Power in public health

Power is one of those big, ambiguous concepts that come up over and over again in politics, geography, and international development. One can not truly understand the world and how it works without spending a good while thinking about how large the role of power is.

I have read a great deal about power in the last few months. In fact, I wrote an essay on the interplay between power and security in development. It is clear that rationality is only a small part of the process of policy making. Self interest has a strong tendency to overrule rationality, which is why it is so important to acknowledge who has the power to  influence decisions made on behalf of nations, or large global organisations and corporations. How they use their power to influence policy is equally important.

The common definition of power is that it is the ability of one person/group to make another person/group do something they would otherwise not do. How this is done varies however and often the use of power for this purpose is not obvious to those being influenced or made to do something.

I was reading about the role of power in health policy while sitting in a café in Edinburgh. It occurred to me how much goes on in the world that we never even realise. In the half a year that I have been studying at the University of Sheffield I have read countless articles and books that have been incredible eyeopeners for me. Power is something I was vaguely aware of, but did not really understand until now.

One thing I have come to see is how dishonest and insidious the actions of the most powerful in society are. That’s not to say I was completely naïve and blind to it, I simply had not realised how extensive the problem is.

In Buse, Mays and Walt’s Making Health Policy there is an incredibly interesting discussion of the different kinds of power. Two of them really jumped out at me.

1. Power as Non-Decision

This is a method of sorts where those with power are able to trick people into believing they have choices, when it fact only the choices that are acceptable to the powerful are made available. This can be done for instance by drawing the public’s attention away from important issues by emphasising other issues. Such as by using the media to drown sensitive subjects with discussions of other, less urgent ones.

As an example of this they mentioned the tobacco industry and its influence on the World Health Organisation. In order to draw attention away from non-communicable diseases that could potentially have been caused by smoking, such as cancer, they used their ‘influence’ to direct the public’s focus on infectious diseases.

It made me think about the Millennium Development Goals. They have been criticised heavily for being too narrowly focused on infectious diseases and other health issues that are mainly a concern in the poorest developing countries. Meanwhile public health issues in many middle income countries, and even developed countries, are largely neglected.

While diseases such as HIV/AIDS and malaria are important, what is more urgent is to provide quality health care to all. With strong health systems these diseases are much more easily tackled and more people can be approached with preventative measures. In most cases a strong health system requires that the state take action and increase its public spending. This goes against the claims of neo-liberalists that the free market is the only way forward. A greater focus on state intervention, public spending and…god forbid…a bit of socialist welfare, is not in the interest of the global elite.

So is the purpose of this skewed image of the global health priorities a way to draw the focus away from the real problem? That the system simply isn’t working? I wonder. Meanwhile they have convinced everyone that they are doing something great, something so good, that few even question whether it is at all effective. This way they can throw lots of money at particular issues and make themselves feel like they are doing something…while avoiding making the hard decisions that are more likely to lead to real change, real long-term change.

2. Power as Thought Control

The media is not only used by the powerful to divert people’s attentions, but also to shape their thoughts and influence their values. As they put it in Making Health Policy:

Lukes argues that A gains B’s compliance through subtle means. This could include the ability to shape meanings and perceptions of reality which might be done through the control of information, the mass media and or through controlling the processes of socialization.

As an example they mentioned how widespread and popular so-called ‘alternative medicine’ has become. The market is drowning in all sorts of ‘medical’ products that no one has been able to prove to even work. The purpose is to make money, and if people get hurt in the process, who cares? Right?

It is not just alternative medicine though, it is everything. A large part of the media does not care whether the information they spread is factual. They want to sell, and controversy sells. Would Andrew Wakefield’s claims that the MMR jabs cause autism have become so widely accepted if it were not so much easier to sell papers that say “DANGER DANGER” than ones that say “no, everything’s fine actually”? Wakefield’s claims have never been confirmed and it has even come to light that he was making lots of money from it.

This is where the issue of authority comes in. People are quick to accept the authority of doctors and scientists because they believe them to have superior knowledge. Most of the time they do, and I honestly believe that the vast majority of them are doing their best to make the world a better place. But it also means that it’s fairly easy for the less honest to get wrong and even harmful information out there. Especially when backed by powerful people with lots of money who have a vested interest in deceiving people into spending more money. Fortunately the good guys do their best to make it right, to correct the information, to fix it. It would be easier however if they did not have to fight a largely corrupt media world which is more interested in news that sell than news that are true.

Who can we hold accountable for this?

Kenya field trip, part 2

The next four days were spent with our guides walking around the village doing research. Farida and I interviewed a lot of people: households, the village doctor, the chief, and the school headmaster. We also took samples from the river to test for faecal coliforms, in order to assess its safety.

There were some frustrations, all of which were very educational. Here are a few examples:

• We had trouble getting people to agree letting us record interviews. A lot of them were very uncomfortable with the idea of being recorded, even though we explained it was only for the sake of getting the information right and that we wouldn’t do anything funny with the recordings. This often made it a bit of a challenge to interview people and get everything down. This is something I now know that I need to prepare  myself for in the future. I hadn’t even thought about this being a potential problem.
• There was a bit of a debate because in the past people who had been interviewed had been given gifts in return for their participation, such as sugar or soap. From this year on we’d been urged to stop doing this for ethical reasons I can’t be bothered to get into here. Farida and I had some people refuse to talk to us because of this. Fortunately it was only to begin with and once word got out people more or less stopped bringing it up. I felt really guilty about it, but at the same time the logic behind the decision is sound.
• The water sample testing took a lot more time than we had anticipated, so I had less time to do interviews with households. I had been hoping I’d be able to get enough people to do at least some statistical analysis, but I ended up not having enough people to do that. Again this taught me to be better prepared.

According to my results, although I haven’t begun the analysis of my data, all the people in the village get their water from the river, except for a few who cross the river to get to a borehole pump some distance from the other side of it. The only people who do this live close to the river so there isn’t that much of a distance. There are three locations on the river where people get their water, depending on how far away they live. Some of them have to go to the river 2-3 times over the day to get water and it takes them up to 2 hours every time.

There are two boreholes in the village, but both of them are broken. One since last summer, and one since December. This means that instead of getting safe water from the boreholes, people have gone back to the river. According to our water samples the river water is not safe for drinking, so this is a serious problem. The problem is that they do everything else in the river as well as drink from it. They bathe in it, they wash their clothes, they fish, they pan for gold, and they play in it.

I had no more problems with the heat after that first day, but the heat did get pretty intense at times. I started burning soon after we got there, much to Thomas’s confusion. At one point he pointed at my arm and asked if the red was because of the sun. I told him yes and that it was quite painful. It was strange talking with someone who isn’t familiar with sunburn.

On the 22nd we wrapped up our research in the morning. Farida and prepared samples of water from the field centre’s borehole, because according to another group that had been there the water wasn’t safe, and we spent the morning getting as many interviews as we could. After lunch everyone got together to talk about our research and prepare for presentations of our findings which we had to do later in the day. People from the village came around and put together a sort of market for us. We spent some time just walking around buying a few things in an effort to help the community. I bought some beaded jewellery and two gorgeous bowls.

In the evening we presented our findings to the chief. It was wonderful to be able to tell him what we’d been doing there and he graciously accepted all of it. The water situation was made clear to him and we were told that efforts would be made to bring an engineer into the village to fix the boreholes and to collect money to put together pipes that would pass water from the boreholes to the villagers so they would be less reliant on the river. It was great because it made me feel that despite everything what I was doing there had led to something positive.

That night a goat was slaughtered for us. Fortunately we didn’t have to actually witness it. I didn’t actually eat any of it because I’d just spent the whole time there walking around absolutely adoring all the goats, so I wasn’t exactly excited at the prospect of eating one. There was vegetarian food on offer as well, so that was ok. A group of dancers from the village arrived after dark and danced and sang for us. It was very funny because occasionally they would run into the group and drag some people off to dance with them. I was able to elude capture. I know that makes me a massive bore, but at least I got some pictures! :P

We got up early on the 23rd. Farida and I checked the water tests for the centre and figured out that as far as we could tell there were not faecal coliforms in the boreholes. At 8am we left Marich Pass and drove for 9 hours back to Lake Elementaita. We stopped for a picnic at the equator, which was awesome!

This time when we got to the Lodge it wasn’t just very nice, it was HEAVEN! We were met at the doors with hot wet towels which were very welcome. We had a really nice dinner that evening and entertained ourselves by playing pool or watching TV. It was incredibly sweet. I also absolutely adored getting a hot shower for once and being able to wash of some of my underwear for the trip home. At this point everything I had was dirty and dusty and I felt absolutely filthy. I was able to pack most of my stuff before I went to bed in the evening because I knew we’d be getting up early the next morning for the game drive.

The 24th was the longest day I have ever experienced. We had to get up at 5am so we could have breakfast and head out at 6am. The sun rose while we were on the way to Lake Nakuru National Park. The drive through the park was awesome. The mini buses had roofs that we could lift up so we could stand on the buses and take pictures. It was really cold to begin with, but once the sun was properly up it warmed up quickly. The first animals we saw were buffalos. There were a lot of buffalos. Shortly after that we saw some lions from afar. I wasn’t able to get any pictures of them, but I had binoculars so I could see them pretty well. One was carrying just killed pray, which was super cool. Soon after that we saw a rhino asleep in the trees. We were so excited and eventually it stood up and walked all the way over to us and crossed the road. It was funny how excited we got at that point, because we actually saw quite a few rhinos later on.

Over all we saw zebras, several kinds of antelope-like animals, rhinos, baby rhinos, giraffes, lions, buffalos, lots of baboons, all sorts of birds, flamingos, and pelicans. I might have forgotten something. It was a huge success and I’m so happy I went. Oh yeah, we also saw some giraffes mating and a rhino-mom accidentally shit on it’s rhino-baby’s head!

We arrived back at the lodge around noon and had lunch. Before lunch I went and showered and finished packing. So after lunch I was completely ready to leave. We left at 2pm. Two of the buses went straight to the airport while the other two dropped the people who were staying on in Kenya off at various places. Unfortunately we were at the airport at 5pm, but the plane didn’t leave until midnight. Let me tell you, waiting for 7 hours at an airport is seriously uncool.

After sitting around talking and wandering about a few of the girls and I sat down on the floor and played Good Morning Queen. It was hysterically funny because we were so tired and we kept messing up and it was just a mess.

The plane ride back to England was looooooong. I had a sleeping pill so I slept for most of it, but I kept waking up every now and then and just wanting to cry because I was so uncomfortable. I sort of remember waking up enough to eat at one point. If anyone had been watching me then it probably would have just been funny. Eventually we made it all the way to London. I took the underground to St. Pancras with a girl called Kat. She had a train to catch at 9am and I had another one to catch at 10am. I was half brain dead with sleepiness the whole way home, but I made it there shortly after noon.

So that’s that. Kenya. :)

Kenya field trip, part 1

Ok so I went to Kenya, spent some time in a field study centre in a very poor, very remote village in the rift valley. I did some research, it was very hot and I saw lots of goats. I also went on a half day safari and saw wild animals.

Umm. You’re saying this isn’t enough? Oh fine, I’ll write a proper post about this. *sigh*

My Kenya trip was packed full of “firsts” for me. The first “first” was simply the fact that I was using a rucksack instead of a suitcase. I tried to pack as wisely as I could and I think I was fairly successful at that. I made a list of things I’d need and I stuck with it. I also had to buy a lot of things, such as a first aid kit, a torch, candles, all kinds of medication, hand sanitizer, etc. All this I packed with as little clothing as I thought I could get away with. Turned out I didn’t really get away with it, I could’ve done with some more clothes.

Another first was the aeroplane. It was one of those huge planes with three rows of three seats. I’d never been on one of those. The plane ride was also incredibly long, 9 hours. I’d never done that before either. On the way out I sat next to two old ladies who were going on a safari in Kenya. One of them was terrified of flying so when we got quite a bit of turbulence over Italy she had a hard time keeping herself calm. The turbulence didn’t bother me, but I felt sad for her. Fortunately I had some sleeping pills so I was able to sleep most of the way.

The third first was Africa itself. I’d never been there before.

We landed in Nairobi early in the morning on the 16th of January. I felt excited and nervous at the same time, as well as absolutely exhausted. It was sunny and warm, and since it was 6 in the morning and the sun had just risen, it wasn’t too warm. We all piled onto these safari-mini-buses and drove through the city on our way to the Lake Elementaita Lodge. The ride wasn’t too long, only about 3-4 hours. I was tired and probably should’ve tried to use the time to sleep a bit, but I was too excited. I basically sat by the window and ogled everything I could see. What I saw wasn’t far from what I’d imagined, I suppose. The nature was a strange combination of green and very dry. I saw big houses built for rich people surrounded by areas full of rickety wood and iron sheet houses for poor people. There were a lot of donkeys and goats, and we also saw some zebras and baboons.

The Lodge was very nice. A lot nicer than I expected. In hindsight I am glad we had that day to spend in comfort before moving on. The surroundings were incredibly green and beautiful and we slept in these little houses spread around the main building. The food was excellent, the waiters were very helpful and professional and the pool was awesome. I slept for a bit before noon, spent some time by the pool, and then some of us went on a walk to the lake with a Maasai guide who told us a bit about the history of the land…and a lot about flamingoes.

I was exhausted that night and fell asleep the moment my head hit the pillow. At one point I woke up to my roommate Sabrina pulling the mosquito nets around the beds and I was so asleep I spoke to her in Icelandic. It actually took me a minute or two to realise something wasn’t quite right and to switch back to English.

We left early the next morning (17 January) on the same mini buses. The ride out to Marich Pass took about 9 hours. To begin with it was all right, but the further we went the worse the roads got. It was also interesting to see how much more pronounced the poverty was the further away from the main highway we got. We stopped twice, one for a few minutes on the equator, and then again in Eldoret for lunch. There was a supermarket there that we went to and it was a strange thing to experience because it was just like any other supermarket I’d ever seen. It didn’t quite make sense to me in all that poverty, but it was cool and we were able to stock up on some snacks and candy. Our priorities were flawless!

The last hour or two of the drive were really bad. The view was stunning, but the roads were horrifying. Reaching Marich Pass was a massive relief. We arrived between 5 ad 6 in the afternoon so the hottest part of the day had passed. We all slept in these round white concrete huts with straw roofs, and again I shared with Sabrina.

Before I got there I’d been incredibly nervous about bugs. When I first saw the hut I’d be sleeping in I had a minor internal panic attack. There was a mosquito net hanging over the bed and once I’d been given a mattress and everything I wrapped the mosquito net around the bed and tucked the ends under the mattress (thanks Lucy for that tip).

The first two days or so consisted of a series of fears I needed to face, such as using the long drop toilets, showering in a dark room where I couldn’t see if there were bugs or not, and actually sleeping in the hut. Bit by bit I calmed down and before long a lot of my fears were overcome. I found that sleeping in a bed completely surrounded by a mosquito net is actually quite nice. As soon as I’d climbed into the bed and closed the net completely around me I felt quite safe and slept easily. It was wonderful because I’d worried that I’d have trouble sleeping.

On the 18th, after breakfast (which was a strange semolina porridge of sorts), we were given guides to show us around. I was teamed with Farida because we were doing very similar research. I was going to look into access to water in the community and the differences between different households, distances and such. Farida’s research was more qualitative in that she was studying what people know about water usage and sanitation. Our guide’s name was Thomas. He grew up in West Pokot and knew he area well. He showed us all around the village. We realised that it was actually bigger than we’d thought. On our way in the day before we hadn’t seen much of it. We found out that the houses are well spread out around the main road that runs through it. According to Thomas the people who live nearest to the Moruny river are usually the most affluent ones, while they are generally poorer the further from it they live.

Shortly after we headed out that day I started getting a headache. It was probably a combination of being too hot and dehydrated, and minor caffeine withdrawals. After lunch a part of the group left us to go spend a few days in Mbara, another village higher up on a mountain nearby. The rest of us were taken to Sigor to see the weekly market. The ride over was quite bumpy so by the time we got there I was already feeling pretty crappy. We spent some time walking around the market and it was fascinating. There were so many people and animals all over the place. They were selling vegetables and fruit as well as traditional medicine, clothes, and beads. I saw a big pile of chickens that had their feet tied together so they couldn’t move. They just lay there breathing really fast and panicked. It made me very uncomfortable.

A few of us bought some mangos and some bought beads. It was a bit chaotic though. The people were of all sorts. Some dressed in clothes that are pretty regular (to me), but others in very traditional clothing. The most fascinating of them were the pastoralists in their colourful clothes, with so much colourful jewellery, and the bright red hats with feathers in them. They were beautiful. Here’s a picture I found of one of them.

There whole time we were there we got a lot of very odd stares. For the first time I felt like maybe I could understand what it must be like to be non-white in Iceland. It wasn’t a nice feeling. Thomas the guide had told me earlier that morning that the little kids there would joke about me looking sort of like a banana. It was funny, but I would only face this kind of scrutiny and amusement for a few days, while for many people they feel like this all the time.

After the market we went to take a look at Tikeet, another village in the area. Or well, we meant to. Some of the group went to Tikeet to do their research every morning. I didn’t envy them because it was difficult to get there. The drive from Sigor took a while and the roads were the worst yet. We stopped by a small hanging bridge over a river and then had to walk from there. It took us about 30-40 minutes to get to the Tikeet Health Centre (which we have been collecting money for, click the link to read about the fundraising efforts). At that point we stopped and didn’t go further. It would have been another 15 minutes or so into the village, but it was too hot and a lot of people weren’t feeling well. We were also running late and had to get back in time for dinner.

At this point I was feeling particularly bad and I was starting to realise that I was in danger of overheating. The walk back was very difficult for me and then the 1.5 hour drive back to Marich was torture. By the time we got there I felt very sick and was just about to lose myself in a panic attack. I stepped off the bus and one of the teachers, Dan, asked me if I was ok. I burst into tears. Oh god how embarrassing!

Deborah (another teacher) had me pour some water over my head and Dan gave me a rehydration sachet. I went to my room and took some painkillers. Unfortunately those came straight back up again. It seemed my stomach had decided it had had enough of all this tomfoolery. Eventually I was able to keep the painkillers down, drink a lot of water with the rehydration salts and then I slept until morning.

After this I made sure to add rehydration salts to my water once every day to be sure I wouldn’t be dehydrated and I had no more problems.

Click here for part 2.

Click here to see all my pictures over on Flickr.

Feminism, disability and fat acceptance

There’s very little going on right now, so I don’t have much to say. I was going to go to a lecture at the Reykjavík University today at noon. My thesis instructor sent me this announcement of the lecture a few weeks ago. It says:

David Sanders, Professor and founding Director of the School of Public Health at the University of the Western Cape, (U.W.C.), South Africa, is a specialist paediatrician with postgraduate qualifications in Public Health. He has almost 30 years experience of health policy and program development in Zimbabwe and South Africa, having advised both governments as well as OXFAM,WHO,UNICEF and FAO in the areas of primary health care, child health and nutrition, and health human resources as part of health systems development. He has published extensively in these fields as well as on the political economy of health, including on structural adjustment and development aid, having authored or co-authored three books: “The Struggle for Health: Medicine and the Politics of Underdevelopment,” “Questioning the Solution: the Politics of Primary Health Care and Child Survival” and “Fatal Indifference: the G8, Africa and Global Health”, as well as over 30 chapters and monographs and approximately 100 articles in peer-reviewed journals. In 2004/5 he was Heath Clark visiting lecturer at the London School of Hygiene and Tropical Medicine where he was also an Honorary Professor. He is also an Adjunct Professor at the Centre for International Health at the University of Bergen, and was a Visiting Fellow at the Globalization/Management Department, Institute of Population Health, University of Ottawa, Canada in 2005.

Dr. Sanders was on the Steering Committee of the United Nations Standing Committee on Nutrition from 2002 – 2006. He is on the editorial boards of and is a reviewer for several international journals. He was a member of the Knowledge Network of the WHO Commission on Social Determinants of Health. He is on the Global Steering Council of the Peoples Health Movement and was a managing editor of the recently published Global Health Watch 2. He is recipient of the Nutrition Society of South Africa award in 2002.

I didn’t go because for some reason I couldn’t fall asleep until 4 or 5 am and then I could wake up early enough to catch the bus and mom went out so I could get the car. The universe was clearly conspiring against me. I guess I’ll just have to find something dr. David Sanders has written and read it.

A friend of mine has been sharing a lot of interesting links of Facebook/Livejournal lately and I thought I should pass them on.

Five Geek Social Fallacies

Within the constellation of allied hobbies and subcultures collectively known as geekdom, one finds many social groups bent under a crushing burden of dysfunction, social drama, and general interpersonal wack-ness. It is my opinion that many of these never-ending crises are sparked off by an assortment of pernicious social fallacies — ideas about human interaction which spur their holders to do terrible and stupid things to themselves and to each other.

This is so very interesting and so very true and probably plays a large role in making geekdom a really difficult place to navigate.

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“I’m not like the others”: nice guys, self-flattery and the myth of uniqueness by Hugo Schwyzer.

Because “boy talk” in American culture so rarely focuses on romantic love, a large percentage of teenage guys who are romantically as well as sexually inclined may begin to flatter themselves with the notion that they are “unlike all the rest.” They do what all teenagers do: they compare how they feel on the inside to how others look and behave on the outside.

I had a conversation with my dad about feminism and how he feels men are being left behind in this battle. While women are fighting the idea that they all have to be so feminine, men are still in many ways stuck with always having to be so “masculine”. I told him that feminism and the fight for equality is supposed to be about all of us, the ubiquitous gender binary hurts us all and if men want change then they have to join the fight. He said something like “but in this era of political correctness men aren’t allowed to say anything, it’s so difficult to get started”. I pointed out that when women started fighting for their rights, it was difficult too.

To many men I think it seems like women have gained more because they are allowed to dress pretty much however they see fit, while men’s choice in clothing is much more limited. We can be strong, weak, “masculine”, “feminine”…but if men show any weakness they are “girly” and “sissies”. What they don’t realize is that this is an issue that touches us all, just the fact that men are sissies when they show “feminine” traits reflects the general attitude that society has toward women. If this is going to change we need to work together, not against one another.

Besides, women aren’t really allowed to dress how they see fit. A woman who is too “masculine” is often rejected as a “dyke” and ridiculed.

No, we don’t have equality, and if we want to get there we need men to help. We need them not just to help us, but to help themselves.

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Fantasy of Being Thin

Because, you see, the Fantasy of Being Thin is not just about becoming small enough to be perceived as more acceptable. It is about becoming anentirely different person – one with far more courage, confidence, and luck than the fat you has. It’s not just, “When I’m thin, I’ll look good in a bathing suit”; it’s “When I’m thin, I will be the kind of person who struts down the beach in a bikini, making men weep.”

My goodness, yes. I am terribly guilty of this way of thinking. I’ve told myself: “Once I’m thin I’ll have lots of friends”, “once I’m thin I’ll be more successful”, “once I’m thin I’ll be beautiful and everyone will want me”, “once I’m thin I can totally go to Hollywood and date Zachary Quinto/Chris Pine/whoever”, “once I’m thin I’ll be more comfortable with my sexuality”, etc. I’ve even worried that I’m too fat to work in developing countries because the heat would make me sweat a lot and I’d be so gross…yeah, fucked up.

Fat acceptance is about letting people be who they are and not hate themselves if they aren’t able to lose weight. There are fat people out there who are perfectly healthy and live a perfectly healthy lifestyle! We’re not all completely out of control pigs. I’m tired of hating my body and always feeling like my weight will stop me from being someone important.

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Disability terminology: a starter kit for nondisabled people and the media

This problem is not limited to the media; a lot of people struggle with disability terminology. People want to use the right word, but they’re not really sure what the right word is, and sometimes some very intriguing circumlocutions and euphemisms are employed in the service of trying to be respectful.

Very useful!

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Putting Gender on the Agenda

Biomedical research continues to use many more male subjects than females in both animal studies and human clinical trials. The unintended effect is to short-change women’s health care.

This is very interesting. I had no idea that there was such a big difference in the number of women and men (and female/male animals) in medical trials. It means that while a drug can be safe for a man, it’s not guaranteed that it’s as safe for a woman and that’s quite alarming. I also found the point about pregnant women really good.

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I think I’ll let this do for now.

My first degree!

So I have just about finished my first degree. Go me! I have finished everything, all grades are in and my graduation is on Saturday. Four days from now I will be a Bachelor of Science in Human Geography.

My thesis ended up being something of a pain. Due to anxiety I put off working on it for too long and then what I did wasn’t good enough for my instructor. I pretty much ended up writing the whole thing in about a week and a half. But I finished it and got a decent grade so all is well.

Here’s the abstract in English:

The aim of this thesis is to explore the effects that globalization has had on the emergence and spread of infectious diseases around the world since 1980. Theories in health geography, geopolitics and political ecology are used to illuminate this development. The conclusion is that emphasis on neo-liberalism and marketization in modern globalization creates and perpetuates inequality and restricts the access of the poor to healthcare and medication. Insistence on more productive production methods has an effect on the environment and nature and increases the emergence of new infectious dieases and increased migration has led to the spread of disease around the world. Attempts to react to the problem have remapped the borders of the world and even increased health inequality.

It’s crap, I know. :P Still, I learned a lot from writing it (mostly that I’m a dork and need to stop being the world’s greatest procrastinator) and my hatred for neo-liberalism has risen to incredible heights. Most importantly I realized that what I’m studying and what I have planned for the future is exactly right for me. I’m even more excited for next winter than I was before.

In September I will begin my post graduate studies at the University of Sheffield. The programme is called Master in Public Health in International Development (read about it here). In January we go on a field trip to KENYA!! I can’t even tell you how awesome that is! I’m going to have to work on my spider/creepy-crawlies phobia until then, otherwise I’m likely to be twitchy the whole time while there and not sleep at all. I’m silly like that.

For the moment I’m just working at a nursing home, trying to save some money. It’s remarkable how hard that is in the middle of a recession. Everything is so expensive it’s fucked up. I moved in with my parents to save on rent and phone bills and such. It’s been really nice, mostly because my mom is laundry-master-extraordinaire. I’m going to miss it when I leave and I’ll have to take care of my own laundry again. *sad face*

I leave for Sheffield in the middle of August. School doesn’t start until late September, but I have to arrive early to try to get a part time job. It’s only about 2 months away and I’m starting to get a bit nervous. Still, it’s going to be awesome!

School, parties and links!

So school has begun. I have a feeling that my schedule this semester is going to be kind of mad. I have two research projects, one for sociology and one for geography. The geography one is a group project and next month we’re going on a 5 day research trip to Vestmannaeyjar. Before then we have to prepare pretty much everything. Then I have three other courses (criminology, sociological theories, and image interpretation and remote sensing). So I won’t have time to slack off. Rest assured, I will definitely be slacking off anyway. I’m stupid like that.

Tonight I am going to a crazy tequila/singstar party. I’ve bought some Strongbow and white wine and I intend to enjoy myself immensely. How can I not? I will be surrounded by crazy slasher chicks who have no sense of shame. We have been known to discuss necrophilia, watch gay porn, and play Supernatural drinking games. We’re insane.

Then tomorrow I have to start packing. I have to clear out my apartment before Thursday and I’ve hardly begun. See? I’m slacking off already.

I have to go get ready, so here are some links to interesting stuff.

BartCop’s letter to republicans.

I’m sick of the way you try to destroy the whole concept of government. You’ve tricked the people into believing that government can’t do anything right, always being careful to exclude the army because you love your bullets and bombs but you’ve so destroyed the public’s ability to reason that they don’t even think of interstate highways, the space program, the national parks program, etc. Government is always great when it’s doing what you tell it and inevitably corrupt when it isn’t. Fuck you.

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Pfizer Agrees to Record Criminal Fine in Fraud Probe.

“When a drug is marketed or promoted for non- authorized, so-called off-label uses, any use not approved by the FDA — as was the case here — public health may be at risk,” Associate Attorney General Tom Perrelli said at a news conference in Washington.

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1/4 of teenage girls suffer physical violence, 1/3 sexual violence in relationships.

One third of girls age 13-17 have been forced or pressured into “unwanted sexual acts”, and a further one quarter have suffered physical violence by their boyfriends, according to a study by Bristol University and the NSPCC. A smaller number of boys reported being pressured or forced into sex or suffering physical violence in a relationship.

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FDA Draft Report Urges Consumption of Fish, Despite Mercury Contamination.

The Food and Drug Administration is urging the government to amend its advisory that women and children should limit how much fish they eat, saying that the benefits of seafood outweigh the health risks and that most people should eat more fish, even if it contains mercury.

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Interview with the author of Autism’s False Prophets, Paul A. Offit M.D.

It’s a statistic that’s quoted at parents constantly, almost casually: the rate of children diagnosed with autism in the United States corresponds directly to the increase in childhood vaccinations that’s taken place over the past ten years. Here’s the problem: it’s not true. Not only is there is no statistical correlation between the rise of autism and an increase in vaccinations, but twelve separate studies have shown absolutely no difference in autism rates between vaccinated and unvaccinated populations.

And here’s a bit of funny just because I love Zachary Quinto so much.

HOSTAGE: A Love Story with Zachary Quinto from Zachary Quinto

Bad science and research registration

I’ve been reading Ben Goldacre’s book Bad Science lately. It’s not only incredibly informative, but also entertaining and inspirational. I usually consider myself a fairly skeptical person, but I had no idea how much of what I’ve heard around me and in the media is pure nonsense. I am now even more encouraged to be more critical about everything I hear.

But the book is not just about the media, but also the less than honest methods of some researchers, especially the ones whose work is intended to make money. One issue that really bothered me is how many of the studies conducted are never published or even registered. If the outcome isn’t what they researchers hoped for then it’s simply discarded. A negative outcome isn’t useless information. Whatever you find out, be it what you expected or not, is valid information and should be easily accessible to all. Especially when it comes to medical trials.

I have been thinking about my thesis for the last few months. I will likely study whether public health in Iceland has changed in the last few decades since globalization reached Iceland. I’m not 100% sure how I’ll go about it, but I will likely look at statistics of particular diseases and see whether they have changed significantly. I took a course last semester where for one project we had to come up with an idea for a study, plan it and then present it to our classmates. Some of them asked me “what if you find out there hasn’t been any change?” I got the feeling that they thought that if the result were no then the study were useless. I don’t think so. It would mean that something’s been done right in the Icelandic health care system and that’s important information.

In light of this I find this blog entry interesting. Larry Husten at Cardiobrief says that mandatory registration of clinical trials hasn’t worked as it should have.

They found that less than half the trials (45.5%) were adequately registered, which they defined as being registered before the end of the trial and with the primary outcome clearly specified. More than a quarter of the trials were not registered at all, while 13.9% were registered after the study was finished. In the trials that were adequately registered, the French investigators found “discrepancies between the outcomes registered and the outcomes published.” In the papers where they were able to assess the discrepancies, the investigators found that “statistically significant results were favored in 82.6%.”

So it’s clear that even initial attempts to address the problem have not been very successful. Hopefully a stricter policy will be implemented in the future.

I’m still here!

I’ve been quiet now for over a month. Sorry about that.

I went to Brighton for 4 weeks. I lived on the University of Sussex campus, learned a lot about global health and met lots of awesome people. Mostly Americans.

I really liked how the classes were set up. We had two seminars each week and instead of the teacher having a long lecture we simply talked about the readings. It encouraged us to read everything on time and to think about the subjects. It was also a fantastic English training for me.

I learned that the Cuban health care system is awesome, the Chinese one is worrisome, Michael Moore is brilliant, the pharmaceutical companies are disgusting, and that AIDS is a bigger problem than I had realized. My interest in this subject is now greater than ever.

I wrote a paper on why the developing countries have had trouble accessing AIDS drugs. It is here if anyone’s interested in reading it.

Brighton is a wonderful city and I really enjoyed my stay, except for the room I got. It was kind of disgusting. There were moths and spiderwebs everywhere and I was twitchy all the time. I need some kind of phobia therapy. There were also bunnies though! Bunnies!! And I saw foxes too! I went on a trip to Stonehenge and Bath, which I enjoyed very much.

During my time there I also went to Sheffield and met with the head of a masters programme I’m interested in. It’s called Master in Public Health in International Development. We talked about the programme and she showed me around the Geography building. I’m going to put my application together this fall and send it in before Christmas. She said I will probably get a conditional acceptance and will get in if my final grade is good enough. I see no reason to think it won’t be. I’m terribly excited.

Now I’m home and school has begun. I have some interesting courses and some not so interesting. I’m not terribly excited for Image interpretation and remote sensing and Sociological Theories is going to be a lot of stuff I’ve already covered for the most part. I have one research project for sociology and one for geography (with a week long trip in October). Then I added Criminology just for fun. I’m looking forward to that!

I also have a job. I’m going to be working at a nursing home every other weekend. It’s not the grandest of jobs, but for some reason I’ve always kind of enjoyed doing this sort of work. I was working this weekend and it was really nice.

So. Now I just have to start being better about coming up with stuff to write here.