In a chilling expose today, Toxic Waters – Clean Water Laws are Neglected, at a Cost to Health, Charles DuHigg of the New York Times covers the impunity of polluters and lax regulation of clean water laws. The NYT then goes a step further – creating transparency through a public database of violations which is ‘more comprehensive than the states or the EPA‘, that you can access to find polluters near you on an interactive map. There is also a nice interactive graphic of the Clean Water Act enforcement record in all 50 states. Deep cuts were made in government funding, and now clearly our Environmental Health Monitoring system needs repair. Democracy needs a strong, free media who reports and then acts. Who knew the NYT would be a key environmental health policy innovator overnight?

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I am bouncing for Beijing this Friday, so I thought it would be a good time to do some desktop clearing. Some good links below:

GIS for a changing health landscape, link
Open Source/Science’s Greatest Need Is … Non-Scientists?, link
Interview with Isaac Holeman of FrontlineSMS:Medic, link
New Female Condom Campaign Set for Uganda, link
Sending out a (Google) SMS in Uganda, link
IDEO Ripple Effect at the Water Summit India, link
Africa Could Feed and Fuel the World, link
Web 2.0 Goes Bollywood-for GOOD, link
Brickmakers and Human Rights in Pakistan, link
Debating Which Aid Works Best is to Miss the Point, link
Who’s in charge of global health spending? link
Poverty tourism is getting a lot of attention lately, link

Bonus: Recycling Solutions
In Mali turning plastic bags into paving stones, link
Global recycling efforts, link
Is paper better than plastic? link
For the do it yourself’ers a plastic laptop bag, link

Related articles by Zemanta

• Designing useful mobile services for Africa (googleblog.blogspot.com)
• 5 US Cities and States Fighting Plastic Bags, 5 Cents at a Time (treehugger.com)
• Uganda’s Appfrica Labs (whiteafrican.com)
• Location Based Services in Uganda using SMS. (mobilewellbeing.info)

I have been talking about this kind of thing for years, well the organization that is one of the best in producing useful health information, the Kaiser Family Foundation has a global health page and tracker. The screen shot below is from our friends at Little Devices that Could. This is a good start, but a lot more could be done, not sure why no one is doing it?

Menlo Park, CA – infoZine – With attention to global health rising on the U.S. policy agenda in recent years, the Kaiser Family Foundation launched a set of new resources, providing U.S. policymakers, non-governmental organizations, journalists and others working in the global health arena with timely information, including daily news summaries, a policy tracker tool, and original research and analysis.

The new Kaiser Daily Global Health Policy Report, synthesizes daily coverage from more than 200 news sources pertaining to U.S. policy discussions and debates on global health, including relevant news from around the world. The daily report will cover HIV/AIDS, tuberculosis (TB), malaria, nutrition, water and sanitation, polio, and maternal and child health, as well as funding, financing and health systems.

The Boston Globe has a set of pictures that I highly recommend you check out. Occupational hazards is something I don’t see discussed very often in the context of global health and it’s a real shame. For more on occ health in general check out the definitive blog that has done a tremendous job of keeping occ health in the conversation – The Pump Handle.

“In East Java, Indonesia lies Kawah Ijen volcano, 2,600 meters tall (8,660ft), topped with a large caldera and a 200-meter-deep lake of sulfuric acid. The quietly active volcano emits gases through fumaroles inside the crater, and local miners have tapped those gases to earn a living. Stone and ceramic pipes cap the fumaroles, and inside, the sulfur condenses into a molten red liquid, dripping back down and solidifying into pure sulfur. Miners hack chunks off with steel bars, braving extremely dangerous gases and liquids with minimal protection, then load up as much as they can carry for the several kilometers to the weighing station. Loads can weigh from 45 to 90kg (100 – 200 lbs), and a single miner might make as many as two or three trips in a day. At the end of a long day, miners take home approximately Rp50,000 ($5.00 u.s.). The sulfur is then used for vulcanizing rubber, bleaching sugar and other industrial processes nearby.” The Boston Globe

Cross-posted from Design Research for Global Health.

Giving talks is not one of my strong suits, but it seems to be a part of the job requirement.  Earlier this month, I had the opportunity (even though I’m no good, I do consider it an opportunity), to give a couple talks, one to the Interdisciplinary MPH Program at Berkeley and one to a group of undergraduate design students, also at Berkeley.  Despite the difference in focus, age, and experience of the two groups, the topic was roughly the same: How do we effectively use design thinking as an approach in public health?

The first session was so-so, and I suspect that the few people who were excited about it were probably excited in spite of the talk.  It started well, but about halfway through, something began to feel very wrong and that feeling didn’t go away until some time later that evening.  Afterwards, I received direct feedback from the instructor and from the students in the form of an evaluation.  I recommend this if it is ever presented as an option.  Like any “accident”, this one was a “confluence of factors”: lack of clarity and specificity, allowing the discussion to get sidetracked, poor posture, and a tone that conveyed a lack of excitement for the topic.

It’s one thing to get feedback like this, another to act on it.

The second session went much better, gauging by the student feedback, the comments from the instructor, and my own observations.  This in spite of a larger group (60 vs. 20) that would be harder to motivate (undergraduates with midterms vs. professionals working on applied problems in public health).  I chalk it all up to preparation and planning.  Certainly there are people that are capable of doing a great job without preparation – I just don’t think I’m one of those people.

Most of that preparation by the way was not on slides.  I did use slides, but only had five for an hour session and that still proved to be too many.  Most of the time that I spent on slides, I spent developing a single custom visual to convey precisely the information that was relevant to the students during this session (see image).  The rest of the preparation was spent understanding the audience needs by speaking to those running the class; developing a detailed plan for the hour, focusing on how to make the session a highly interactive learning experience; designing quality handouts to support the interactive exercise; and doing my necessary homework.  For this last one, I spent 20 minutes on the phone with a surgeon friend, since the session was built around a case study discussing surgical complications and design.

Three resources I found really useful:

1. Why Bad Presentations Happen to Good Causes, Andy Goodman, 2006. This commissioned report was developed to help NGOs with their presentations, but I think there is value here for anyone whose work involves presentations. It is evidence-based and provides practical guidance on session design, delivery, slides (PowerPoint), and logistics.  Most importantly, it is available as a free download. I was fortunate enough to pick up a used copy of the print edition for US$9 at my local bookstore, which was worth the investment for me because of the design of the physical book.  It’s out-of-print now and it looks like the online used copies are quite expensive – at least 3x what I paid – so I recommend the PDF.
2. Envisioning Information, Edward Tufte, 1990. I read this when I was writing my dissertation. Folks in design all know about Tufte, but I still recommend a periodic refresher.  This is the sort of book that will stay on my shelf.  Also potentially useful is The Visual Display of Quantitative Information. For those working in global health, don’t forget how important the display of information can be: (a) Bill Gates and the NYTimes, (b) Hans Rosling at TED.
3. Software for creating quality graphics.  The drawing tools built into typical office applications, though they have improved in recent years, are still limited in their capability and flexibility, especially if you’re looking at #2 above.  In the past 10 days, three people in my socio-professional network have solicited advice on such standalone tools, OmniGraffle (for Mac) and Visio (Windows): a graphic designer in New York, an energy research scientist in California, and a healthcare researcher in DC.  Both are great options.  I use OmniGraffle these days, though I used to use Visio a few years back.  If cost is an issue, there are open-source alternatives available, though I’m not at all familiar with them (e.g., the Pencil plug-in for Firefox).

Last Thursday, I had the opportunity to view a PhotoVoice exhibition at the University of California, Berkeley organized by Haath Mein Sehat (HMS), a group working to improve access to clean water and sanitation in six slums of Hubballi and Mumbai, including Dharavi.

It was exciting to see a group effectively blend the advocacy elements of PhotoVoice with the design elements of cultural probes. The difference between the two approaches is less in the methods and more in the use of the outputs. In this case, they organized the exhibition to raise awareness and break down stereotypes of slum life, and they are using the photographic corpus to guide the design of both programs and technologies related to their core mission.

What I was most interested in from a design perspective were the instructions given to community photographers and how this tied back to the mission of HMS. The results below followed from the simple prompt: “Represent your daily experience with water”.

Purely as entertainment I enjoyed Slum Dog Millionaire and because of the Oscar victory people have become more curious about global slums. How do I know this? The hits on this blog have increased in the past two days with people specifically drawn to a previous post we did: Dharavi: Mumbai’s Shadow City. Take the following with a grain of salt, but note the increase in interest:

“Movies have a powerful ability to evoke a sense of the exotica about the locations in which they are filmed. They are widely acknowledged to inspire travel to those destinations….According to Expedia sources, post ‘Slumdog Millionaire’, Mumbai now tops the chart of global tourist destination.” Source Yahoo News

Additionally, OneWorld Health has decided to explicitly use the movie as a avenue to educate people more about global health needs:

The Institute for OneWorld Health, the non-profit pharmaceutical company that develops drugs for people with neglected infectious diseases, announced it is launching a new awareness campaign inspired by the highly acclaimed Oscar-winning film, Slumdog Millionaire…OneWorld Health is running a full-page ad in the New York Times on Monday, Feb. 23. Slumdog Millionaire, an underdog story about poverty, love and hope, won eight Oscars at last night’s Academy Awards ceremony, including Best Picture. For the full story see OWH here.

A by product of Slum Dog is that tens of millions of people who previous had very little knowledge about global poverty got a little glimpse into that world. Picking up on this curiosity, another place to learn more is a fantastic multimedia project by Magnum Photos that is well worth your time (hat tip to TinkuB) :

Other Perspectives:
Does Hollywood spotlight risk slumsploitation? The Business of Giving
A Hollow Message of Social Justice. RaceWire

Sunday night there were two films related to global health and poverty that were nominated for an Academy Award in the best short documentary category. Smile Pinki took the award in the short’s category this year. The other film was The Final Inch (about polio eradication efforts, see the Google.org link below):

• Smile Pinki: Pinki, a girl in rural India whose cleft lip has made her a social outcast, has a chance for a new life when she meets a dedicated social worker.
• The Final Inch: Contributing to the global efforts to eradicate polio worldwide, dedicated individuals in India travel throughout the country urging parents to vaccinate their children against the disease.

Oscar’s past have been given to other global health related films -Born into Brothels which one the best overall documentary in 2004 – and it is good to see this continue. Megan Mylan, a UC Berkeley graduate, who also did the Lost Boys of Sudan, directed Smile Pinki, below are excerpts of an interview with her:
———
IDA: What inspired you to make Smile Pinki?
Mylan: As a filmmaker who focuses on social issue documentaries, it’s rare that I get into a film knowing we’re likely to have a happy ending. I was excited to tell the story of this beautiful hospital and a team of doctors and social workers treating their patients with such compassion and quality care and making a positive impact. I continue to be inspired by the simple idea that the better we know each other, the better this world is, and I hope people come away from my documentaries feeling like they better understand the life of someone living a very different reality.

IDA: What were some of the challenges and obstacles in making this film, and how did you overcome them?
Mylan: The biggest challenge for me was communicating and finding common ground with the patients and families in the film. Like many of the patients, Pinki’s parents are illiterate dirt-farmers. They had never seen a movie or met a foreigner. I really wanted them to understand my motivation for making the film and gain their trust. I worked with a great field producer, Nandini Rajwade, who along with Pankaj Kumar, one of the social workers in the film, patiently translated my conversations from English to Hindi to the family’s dialect and back, but it was still hard to know through the levels of translation that I was being respectful and clear. I chose to trust the sensitivity of my team and rely on eye contact and instinct.
———

Global health could certainly use more in the way of video, film, and other creative outlets that help spread success stories. Check out out previous post on global health video outlets.

Want to know what 50 cents can buy? Watch the video in full, read the press release below (announcement to be made today at Davos) and check out http://www.just50cents.org/:

[youtube=http://www.youtube.com/watch?v=z1bJevMDf3o]
I will link to the full press release when it’s up, in the meantime here is the intro:

Global Network for Neglected Tropical Diseases Receives $34 Million Gates Foundation Investment to Scale up Prevention and Treatment Efforts

New “End the Neglect 2020” Campaign Aims to Greatly Reduce the Burden of NTDs Davos, Switzerland, January 30, 2009 –

“The Global Network for Neglected Tropical Diseases today announced that it has received $34 million through a grant from the Bill & Melinda Gates Foundation to the Sabin Vaccine Institute to step up the global effort to prevent and treat neglected tropical diseases (NTDs). These debilitating and sometimes deadly diseases affect 1.4 billion people worldwide who live on less than $1.25 a day. With the new grant, the Global Network is launching a campaign to catalyze additional funding and will establish a global alliance to scale up NTD treatment and prevention efforts. ”

Controlling NTDs is considered a “best buy” in public health because of the availability of extremely low-cost interventions and the resulting high return on investment. For approximately 50 cents per person per year, the seven most common NTDs – which together represent 90% of the global NTD burden – can be effectively treated. ”

1. Microsoft is funding research in Argentina and India into low-cost electrocardiogram (ECG) machines. The devices, which can cost less than $100, use cell phones to transmit data to a computer, where it can be analyzed and then conveyed to a doctor.

2. Using Rubinsky’s gear, a doctor could use a cell-phone screen to view a cross section of tissue. In this image, a doctor uses a cell phone to magnify a patient’s breast tissue and examine it for a tumor.
SOURCE: Business Week

==============================================================
This is our third post on mobile phones and international/global health (post 1, post 2). This post is largely imcomplete, but I wanted to get it up. The above pics and quotes below are based on a feature in Business Week:

“It’s not easy to lug an ultrasound machine into a remote village’s health clinic—much less keep it running. But a cell phone? No problem…”

“According to the World Health Organization, about half of the imaging equipment sent to developing countries goes unused because local technicians aren’t trained to operate it or lack the necessary spare parts. So researchers are stepping up efforts to employ wireless technologies to deliver crucial medical services, particularly in underserved areas…Scientists from the University of California, Berkeley, have just developed a prototype technology that uses cell phones to deliver imaging information to doctors.”

“The University of California professor says that by reducing a complex electromagnetic imaging machine to a portable electromagnetic scanner that can work in tandem with a regular cell phone and a computer, he has essentially replicated a $10,000 piece of equipment for just hundreds of dollars.”

Another source – Imaging technology could be useful in poor countries:
Some types of medical imaging could become cheaper and more accessible to millions of people in the developing world if an innovative concept developed by an engineer at the Hebrew University of Jerusalem fulfils its promise. The device uses cellular phone technology to transmit magnetic resonance images, computed tomograms, and ultrasound scans (PLoS One 2008;3:e2075; doi: 10.1371/journal.pone.0002075)

One other recent article in this area, from PC World -
Mobile Phones and the Digital Divide: Whether you’re building an application for the 3G iPhone in the United States or trying to figure out how to deliver health information via SMS (Short Message Service) to a rural community in Botswana, the mobile space is diverse and exciting in equal measure.

Also be sure to check out:
- Why people seek out health information, link