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Winter 2014-2015 Newsletter

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Dear Friend of GlobeMed,

Happy new year from GlobeMed at the University of Chicago! We’re really excited to present to you our newsletter for Fall 2014, which is packed with information on what we’ve been

up to this year. In particular, we are very proud to announce that our application with ASPAT to the Grand Challenges Stars in Global Health grant was successful, and ASPAT has received CA$112,000 to pilot the innovative eCompliance biometric system in Peru - more details within! For those of you less familiar with us, we’re a global health organization run complete-ly by undergraduates at the University of Chicago. We are 1 of 55 chapters nationwide, each partnering with local, community-based grassroots organizations combating glob-al health inequities. Our chapter partners with ASPAT-Peru, a community-health NGO in Peru working to eradicate tuberculosis (TB). Almost all TB patients in Peru are poor and all face heavy stigma from society, friends and even family. While TB treatment is provid-ed for free by the Peruvian government, TB patients often lose their jobs because of dis-criminatory employment practices, while the side effects of medication make it difficult to continue working. A combination of the loss of working income and social stigma forces many patients to end treatment early, which leads many to develop drug-resistant TB. In short, TB derails lives. ASPAT-Peru seeks to ease these problems through the education of TB patients on treatment and prevention, the provision of both material and psychoso-cial support, as well as through advocacy and collaboration with the Peruvian government. This year, our main goal is to re-focus our work as a chapter around our partnership with ASPAT. While partnership is a core value of our mission, we decided that we needed to do more to ensure that ASPAT’s needs and goals were always central to the work we did as a chapter. This is reflected in our 2014-15 Partnership Action Framework (PAF), a document which charts our partner-ship with ASPAT for the academic year. Our previous PAFs each focused on one major project for the year, but we decided to do things differently this year. ASPAT is currently embarking on

Introduction from the Co-presidents

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Jeanne Chauffour Tze Ern TeoInternal Co-President External Co-President

many exciting new projects such as Desayunos, the charlas educativas and eCompliance, and we both felt that the best way in which GlobeMed could support ASPAT was by covering var-ious out-of-pocket overhead costs that are traditionally very difficult to obtain funding for. Among other things, we will be providing funds for office remodeling such that ASPAT can hire new staff, and ASPAT’s participation in the Union World Conference on Lung Health. On campus, we are working to improve our fundraising efforts, and we have raised more than $1,000 through the great work of our Campaigns team. Through our Glob-al Health University team’s efforts, all our members are well-versed with ASPAT, its mis-sion and its work. Our Communications team has been supporting our fundraising ef-forts as well as our Desayunos project with ASPAT by designing a nutritional guide for TB patients. Finally, our Partnerships team has been working closely with ASPAT, our partners and our alumni to ensure the Grand Challenges grant is implemented smoothly as well as to connect ASPAT with potential partners within the global tuberculosis space. In closing, we hope that you’ll enjoy reading our newsletter. If you would like to support our work with ASPAT, please consider donating to our cause by clicking here. Also, please feel free to email us at uchicago@globemed.org with any comments, questions or sugges-tions. We would love to hear from you!

Sincerely,

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eComplianceLast spring, GlobeMed at the University of Chicago worked with ASPAT on an application for a CAN $112,000 Grand Challenges Canada grant opportunity, submitting a proposal for a pilot program for a biometric TB patient tracking system in Lima. The seed for the project idea began when our former co-president met the director of an Indian non-profit, Operation ASHA, at a conference at the University of Chicago. Operation ASHA has developed and implemented a similar system in India, Cambodia, and Uganda, successfully reducing the patient non-com-pliance from double digit rates to 3 percent or less. With Operation ASHA’s help, ASPAT and GlobeMed at the University of Chicago collaboratively wrote a proposal that adapted the idea to the Peruvian context, which we then translated into English and French, and represented in a short video.

After a round of popular voting in late spring, ASPAT was informed that they had been selected as finalists while the GROW team was in Peru. Together we clarified and reworked the budget, and the GROW team was able to translate further documentation of ASPAT’s leadership and the project’s monitoring and evaluation goals on the spot. In November ASPAT’s standing as a grant recipient was finalized. We also found out that half of the grant would be funded by the Peruvi-an government via the National Science and Technology Bureau, which has entailed additional changes but also opened up incredible opportunities for direct collaboration between ASPAT and Peruvian national health policy makers.

Currently, project development is well underway, with ASPAT overseeing software develop-ment by Peruvian developers recommended by the National Science and Technology Bureau and working closely with the National Ministry of Health to ensure the software is integratable with the rest of their data collection systems and TB treatment manual. The program will begin implementation in mid winter 2015.

For more information about eCompliance or the Grand Challenges Canada project, please visithttp://www.grandchallenges.ca/grantee-stars/0666-01-10/

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A day in the life of a GROW intern#uchicaGROW2014

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Wake up and get dressed

Start the apartment’s coffeemaker on the way down to the gym for a run

Shower; eat yogurt and fruit for breakfast

Go down to the street and wait for a combi (mini-bus) going to Ventanilla to pass

Squeeze into combi and try to avoid squishing the woman next to you every time you stop

Arrive at ASPAT’s office; greet Melecio and Lisette

Listen to Melecio give a presentation to the GROW team about TB statistics in Peru

Work on developing the job description for a potential Metcalf intern

Walk to lunch together at Judy’s mother’s restaurant; order arroz a la cubana (ricewith a sunny side up egg and plantains)

Return to ASPAT with Melecio’s son Sebastian in tow

Get updates about last year’s micro-business project from Melecio and make a plan to meet at the municipality tomorrow to sit in on an important meeting

Climb back into a micro (bus) and head back to San Isidro (the neighborhood the GROW team stayed in)

Get home and rest for a few minutes before heading together to a neighborhood coffee shop to study and do personal writing

Return home and start to cook dinner

Sit down to share a homemade attempt at Peruvian locro (stew) and cheese bread

Download the pictures from the day and discuss the Facebook post

Work on a blog entry

Make some tea and do some pleasure reading

Brush teeth and go to bed

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“Yesterday was a comparatively unadventurous, yet nonetheless rather exciting, day spent reveling in the beauty of in-person communication at the ASPAT office in Callao.

Our first achievement of the day was proving our recent mastery of the Lima public transit system, a sprawling, decentralized tangle of privately-managed vans and buses that run along the city’s main thoroughfares. In fact, many of the ubiquitous posters for mayoral candidates tout platforms of transit reform, reassuring us that we are not the only ones who find the sys-tem chaotic. We were more or less mentally prepared for a distinctly non-Western commuting experience when we realized about a month before leaving that there is no such thing as a map of Lima’s public transit system in existence. Indeed, the difficulty of creating one is perceived to outweigh the potential profit of selling it to thousands of tourists (especially since most of them travel by foot, city tour bus, or Lima’s cheap taxis). We have yet to have encountered other tourists on our bus trips. Yet, we have been pleasantly surprised at how relatively quick the buses actually are, at least in contrast to how deteriorated they feel, though they are not particularly speedy compared to how long it would take to travel that distance in the U.S. Their speed seems to be in large part due their barely stopping to pick up passengers, and being able to swerve among cars. Thus the upside of the transit system is that it has led us to an important new theory in the scientific understanding of time: time slows down at a rate equal to the square of the amount of pressure that the other bodies you are crammed between exert on you, multiplied by the number of transfers you have to make. We’ve now got the route to ASPAT’s office perfectly timed and perfectly planned, with the motive of maximizing morning sleep, of course.

ASPAT’s office itself is very modest; no exterior indications or signs: you knock on a house front door and enter one room divided by a wall. The back area is Melecio’s office: a central desk, a few cabinet, and bare walls. The front part of the room is the ASPAT common working space, made up of a desk with PC, a large table seating up to six people, a few book shelves, and piles of empty hardback binders. ASPAT’s humble quarters (protected by several locks and out of sight from passer-bys thanks to window shades) are located on the bottom floor of Melecio and Judy’s small two-story purple house, which they share with their five year old son, Sebastian, and Judy’s mother and sister. The first floor includes another bedroom and bathroom, and the upper floor

Updates from the

ASPAT Office

by Jeanne Liebermann, a 2014 GROW Intern excerpted from the UChicago GlobeMed blog

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common living quarters, as well as an open-air terrace which where clothes are hung to dry. Be-low, the street is dusty and dirty: garbage is strewn on the sidewalk, there are no plants or grassy areas, and stray dogs watch the come-and-go of cycle rickshaws. This means there is largely no hard and fast separation between work and home life for Melecio, which seems to have both its pros and cons. We’ve learned that Melecio often works on Saturdays, especially since that’s the only day that some of ASPAT’s volunteers are available, yet, even during the week, he also needs to be available for Sebastian when he gets off school to meet him for lunch at Judy’s mother’s restaurant around the corner. We are immensely impressed by what ASPAT is able to achieve with such modest human, spatial, and financial resources.

In that vein, we were able to get a lot of substantial updates from ASPAT about many of the proj-ects our partnership with them has touched on over the past 4 years:

1. Canastas: A couple of years ago, GlobeMed at UChicago’s Memorandum of Understanding (MOU) funded the delivery of food baskets to low-income patients receiving TB treatment at some of the clinics that ASPAT regularly works with, and the positive results of that proj-ect are finally trickling through the government bureaucracy and beginning to influence the Peruvian Health Ministry’s (MINSA) policy proposals. MINSA currently gives some very basic food supplies to low-income patients who have lost their jobs as a result of starting daily TB treatment, but not enough to prevent malnourishment. Melecio says that MINSA is currently discussing increasing the food baskets they provide to be much more similar to the ones that ASPAT was delivering, increasing their investment per basket per month from a cost of 50 nuevos soles (about 18 USD) to 300 soles (about 110 USD). This comes proba-bly in part as a response to an analysis of government policy by some low-income Peruvians that Melecio encapsulated as, “the national economy has improved recently but that has not translated into better social services and policies.”

2. Desayunos nutritional guide: While the UChicago chapter is working on raising the last of our funds for our previous MOU, ASPAT is working on getting everything lined up to begin the implementation of the Desayunos pilot program we are funding. One of the final steps in that process is finalizing the recipes and beginning the creation of the nutritional guide. We learned today that the initial nutritionist who was supposed to work with ASPAT on refining a menu tailored to the needs of TB patients has virtually dropped out of the proj-ect and no longer answers Melecio’s emails. But we got the good news that Judy has found two young nutritional consultants with a wide breadth of experience and expertise between them, who are now collaborating on the recipes. A draft is expected in about a week, mean-ing that Desayunos is finally almost ready to get up and running.

3. Micro-Business Seminar: Workforce discrimination is a huge barrier faced by many TB pa-tients, exacerbating the financial strains that are often a large contributing factor in creating the conditions that lead to their contraction of TB in the first place. In response, GlobeMed and ASPAT collaborated last year on the development and execution of micro-business training seminars for fifteen TB patients so that they could start their own small businesses to give them a flexible source of income while they continued to comply with treatment. Melecio let us know today that, despite initial difficulties in finding interested candidates

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who had the initiative to follow through and run a business, ASPAT was able to identify and train fifteen patients, all of whom successfully started their businesses in the beginning of 2014. Some of the patients have returned to higher paying employment since finishing their six month regimens, or have moved back to provinces outside of Lima to rejoin their fami-lies, but a number of them are still running their businesses. We are hoping to meet some of them in the days to come.

4. STOP-TB grant: ASPAT was recently awarded a new grant from the international organiza-tion STOP-TB giving them funding to start a leadership training program for patient advo-cates from other provinces outside Lima. True to their title (the Associacion de Personas Afectadas por Tuberculosis), the heart of ASPAT’s mission is enabling and amplifying the voices of TB patients themselves in Peru’s conversation about public health and policy. This new program will allow them to take big steps towards that goal.”

To read more about the 2014 GROW trip, please visit http://globemedatuchicago.tumblr.com or visit our #uchicaGROW2014 Facebook album.

Picture GROW! Reflections by Jeanne Chauffour,

a 2014 GROW Intern

“This photo (next page, top) taken during the University of Chicago GROW trip, does not depict partnership as directly as other submitted pictures to the GROW photo competition do, and it does not showcase the dimensions of the trip in the same manner either. Instead, this picture symbolizes

another crucial side of the partnership that goes beyond fundraising, shadowing, and logistics: a side which can solely be developed on the ground.

The University of Chicago’s partner, Asociación de Personas Afectadas por Tuberculosis del Perú (AS-PAT-Peru) was founded in 2007 in the port city of Callao, Peru. ASPAT works to increase psycho-social support for low-income patients and to educate the general population on the basics of TB transmission, prevention, and treatment. In over five years of partnership, ASPAT and GlobeMed at the University of Chicago have focused on programs that are largely aimed at improving patient adherence to treatment.

While in Peru, the UChicago GROW team spent all their off-time immersing themselves in the Peruvian culture and rich history by exploring Lima’s many archeological and art museums, wandering the streets of the Barranco and Barrio Altos neighborhoods, admiring the diverse styles of the city’s architecture,

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and devouring traditional fare at the National Peruvian food festival “Mistura”. Indeed, in a country still extremely segregated between the “mestizos” and the “Peruanos”, where ethnicities range from native Quechua-speakers to East Asian immigrants, and where methods of care, treatment, and healing also range from Western hospitals in urban centers to shaman rituals and sacrifices in the Sacred Inca Val-ley, working with a partner in Peru does not stop at a conversation with ASPAT volunteers in Callao. It demands an understanding of the history, culture, and politics of a nation very much unlike any of its neighbors.

For American students, working in Peru therefore can not limit itself to commuting between Miraflores and Callao, but must encompass an understanding of how the deep roots of cultural identity, religion, and tradition play out in Peruvian daily life. This history influences the present and the recurring chal-lenges ASPAT sees in the lives of its patients: lack of government advocacy and support for the vulnera-ble, social stigma within segregated communities, and the daily hardships of being a woman.

This specific picture captures an ultimate moment of cultural immersion and solidarity. After the formal work portion of the GROW internship was over, Ali Greatsinger (A.B.’14, Former ghU Coordinator) and Jeanne Chauffour (A.B.’15, Rising Internal Co-President) spent five days trekking to Machu Picchu with a Quechua guide, learning about Inca history, heritage, and the impact of the tourism industry on Peruvian ancestral traditions and sacred sites such as this one. The glorious arrival to the sacred Inca city not only symbolized a connection with Peru’s most precious site, but also the encounter with a place of Peruvian unity and pride.”

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Chapter News

This year, sustainability has become the motto for the campaigns team. Currently, we are working to devel-

op and initiate several fundraisers tailored to the interests of the student and neighborhood body that can be rep-licated every quarter. These include collaborations with local restaurants to bring food to students, auctioning off Kaplan classes at a discount, offering baby-sitting services for Hyde park parents, and working with the independent coffee shops to bring a unique Peruvian drink to the to the menu. We are also continuing traditions by bringing back the greatly-anticipated Laser Tag Night in the Winter and the Rummage Sale in the Spring. Finally, we are excited to break some ground in campaign-ing to the greater Chicago population and to those in the professional (Health and Ethics) fields with the Benefit Dinner in the Spring. At this year’s dinner, we will also be auctioning off a painting by the incredible Costel Iarca. Look forward to this informative and elegant event and the reveal of our guest speaker soon!

Campaigns

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ghU CurriculumFall 2014 Recap

Week 3: Advocacy What is advocacy? In this lesson, GlobeMed discussed the various models of advocacy and the critiques and advantages pertinent to each.

Week 5: EbolaExploring the ebola outbreak on a country by country basis, and outlining the history of the disease, ghU facilitated thoughtful dialogue surrounding the current crisis and the possibility of a widespread outbreak in the United States.

Week 6: The Ice-Bucket ChallengeIn a continued theme of public health awareness and advocacy, members of GlobeMed debated over the pros and cons of the ice-bucket challenge phenom-enon, followed by a discussion of its history and the impact of such movements on public health nonprofits like GlobeMed, especially in regards to their fundrais-ing efforts and relative morality.

Week 7: Midterm election results and the Affordable Care Act (ACA)Could midterm election results mean a sad end for the implementation of the ACA? In this lesson, the ghU team offered a brief overview of the ACA, and discussed potential impacts of the recent conservative victory in the midterm elections.

Week 8: Conversations with Becky DeBoerFor Becky DeBoer, MD, public health and the human-ities collide. This week, Dr. DeBoer gave pesronal in-sight into her academic career and her upcoming work in a Rwandan Cancer facility, describing an overview of philosophies that motivated her work.

Looking forward: Winter 2015 Lessons

Conversations with Evan Lyon Dr. Evan Lyon, MD, will share his own academic inter-ests that encompass global health, human rights schol-arship and advocacy, social medicine, prisoner health, and medical education. Dr. Lyon has collaborated with Partners In Health [www.pih.org] in Haiti and at other sites for more than 15 years. Beyond assisting with provision of health care in Haiti, Dr. Lyon has worked to strengthen general health care systems in addition to building disease-focused programs to prevent and treat HIV and TB.

Structural violence How is it relevant to health, and how can one recog-nize it? Health disparities do not exist in a vacuum, but emerge as a result of a wide range of societal issues. This week’s lesson plan will concentrate on these issues.

Health: Is it really a human right?As the title suggests we will be discussing whether health care truly is a human right and if so what as-pects of care fall under this classification. It is likely we will discuss the difference between equity and equality in regards to these issues.

Film Festival & Health Week!In collaboration with a number of other health-related student organizations, the Film Festival and Health Week, to be held 8th week, will feature a variety of speakers and educational films in a discussion of various germane topics on global health. Stay tune for details!

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GlobeMed UChicagoExecutive Board

Alexandra Berthiaume Interim Co-Director of Campaigns Jeanne Chauffour Internal Co-President Aixin Chen Co-Director of Campaigns Carrie Chui Co-Director of Communications Olivia Clink Director of Partnerships Kathy Deloso Co-Director of ghU Louise Judge Co-Director of Campaigns Victoria Liu Co-Director of Communications Adil Menon Co-Director of ghU Priyanka Mysore Director of Community Building / GROW Coordinator Tze Ern Teo External Co-President

General Members

Communications Eleanor Kang Maggi Kreisheh Caryn Tin ghU Vanessa Angelova Salman Arif Abigail Brockman Alexandra Ding Nadia Perl Darren Wan

Partnerships Shweta Desiraju Nicholas Hadjimichael Jeanne Lieberman Theodore Watler Campaigns Alexandra Berthiaume Sydney Birnbaum Aliya Moreira Isabella Pan Chiara Pandolfi Preethi Raju Stratton Tolmie Daniel Weis Finances Michael Lizza