G’day mate. I’m the ‘land down under’. –I promise that will be the last of the Aussie references. I’m here as an ambassador for a Los Angeles NGO (SimplyHelp) and attending a UN Conference. I wanted to give you a brief background on the Conference before I got into the excitement of the Conference details.
63rd Annual United Nations DPI/NGO Conference – Advance Global Health/Achieve the MDGs
History of Conference – The UN holds a conference annually for interested Non-Governmental Organizations (NGOs). The topics of the last four conferences were human dignity and security, climate change, human rights, and nuclear disarmament. Only the last three years has it been held outside of New York. This year it is in Melbourne, Australia.
Goal of Conference – As I understand it, the aim of this Conference is to provide a venue for NGOs working on the MDGs to collaborate and hopefully be more effective deliverers of global health programs. The hope is this meeting will spark suggestions for the upcoming UN Summit in New York.
The projects of the NGOs present at this conference are diverse and include chronic diseases, blindness, HIV/AIDS, drug use, migration, women empowerment, mental health, maternal and child health as well as indigenous health concerns.
Review of Millennium Development Goals (MDGs)
1. Eradicate extreme poverty and hunger
2. Achieve universal primary education
3. Promote gender equality and empower women
4. Reduce Child Mortality Rate
5. Improve maternal health
6. Combat HIV/AIDS, malaria, and other diseases
7. Ensure environmental sustainability
8. Develop a global partnership for development
Website: http://www.un.org/dpi/ngosection/conference/
8/29/10
Pre-Conference Concert the night before
I attended a concert to welcome the NGO delegates to the Conference in Melbourne. It was spectacular to say the least. The concert began with a ‘Laser man’ who bent light and created a sense of awe in the audience. I can’t begin to explain how he possibly manipulated the laser as he did. Traditional dancers representing various countries including Greece, Australia, Britain, Japan, China, India, the USA, Africa, etc followed up the ‘Laser man’. The concert was an exciting way to receive the delegates and set the tone for a global conference. I'll post a video of the laser man just as soon as I figure out how to do that.
8/30/10
The Opening Ceremony
The Opening Ceremony inspired passion toward achieving the MDGs. By inviting keynote speakers from the Australian Parlament, UNAIDS, an Aboriginal health advisor, and Equality Now to name a few.
Michel Sidibe the Executive Director of UNAIDS was my favorite. He spoke of social justice as being an integral part of attending to any global health need. In fact, he mentioned that the social movement to eradicate HIV/AIDS was the first of its kind. Further, that this momentum need be continued for other diseases. Also, he stated what I think many of us struggle with as novices entering the field. That there should be integration of NGOs working together for similar causes. Finally, he also noted that the MDGs are not independent of one another. If we as global health interested individuals need to address them as a unit.
Workshop
My first workshop entitled “Nyumbani Village: Responding to Children and Families Living with HIV/AIDS” was a great way to start off the Conference. This is an amazing organization and one in which people should check out.
This is the brief description: Nyumbani (meaning home) was started in 1992 by a Catholic priest and nuns in Nairobi, Kenya to help orphaned children with HIV/AIDS. They have 3 projects: a home for orphaned children, a village of orphaned children and their affected families, as well as a community support program that helps provide basic needs for families in the home with children who are HIV+.
Their successes include 100% of the kids are in school and 100% are on ARVs. They have an impressive sustainability program with irrigation systems that irrigate crops to feed the kids. They offer vocational training to the surrounding community so that they can provide services to Nyumbani (such as bee keeping and egg production). They offer micro-credits to the families involved in the community support program so that they can be weaned off the donations. They also are involved in reforestation projects. They do it all.
But they do face heart-wrenching obstacles. Apparently, the ARVs available are only a standard first line and a second line drug. In the US, the protocol is to test an individual’s resistance and tailor the first line drug to their specific strain and if that isn’t sufficient there are second and third lines available. However, in Kenya they only provide a generalized first line drug and if resistance is observed a generalized second line. Sister Mary, the head nun, mentioned that right now there is a 15 yr old boy who was determined to be resistant to the second line drug but they don’t have any other options available for his treatment. She refuses to tell him that he is going to die because drugs that are available in hi-income countries are not reaching his lo-income country. So, she is lobbying at this Conference and other areas in order to seek help in getting the third line drug.
This charismatic, passionate sister with a wealth of knowledge about this population mentions that if social justice isn’t a good enough reason for people to help perhaps being reminded that this newly bred super resistant strain will reach the developed world eventually - The Catholic nuns don't disappoint on offering threats! ;-)
Nyumbani www.nyumbani.org
Protis Lumiti Chief Manager protis@nyumbani.org
Mary Owens Executive Director mary@nyumbani.org
Roundtable Discussion – The Role of NGOs and Civil Society in Helping Achieve the MDGs
The Roundtable discussions consist of multiple panelists that discuss questions posed to them from the audience regarding the specific subject of the discussion. I have to mention it gets a little lively when you give people the freedom to stand up on their soapbox for one minute to preach their viewpoint. The questions posed by the audience were at times insightful and at times anarchist.
This panel included individuals from an Afghan education program, an Australia midwife from World Vision, an African doctor, and a Cuban physician. The overall message was that programs need to be of benefit for the government in order to receive support, that community mobilization and ownership of the MDGs is essential in their success, and that the lack of primary healthcare is causing a gap that the NGOs are compelled to fill.
Dr. Aleida Guevara, the Cuban physician, was exceptionally well spoken and her words remain with me. When speaking on healthcare as a right she mentioned that “the right to life is non-negotiable.” Additionally, she believed that in order to gain community support an NGO must “not say what need to be done but do what need to be done”.
Dr. Ruth Bamela Engo-Tjega, the African doctor, touched on a point that I naively had not previously considered regarding the barriers to NGO collaboration. She enlightened me by stating that often times because funding donors come from diverse backgrounds and often dictate relations they segregate the NGOs.
Opinion
After day 1 of the Conference I am inspired by the work these NGOs manage to accomplish given the lack of resources, lack of collaboration and support and often inefficient methods. I believe they are innovators and visionaries that offer a wealth of knowledge about their populations and the fields of interest. Plus, most of them are incredibly talent public speakers.
8/31/10
Roundtable Discussion – Equity, Rights and Progress toward the MDGs
This discussion started off with a conversation on data collection and analysis. Fortunately, my epi and biostats classes provided me enough background to not follow the discussion but also see the value and limitations of such research. Thank you USC faculty.
The major themes addressed here were again community ownership of the data. Justin Narayan, an Aboriginal representative, mentions it is important to ask the community what measures indicate the outcomes of interest, to train the community to collect the often times difficult to obtain data due to cultural barriers and geography, and to make sure the analysis is benefiting the community. I understand the purpose of data analysis and research is to verify a program’s success or usefulness. However, the data itself must also be useful in the community. I was surprised to hear opponents of data collection. Their argument was that numbers are meaningless to vulnerable communities and that limited resources must all go to the community. I understand the frustration of wanting to help the most people possible but I think it’s more cost effective to evaluate a NGOs efforts.
Dr. Claudio Shuftan, member of PHM and an adjunct professor at Tulane University, spoke about the MDGs as quick fixes that do not address the root of the problem, which is human rights violations. He boldly continued by saying that achieving the MDGs will not result in global health. In fact, he seemed to condemn NGOs for only aiming to advance the MDGs. He stated that human rights should not be woven into programs aimed at the MDGs but they should be the ultimate aim themselves. I think he’s probably correct about human rights violations being the root cause of deficits needing to be overcome by the goals. However, I’m not sure pragmatically how one addresses these violations without restructuring societies as a whole. I hope someone smarter and more experienced than I can offer tangible suggestions.
Workshop
The second workshop I attended was titled “Primary Health Care Prioritizing Women and Children Delivers MDGs”. Speakers in this workshop represented a few organizations including the Burkett Institute and Save the Children.
What struck me about this workshop was Jilda Shem’s work in Vanuatu. She detailed a program sponsored by Save the Children that trained village health workers (VHW). From what I can gather, Save the Children has developed a program that trains rural community leaders to provide basic health care needs and dispense basic medicines. The VHW tasks include delivering babies to malaria testing and treatment. For example, they are so successful at reaching, diagnosing and treating malaria patients that the community is on track to eradicate malaria in by 2015. The VHW are community volunteers that do not receive financial remuneration. The NGO additionally works with the community leaders to support the VHW by providing their families with food, for example. I think that this builds community ownership of the health concerns and builds sustainable community resources.
Workshop
The third workshop I attended was “Slipping Through the Crack: Women and Infectious Disease (TB & TB/HIV)”. The NGO presenting this workshop was Result.
I learned that women are more prone to TB infection and complications. Women’s traditional role as caregivers in the home puts them at greater risk for acquisition. Additionally, I am aware that HIV transmission rate is greater for women and therefore the complications from TB/HIV are more prominent in women. Shockingly, the TB test most often used was designed over 120 years ago and the most common drug prescribed was identified in the 1960s. Their message was that TB is detrimentally overlooked. Additionally, 70% of the funding for TB comes from a single source, the Global Fund. Governments are apparently debating right now on how much to refinance the Global Fund due to recession demands. Therefore, Result was asking the audience to appeal to their governments for aid.
Lucy Chseire, a member of Kenyan AIDS NGO Consortium (KANCO) and a HIV+ public health worker, spoke eloquently about her experience being diagnosed with HIV and the stigma she faced as well as her complications for TB infection.
Opinion
To be honest, the second day was a bit disillusioning. From the perspective of a student trying to forge ahead in this field, I feel there was a lot of rhetoric about the problems and theoretical solutions but few practical options were offered. The lack of publicized and dramatic change is often a criticism of the UN. I don’t necessarily prescribe to that perspective because I think the issues they face are challenging. There was a need for the formation of the UN and NGOs because other governmental organizations and individuals were not accomplishing this task either. The challenges they face are difficult to accomplish for a number of reasons. Additionally, some NGOs at this conference have an agenda to only promote their work and get more funding. This gives the impression that they are not open to hearing new experiences or even on collaborating. While individual NGOs are accomplishing great strides locally I believe grand scale collaboration and organization is required to make significant changes in global health.