2014

The GHC Alumni Agenda

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The Global Health movement has grown beyond its earliest ideals, encompassing professionals of all manner and kind. The reality of Ebola, today, shows us that all of us, undeniably, play a part in the health of our communities. No-longer can we blame cultural practices, or hide behind the hope of miraculous signs and wonders – today, we all actively take part in the shape and form of our health. Or God forbid, we die.

The GHC Model takes a young and passionate generation of global health enthusiasts and places them at the forefront of health care, in deserving communities. For 1 year, I served as a fellow, I learned, I grew and now I am a sold out advocate. But the journey for health equity is a journey of a lifetime. GHC has launched Alumni programs across the 2 continents, to keep the candle burning.

Fellows, Alumni and Friends, today, I present to you the GHC Alumni Agenda.

Alumni are critical to the mission of mobilizing a community of emerging leaders to build the movement for health equity. 6 years after the first class, there are now more alumni than fellows. Alums are unique because after the fellowship, they are blown by winds further and in more industries than GHC could have managed to place them. While there, their collective experiences can still be harnessed towards improving the health of those most in need, both in their own countries and beyond. GHC is committed to supporting alumni in their leadership development and involvement in the global health equity movement.

The alumni program is guided by GHC’s leadership practices and framework that integrates professional development, interior formation and intellectual formation within the context of the self, world and community. GHC believes that leadership qualities and skills crucial to achieving social change and progress in global health are not innate and require regular attention and practice.

GHC leaders (Fellows and Alumni) are agents of change who: Are committed to social justice; Collaborate;  Inspire and mobilize others; Adapt and innovate; Are self-aware and committed to learning;  and Get results.

To date, Alumni Committees have been established in all countries where GHC has fellows. It is the role of the Alumni Committee, facilitated by the GHC Program Manager in that country, to determine the priority activities and approaches for the year. This strategy should reflect strategies that reflect on GHC’s vision of movement building and in particular, goals for the alumni program and our approach to leadership development.

We have ambitious plans, to hold a sports gala for our placement organisations, and a hackathon to solve pressing needs for KCCA. We also plan to support each other in personal endeavors. We will expand the annual East Africa alumni retreat in January 2015, as well as supporting the recruitment of new GHC fellows

Similar to GHC’s fellowship programming, the Uganda Alumni committee would like to achieve the following objectives for Alumni and fellows:

Knowledge Sharing and Communications – We would like to see alumni interact with each other in ways that sharpen one another, including targeted workshop sessions. Alumni  should tap into each other’s wealth of experience and knowledge in health and development and allow for greater information sharing and collective wisdom.

Community Building and Networking: We hope that Alumni achieve the objective of remaining plugged and connected post-fellowship. We will enjoy our company as well as that of new partnerships and relationships. We will encourage networking opportunities and even work/project collaborations. We will support GHC recruitment for new fellow classes, because we would like to add the best to our community.

Professional Development: Even as Alumni, we hope that you continue to prioritize skills development and the sharing of professional resources to allow alums to better perform in their jobs and open the doors to new opportunities. Moreover, Alums are already signed up to support fellows, as part of the mentor-ship program.

Accompaniment/Self-care: As members of the Global Health Corps community, we live out our values through our behavior and our dealings with others. We transcend ourselves and our immediate identity as we expand our circle of care and concern to include our organizations, our fellow corps members and, last but not least, the very communities we are called to serve in throughout our careers.

I encourage the Global Health Corp Alumni to support the Alumni country program. Together, we continue to achieve the dream for health equity and social justice.

Men Can Help Stop The Spread of HIV to Infants and Children

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Together with GHC CEO, Barbara Bush, find out how Men can help STOP the spread of HIV to Infants and Children: http://www.huffingtonpost.com/barbara-bush/how-can-men-help-stop-the_b_5862200.html

Uganda’s Policy and Strategy on FOSS and Open Standards

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The National IT Authority of Uganda (NITA-U) has released, for public review,  The National Free and Open Source Software, and Open Standards Draft Policy. Download PDF Here: Open Source Policy V0.3 2014-09-21

NITA-U has also released the accompanying strategy:  Open Source Strategy V0.3 2014-09-21.

It appears that both documents have received input from James Wire (@wirejames; ), a Kampala based FOSS Advocate. As of this writing, NITA-U seeks input from members of the ICT Association of Uganda, a body that brings together professionals in the sector.

The policy makes some exciting declarations:

Where there is no significant overall cost difference between open and non-open source products, open source will be selected on the basis of its additional inherent flexibility.

The Government will expect those putting forward IT solutions to develop a suitable mix of open source and proprietary products to ensure that the best possible Value mix is obtained. Vendors will be required to provide evidence of this during a procurement exercise. Where no evidence exists in a bid that full consideration has been given to open source products, the bid will be
considered non-compliant and is likely to be removed from the procurement process.

The Government will, wherever possible, avoid becoming locked in to proprietary software. In particular it will take exit, rebid and rebuild costs into account in procurement decisions and will require those proposing proprietary software to specify how exit would be achieved.

…and some even more interesting commitments:

All IT investments shall comply with Open Standard unless specific project requirements preclude use of an Open Standard or if the Open Standards are not appropriate. The Government will support the development of open standards and specifications.

The Existing IT systems shall be reviewed for Open Standards compatibility where appropriate.

There are also some places where a firmer voice could work better, in the interest of developing FOSS:

Because participation in the ongoing development and improvement of FOSS is the underlying basis for the promotion of FOSS solutions, MDAs/LGS should consider the extent to which they may wish to actively participate in the development of FOSS solutions that fall short of the project requirements for which the solution is used

And some places where the spirit of licensing derived works is broken:

No Discrimination against Fields of Endeavor: The licence must not restrict anyone from making use of the program in a specific field of endeavor. For example, it may not restrict the program from being used in a business, or from being used for genetic research.

 

Are you concerned about Free and Open Source Software? Does your government have a different policy? I would like to know. Well then, take a read and let me know what you think.

My Speech to the GHC Uganda Community – 19th July 2014

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I knew I wanted to work with computers from as early as Senior 2, and I wasn’t contented with pioneering the computer club at my high school. Out of University my first job was far from computers, it was with children, orphaned children. They were singing their way to donations, inspiring people from other continents to provide for their needs. Those were the first seeds sowed against social injustice.

I was raised as a middle child, indeed my mother confessed to remembering me long when my diaper was leaking. Single mother, a house wife, I grew up in 7 suburbs in this city, and never in our own home. Those were the second seeds of consciousness to social injustice.

When I stopped looking after children, I was opened up to the world of health information systems – there I saw numbers. 327 HIV positive mothers; 45 malaria cases; any number you can name, we probably have a health statistic for it. On a computer screen, they are numbers, but in the field, they are people. Children, Mothers, Fathers – wasting away because there are no drugs; alas, there are no medical professionals to attend to them.

Now I couldn’t go back – it was not just a 3rd seed sown, it was time to be part of the solution.

We know that for people like me, ICT professionals, opportunities for us are scarce because our backgrounds are outside of healthcare. How do I use my unique skills in global health? At the same time, for those who work in traditional health fields, a lack of community with people (and professions) like mine limits collaboration, knowledge sharing and support.

GHC believes that a global movement of individuals and organizations fighting for improved health outcomes and access to healthcare for the poor is necessary in order to change the unacceptable status quo of extreme inequity.

GHC provides opportunities for young professionals from diverse backgrounds to work on the frontlines of the fight for global health equity.

In 2008, the Ministry of Health estimated that abortion-related causes accounted for 26% of all maternal mortality. This proportion is considerably higher than the World Health Organization’s estimate for Eastern Africa (18%)

In 2011, Uganda had a maternal mortality ratio of 438 maternal deaths per 100,000 live births—well above the average of 240 per 100,000 among all developing countries. Many of these were unsafe abortions. [1]According to a survey of 1,338 women who received post-abortion care at 27 health facilities, on average, Ugandan women paid 59,600 shillings (US$23) for their abortion procedure and any treatment received prior to arriving at a health facility.

If you have lived in this city most recently, you may be familiar with civil servants who “erroneously” earn 96 million shillings a month (that’s about: $35500/mo; $222/hr), and you may have heard that our development partners are redirecting aid, and in some cases it will make the difference between a pregnant mother being tested for HIV and placed on option B+ or not… literary affecting our national dream for an HIV free generation.

[2]In 2012, an estimated 168,000 women in Sub-Saharan Africa died from pregnancy and birth-related causes; 62,000 of these women did not want to become pregnant in the first place. Fully meeting all need for modern contraceptive methods would have prevented 48,000 of these deaths—a 29% decline in maternal mortality.

[3]Every shilling spent on family planning/Contraception will save more than 6 shillings in post-abortion care services averted. The cost of providing contraception in Uganda for one year has been estimated at around UGX 57200/= per user, while the overall cost per case for treating post-abortion complications is UGX 340,600/=.

 96 million shillings would provide 1678 Ugandan women a year’s needs for contraception. What else can it do now?

[The entire stipend needed for all of us 65 fellows this month!]

In this room, there are young professionals from all walks of life. You are here because you decided to be available for the Global health Movement. Something tagged at your heart and you answered the call. I challenge you, stay at your post. Remain present, remain engaged, and remain plugged. It is young people like you who are going to make a difference in the way we think about the future of this continent.

There are also partners, and the organizations where new fellows are going to be placed – you have made available room and board, time and space to tap into the passion in this room. I urge you, open up more doors; there are a lot of young unemployed (and indeed unchallenged) graduates who are willing to get their hands dirty. GHC has proved it, because the growth remains visible, next year, there will be more than 150 fellows!

Where do we go from here? This is Step #6 in how GHC Works: Fellows collaborate, Grow as leaders, Deepen Impact BEYOND the fellowship year.

Let’s see, my good friend Edward heads to Mbale to serve local communities with microfinance, as the country director for Spark MicroGrants; Cassandra has left Kyangwali Refugee community for medical school in the US – she’ll become a doctor soon enough. Brian? I will lead a team of ICT professionals – you can guess how they will turn out in a year – Global Health advocates! Many of us are going to do different things.

But oh how we are changed. How the fellowship has given us new eyes, I will never look at a health stat and not imagine the people represented; I will never lose consciousness of the health challenges of my community. I have not just grown professionally – learning what PMTCT is and the technical language around HIV and AIDS, I have also been intellectually stretched, when debating interventions for young people, and debating with my class about aid cuts and their impact on health. These discussions have made me grow, but perhaps more profoundly, I now question my own values, ethics, and motivations for engaging in this movement.

Joan, go and be a star! Brian, one year from now, you will be more than just a world changer. Sam, there is room for ICT professionals like you and me in the movement for Global Health Equity!

You and I, all of us have got to remember, we are part of a global community of emerging leaders to build the movement for health equity. We are building a community of change-makers who share a common belief: Health is a human right.

Once a Fellow, always a fellow!

Thank you.

 

[1]Sundaram A et al., Documenting the individual- and household-level cost of unsafe abortion in Uganda, International Perspectives on Sexual and Reproductive Health, 2013, 39(4):174–184

[2] Adding It Up: Costs and Benefits of Contraceptive Services—Estimates for 2012, New York: Guttmacher Institute and United Nations Population Fund, 2012.

[3] Vlassoff M et al., The health system cost of post-abortion care in Uganda, Health Policy and Planning, 2014, Vol. 29, pp. 56–66

Will Uganda have a “Mississippi Baby”?

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Last week, was it was reported that the Mississippi baby previously thought to be cured of HIV was in fact carrying detectable amounts of the virus.

The child, born in 2010 to an HIV-positive mother who received no prevention of mother-to-child transmission of HIV (PMTCT) services during her pregnancy, tested positive for HIV shortly after birth. She was given a high dose of antiretroviral medications at 30 hours of age and remained on antiretroviral therapy (ART) for 18 months before she was lost to follow-up care.

Five months after being lost to care, the child was again examined by medical staff and found to have undetectable levels of HIV, and remained so for more than two years. This was the basis of her Care and Treatment advisors declaring her cured.

This month, at almost 4 years of age, detectable levels of HIV were found in the child’s blood, along with a decreased level of CD4 T-cells and the presence of HIV antibodies—signals that the virus is actively replicating in the body. According to NIH, the baby had (16,750 copies/mL). Repeat viral load blood testing performed 72 hours later confirmed this finding (10,564 copies/mL of virus).

Additionally, the child had decreased levels of CD4+ T-cells, a key component of a normal immune system, and the presence of HIV antibodies—signals of an actively replicating pool of virus in the body. Based on these results, the child was again started on antiretroviral therapy. To date, the child is tolerating the medication with no side effects and treatment is decreasing virus levels. Genetic sequencing of the virus indicated that the child’s HIV infection was the same strain acquired from the mother.

There are a number of things that caught my attention when i read up the details on this story:

  1. That a mother went to deliver in the hospital, even though she had not received PMTCT services during her pregnancy – this is something for which we are yet to achieve 50% as a nation. Are we able to reverse this? Because whenever a mother does not deliver from the facility, its not only a missed opportunity to test for HIV, it means we cannot catch other birth related complications, and as such we continue to stare into grim figures of Maternal and Neonatal deaths.
  2. There was a lab and test kits to test for HIV, and CD4 count of the baby at the various stages of development. Is this something that we can ensure? What is the proximity of an HIV testing centre to the 2.2 million ugandan babies born annually? As you can imagine, the presence of a lab is inconsequential if the reagents and test-kits are not present. In many areas where the labs are not present, regional hubs function to carry out the tests. A sample transportation network is critical for DBS samples for exposed infants, indeed for all children and mothers.
  3. One of the salient successes of this story is documentation – the presence of mind to notice something unusual at your job, and you take a keen interest in it, choosing to follow it up and ask the questions that some people may consider hard to ask. I wonder if we are able to take a keen interest in something scientifically unusual and cause it to be the centre of a full fledged research, as this case turned out to be.
  4. How about the patience to look at the numbers (facts and figures) 4 years later? In science, this institutional memory is very important, because it makes for very interesting research findings all the time. Every picture, every story, every record, as long as it is not treated with contempt, has the potential to reveal something to us if we listen to the numbers more closely. And yes, sometimes, its years later, but if we are keen, we will hear the numbers speak to us.

As the world of science grapples with the apparent set back, players and actors in the sector remain committed to advancing HIV/AIDS research. With programs that focus on HIV prevention and treatment as the best tools to end pediatric HIV international and national partners are making great strides toward eliminating mother-to-child transmission of HIV globally.

Right now, we know, that by providing a pregnant or breastfeeding  HIV positive woman ART we can almost completely eliminate the possibility that she will pass the virus onto her baby during pregnancy, child birth, or breastfeeding. However, every day 700 children become newly infected with HIV. We must quickly identify and begin treating these children to ensure they can lead healthy lives.

As a nation, our job isn’t over until no child has AIDS. Uganda must ensure that communities and health facilities have the tools they need and the resources to plan, implement, and sustain their HIV programs so that all families are reached with services. Otherwise, Uganda will never have a Mississippi Baby.

In Awe… a firm foundation

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I am in awe of my City’s Executive Director, Jeniffer Semakula Musisi.

Its been 3 years since she’s stepped into office. Kampala has started to feel like a city. There’s a lot of things that have been said, about her style of work and her methods. I listened to her one day, when she pleaded her case before Kampalans – we had forgotten what the difference was, between right and wrong. We had lived for so long in a dysfunctional city, that we had become used to it.

Today, I exchanged emails with the ED, and i learned something new. In her email signature, just below her name was a scripture. So i dug it up –

Ezekiel 36:33-36 New International Version (NIV)

33 “‘This is what the Sovereign Lord says: On the day I cleanse you from all your sins, I will resettle your towns, and the ruins will be rebuilt. 34 The desolate land will be cultivated instead of lying desolate in the sight of all who pass through it. 35 They will say, “This land that was laid waste has become like the garden of Eden; the cities that were lying in ruins, desolate and destroyed, are now fortified and inhabited.” 36 Then the nations around you that remain will know that I the Lord have rebuilt what was destroyed and have replanted what was desolate. I the Lord have spoken, and I will do it.’

Yes, its common knowledge that the ED is a bible professing christian, and so you can expect some biblical influences in her life. Uganda is said to be over 60% christian, but when you walk through Kampala, and see how we drive, and where we trash, you have to wonder if any of the biblical influences of stewardship have infiltrated our hearts.

So, this is why am in awe, that my city’s ED is influenced by a passage of scripture that brings hope to a city in ruins like Kampala! Is it the reason she fearlessly goes about her work? Indeed, Kampala is shaping up and is looking more beautiful and inhabited by the day.

The neglected land will be worked again, no longer overgrown with weeds and thistles, worthless in the eyes of passersby. People will exclaim, “Why, this weed patch has been turned into a Garden of Eden! And the ruined cities, smashed into oblivion, are now thriving!” Ezekiel 36:33-36 (The Message Bible)

Thats how the Message Bible puts it.

There is an air of hope and optimism about this city. I dont think its enough for one woman (even at the helm) to be greatly inspired to make this city liveable and thriving, its time for each one of us to ask ourselves – what will your role be in rebuilding this city? You may not be equally inspired by the Bible, but what is it you commit to do in making this city grow and prosper?

Jennifer Semakula Musisi will rally us towards a better city, but the bigger challenge is how many of us (christian or not) will choose to walk with her, as we make this city the best place to raise our children’s children!

I will, what about you?!

 

eLearning Africa, 2014. Welcome to Uganda!

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This week, #ela14 takes place at the fancied Munyonyo Resort, 12km south east of downtown Kampala. eLearning Africa is the largest gathering of elearning and ICT supported education professionals on the continent. And it happens annually. I attended Cotonou 2 years ago and Dar es Salaam prior to that. I can confirm that if elearning, online learning and ICTs for education interest you, this is a great place to be. So lets examine a little what kind of Ugandans would attend elearning africa – Teachers of ICTs, University ICT departments, elearning Service Providers, Policy makers from the Ministry of Education, and a ton of exhibitionists – software vendors, technology vendors and as always, a number of schools looking to attract support from represented donor agencies. The potential to network gainfully is enormous, as this conference averages 1400 professionals over 3 days!

 

Last year in Windhoek, Namibia, 86% of the participants came from African countries. It is not clear how many came from within Namibia. That would be an interesting statistic, because as the ICT Association of Uganda has already lamented, the conference fees for the category ‘African Nationals based in Africa’, stands at €380 (an equivalent of Ushs 1,350,000 – One Million Three Hundred Fifty Thousand Shillings.) To get the context right, this figure represents about 4 times the net salary of a primary school teacher, and about the gross salary of a university teaching assistant! 

I have had the honor of serving in a senior management position at a university, and facing the National Council of Higher Education. Particularly, my interest was tweaked when an NCHE representative asked the University to guarantee that elearning students would access their courses – either by providing internet access to the hosted learning materials and/or providing the means (read gadgets) for the students. Access to the internet remains a critical factor in any online and elearning venture. 3 years later, I am happy to note that overall access to the internet in Uganda has increased – but that is to the outside. It is still not clear what the national policy for elearning is – I hope this conference will bring us to the table.

Within Uganda, one of the hugest drivers for elearning will be the Research and Education Network for Uganda – RENU. Over the last 8 years, RENU has gone from a concept on paper to become a driving force in promoting research collaboration between institutions of higher learning in Uganda and beyond. Through its mission, RENU hopes to promote knowledge creation and sharing amongst scholars and researchers through the provision of advanced network services. The realisation of RENU’s vision and mission is closely intertwined with elearning and online learning. RENU seeks not to create superstars, but a network of like minded centres of excellence in research and education. 

Online learning (and indeed, some aspects of  elearning) present a new problem for our age-old standards. MIT, Harvard and Berkeley have Free Online Courses -the question is, and appropriately for this day and age,if i covered 15 online courses, from various providers, totaling enough credits for a degree, would I be awarded?

Is the Uganda National Examinations Board (as well as the National Council for Higher Education) ready to accredit and honor hours spent learning online?

I have also scoured the Uganda Ministry of Education website for any policy documentation on elearning and i did not find any. Does that explain why the chief hosts are the ministry of ICT and the Uganda Communications Commission? I appreciate, the role of technology in elearning but i also sense that the leading policy body for education, at an event hosted by the ‘Government of Uganda’ – the Ministry of Education is on a long leash.

This year’s theme, ‘Opening Frontiers to the Future’, is one that calls to mind, what we would like elearning and online learning to be like – when our children’s children go to school. Uganda – what is your frontier to the future of elearning?