Student Sphere 2011

By Amanda Eastwood
Maternal and Child Health, MPH

My life has been an absolute whirlwind. Fortunately the breeze is warm and refreshing. It's been a long while since I've caught you up to speed so in my limited moments of free time before bed let's see how much ground we can cover.

My first year of grad school was so fresh, new, and even restful. Knowing that I was on the path to following my heart into a career that I'd dreamt of since the age of 15 played a huge part in the wonderful year that was September 2009 to September 2010. My good friends know that sleeping well is not my strong suit. However, upon entering grad school and pursuing my master's in public health, believe it or not I began to sleep upon going to bed. A novel concept. When I returned from Mexico last August after an indescribably invaluable and positive experience working in cervical cancer prevention I couldn't have imagined how different the second year of school would be from the first. Upon finishing my work in Chiapas last summer, I spent a few days by myself at a rustic beach in Oaxaca to relax, reflect, and journal about my experience and my thoughts about the work I had done and the goals I had for moving forward. I was very specific about the things I wanted to do in the following school year and post- graduation writing about skills I hoped to use, the office environment I hoped to work in, and where specifically I'd like to be. Going out on a limb I wrote that I thought it would be pretty amazing to work six months in a Latin American country followed by six months in either Tanzania or Kenya. (Keep this in mind as it has a GREAT significance slightly further along in this blog)

Having had a taste of the work I had longed so many years to do, I began to again lay awake at night pondering what I hoped to do after graduation (nine months later..ridiculous..I know). These pondering and even nervous thoughts continued on into the first semester and sailed right on into winter break. Entering the new year something happened. I realized that I would soon be finishing at my coffee job come the end of March. While the process of leaving the company was a sad one for me, it also allowed me to dream outside of the boundaries of my office and the work I had done for nearly five years. The world was my oyster, mine to conquer. As I slowly realized how deep and wide the options really were, I actually began to fall asleep at night and dream of green, lush mountains and fresh, roaring rivers flowing down them. I dreamt like this for two weeks straight. Can you imagine? It was like escaping to the source of life each and every night! After months of restless nights and unsettling dreams, this was unexpected but happily received.

At the end of those two weeks, I found out about a job opening at the organization that had sent me to Mexico. It was a program manager position located in Vermont. While I had spent years desiring to move out of the States, this job was just too good to not apply for. So I did. And in the meanwhile, I dove into research about Vermont investigating the culture, activities, food and drink scene, lakes and sidewalks, and so on and so forth until I was convinced that I could live there and be excited about it. My interview went well ; Since I knew the woman interviewing me, it felt more like a catch up and conversation about my goals than the scary interview we all fear. In the end, I had no idea what to expect but was told that I was a strong candidate and that they hoped to make something work to get me on the team. I had subtly (or perhaps not so subtly) mentioned how much I enjoy spending time IN country working IN the community and that I feel that I truly *sparkle* in that environment. The following week, I received the much awaited call from the executive director but the news she shared was the LAST thing I had expected to hear. "Amanda, what would you think about spending six months on the ground in Nicaragua and perhaps six months on the ground in Tanzania?" I was SPEECHLESS. SPEECHLESS. Before I could say much, she told me to take the weekend to think about it. "You're on your way to Sacramento. What a perfect place to think about what you want!" So think I did. Even though all along I knew that I wanted to go. The following week we continued the conversation covering the details and a few days later I excitedly accepted the opportunity.

Two short weeks later, I found myself in Vermont for a quick two day orientation to my site in Matagalpa, Nicaragua including the work I'd be doing, the key players involved in our program and various sites, and all of the other nitty gritty details that make the magic happen. I've been hired to work on a UICC funded pilot evaluation of the sustainability of their cervical cancer screening and treatment model in the Matagalpa region. In addition, I will be working to train a new team of community health promoters at the location of a new site to be launched in September. I will also be working to collaborate with other local NGO's to provide family planning education and services to the women that we serve. All of this will be done in collaboration with the Nicaraguan Ministry of Health and a number of different coffee cooperatives in the Matagalpa and Madriz regions of Nicaragua. - The wonderfully crazy thing about all of this is that I am going to be doing exactly what I had written about/asked for (as mentioned earlier here) last summer with regards to location and the specific responsibilities and project types. CRAZY. Folks, I'm tellin' ya, DREAM and dream BIG! Why not? Really? And be SPECIFIC about your dreams. I dare you. I know you want something. You do. You have goals and dreams related to the person you want to be, the places you want to go, the relationships that you desire, and the kind of work that you long to do. Dream it. Be specific. Tell others about it. Do it. Grow into it!

Another dream come true was the opportunity to go to Europe with a friend for the first two weeks of May. Taking the good advice of a couple of friends, I cashed in my Delta miles and paid $171.00 tax to purchase a round trip ticket to London where I'd meet my friend Lauren for a two week jaunt through England and Spain. So I moved out of my apartment of five years, defended my thesis, did my laundry, and packed for Europe and Nicaragua in the course of four days. On the fifth day, I hopped on a plane to London admittedly in a somewhat frazzled state of mind. However, by the time my layover in JFK rolled around, I was in a 100% European Holiday state of mind. Over a beer during my layover, I had the oh-so-good fortune of meeting a wonderfully kind and even dreamy British gentleman who generously shared three pages worth of London suggestions for me. Nine hours later, give or take, I found myself at the Heathrow airport meeting my friend and aside from the intense fatigue, ready to conquer the world.

Of course there is so much more to share but for the sake of time I'll leave you on that note. I write to you from Managua on my second night in Nicaragua where I find myself with my first free and alone time with a laptop in weeks. Saludos to you all. Until soon....

By Kathryn Nelson
Community Health Education, MPH

Someone once told me, "When you go to Africa, it stays in your bones."

Though it may sound cliche, it seems as if this simple statement has resonated in my soul since I first set foot on Kenyan soil.

Last weekend, The Nafula Foundation was blessed to throw a benefit concert, Be"CAUSE" of Kenya, at Cause Spirits and Soundbar in Minneapolis. Many bands, fans and a handful of groupies came out to support our work, which culminated into raising around $1,000 for a clean water system that will be installed at Chebukwa Secondary School this August.

Many School of Public Health students attended the event, showing that we are engaged and interested in helping the world around us. Though I spent most of my time running about, coordinating bands, asking for donations and MC-ing the concert, I felt humbled that so many friends, family and students came out to support The Nafula Foundation.

Though I was previously unsure about my summer plans several months ago, I have - helped along by the excitement derived from the concert - decided that I need to return to Africa to pursue my nonprofit work with the Foundation.

But it will not solely be a "charity-trip" to Bungoma, Kenya. I have also chosen to return to a career of freelance writing - conflict journalism - in East Africa.

There are several reasons for this decision. One, being that I believe public health needs journalism and the media to be successful. And secondly, after watching day by day the suffering occurring across the region, I know that using my writing talents to shed light on the conflicts in Central Africa is the right choice to make.

Starting off in Dar es Salaam, Tanzania with photojournalist Jonathan Kalan, we will be trekking East and Central on a motorcycle, seeking new adventures and finding untold stories of the continent. We're hoping to travel through at least six countries.

Along the way, I will be applying my first-year's worth of public health knowledge, volunteering at health clinics in the slums of Kibera and returning to the village of Chebukwa to install our rainwater collection system.

I am thrilled to make this announcement as it is something personal and close to my heart. And even more excited to use what I've already learned in my classes on the ground.

As they say in Kenya, "Asiyefunzwa na mamaye, hufunzwa na ulimwengu." - "What your mother doesn't teach will be taught by the world"

By Amanda Eastwood
Maternal and Child Health, MPH

In my next entry, I will share more details about the new journey I am about to embark upon. Much of my master's work has revolved around the prevention of cervical cancer and I am SO pleased that my work post graduation will draw from the hours and hours on the topic of cervical cancer prevention. Below is a reflection I've written about one means of prevention through the administration of the HPV vaccine. Happy reading!

While suggested or even mandatory Human Papilloma Virus (HPV) vaccines for young girls in the United States has been a highly controversial topic over the past few years, the risk of HPV among females in developing countries is a topic of equally important value but receives little publicity within the United States. While I don't argue that the HPV vaccine should be mandatory for all young females anywhere, I do believe that it should be made available at little to no cost to young females, not only in the United States and other developed countries, but also in developing countries where cervical cancer screening is less common and often less effective.

The World Health Organization holds a similar stance to my own on the topic by recommending that:

"...routine HPV vaccination should be included in national immunization programmes, provided that: prevention of cervical cancer or other HPV-related diseases, or both, constitutes a public health priority; vaccine introduction is programmatically feasible; sustainable financing can be secured; and the cost effectiveness of vaccination strategies in the country or region is considered1."

Further emphasizing that all young women should have affordable access to the HPV vaccine, Part Two of the 25th Article of the Universal Declaration of Human Rights states that, "Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection2." As an upcoming public health professional with a deep-rooted desire for advocating for women's reproductive health, I believe that cervical cancer is a threat to the livelihood of women, families, and entire communities and that access to the HPV vaccine can help to protect this right.

Cervical cancer, caused by HPV in almost all cases, is the leading cause of cancer deaths among women worldwide. Often referred to as a disease of the poor, of the roughly 500,000 annual cervical cancer deaths worldwide, approximately 80 percent are in developing countries where it should be most considered a public health priority meeting one of the criterion of the WHO stance on including it as part of a country's vaccination programme3. One positive aspect of cervical cancer is that it is extremely slow to progress allowing time to detect it in its early stages. When un-detected in its most preventable states, it often presents during a woman's years of greatest productivity from her 30s to 50s. The good news is that cervical cancer can be prevented quite feasibly and easily through the prevention of HPV and through the early detection of pre-cancerous cells through cervical cancer screening3. The downside is that in many low-resource settings adequate screening and treatment services are generally sub-par which is why so many women in these settings perish at such a young age to a preventable cancer.

GlaxoSmithKline's (GSK's) Cervarix® and Merck's Gardasil® are the two leading HPV vaccines consisting of a three-series shot administered to prevent the four main cancer causing strands of HPV. The vaccine, consisting of a series of three doses, averages $10 to $25 U.S. dollars per shot to all recipients unless their country of residence is considered an "extremely poor" country by the standards of the pharmaceutical company. Protection rates are highest (90 to 100 percent in clinical trials) after the administration of all three doses but the vaccine still shows high rates of efficacy after as little as one dose1. The cost is a seemingly small amount by American standards, however, an impossibly large sum to many poor women in country's not considered to be "poor enough". The problem is that many developing countries are comprised of a large, very poor population with a very small middle class and an even smaller but very rich upper class. Therefore, the economic status of such countries is skewed by the small population with extreme wealth and not considered "poor enough" to receive discounted vaccines.

There are several avenues one could take to approaching the issue of availability due to prohibitive pricing. One would be to demand that pharmaceutical companies consider vaccine rates on a more region or community specific level as opposed to a country-wide assessment. A second option is to tap into external sources that provide funding for vaccines in low-resource countries. Frankly, I would prefer to see the pharmaceutical companies reevaluate their current system of assigning countries an economic category or even consider the donation of vaccines to extremely impoverished settings. However, I don't see this as extremely likely so will err toward the option that is already in place and functioning.

The GAVI Alliance is a source of external funding for vaccines in countries with a Gross National Income of less than $1,000 U.S. dollars per capita. Approximately 54 percent of cervical cancer cases are found in qualifying countries which could indicate huge strides in lowering both cervical cancer rates and deaths! Achieving success, however, will require some work on behalf of qualifying countries. Countries must apply to the GAVI Alliance and the Alliance does reserve the right to approve or deny applications. Nevertheless, once approved, countries are asked to contribute a maximum of 30 cents U.S. per vaccine depending on the Gross National Income of the country, and the GAVI Alliance will cover the rest4. Not only does this option reduce the financial burden to vaccine recipients, it also meets the WHO criterion of the security of sustainable funding. When looking at this from a cost-benefit approach, spending 30 cents U.S. now to prevent cervical cancer is a great deal less than the costs associated with trying to treat a very lethal cancer thereby making the vaccine a good long-term investment. I will not address the WHO criterion regarding the feasibility of programme introduction within this reaction but do want to acknowledge the importance it.

The fact that cervical cancer is the leading cancer killer among women worldwide should indicate its status as a public health priority. What's more is that there is a known method which demonstrates high levels of efficacy in the prevention of HPV. As public health professionals, there is a level of accountability in making it available to women worldwide but particularly in low-resource settings where incidence rates of cervical cancer are highest. As many as 500,000 women worldwide die each year; each of them mothers, daughters, sisters, friends, wives, and companions in the peak of their lives3. The prevention of HPV among young women of this generation paired with effective cervical cancer screening among all women makes the fight against cervical cancer is one that we can win.

References

1. (April 10, 2009). Human Papillomavirus Vaccine WHO Position Paper. Weekly Epidemiological Record. No. 15, 2009, 84, 117-132. Retrieved from
http://www.rho.org/files/WHO_WER_HPV_vaccine_position_paper_2009.pdf.

2. (December 10, 1948). Universal Declaration of Human Rights. Article 25, Part 2.
Retrieved on February 12, 2011 from: http://www.un.org/en/documents/udhr/index.shtml.

3. (2007). Cervical Cancer, Human Papillomavirus (HPV), and HPV Vaccines; Key
Points for Policy-makers and Health Professionals. WHO Press. Ref WHO/RHR/08.14. Retrieved from http://whqlibdoc.who.int/hq/2008/WHO_RHR_08.14_eng.pdf.

4. (2007). Making Cervical Cancer Vaccines Widely Available In Developing
Countries: Cost and Financing Issues. Retrieved from http://screening.iarc.fr/doc/IAVI_PATH_HPV_financing_brief.pdf

By Mary Winzenburg
Public Health Nutrition, MPH

I am in the midst of completing my first Field Experience at the St Paul Public School District Student Wellness Office, and while I have only been there a few short months, one day a week, I have already learned so much by getting a hands-on experience. Some of the lessons I have learned observing and working on projects:

1. Remember those days of elementary school where you celebrated something at least twice a week with home-baked, sugar-filled treats? Gone! SPPS has a "Sweet-free zone" where only once a month can a classroom have a sweet treat to celebrate something. In its place? Kids can share stickers, pencils, or they get their own special, show and tell time. From talking to teachers and staff, even a small step like this has changed the health environment in schools.

2. The days of exercise reserved only for PE class are gone. I have witnessed "Yoga Calm" training, a session to instruct teachers how to use yoga in their classroom, all with fun animal names for different poses. "Jammin' Minutes" and other short stretch or exercise breaks are also used in the classroom. In a time when schools must meet national and statewide testing standards, SPPS teachers still manage to fit a few activity breaks into their day and it shows a positive improvement in behavior.

3. Teachers and staff are truly jacks-of-all-trades. Ever since SPPS set up "wellness champions" in every school, nurses, counselors, teachers and administrators have volunteered precious time to attend meetings, put together events and work to better the wellness environment in their own schools.

4. While I don't think my true calling is to work directly in schools, its a much-needed opportunity to go into a school district and observe, learning the progressive things that are happening and what needs to be changed at the local, state and federal policy level in nutrition and student wellness to better education.

By Natalia Espejo
Public Health Administration and Policy

Not only is this classic by Europe, one of my favorite songs, but the refrain very accurately reflects my feelings about the next few weeks. I've been a student/professional intern for the last 26 years, and now as I prepare to start (deep breaths) a career I am both excited and nervous about what life after May (graduation) will be like.

Since I am interested in working abroad I started a job search in February. As I noticed job descriptions that required between 5-7 years of experience, I began to get worried about how I might realize my professional goals. After some initial anxiety, I developed an application plan, knowing that if I wanted to be in control of my future, I'd have to approach the job-search with persistence, dedication, and most importantly, discipline.

The plan I created was three-tiered, and included networking, resume-revising, and application-completing phases. During the first few weeks of February I created a list of organizations and fellowships that operate in the field of public health, which I then organized according to deadlines and requirements. After that, I set-up a schedule which included not only job prospects, but also my academic responsibilities. In March, I sent out a series of emails to contacts that I had acquired both informally and through various work and school-related activities, inquiring about job opportunities and also advice that might help define/narrow my search.

This process though arduous resulted in two interesting opportunities that though not yet defined, have given me increased confidence about my ability to compete in the global job market.

As I try to enjoy my last couple of months as a student, while also preparing to begin a new chapter of my life, I am happy to know that the choices, both academic and professional that I have made so far have led me to job options options that align with not only with my vision for the future, but also my commitment to service. The challenge has been trying to get my diverse experiences to tell a consistent story; however, the process of reflection and searching, that was motivated by my initial anxiety a couple of months ago, has given me a sense of clarity and happiness that is allowing me to complete my studies with renewed vigor, while also remaining vigilant about what lies ahead.

By Kristopher Kapphahn
Biostatistics, MS

A few nights ago, something came together. I have had vague notions of writing an epidemic simulator for a long time, probably since my first programming class way back in the fast and loose mid-oughts. I'm not sure why. It likely has something to do with the ability of a good simulation to generate data with the mere push of a button. I've worked on the data gathering part of a couple projects. It isn't always the sweetest job (though I've got a funny story about bed bugs).

As occurs with a fair amount of my ideas, implementation was hampered by a lack of ability. Despite my semester-long course in introductory C++, I lacked both real programming abilities and the time required to earn them. So the idea stewed. I had children. Got a bachelor's degree. Became more familiar with other programming languages.

When I started here last fall, I had the opportunity to direct the focus of one of my assistantships. One of the first subjects I looked into was that of epidemic simulation. I read through a few papers. I learned that shutting down schools is an effective way of limiting spread (but very expensive), but that vaccination was key. I also learned that I still lacked the programming abilities required to download and make work the few simulators that were available. So that was kind of a dead end.

Last week, things changed. Or, last week, I realized that things had changed. R is an open source statistical analysis language. It works well for many things, and unlike many of the other big names in computerized statistical analysis, it is free. Over the academic year, I've been slowly accumulating R experience doing various homework assignments. I've also become familiar with a plotting package for R that allows all types of flexibility in the presentation of data. Yawn, right?

Last Thursday, I realized that I had the chops to write one of these things myself. It wouldn't be incredibly complex. It wouldn't necessarily be useful. It would very likely take a long time to do anything on my computer. But I could do it.

So I sat down after the kids were asleep and started writing. 6 hours later, I had 400+ lines of glitchy code. But I also had pretty pictures. Pictures that I could produce iteratively and stitch together to make a short film. After several nights of refinement, I had something that actually worked.

The results are shown here, click on the blue box to see them. A bit of explanation. The blue box is a map. It contains 250,000 squares and each square represents a person. At the beginning of the simulation, I gave 5 people a disease. I stacked the deck so that each of their neighbors had a 1 in 6 chance of becoming infected. Upon infection, each of these poor saps then had the same chance with regard to infecting their neighbors. Each diseased person has a period of symptom display and a period of contagiousness, and these two periods aren't necessarily equal. All symptomatic people have a 1/1000 chance of death.

During each iteration, the number and location of newly infected folks are determined and they are assigned their initial symptom severity and contagiousness duration. The already symptomatic and/or contagious people get slightly better. Some folks die. After everything is calculated, the big array that keeps track of these things is updated, the plot is produced and the next iteration begins.

The video shows color as a function of symptom severity for these 250,000 people. Blue is asymptomatic, red is dog-sick. Black is dead. I originally hoped to have 240 frames here, but after about 4.5 hours of simulation time, only about 95 had been produced. At this point, ~4200 people were symptomatic and ~50,000 people had become infected. Only 17 had died. ~50,000 were contagious (I made contagiousness last about three times as long as symptoms). Fortunately, it isn't possible for these folks to get sick twice.

While it may be natural to think of the map as one of physical geography, it makes more sense as a map of connections. So instead of envisioning each person as being physically adjacent to their neighbor squares, envision that each person interacts with the people represented by the adjacent squares each day and it is through this interaction that they become susceptible to disease transmission. That way, the model is slightly less of a completely lame simplification of reality (which isn't to say that modelling everyone as having exactly 8 social connections is all that accurate either).

Also, while I have framed the model in terms of disease transmission, I think it also makes sense in the context of other socially transmissible phenomena, like ideas or emotions. Modifications to the model structure would make it more apt for these types of things.

By Kristopher Kapphahn
Biostatistics, MS

Things are busy. I've reached the point in the school year where my head feels full. I don't know what sort of storage scheme my brain uses. Maybe thoughts are packed in like apples in the produce section? Maybe they're more like self-important diners, waiting for their table in a busy restaurant.

Actually, right now my head feels more like the inner tube of a bicycle tire: a lot of pressurized air floating around a small space. Frequently, there is a spinning sensation. I've checked the side of my head, and I don't see any capacity specifications. I actually have no clue what the appropriate units are. Cogitations per cubic centimeter? The current strategy is to just keep cramming information in with fingers crossed in the hope that my brain doesn't burst. It's a variation on "fake it till you make it" called "when all else fails, pretend like you don't know that things could go horribly wrong and hope for the best". It's a good general strategy for life.

One nice thing about the biostats program is that there is considerable overlap in subject matter between classes. This means that each class informs and reinforces the information presented in the other classes. This dynamic allows for a more efficient use of information. It's an experience wholly different from being an undergraduate, where each semester saw me with disparately distributed subject matter. I suppose that's the point of a graduate degree: focus.

It's almost time to register for classes for next semester. One of the ways in which I am a nerd manifests as my excitement over this fact. There are so many classes I'd like to take. Statistical Methods for Correlated Data? Well, everything is kind-of correlated, right? Sign me up. Nonparametric Methods? How could I resist? Have you ever tried to manually perform a Wilcoxon Signed Rank Sum test in Excel? It sucks. I almost wish that the program was a year or two longer just so I could take all the classes that look interesting. The three electives I get just don't seem like enough.

By Mary Winzenburg
Public Health Nutrition, MPH

Happy International Women's Day (and Happy 100th Anniversary to you, International Women's Day). The best way I could think to celebrate this important day is to break out "Half The Sky", an amazing book by Nicholas Kristof (of NY Times) and Sheryl Wudunn. The husband and wife team present to you in each chapter an issue facing women internationally, be it honor killings, the sex slavery industry, female genital mutilation, fistulas. Gruesome and sobering topics, I know, but the best thing about this book is, Wudunn and Kristof don't just leave you hanging. The second part of every chapter is a story about someone or some organization working to combat this very issue. At the end of the book they present to the reader a little toolkit on how to get involved. Want to skip right to the "Get Involved" part? Go here: http://www.halftheskymovement.org/get-involved.

Often times I think I procrastinate (writing this blog, writing a paper, starting a project) because I am worried I won't finish it perfectly. Lame excuse, I know, and completely irrational, but often times I stew over a project (especially one that is long-term) until I am either 100% ready or I have a deadline. I think this is partially true with giving too. You (collective you) might be hesitant about doing anything for charity or volunteering or giving money until you are ready to give (time, money, skills) completely or to a level that you think is sufficient. But here's the deal: the adage "every little bit helps" truly does apply here. The cost of living is very small in a developing country compared to here that I could personally microfinance a woman's business for $50. How cool is that, from one woman to another, that I could help end a woman's life of violence just by financing a project halfway around the world.

So this International Women's Day celebrate by not letting the perfect be the enemy of the good, get out there and do something small to help a woman in need.

By Natalia Espejo
Public Health Administration and Policy

March is Women's History Month, which I personally find fitting for a very specific reason. My mom was born on March 8th and as what would have been her 50th birthday approaches, I find myself reflecting about her life and legacy.

My mother was, to put it very simply, remarkable. As a teenager, her travels to Peru, Bolivia, and Mexico taught her about inequality and injustice, social problems that she spent the rest of her life fighting as a nurse and advocate. When I was seven, I accompanied her on a health-promotion trip to Huaraz, and what I observed has stayed with me to this day. As I watched my mom, a Fargo-girl (who decided to make her life in Peru) talk to local women about the importance of nutrition, prenatal care, and sanitation I was moved by her empathy, engagement, and genuine interest. Her objective was not only to educate, but also to learn; as I begin the process of starting my own career in public health this is my primary motivation.

My mother also taught me about the important role that professionals must play in addressing inequality. From her and my father, I learned that economic and social privilege should not define the natural order of things, and that as active and engaged individuals we all have a responsibility to work in the interests of the poor, disenfranchised, and vulnerable.

Unfortunately, despite recent gains, gender inequality continues to be a problem in the United States and throughout the world. Women are not only more likely to be poor than their male counterparts, but also disproportionately bear the consequences of war, colonization, and poverty. While studies have demonstrated that economically empowering women is the best way to promote development and better health outcomes, sexism persists both at home and abroad. In the U.S. and around the globe women continue to struggle for reproductive rights, equal pay, and against domestic violence. These issues represent a unique problem that requires the development of innovative, proactive, and cross-cultural solutions, but first a recognition that gender inequality is in itself a social-issue that must be addressed head-on.

As I remember the woman who gave me life, and think about the sacrifices that she and other members of her generation made so that young women today might have brighter, healthier, and empowered futures, I am both grateful for and motivated to continue their/our ongoing liberation project.

It's been ten years since my mother passed away. However, her unwavering commitment to social justice and unconditional love for the poor and vulnerable keep her ever-present in my life, and it is in her honor that I write this post. Happy birthday Mom! I love you always.

By Roshani Dahal
Environmental Health Sciences, MPH

Three weeks ago, the School of Public Health along with other sponsors hosted the Gaylord Anderson Lecture. The speaker this year was Dr. Kelly Brownell, a renowned professor and advocate for reducing childhood obesity, who gave a talk titled "Is There Courage to Change the American Diet?". Having read many of his scientific papers and spent a semester in exploring obesity interventions at an individual, community, economic, and policy level (please refer to my earlier blog 'My Sweet Tooth for Learning'), I was more than enthusiastic for Dr. Brownell's talk. I was ready to put a face next to the name I had so frequently encountered. Most public health courses emphasize that we need to address childhood obesity problems. We can raise awareness about the harm of obesity. We can cap the number of fast-food restaurants in poor neighborhoods. We can encourage the poor and obese to consume more fresh food and vegetables at homes and in schools, and mitigate these costs by providing coupons. We can disseminate information on benefits of exercise. In all these interventions, the focus is on the individual behavior change. Sure, this is one way of combating the obesity issue, however, the work is both cost and resource-intensive. Why not target the issue at a policy level? After all, policies impact a far larger audience. For instance, cereal companies spend 100million dollars in marketing in four days and have special interests groups representing them at Washington. Who do we have representing us at Washington? With reduced federal funding, how can we afford to work continue working at an individual level? We cannot compete with food companies; we simply do not have the financial resources.

My proposal: Public health students should be well trained in understanding public policies and consider it to be one of their most important tools. Let's face it. Most of us are uncomfortable being politically active for various reasons: 1) we do not feel well versed in public health policies, 2) we are too busy with our course assignments, 3) we cannot find the time for political activities due to work and other personal commitments, 4) we may be concerned with upsetting others within and outside the school, 5) we don't know where to start. I will admit that I fit all the reasons listed here. Here is what has changed for me in the recent months: Professor Mike Osterholm's 'Emerging Infectious Disease' class. Listening to him every Monday morning for three hours on the importance of representing public health voice at a policy level is changing the way I perceive the impact of public policy. Part of the course requirement is to stay updated on current public health news, and this has now made me aware that what happens nationally and internationally will impact public health along with my future work. For example, the political unrest in Tunisia, Egypt, and now Libya significantly impacts US oil imports, which in turn affects our petroleum-based society. The freeze on 'discretionary spending', which is a mere 12% of the federal budget, will impact air pollution, water quality, research and development, CDC, energy policies, transportation, etc. This is our future career, and we are not voicing our thoughts as public health students. Now I must admit, I did not always find politics and public policies to be incredibly interesting, but as I familiarize myself on the public health policies and the threat of the current federal budget, I cannot help but ponder why we are not meeting and discussing this outside of our courses. The more I read on each issue, the more I find myself with a voracious appetite for understanding the intricate relationship between Washington politics and public health. To understand political figures platforms, I watch politically oriented shows such as Meet the Press, Real Time with Bill Maher, and The Charlie Rose Show. Additionally, I work on finding time to stay updated on health news and policies. For the first time in my MPH degree, my focus has become understanding public health not only from an infectious disease point of view, but rather from all public health disciplines. I try to not only read and complete the required materials, but explore further into the significance of learning the assignment. After all, we don't like our bread without the butter, right?

Lastly, I must make a case for integrating different disciplines of public health through mandatory seminars for MPH students. Other MS and PhD students at the University are already involved in attending seminars from multiple different fields to better understand and contribute to their research. I would argue that public health needs to do the same. Inviting guest lecturers from MDH, CDC, and local health departments will paint a more realistic picture of public health practice. To maximize participation at the MPH seminars, we need to hold this at a centralized location. Last, but not the least, it is incredibly important to interact with public health students from all different disciplines since as public health practitioners, we will rarely be surrounded by 30 other similar minds. Learning to crosstalk in public health is an essential skill that we simply cannot miss out on!