that I think history will look back on and say, ‘These are the people, this is the generation of humankind that went through a transformation that made the future of life possible. These are the people who had the courage to make profound changes in the way they were thinking, as well as in the way that they were behaving, that gave the future to life itself.”

Written by Aman

April 2, 2009 at 8:00 pm

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