Tagged: HIV

Ten Great Books About Women’s Health

I'm committed. So don't spoilt the ending.

I’m committed. So don’t spoil the ending.

I don’t read too much non-fiction these days. Right now I’m speed reading  Gone Girl . It’s kinda sorta okay but makes me feel like my brain is melting. I don’t really like Gone Girl, but I can’t stop reading it. It’s kind of like my sugar addiction.

On my shelf waiting to be read I have Swamplandia and The Time Traveller’s Wife. This month my reading list fits  my demographic profile way too neatly. Amazon could peg me perfectly.

To my credit, the last time I went to the library, I checked out Far From the Tree, Buddhism for Mothers and  In the House of the Interpreter. But I haven’t read them yet. This summer I read everything Jamaica Kincaid ever wrote (except this one) . She is so perfect. But I also read The Happiness Project.  Please don’t let me read Jodi Picoult. If I read Jodi Picoult, it’s all over.

Anyhoo, back when I was a full-time smarty pants, I spent countless hours reading nonfiction, I read about health. Particularly women’s health. There is so much out there, and I feel lucky to have been introduced to it. So in case you’re looking for something to read that’s not a white lady novel, here  we go.

Ten great books about  women’s health:

1. Killing the Black Body: Race, Reproduction and the Meaning of Liberty. Dorothy Roberts is a great writer. This book will help you understand the racist undertones of much of American political discourse about reproductive health and entitlement programs.

2. How the Pro-Choice Movement Saved America: Freedom, Politics and the War on Sex. Cristina Page. Best title ever

3. Cunt. Speaking of titles… okay, it’s a little crass and the language is tiny bit outdated, but Inga Muscio’s take menstruation, reproductive health and sexual freedom is still empowering

4. A Darker Ribbon. One of the most well-researched critiques of the breast cancer movement that is not preach or overly academic.

5. Reproductive Rights and Wrongs: The Global Politics of Population Control. This should be required reading for anyone working for — or wanting to work for —  an international development organization.

6. The Spirit Catches You and You Fall Down : A Hmong Child, Her American Doctors and a Collision of Two Cultures. A can’t-put-it-down kind of read written by a journalist.

7. Testing Women, Testing the Fetus: The Social Impact of Amniocentesis on America.  An ethnography of genetic counseling. A little bit on the jargony side, but still a good read.

8.   Pathologies of Power: Health, Human Rights, and the New War on the Poor.Paul Farmer will make you want to try and save the world.

9. Safe Food: The Politics of Food Safety. You are what you eat. Marion Nestle.

10. How to Have Theory in an Epidemic: Cultural Chronicles of AIDS. Would get the award for best title if I hadn’t already given it to Cristina Page. Paula Treichler is one of my favorite smarty-pants writers.

And one bonus book…

11. Birth as an American Rite of Passage. Robbie Davis-Floyd. A classic. Read it.

What about you? What are your favorite women’s health books? What did I forget?  And hey, what are you reading? I’ll forgive you if it’s Jodi Picoult.

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Silence still equals death

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Did you know that Saturday was World AIDS Day?

I wasn’t paying attention. Like so many Americans, I have the luxury of acting as if the virus doesn’t exist.

But AIDS is still a major problem in the US. I live in the South, the region of the country that experiences the highest rate of the disease. But most of the time (or even all the time) it’s completely off my radar. There are lots of reasons for this, one of which is the fact that people living with HIV/AIDS are largely invisible. For all I know, my neighbor could be HIV positive, but I would have no idea. Unlike breast cancer or even depression, HIV is so stigmatized that people with the disease remain completely hidden.

Remember that old mantra, silence= death? It still does.

When was the last time you saw a “I’m HIV positive” bumper sticker? Or even a red ribbon?

HIV continues to be a disease that highlights social inequality. According to a new report:

  • Black women account for 64% of all new HIV diagnoses in the country
  • Nine of ten of the states with the highest death rate of HIV are in the South
  • Approximately 1 in 16 Black men will be diagnosed with HIV in their lifetime

If these numbers make you shudder, they should.  I know 16 Black men, many of whom are family. Statistically, one of them could have HIV, but if they do, I wouldn’t know it. We don’t talk about it.

One innovative  strategy for addressing this issue developed by the NAACP in partnership with Gilead Sciences is to engage Black churches as partners in preventing the onslaught of this disease. They’ve  developed a training manual for pastors in Black churches, guiding them on how to address HIV/AIDS in their communities and emphasizing that it is a social justice issues.

Highlighting the interconnectedness of social inequality to health disparities is one of the most crucial ways to improve public health. The training manual encourages pastors to be inclusive to gay and lesbian congregants, and to exercise compassion as part of a mission to save lives.

It’s an unlikely partnership in some ways, but one that is meaningful and that will hopefully prove to be effective.

What do you think? Has HIV/AIDS affected you at all? Have you heard of other unlikely partnerships aimed at preventing other diseases?

 

 

 

 

Getting naked for social justice

Back when I was young and idealistic, there was nothing I loved more than a good protest.

I vividly remember the first time I attended a demonstration — it was on Parliament Hill in Ottawa, Canada and were were protesting the incarceration of Nelson Mandela. After that, I was hooked.

I’ve  marched against police violence in Seattle, white supremacy in Montreal, and sexual assault in Iowa City. I’ve taken back the night more times than I can count, and I’ve  faced off against loggers (one of whom was wearing this T-shirt)  in British Columbia’s Clayquot Sound as part of a protest against clearcutting.

I once demonstrated against impending restrictive abortion regulations in Seattle, and carried this sign:

On my way home, a young boy stopped me and asked me to explain what the sign meant. Awkward.

I used to get goosebumps and a thrill at the first sound of a good chant. I loved rousing speeches promising social justice, peace and equality. During the Bush reign of terror administration, I took a bus from Iowa to Washington,DC to protest the invasion of Iraq. The experience was thoroughly exhilarating at the same time that it was extremely depressing. Enormous demonstrations were held all over the world, but we all know what happened in the end.

It was this lifelong interest in social justice that propelled me to seek employment in the non-profit women’s health field. When I finally got a full-time job writing for a major reproductive health and HIV organization, I was beyond excited.

But instead of rousing speeches and radical movement toward social justice, I found career climbers and male dominated board rooms. Public health initiatives seemed top-heavy and destined to fail, success was measured in tiny percentage points. People talked about “stakeholders” and “gender champions” and said things like “scale-up” and “roll-out” and “capacity building.”

The employees at this non-profit didn’t protest, in fact, they found protestors to be quite threatening. I was enlisted to help write a paper about the travesties committed by ACT-UP. And yes, dear readers, I did it.

This morning, there was an article in the L.A. Times  about a group of young people disrobing in front of John Baynor’s office in protest of cuts to domestic AIDS funding.  I found myself thinking about the importance of this type of dramatic, confrontational action. There’s no worry about funders disapproval or concern that you might be burning bridges with potential allies. This kind of action  reminded me that there are still plenty of people who are able to concoct creative ways to engage with the political process, to express rage at inequality, and yes, even to demand social justice.

I’m not much of a sign-holder anymore, perhaps those kinds of actions are best left to the young and idealistic. But while I might not be one of the people who strips naked on Capitol Hill, I’ll always be sitting on the sidelines, silently cheering them on.

What do you think? Do you go to demonstrations? Do you think that protests like these are good tools for political change, particularly when it comes to health policy?

Profiles in Health: Sarah Harlan

Today I’m excited to launch a new feature called Profiles in Health. Every week I’ll interview a woman (and maybe even a couple of men!) working in women’s health. I’ll talk to clinicians, activists, policymakers, public health professionals, midwives, writers and more.

For my first interview, I’m profiling my former colleague and friend, Sarah Harlan. She’s currently a Program Officer for Knowledge for Health at the Johns Hopkins Center for Communication Programs.

Sarah has a BA from Grinnell College in Iowa, and an MPH from UNC Chapel Hill. She’s worked for Planned Parenthood, Ipas and Family Health International, and has traveled to six countries – including Nicaragua, India and South Africa – doing  reproductive rights work. She’s a calm, focused presence with a knack for making order out of chaos, a much needed skill in a field that is often filled with frantic deadlines and hectic schedules!

I talked to her last week about reproductive rights, HIV and what it means to be a woman working in international public health.

Sarah Harlan, MPH

You have an MPH in Maternal Child Health, and you’ve been working in the reproductive health field for about ten years. What do you do in your current job?

I work on the research, monitoring and evaluation of the Knowledge for Health Project (K4Health) at the Johns Hopkins University Center for Communication Programs. It’s a USAID-funded 5 year project that’s working to improve the dissemination and uptake of current knowledge on reproductive health, family planning and HIV in low and mid-income countries.

I analyze the needs of various countries in order to inform the materials that are produced, like eLearning courses and online toolkits. Once we produce the materials, I help evaluate them, asking questions like: How do people like them? Can they be improved? What can we do better in the future?

It’s important to know whether what you are doing is actually working, and figuring that out is part of my job.

What do you do on a daily basis? What does an average day look like for you?  

Even though I work for Johns Hopkins in Baltimore, I’m a remote employee: I live in North Carolina! That means there are a lot of phone calls; I’m often on the phone for two or three hours a day with different colleagues. I do a lot of writing reports, online publication, a journal manuscript and blog posts. I also look at data about the tools that we are using and analyze it, drawing conclusions about the success of the project and reporting that to our funder.

One great part of my job is that I get to travel to see what our offices are doing in the field. Most recently, I went to Addis Ababa, Ethiopia for a week and a half. We had done a series of needs assessments in 5 countries, looking at the information needs of family planning and reproductive health providers. I went Ethiopia to facilitate a dissemination workshop on the study we did there. We invited about 50 health professionals  and  had a daylong meeting to talk about the results of the needs assessment. We got to hear their ideas about what to do, based on that information.

The project I’m working on now is based in Indonesia, so I’ll be traveling there some time in the new year.

You were a Religious Studies and Latin American Studies major in college: what made you decide to pursue public health?

I first became interested in women’s health while I was studying the Catholic Church’s effect on women’s reproductive rights in Latin America. I thought about going to graduate school in Latin American Studies, but that didn’t seem right. Then, at one point I thought of becoming a nurse or nurse practitioner, but I wasn’t sure that the focus on science was going to be the right fit for me.

Before I went to graduate school I worked at a Planned Parenthood clinic as a health care assistant. At the time the health care assistants were doing everything from answering the phones, to providing intake counseling, to doing injections.  I speak Spanish, and we had a lot of Latino patients, so it was a great opportunity. One thing I liked about Planned Parenthood was that it was a woman-driven organization. That’s not that it didn’t have men employees, but the priorities were set by women, and that was really nice.

I knew I was interested in reproductive health and family planning. After working at Planned Parenthood, I realized I was more interested research and policy than in being a clinician, and I thought public health would be a good balance of the topic area and the methods that I was familiar with as an undergraduate. Public health is so interdisciplinary. You have to know about history, anthropology, and you have to be a good writer.

When people think of the health fields, they mostly envision doctors and nurses, the actual health providers, they don’t usually think about public health. What is the difference do you think? Why is public health important?

There are a lot of things that go into health and medicine. That larger view of health on the population level is such a compliment to science and clinical work.

I’ve been reading Tinderbox, the book about the AIDS epidemic in Africa by Craig Timberg and Daniel Halperin. In it, they talk about the things the West has done to combat AIDS that actually made it worse, and much of it has to do with neglecting the bigger picture.

During the Bush administration when PEPFAR was created, the administration appointed clinicians who were focused on treatment but weren’t trained in population level care and programmatic and policy issues. They didn’t really consult anthropologists or public health professionals – if they did, it was minimal. That was a real weakness of PEPFAR at the beginning – that public health people weren’t helping steering the priorities.

If clinicians and public health folks were working together more, there would have been a more comprehensive plan that focused on the bigger picture, not just on treatment. The book is a great illustration of why it’s so important to have a social science approach and a clinical or “hard science” approach to addressing health issues.

I’ve written about the gender gap in both clinical medicine and in medical research, but haven’t addressed gender issues for women working in the public health sector. What is it like being a woman working in this field? From your perspective, does it seem like international public health is a field where women can succeed professionally?

From what I can see, public health seems to be dominated by women, and the trend is that women are having more positions of power. Or maybe this is just the case in reproductive health, but I think it’s happening in HIV too, because of a renewed focus on women’s  prevention options like microbicides and pre-exposure prophylaxis.  Whatever the reason, it seems like more and more primary investigators and spokespeople are women.

At the same time, in every organization I’ve ever worked, there are more women than men, but the men tend to be in charge. It can be frustrating, but I think it’s starting to change.

Should this guy be setting funding priorities in women’s health?

A lot of this work is grant funded, which means that organizations tend to focus on what Bill Gates thinks is important, or what presidents of various nations are important. That’s one reason why family planning issues fell of the radar for a while in the 1990s: funders decided there were other health priorities that didn’t focus on women. HIV has traditionally been given a male face – even though women and children make up such a huge population of new infections – and a lot of that is because decisions are made and funding is men.

What do you like the most about the work that you are doing now?

Too often, organizations jump into planning an intervention without knowing if there’s a need.

K4Health is research-based advocacy: you’re going and collecting the evidence, finding out where the needs are, planning an intervention around that. I like that I know we’re evaluating whether things are effective. To me, it just makes more sense: it leads to a better use of resources, and ultimately can do a lot more good.

What advice would you have for women who are thinking of pursuing a degree in public health?

Before you do the degree, look around and see what public health organizations are actually doing. When I went into the Maternal Child Health program, I was very idealistic.  I don’t want to tell people to curb that, but you have to realize the limitations of working within institutions and structures.

Remember: unless you get to be at the very top of the field, you’re not setting the priorities or determining the focus of a project. You can put your own personality and creativity into it, but you need to be realistic about where the jobs are.

That said, there are a lot of unique and interesting opportunities in the field. I’ve learned how to use a video camera and do video editing and  given professional presentations. I’ve published in journals, taken photographs, and gained some public health programmatic and research skills at the same time. These are things I didn’t predict I would be doing. There is so much new energy in family planning and reproductive health, with the London Summit and (hopefully) renewed funding, and it continues to be an exciting field.

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Thanks Sarah! Best of luck in your work, and we’ll be sure to check in with you again sometime. If you’d like to be profiled or know someone you think I should talk to, send me an email at jcmoffett at gmail dot com.