Monthly Archives: September 2014

MPH Alum is the New Director of Programs

Shalini_Iyer_croppedWe are so pleased to share the accomplishment of MPH Alum Shalini Iyer as she assumes her new position as Metta Fund’s Director of Programs.

As Director of Programs, Ms. Iyer will manage all aspects of the Foundation’s grantmaking program, which will total $3,000,000 in 2014. In addition, she will oversee Metta Fund’s community collaborations and partnerships. She will play a key role in achieving the Foundation’s mission of creating a healthier San Francisco. Ms. Iyer has recently been elected to sit on the SFHIP Steering Committee representing the Philanthropic Community seat.

A passionate advocate for low-income communities and communities of color, Ms. Iyer most recently worked for the San Francisco Foundation, beginning her tenure as Multi-Cultural Fellow and moving into Community Health program grants. A native of Philadelphia, she has worked for the Philadelphia Department of Public Health, and the New York Department of Health and Mental Hygiene.

Congratulations, Shilini!



Across the Border

CerezosI was ill prepared for the two-hour hike up the long, winding dirt road of the third community I was to survey. My flip-flops were chaffing my worn feet, and red lines were hastily forming around the border of my tank top. By the time I reached the final house, I wanted nothing less than to ask yet another woman about her cervix. But the family kindly ushered me into their living room and placed a cup of coffee on the table beside me. The woman I was supposed to interview, however, lay asleep on the couch, nothing more than a small swelling under several large blankets. “She has breast cancer,” her family whispered to me as I sipped my twelfth cup of coffee that day and tried to recall how far away the last house with a latrine was. “The doctors say she came too late and there is nothing they can do to help her.”

My main objective this summer was to conduct a women’s health needs assessment in the communities of Restauración, Dominican Republic and Tilori, Haiti, where Philadelphia-based NGO Federation for International Medical Relief of Children has been working since 2012 to improve community health. Through qualitative interviews with key stakeholders and quantitative surveys with women who had recently given birth, my goal was to gain a deeper understanding of the women’s health care situation in both communities. The information I gathered would then be used to help inform the development of an antenatal care program. Both the Dominican Repub
lic and Haiti have relatively high maternal and neonatal mortality rates and proper prenatal care has been shown to help reduce such deaths.

Although I have not yet completed any analyses, I believe the narratives I took away, between collections of quantitative data, yield just as important a story. That woman, a mother of three now slowly dying of breast cancer under the heap of blankets, had been to the local rural clinic with concerns of pain, but had been turned away with nothing more than ibuprofen. By the time she had traveled the four hours to the closest specialist, her family told me, the cancer had already progressed too far. The presence of advanced cancer treatment centers in the large cities of the DR does not help rural women who have limited access to screening.

And for the women living across the border in Haiti, access is even poorer. My Haitian-Creole translator who assisted me during my visits to those communities would often get frustrated when I asked her to translate questions like “Have you ever heard of a pap smear?” or “Have you ever had a breast exam?” “You know what her response will be,” she would argue. She was usually right.


Restauración is a small town of about 7,000 habitants, located in the second poorest province of the DR. Only 12km from the Haitian community of Tilori, it is a popular place for Haitian migrant workers who cannot find jobs in their own country to set down roots.

In theory, this short distance also enables Haitians, who are unable to find the health care they need in the small rural clinic of Tilori, to access it 25 minutes down the road in Restauración. And while many ultimately do, the process is not so simple. For me – a white American female – crossing between the two countries required nothing more than a nod to the guards resting lazily at each of the three checkpoints along the road between Restauración and the bridge to Haiti. But for Haitians without papers, the short trip can be difficult and costly, with each guard usually requesting a “fee” of $100 pesos (about $2.30 USD). Even getting my Haitian translator back into Restauración, where she has lived and worked now for several years, was often a struggle. Although it never ended up costing us anything, the exercise almost always put my Spanish to the test.

Sadly, the journey was not the only deterrent. Many of the Haitian women I spoke with, including those who lived in the DR, were often met with such discrimination at the Dominican health centers that they regularly delayed or even declined seeking care. For these women, proximity to health care services did not translate to access.

HaitiOne Haitian woman I spoke with summed it up this way: for a pregnant woman facing complications during labor, access to emergency obstetric services requires a four-hour drive to the closest Haitian hospital, or an expensive commute through the DR where care is not even guaranteed. With vexation, she added, “What kind of decision is that?”

Written by: Tara MacDowell, MPH

MPH/MSSP candidate Savannah Knell’s White House Experience

MPH/MSSP student Savannah Knell spent her summer at the White House working in food policy. She noticed that with the growing obesity trends, topics such as food access, physical activity patterns, and unhealthy dietary habits are of greater interest to the research community. Many studies now focus on school-based studies to better understand childhood obesity trends since many children receive a significant portion of their meals at school.

In addition to research, legislation like the Healthy, Hunger-Free Kids Act of 2010 demonstrates a political approach to help children get the nutrition they need to learn, grow, and succeed in school life. A highlight of the bill was giving the USDA the authority to set nutritional standards for all foods sold regularly at schools during the day, including vending machines (White House Task Force on Childhood Obesity, 2011).

Overall, the combination of policies addressing increasing healthy food access, nutrition education efforts, and physical activity opportunities prove to be helpful in combating the epidemic of childhood obesity.

Read Knell’s full article here.

Substance Abuse, Violence, and HIV: Changing Environments to Reduce Risk

Conversations around Cultures of Health: Substance Abuse, Violence, and HIV: Changing Environments to Reduce Risk

Thursday, October 16th, 5:00-6:30pm
Alumni House, 3533 Locust Walk
Wine & Cheese Reception. | RSVP

Philippe Bourgois, PhD is the Richard Perry University Professor of
Anthropology and Family and Community Medicine. He has been conducting
participant-observation fieldwork in the US inner city since 1985 with NIH support
on substance abuse and HIV in the urban United States. He has published over
150 articles in public health, the humanities and the social sciences analyzing
social inequality, urban segregation, labor migration, ethnic conflict, violence,
homelessness, substance abuse, and poverty, interdisciplinary methods, HIV and
structural public health interventions. He is best known for his award-winning
books: In Search of Respect: Selling Crack El Barrio (Cambridge University Press)
and Righteous Dopefiend (University of California Press). In 2013-2014 he received
a Guggenheim Award and an American Council of Learned Societies Fellowship to
work on a book manuscript entitled, Cornered, based on five years of fieldwork in
the heart of North Philadelphia’s open-air heroin and cocaine markets.

Brian Work, MD, MPH is Internal Medicine Faculty at the University of
Pennsylvania Perelman School of Medicine and co-directs, attends, and teaches
at the United Community Clinic at First African Presbyterian Church in West
Philadelphia. Dr. Work focuses on community outreach, community public health,
and providing free and low-cost care out in the community. He has extensive
experience in substance abuse treatment and research and is an integral part of
Prevention Point Philadelphia and its Street Side Health Clinic. Prevention Point
Philadelphia is the only sanctioned organization that offers syringe exchange in
the region and has won an Impact Award from GlaxoSmithKilne for working in the
community to help reduce the spread of HIV.