Notes from the Field 2009

Doing a field experience this summer has been one of the best things that ever happened to me. To me it's been more of a major learning experience than anything else. It took me out of my usual comfort zone into a real world work scenario dealing with major public health policy issues. It was a new and challenging experience and I embraced it all in one.

After my first presentation like I mentioned earlier, my colleagues and I were charged to do a joint presentation using six countries namely Uganda, Burkina Faso, Fiji, Philippines, Niger and Ghana as case studies and this was to end my scope of work. We based our analysis of the countries' policies partly on the Landscape Analysis which is a World Health Organization's (WHO) ongoing analysis and evaluation of countries' readiness to speed up their nutrition action. This ongoing analysis also seeks to support these high-burden countries in developing an operational plan after developing nutrition policies. In addition, countries will be supported in understanding where and how best to invest in expediting the reduction of maternal and child undernutrition. To me, this is very crucial work in ensuring that countries are able to set their nutritional priorities right and to invest appropriately and it's great to be part of this important ongoing work! So now let me tell you about some of my adventures of exploring Europe when I am not working as a full time intern!

The Saturday prior to our big presentation, my colleague and I decided to take a trip to the famous Nestle chocolate factory in Broc-Fabrique (in the Fribourg region of Switzerland) known as the Cailler of Switzerland and then later headed off to Gruyere to explore the cheese factory known as "La Maison du Gruyere" to eat "fondue" right from the source. I was particularly excited about trying the fondue because a lot of people had described it so well that I just wanted to try the original meal from a cheese town! Sadly to say, it happened that the fondue was more like comfort food eaten mainly during the winter months to keep warm because it is a very hot food made from different cheese types with wine and spices eaten with either bread in bite sizes or boiled potatoes. It is also usually prepared in some special crockery which was beautifully displayed within the factory's forecourt. Since it was summer and very warm we were advised not to take a cold drink right after eating but rather drink wine or warm beer if we dare get the fondue. This is because it may take forever to digest. Since as tourist, we didn't have the pleasure of time (We needed to catch the next available train to get to Geneva in good time) we didn't try it so I will still be looking out for it. After taking a self-guided tour of the cheese factory and going through the various stages of cheese making through a very fancy mobile earpiece and various work stations we headed up to the Castle known as Chateau du Gruyere which is a very ancient castle housing the counts of Gruyere years ago. Upon entering the Chateau, it was a very different scene! The castle was very much alive with several souvenir shops and restaurants surrounding the forecourts bustling with throngs of tourist with a fountain right in the middle of it. One thing that caught my attention was how people will come by the fountain; dip their hands into the water and splash water on their foreheads or on their heads in a sacred cleansing manner! I am not sure what powers or blessings therein but I guess belief makes all the difference.

In my course of duty, I also got the chance of speaking with people from other departments and had the singular honor of speaking with the Deputy Director General of WHO, Dr. Asamoa-Baah. It was more of an informational interview and future directions for public health and my career trajectory. He was very pleasant to speak with and I think I ended up smiling throughout the entire conversation and oh yes! He was that pleasant and intellectually stimulating at the same time! I took lots of pictures along the way and during other activities and hope you enjoy the slide show.

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This past few weeks have been incredible, with several activities going on. Even though I knew working at the World Health Organization (WHO) will be more of a multicultural experience, it has been more of that even outside of the office. The week started well with me doing a desk review of the National Health Policy (NHP), Food and Agriculture Sector Development Policy (FASDEP I & II) as well as the 5-Year Program of Work (5YPOW) of Ghana which I was due to present during an upcoming Team meeting. This involves reading the available policy documents either soft or hard copies and strategically analyzing the information in terms of the time frame of the plan of work, the scope of coverage of vulnerable population sub groups, issues on infant and young child feeding, multivitamin deficiencies and programs to address them. In addition, I had to do an analytical review of what policies they had on elimination of infectious diseases like HIV/ AIDS, TB and malaria as well as policies on agriculture, trade and the state of legislative code on the marketing of breastmilk substitutes in the country. This has all been very interesting since it shows me a broad and multi-faceted approach in dealing with public health nutrition issues. Ghana is described as one of the 36 high-burden countries as described by the Lancet Nutrition Series having more than 20% rate of stunting. During the 1992 International Conference on Nutrition (ICN) in Rome, member states agreed to develop National Plans of Action for Nutrition (NPAN) which will address major nutritional issues in their countries in terms of the priority areas. A global consensus was reached to address the following objectives or working areas that was of priority at the time. The themes were:

· incorporating nutritional objectives, considerations and components into development
policies and programmes;

· improving household food security;

· protecting consumers through improved food quality and safety;

· preventing and managing infectious diseases;

· promoting breast-feeding;

· caring for the socio-economically deprived and nutritionally vulnerable;

· preventing and controlling specific micronutrient deficiencies;

· promoting appropriate diets and healthy lifestyles;

· assessing, analysing and monitoring nutrition situations.

A review of Ghana's NHP and 5YPOW indicated that each of the nine working areas and objectives had been considered and programs have been developed to address some of the issues. This is still very much work in progress with the Ministry of Health as the main implementing and coordinating body and the Ghana Health Service as the main operational face of the ministry. Different 5YPOWs have been developed over the years and the current one spans the period between 2007 and 2011. This living document has been developed at a time when the government is accelerating its efforts towards wealth creation and poverty reduction as part of its goal of achieving the Millennium Development Goals (MDGs). The priorities and strategies spelt out have been developed within the framework of the government's development agenda as stated in the Ghana Poverty Reduction Strategy papers and the three priority areas of transforming Ghana into a Middle Income Country by the year 2015 which are Private Sector Development, Good Governance and Human Resource Development. Other stakeholders and agencies like the United Nations World Food Program (UNWFP), WHO, UNICEF, GAIN and FAO serve as developmental partners offering financial and technical support for these nutrition intervention programs in the country. I will bring you more of what my work entails and how this whole global nutrition policy review began and how this crucial work will help countries scale up actions towards nutrition.

working cheerfully behind my desk on a bright sunny day

Life after work is so much fun and very multicultural as well. I thought I was going to be immersed in a lot of European culture and yes! I get more of that when I am in town as well as WHO where I hear a lot of people speaking French or German or Italian as well as their mannerisms. On the other hand though is my encounter with the Kenyan culture. My hostess is a Kenyan and she has a large group and network of friends who are Kenyans as well working in various UN agencies and the Kenyan mission here in Geneva. She had recently moved into her new apartment and organized a house-warming party where I ate among other things "chapati", more like tortilla made with unbleached wheat flour and "Pilau rice" made with chicken and the Pilau spice which is a very typical meal in Kenya. It was so fun meeting a lot of very friendly Kenyans. I even made a new young friend called Prince.

The delicious pilau rice

beautifully sliced chapati

Party time!

with my lovely new friend Prince

Within that same week on Friday, Joseph, our Kenyan friend who is interning at the UN headquarters invited us for a Kenyan dinner of "Ugali". We were so excited that my colleague at work, Giulia (Italian) who was not familiar with eating with the bare hands and fingers ended up making the chicken sauce that was to go with the Ugali! In the end, she mastered the art of eating Ugali and chicken without cutlery! We had so much fun after which we watched a movie and ate some delicious chocolate ice cream for dessert. It was just a nice way to round up the week and enjoy a Friday night!

Giulia and I busy in the kitchen

Jacquline, Joseph and Giulia

Saturday was no different and the fun continued. My uncle's friend whom I had met at WHO as a Health Systems Adviser, took his nephew and I round for a ride and later to the famous lake parade of Geneva and this was definitely a crossroad of cultures! The lake road was filled with people from all over the world and people dressed in funny clothing happily moving about and dancing following the trucks that carried people with live music. Other trucks also seemed to be advertising for one product or selling drinks to people who were thirsty long the parade route and others just sat along the road to watch it all.

Dr. Dovlo and I at the parade

Rudy and I with the Jet d'eau right behind us

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Coming from a city in a developed state like Minnesota should make my transition into an European city easy....and yes! It was but I can't seem to get over my fascination with just about everything here in Geneva. From their extensive, well developed and functional transport system throughout the whole of Switzerland, to their beautiful architecture and the mixing of old and historic buildings and modern buildings standing side by side. The public transport system include buses some of which run on electric lines, the trains which are high speed as well as trams which also run on electric lines but relatively slower. The trams are however very similar to the Metro transit light rails we have in Minnesota which runs from Mall of America to Downtown Minneapolis. The difference is that these have tracks which run in town alongside the lanes for private cars. One other fascination is the presence of lots and lots of water fountains that carry potable water throughout the city and beyond. The supposedly highest fountain is the Jet d'eau which can be found in the Geneva Lake close to the centre of the city.

The jet d'eau is on the far right

It's an incredible sight to behold and seems to be the major tourist attraction for most people who come to Geneva for the first time. We the interns at World Health Organization (WHO) usually have our drink ups along the Lake and it's always a refreshing moment when after a long day, we relax on the lawns along the lake listening to the splashing sound of the water and having good conversation about how the internship is going so far in the various departments of WHO and other international organizations like the UN, ILO and UNAIDS as well as tourist sites that others have been to and recommend.
One could not miss noticing the very narrow streets of Geneva and I have been told by residents that it's very difficult to get packing space due to this. One has to roam the same street over and over again to get a place to park.

Otherwise you could park very far away and walk about a few blocks to your destination. One interesting thing that piqued my attention was the neatness of the streets in Geneva! The streets are so neat and every morning on my way to work, I see cleaners on every corner of the streets cleaning up and emptying trash bags. Sometimes, they even use high pressure pumped water to clean the dirt off the street! This was entirely new to me since I never saw this in my home city of Accra.
I live in Grand Lancy which is about 18 minutes to Gare Cornavin, which is the main station for most buses, trams and the train as well as all tickets and shopping centers. Grand Lancy is a beautiful part of Geneva, away from the city centre surrounded by mountains, modern apartments and flowers with grocery shops in walking distance. The two main grocery shops here are called Migros and Coop which is akin to Target and Walmart in the US and both shops happen to be on my street! The tram I take to the Gare is just about a 5minutes walk from my house and makes life easy for me. The tram 13 or 15 goes as far as the Nations (usually pronounced in French). This area showcases very tall and magnificent buildings of the UN, UNHCR and ITU with a large water fountain in the open space separating these offices. I then connect with bus number 8 which is the only bus that goes to the WHO office building. One can't help noticing the people that get off the bus when it arrives at WHO. People from all over the world with different shades of complexion, Americans, Indians, Africans, Europeans, Canadians and Asians as well as able-bodied and disabled men and women. This is what makes me proud working for an organization such as the WHO which employs people from all over the world regardless of nationality, race and have respect and value for disabled persons as well.
My day at work usually involves reviewing national nutrition policies, program of work as well as strategic nutrition plans for some high-burdened countries of the WHO member states. My colleagues and I are working on countries such as Thailand, Fiji, Philippines and I get to work on my own country Ghana! This involves systematic review of these documents and extracting information that would be used for country analysis to assess their national nutrition situation and to map out priority areas that would need action as well as the nutrition capacity development. This is in the initial stage of the follow up to the Landscape Analysis and I am glad to be part of it.
My first couple of weeks here has been very fun and exciting with parties here and there almost each week! My hostess, Neddy who is Kenyan invited me for a barbecue party over the first weekend and then to a surprise birthday party for one of their friends in Carouge, an old part of the city which is about 10 minutes from where we live. This was then followed by a lunch date over at our Lady Pastor's house for some local Ghanaian dish ( Banku with okro stew with spinach) which I missed very much amidst good conversation. The week following my arrival at work saw another colleague intern, Tina who had just finished her internship and was ready to leave. The Nutrition Department organized a breakfast meeting to listen to her experience so far and her plans for the future.

Tina is second from left of those sitting. To my right is Haryeom from korea and to the left is Jason from the Micronutrient section of the Nutrition Department

Her account was motivating and we the interns were challenged to work hard whiles here.
This coming week, I get to present what I have been working on so far with the Ghana situation, so I look forward to a productive week and probably some fun activity with my colleagues from the UN! As usual, we always keep in touch and get busy after work!

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It has been one long week for me in the past few months. Whiles the anticipation of seeing and being in a new land builds up and the excitement heightens, fear and anxiety sets in. My week started very well shopping and getting ready for my trip to Geneva for the first time and broadly to Europe for that matter. I have been looking forward to doing my internship with the World Health Organization (WHO) since 2008 when I applied for the summer internship. It is a very competitive process and I was very excited I got selected to work with the Department for Nutrition for Health and Development (NHD). My official acceptance letter came in quite too close to the time I had to leave for Geneva but from the immense support I got from the School of Public Health, my friends and family, I am now very confident that I will have a very enjoyable experience in Geneva. So I started my week with a lot of anticipation that I was going to get everything settled the middle of the week which was Wednesday since my flight was Thursday. Somehow, by Wednesday night, I still had no idea where I was staying or which address to go to when I landed on the soils of Geneva even though I had communicated with a few people since I did not know anyone personally in Geneva. I had all my immunizations completed a couple of months ago and knew that was no problem and that item was immediately cancelled off my to-do list after I had found all the documentation.
After being so busy in Downtown Minneapolis in the IDS Tower trying to do my forex exchanges and getting a brand new camera for my trip, I was refusing to accept the fear that took over me when I thought of my homelessness situation. On Thursday and within a couple of hours that I had to leave for my flight I was called and told that I had a lady who was going to host me for the period! And yes! I was so excited and relaxed. I later got to know that she worked for the WHO as well and I felt like that solved all my problems! And was in for a wonderful experience of my life! For those of you whom I haven't met or spoken to yet, I am Eunice Abiemo, originally from Ghana and just completed my first year of my Master of Public Health (MPH) degree. I am offering Public Health Nutrition with an interdisciplinary concentration in Global Health. As my field experience, I will be interning with the Global Nutrition Policy Team of the WHO/NHD during the summer assisting in reviewing national nutrition policies, drafting case studies and doing some data management that will eventually reflect in the lives of vulnerable population groups in developing countries. I am so elated that I can't wait to explore Geneva and possibly some other parts of Europe! I will appreciate your advice and comments even as I psyche myself for this extraordinary experience of a lifetime!

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