Earlier this week we received the following announcement from MEDICC which we are reproducing with their permission. Opportunities to visit Cuba and do research are very limited:
MEDICC is contacting community health professionals to announce an exciting opportunity for research on Cuba’s primary care health system, December 7 - 14, 2008.
MEDICC (Medical Education Cooperation with Cuba) supports US health professionals undertaking field research in Cuba by providing background materials, guidance on research objectives, and opportunities for publication of research findings. Please see our on-line publications athttp://www.medicc.org.
Over the past several decades, community clinics in the US have mobilized to confront issues of growing disparity and lack of access to health care - all in the face of enormous challenges.
Cuba’s health outcomes often resonate with those in the United States working to find innovative approaches to health problems in medically underserved communities. Despite high levels of poverty, health indicators in Cuba are on par with industrialized countries, including the U.S. Particularly noteworthy are Cuba’s emphasis on community-oriented primary care, the integration of clinical medicine and public health, preventive medicine and effective use of limited resources (see attached article).
The research program in Cuba will be tailored to participants’ interests, and will include meeting with Cuban colleagues and community health leaders, as well as field research on Cuba’s functioning models of primary care, including:
Polyclinics (the centerpiece of the community-based system)
Family doctor-nurse offices (or consultorios)
Community mental health clinics
Maternity Homes (for high risk pregnancies)
Community organizations such as the sanitary brigades and the Federation of Cuban Women
Health programs for the elderly (circulo de abuelos)
Full time health professionals conducting research in Cuba are allowed to do so under the US Treasury’s general license for professional research (see attached). Marazul Charters, an agency licensed to provide travel arrangements to Cuba, organizes the program and books travel. Costs usually range from $2600-$2800 for a week, including airfare from Miami or Cancun. MEDICC serves as an academic consultant for the actual research program and in some cases may be able to provide partial fellowships.
If you are interested in participating in this December 7 - 14 opportunity or would like further information, please let us know by July 2 by writing to admin1@mediccatlatna.org. We will then contact you to discuss your research interests. You can also contact Marazul Charters directly at 1-800 223-5334 ext. 16 for further information on traveling to Cuba on the US Treasury’s general license for professional research. Also, please let us know of any colleagues affiliated with community clinics whom you think might be interested in this opportunity and we will contact them. We look forward to hearing from you.
We wanted to share an article we just published in Public Health Reports on using Google Earth for community mapping. We have found Google Earth a very useful tool that allows non-experts to make maps illustrating the community context for health problems. This post contains two of the maps created by our residents and medical students.
Using Google Earth as an Innovative Tool for Community Mapping
SYNOPSIS
Maps are used to track diseases and illustrate the social context of health problems. However, commercial mapping software requires special training. This article illustrates how nonspecialists used Google EarthTM, a free program, to create community maps. The Bronx, New York, is characterized by high levels of obesity and diabetes. Residents and medical students measured the variety and quality of food and exercise sources around a residency training clinic and a student-run free clinic, using Google Earth to create maps with minimal assistance. Locations were identified using street addresses or simply by pointing to them on a map. Maps can be shared via e-mail, viewed online with Google Earth or Google Maps, and the data can be incorporated into other mapping software.
Authors: Theodore B. Lefer, Matthew R. Anderson, Alice Fornari, Anastasia Lambert, Jason Fletcher and Maria Baquero
Sources of Food and Exercise around the Montefiore Comprehensive Health Care Center; Legend: Red cross = Comprehensive Health Care Center; Grocery cart = Grocery Store (n =10); Fork and Knife = Restaurants (n=16); Red dot = Fast Food outlet (n=32); Yellow dot = Bodegas (small variety stores, n=44); Green tree = Exercise site (n=11). Note the old Yankee stadium on the lower left of the map.
Food stores around ECHO Free Clinic, ranked by variety and quality of produce for sale; Legend: Red Cross = ECHO Free Clinic; Small red icon of shopping cart = “no variety” (n=33) ; Yellow cart = “Poor variety” (n=67); Blue cart = “Limited variety” (n=50); Darker green cart = “Better variety” (n=11); Larger, lighter green cart = “Good variety” (n=15) ; Blue -shaded area = Study area
If you are interested, you can also download the original KMZ file.
Out in the RuralProduced by Judy Schader Rogers, 1970
If you have problems with the streaming video, you can download the film here. It is 22 minutes long and may take some time to download.
A classic film in community health…
Shot in the fall of 1969 and the winter of 1970, “Out in the Rural: A Health Center in Mississippi” highlights one of the very first Community Health Centers in the United States: the Tufts-Delta Health Center of North Bolivar County, Mississippi. The film captures the broad vision of a community health center involved in far more than traditional medical diagnosis and treatment. For more information on this film, please see an article published in Social Medicine by Dr. Carolyn Chu. This film is posted with the kind permission of Dr. Geiger.
Doctors for Global Health will be holding its 13th Annual General Assembly from July 18-20th in Iowa City. DGH is a organization of health activists that was founded in 1995 in solidarity with communities in war-torn Morazan Province in El Salvador. It has grown quickly over the past 13 years and now has projects throughout the world. [Information on registration for the conference can be found at their website.]
DGH has always had an activist and community bend. The day the conference opens (7/18) visits are planned to some of Iowa City’s local projects including the Proteus project which provides healthcare to farmworkers and immigrants; The Free Clinic, one of the oldest in the country, serving new Iowa communities without access to health care; and Scattergood School Organic Farm, part of the local food movement.
DGH promotes a vision of Liberation Medicine: “The conscious, conscientious use of health to promote human dignity and social justice.”
DGH maintains a very comprehensive and useful website where you can go for more information about the organization.
[This post, by Naveen Thomas, was originally published in June of 2005]
In January 1984, a group of doctors and other professionals who left their jobs in mainstream medical colleges started a community health study-reflection and action group in Bangalore, South India. Community Health Cell (CHC) which grew out of this group, was supported by the Centre for Non-Formal and Continuing Education, Bangalore, till 1990. In June 1990, the project was reviewed and the Society for Community Health Awareness, Research and Action (SOCHARA) was established and registered. Community Health Cell became its functional unit.
As the name suggests, the main aim of SOCHARA was to promote community health awareness, action and research. SOCHARA’s mandate also included evolving educational strategies in Community Health and Development. SOCHARA recognised the need to dialogue and participate with policy makers and implementers to enable the formulation and implementation of community oriented health policies. As a part of efforts to promote community health, SOCHARA also established a library, documentation and interactive information center in Community Health.
SOCHARA consists of 32 members who are distinguished in their own areas of work. CHC, the functional unit of SOCHARA consists of a small core team of 20-25 people, including health and social science professionals, office and library team, research and training assistants, supported by a large informal network of professional associates and friends. The strength of SOCHARA has been its wide network leading to a rich and diverse web of interaction among persons and groups involved in Community Health in India and across the globe.
SOCHARA/CHC have been involved in participatory community health training at middle and grassroots level, primarily with voluntary agencies in South India. On the medical education front, CHC collaborated with the Rajiv Gandhi University of Health Sciences, Karnataka to reorient the vision and mission of medical colleges, to improve their management and to introduce medical ethics, rational drug education and other socially relevant topics in the medical curriculum. In addition, SOCHARA/ CHC were also involved in research on strategies for social relevance and community orientation of Medical Education and follow up initiatives with colleges and universities.
Promotion and awareness building concerning rational drug prescribing, rational drug policy, patents and alternative systems of medicine is another area of SOCHARA/ CHC’s functioning. SOCHARA/ CHC also took an active part in the recent Global Campaign against Indian Patents Amendment (GCAIPA).
SOCHARA/CHC has been providing active support to research and awareness building on environmental health issues including mining, Bhopal gas disaster, etc. The other disasters that SOCHARA/ CHC has been actively involved in facilitating relief and rehabilitation efforts include the Bangladesh cyclone disaster, Uttarkashi, Marathwada and Kutch earthquakes and Tsunami in Southern India.
Over the past two decades, SOCHARA/CHC have been motivating and guiding young professionals who were in the process of reflecting about their personal interest or commitment to community health. They spent 3 - 12 months in CHC where they went through a learning process that was person-centred, with peer support, short assignments, self-study, presentations, writing of reports, etc. Today, over 95% of the professionals continue to work in the area of community health.
A review of SOCHARA/CHC in 1998 and subsequent reviews suggested that CHC expand its training and mentoring role. As a result, a Community Health Fellowship Scheme commenced in April 2003, providing an opportunity for young professionals to learn about community health and its various options by involving themselves in a person-centred, semi-structured training programme. This role of SOCHARA/ CHC is being further consolidated, and CHC is evolving into a research and educational centre in community health, public health and health policy.
The other area in which SOCHARA/CHC has been greatly involved is in building a people’s movement in health. The SOCHARA/ CHC review had also suggested that CHC utilize its network and relationships built over the years to contribute to a mass movement in health. This came true in 2000 A.D., with the Indian Health Assembly held in Calcutta, India and the first People’s Health Assembly (PHA-1) being held in Savar, Bangladesh in December 2000. CHC contributed in mobilizing people and organisations, and in conducting both these assemblies. CHC was also deeply involved in the formation of the People’s Health Movement (PHM) and in drafting of the People’s Charter for Health.
In 2002 two years after the first PHA, PHM secretariat was shifted from GK, Savar to the PHM India region, and CHC was asked to host it on behalf of region. Ravi Narayan is currently the co-ordinator of the PHM Secretariat (Global) based at CHC, Bangalore. The People’s Health Movement has come a long way, and five years after its formation, is getting ready to host the second People’s Health Assembly (PHA-2) at Cuenca, Ecuador in July 2005.
To know more about SOCHARA/CHC, get in touch with us, or email Thelma Narayan, the co-ordinator of CHC.
Naveen I. Thomas, Health Policy Fellow, CHC (June 2005)
School of Social Medicine Genogram and Next Generation Medical Education
When Merle Cunningham MD came to visit the School of Osteopathic Medicine in Arizona (SOMA) the other day, the topic got around to the merger of two fine family lines. Merle has been active in Community Health Centers, NACHC, the National Health Service Corps, and health care access in NYC. He has been instrumental working through NACHC and Gary Cloud to help make SOMA a reality.
Forrest Lang MD was the second family line. He took his Social Medicine training to NHSC, Appalachia, East Tennesee State, and the Appalachian Preceptorship. I have the honor of being his adopted mentee. He brought me to TN and helped me to develop the ETSU Rural Fellowship, the Minifellowship, the Rural High School Career Fair, and the initial work toward the Mountain City rural site. One of the Rural Minifellows, faculty that were developing rural programs, was Tom McWilliams DO. His rural program for the Minifellowship was the revision of the Kirksville family practice preceptorship. Much “Social Medicine” type collaboration was involved in the Rural Minifellowship.
Tom McWilliams moved on to develop the first osteopathic school in Arizona at AZCOM and then the new ATSU SOMA, working back with the Kirksville folks. The preferential admissions process used was borrowed from my work which was borrowed from the various interactions with the Rural Minifellows. Tom hired me, Forrest Lang’s mentee, to come to Arizona to help develop this new school. Tom also shares NHSC background and helped recruit Barb Doty who helped found the Alaska FP training program that has top rates of underserved graduates in CHC And Native Consortia practice locations (about 43%). The Minifellowship, like the School of Social Medicine, helped keep ideals and ideas alive to translate them into action.
The School of Osteopathic Medicine of Arizona works with CHCs to funnel in applicants familiar with work with the underserved. SOMA admits medical students with a top priority on service orientation. The top priority is a match to the mission of returning them to CHC locations as long term primary care physicians. After one year at Mesa AZ, the medical students depart Mesa for sites from Hawaii to Brooklyn. The first class will begin in Brooklyn at Sunset Park in a few months. One of the faculty hired here at the same time was a lab tech at Sunset Park, Noel Carrasco, MD. who later did research, U Autonoma De Guadalajara, Neonatology, and Complementary and Alternative work with Andrew Weil.
Just wanted you to know that some epidemics are worth spreading and the School of Social Medicine is one of the best vectors.
When the new medical students arrive at Sunset Park, might just be worth “completing” their training where it began.
In 1999 the Kark’s published Promoting Community Health: From Pholela to Jerusalem, a book summarizing their work in Community Oriented Primary Care.
A detailed discussion of their principles can be found in “A Practice of Social Medicine” a chapter authored by them in the early 1960’s. It was republished in 2006 in the online journal Social Medicine.
You are currently browsing the The Social Medicine Portal weblog archives for the Community Health category.
The views and opinions expressed on this site do not necessarily reflect the views of Montefiore Medical Center, Albert Einstein College of Medicine, Yeshiva University or the Social Medicine Publishing Group.
