Saving lives, millions at a time

When people ask what I’m doing over here, my standard response – with a wink and a smile – is, “Saving lives, millions at a time” – the tagline for the Johns Hopkins Bloomberg School of Public Health. While catchy and true, it is admittedly ambiguous, and typically leaves the inquirer unsatisfied. Seeing as this, “Whatcha doing?” question is the highest in demand, and the whole reason I’m here, I figure I should explain before continuing down the culture/food/fun path.

But first, indulge me in a quick trip down memory lane. I’ve received a surprising amount of correspondence from folks I haven’t spoken to in eons. So, for their benefit, and the benefit of those that (used to) see me on a regular basis and still have no idea what I do or why, a brief history. Those that already know or don’t care: permission to skip.

After undergrad, I made my way down to Baltimore to do my Masters of Health Science (MHS) in health communication at the Johns Hopkins Bloomberg School of Public Health (JHSPH). Between Ithaca and B'more (and Fulton, too!), I found myself surrounded by passionate, fascinating people from around the globe, and was suddenly itching to see more, know more, do more, taste more.

In the summer and fall of 2005, I got my first “taste” of Africa when I spent 5 months in Zambia doing my internship with the Health Communication Partnership, working on HIV prevention programming for young people. The three month trip morphed into five, and I came away with the deepest of desires to get back. So, I weaseled my way into the Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (CCP), the organization that sent me to Zambia, and in the last two years have single-handedly covered almost every junior level position there – unpaid intern, paid intern, consultant, full-time temp, benefited and salaried Program Coordinator, and now, a benefited and salaried Program Officer. A lesson to you young’uns - persistence pays. Although not always in dollars.

In the nuttiest of nutshells, CCP designs and implements strategic communication programs, increases access to/exchange of information to improve health, and conducts research to guide program design and evaluate impact. We run health programs in over 30 countries, each very different from the next depending on the health needs and context of any particular country or population.

This is done through a huge variety of mutually reinforcing, multichanneled communication approaches: print, radio, television, electronic media, interpersonal communication and counseling, community mobilization, sports for development, peer education, entertainment-education, trainings, capacity building of local staff and partners…

In several different health areas: HIV/AIDS, reproductive health, child survival, infectious disease, safe motherhood, safe water, environment, democracy and governance…

With a limitless number of target audiences: couples of reproductive age, caretakers of children under five, people living with HIV/AIDS, pregnant women, young people, service providers, traditional and religious leaders.

I like to think of it as taking all of the clinical/medical/research/policy technical mumbo jumbo and distilling it down into manageable pieces of engaging information for different audiences in a way that motivates positive health behavior, e.g. correct and consistent condom use, contraceptive use, insecticide treated bednet use. Think the “Truth” campaign.

Moving right along, CCP recently started a new fellowship program for more junior level staff to get to the field – where all the action is, where most of us really want to be, and where those of us without husbands or kids or mortgages or dogs can be, with relative ease (especially when you have huge-hearted family and friends who help you move your life into a 10x10 storage unit out on Pulaski highway). The first country CCP guinea pigged for the fellowship program was Uganda, and the first person to go is J-to-the-e-to-the-n-n-y.

So, I’m working 50:50 on two different CCP projects out here, the Health Communication Partnership (HCP) and the AFFORD Health Marketing Initiative. Why yes, this does indeed involve two different offices, two different teams, two different computers, two different email addresses, two different notepads, and two different to-do lists. Why no, it’s not confusing at all and I definitely never leave anything I need in one office at the other one. What ever makes you think that?

Fast facts:
- Approximately 6.3% of the adult population in Uganda is estimated to be HIV positive
- Malaria is endemic in 95% of the country.
- The country’s total fertility rate, or the average number of children born to a woman over her lifetime, is 6.7, one of the highest in the world.

It is within this context that HCP and AFFORD were born and now operate. Both are funded by the US Agency for International Development (USAID). In the interest of time and sanity, I’ll spare us the details of each project and focus on me, me, me (blogs are incredibly self-centered, eh?).

For HCP, I’m helping to develop the new national campaign to promote HIV counseling and testing (HCT) services. At the moment, this involves a literature review of all the HCT research, programs, and policies in the country, and will eventually involve a strategy design meeting between all stakeholders, campaign and materials development, pre-testing, campaign implementation, and monitoring and evaluation. Below, a few tidbits that grabbed my attention while reading. Not anything that will make it into the lit review, but interesting examples of things you’d probably wouldn’t see if doing a lit review on testing services the US:
- “Basic furniture at a static HCT site is two or three chairs and a table. In community settings HCT may be carried out with the counselor and clients seated on mats. In such cases the counselor may require a clipboard to make writing easier.”
- “As in pre-test counseling, people in polygamous marriages should be given options to come all together, in separate pairs with the husband, or as individuals.”
- “A household was defined as persons who shared food cooked at a common hearth and slept in the same house or cluster of houses for at least 5 days in a week for the preceding 3 months.”
- “Likewise, in northern Uganda, most IDP [internally displaced persons] camps are of small geographical size characterized by over-crowded IDP dwellings which are in close proximity to most health services…Since all three camps were in the same security phase as classified by United Nations (phase III), we presumed that there was no significant differences in the level of violence that would effect [service] utilization differently among districts.”

Food for thought.

Switching gears, AFFORD is a social marketing project that markets a number of health products to different market segments – Protector (condoms), Injectaplan (injectable contraceptive), Pilplan (oral contraceptive), MoonBeads (natural method of family planning), ZINKID + RESTORS (zinc and oral rehydration solution product to treat diarrhea in children under five), and Aquasafe (water treatment product) are on the market now, with several others in the pipeline. We’re in the third of five years of this project, and are in the process of preparing for our mid-term evaluation and writing a continuation application to USAID for the next two years. I’m also a part of our “good life” movement – an overarching marketing communication umbrella under which we’re positioning all of our products, practices, and services. More on that later, I’m sure.

AFFORD highlight from last week: an email brainstorming session to kick around brand names for our most recently approved product, Acycolvir, used for treatment of viral infections like genital herpes simplex, herpes zoster classified and sexually transmitted infections. My suggestion? HerpEase ;-)

Work entry…check!