HEALTH ADVOCATES Working in Global Health € Course Syllabus € Fall, 2000 Working in Global Health is a nine-week series of seminars which provide an overview of issues in global public health. It is especially designed for people who are interested in working in the field of international health, but is appropriate for anyone with an interest in international health and development. Sponsor The course is presented by Health Advocates, a community health consulting organization which specializes in cross-cultural, immigrant and international health issues. Co-Sponsors Working in Global Health is also sponsored by: … the School Of Public Health of the University of Minnesota, … the Refugee Health Program of the Minnesota Department of Health, … Community Health International, a Minneapolis-based consulting group for international health and development organizations, and … Patten Associates, a partnership working internationally to help improve the human environment. Time and Place 6-8:30 PM, Tuesdays, October 10-December 5, 2000 (optional exam session December 12) MN Health Department Service Center 1645 Energy Park Drive, St Paul Course Description Course topics include global epidemiology; cross-cultural medicine; economic globalization and its impact on health; health effects of natural and man-made disasters; malnutrition and reproductive health. Two sessions are devoted to employment and volunteer options. Weekly sessions are usually divided into two 45-minute lectures per class, each followed by a 20-minute discussion and question session. Two books are recommended for purchase, along with a packet of additional readings. Readings Two books are highly recommended for all participants, especially for students enrolled for academic credit. They are: … Kim, J., et al. Dying for Growth (2000) Common Courage Press, Cambridge MA … Ohmans, P., Osborn, G. Finding Work in Global Health (1999) Health Advocates Press, Saint Paul MN. The books can be purchased at the University of Minnesota campus bookstore in Moos Tower, or in class after the first session. In addition, a list of readings has been compiled. This list will be distributed at the second class session. The readings packet will be available for purchase at the Kinkos Copies on Washington Avenue. These readings will enhance in-class discussion, and are required reading for students enrolled for academic credit. A set of books and a readings packet will be placed on reserve at the Diehl Biomedical Library at the University of Minnesota. Accreditation The course has been designed to meet the Minnesota Board of Nursing requirements for 18 contact hours. The course is appropriate for elective credit from several departments of the University of Minnesota and other colleges. Tuition for academic credit is not included in the course fee. Dr. Ian Greaves will supervise students from the School of Public Health of the University of Minnesota who wish to enroll for credit, under the course number 5100 ³Topics in Public Health.² For one academic credit, students must complete a final examination (scheduled for December 12); for two credits, students must pass the final exam and complete a 10-page paper on a relevant topic. Other students should consult with course coordinator Patricia Ohmans regarding possible elective credit arrangements. Course Sessions Session One October 10 Class Introductions Ten Myths About Global Health Patricia Ohmans, MPH Session Two October 17 The Global Burden of Disease Moise Desvarieux, MD, PhD Session Three October 24 Health, Labor and the Global Community Larry Weiss Health and Human Rights Doug Johnson, MPPM Session Four October 31 Cultural Definitions of Illness Sonia Patten, PhD Session Five November 7 Malnutrition Chery Smith, PhD Agricultural Development and Health Sonia Patten, PhD Session Six November 14 War, Refugees and Health Huy Pham, MPH Reproductive Health Sonia Patten, PhD Session Seven November 21 Environmental and Occupational Health Ian Greaves, MD, MPH Child Labor Worldwide David Parker, MD, MPH Session Eight November 28 Trends in Infectious Disease David Williams, MD Global Health Stakeholders Patricia Ohmans, MPH Session Nine December 5 Six Ways to Work in Global Health Garth Osborn, MPH Session Ten December 12 (optional) Evaluation/ Exam (academic credit students only) Session Descriptions Session One: October 10 Class Introductions/ Ten Myths About Global Health Patricia Ohmans, MPH Our first class provides a time for introductions, as well as an overview of the course content and structure. In the second half, course coordinator Patricia Ohmans will describe some common misperceptions about the field of international health. Session Two: October 17 The Global Burden of Disease Moise Desvarieux, MD, PhD How can we get a handle on disease trends world-wide, and over time? It helps to know about the human and environmental factors that contribute to the spread of disease. Dr. Desvarieux, on the faculty of the School of Public Health, will offer a global health snapshot of disease patterns and look at recent worldwide trends, such as increased prevalence of chronic disease in developing countries. Session Three: October 24 Health, Labor and the Global Community Larry Weiss Health and Human Rights Doug Johnson, MPPM Everyday economic decisions we make here in Minnesota can have important repercussions on the health of others around the world. Larry Weiss from the Resource Center of the Americas will provide powerful examples. In the past 20 years, activists have worked hard to redefine health as a human rights concern, applying accepted international standards and laws. In the second half of this session, Doug Johnson, director of the Center for Victims of Torture, will talk about the connection between rights and health. Session Four: October 31 Cultural Definitions of Illness Sonia Patten, PhD Anyone who's traveled overseas‹or who has met someone from a different culture‹knows that people attribute different meanings to the notions of illness, medical authority and effective medical treatment. As a cultural anthropologist, Dr. Patten is an expert on culture as a factor in health. Her lecture will provide a look at traditional healers and the medical systems they use, as well as guidance on conducting a health assessment in a culture that is new to you. Session Five: November 7 Malnutrition Chery Smith, PhD Agricultural Development and Health Sonia Patten, PhD Hunger kills more children worldwide than any disease or disaster. Dr. Smith, a nutritionist who has worked extensively in Nepal, will discuss this phenomenon and will describe the clinical manifestations of malnutrition.The class will also cover the basics of combating malnutrition in children: providing nutritious food (including breast milk); treating children's diarrhea with a simple rehydration therapy; and vaccinating children against common illnesses. Dr Patten returns in the second half of the class to discuss the critical link between agricultural development programs‹especially those which focus on income-generating projects for rural women‹and the health of families. Session Six: November 14 War, Refugees and Health Huy Pham, MPH Reproductive Health Sonia Patten, PhD War or a natural disaster can place impossible burdens on a poorer country's health care structure, in addition to displacing people in huge numbers. Huy Pham will give an overview of the current refugee situation worldwide, providing useful definitions and numbers. He will also describe the work of American Refugee Committee, one of the largest refugee relief organizations. In the second half, Sonia Patten reviews critical components of reproductive health for women‹and men. With input from a guest speaker, the session will review the progress made in the past twenty years, and provide practical advice for those interested in education and promotion for reproductive health. Session Seven: November 21 Environmental and Occupational Health Ian Greaves, MD, MPH Child Labor Worldwide David Parker, MD, MPH An essential part of individual and community health is clean, potable water and unpolluted air, both of which are denied to over one fifth of the world's population. Dr. Greaves, a physician and professor at the School of Public Health, will review examples of environmental health crises around the world, and discuss some of his recent environmental health work in the Philippines. As an occupational medicine physician, David Parker has traveled worldwide, documenting abusive child labor practices. His slide show provides moving testimony of the toll that child labor takes on young bodies and minds. Session Eight: November 28 Trends in Infectious Disease David Williams, MD Global Health Stakeholders Patricia Ohmans, MPH Infectious diseases are still common sources of illness and death throughout the world, especially in developing countries. Dr. Williams, an infectious disease specialist at Hennepin County Medical Center, will describe several of the most prevalent and challenging of these diseases, and provide a framework for the study of new and emerging infectious threats. What shapes our assumptions that the health systems of developing countries are in need of our assistance? In the second half of this class, course coordinator Patricia Ohmans will review models for community-based health outreach worker programs, and direct a group exercise that examines the motivations that international stakeholders bring to health programs in developing countries. Session Nine: December 5 Six Ways to Work in Global Health/Next Steps Garth Osborn, MPH A veteran international health consultant, Garth Osborn will describe the range of opportunities available for people interested in the field, focused on assessing your motivations and possible role. An overview of global health organizations and tips on personal preparation for overseas work will also be provided. Joan Velazquez, co-director of Mano a Mano, a local organization that works with communities in Bolivia, will describe how the organization she operates with her Bolivian husband grew from a simple desire to help out, to a full-fledged non-profit organization. Session Ten: December 12 Evaluation/ Exam (academic credit students only) Faculty Course Coordinator Patricia Ohmans, MPH Director Health Advocates Lecturers Moise Desvarieux, MD, PhD Faculty, School of Public Health University of Minnesota Ian Greaves, MD, MPH Professor, School of Public Health University of Minnesota Doug Johnson, MPPM Executive Director Center for Victims of Torture Patricia Ohmans, MPH Director, Health Advocates Garth Osborn, MPH Principal, Community Health International Sonia Patten, PhD Partner Patten Associates David Parker, MD, MPH Co-Director, Center for Occupational Health and Safety MN Department of Health Huy Pham, MPH Senior Program Officer American Refugee Committee Chery Smith, PhD Professor, Food Sciences and Nutrition Department University of Minnesota Joan Velazquez Mano a Mano Saint Paul, Minnesota Larry Weiss Program Coordinator Resource Center of the Americas David Williams, MD Department of Medicine Hennepin County Medical Center Learning Objectives After attending all nine sessions of Working in Global Health participants should be able to: Session 1. Define a focus and possible venue for international health work, based on personal interests. List several common misperceptions about global health. Session 2. Discuss disease trends world-wide and over time, including recent changes in disease prevalence in developing nations. Session 3. Identify the connection between global economic development and health. List at least two global campaigns linking international health, human rights, and consumer goods. Describe two political and human rights issues in international health and development. List two international legal conventions that apply to health and human rights. Session 4. Give two examples of common health conditions for which there are widely differing culturally-based explanations. Discuss the implication of such differences for international health care practice. Explain the importance of cultural assessment. Session 5. Identify and differentiate between forms of malnutrition, such as kwashiorkor and marasmus. Describe traditional public health approaches to maternal health and child survival: growth monitoring, oral rehydration, breastfeeding and immunization. Explain the relationship between agricultural development and health. Session 6. List three reasons why people become refugees, and four primary health concerns when establishing a refugee camp. Describe four major challenges in ensuring reproductive health for women worldwide. Session 7. Identify three central environmental problems faced by developing countries, and list possible solutions. Describe working conditions for child laborers in developing countries. Session 8. Give an overview of at least six major infectious diseases and three chronic health conditions which are prevalent in developing countries. Explain the impact of stakeholders in planning and implementing successful international health programs. Session 9. List and differentiate among several agencies and organizations which offer international health opportunities. Describe the role of the community health worker in prevention and primary care of disease.