Wednesday 24 February 2016

Tom Rogers Muyunga-Mukasa, APHA

               One day, I happened to be walking by a lane to stretch my legs. While I looked at the surroundings a dazzling light from a far kept glittering. This took away much of my attention and I missed my turn. But, alas! It was a blessing in disguise. For coiled in a deadly s-shape was the African cobra.  It must have been chasing a rat which I saw earlier crossing the road in a rather dazed way. I never gave it a second thought, as these things happen in this part of rural Uganda. Up until then, I had not heard the hissing and rhythmic slashing sounds against the grass. My thudding footsteps made much louder by my gumboots must have saved the rat, but got in the way of a hairy meal for the snake.
                  As if from nowhere a speeding motorbike passed me by before I could point out the big black and green snake. The vroom-vroom sound and the smell of fuel must have scared away the snake which crawled so fast back into a nearby anthill. The anthill, the size of two minivans, harbored a snake few had ever seen. This anthill was as old as our village. I continued walking until I came to a turn which led to the village chief's home. I told a child at this home to switch off a light that was left on. Electricity supply is irregular in this area and so it is common for people to forget to switch off security lights. That is what I saw, from a distance, as a glitter. This was the chief's home.
                  Life is like that most times. It is both a journey with objects that fascinate or scare. Life is a destination too. Journeys get us somewhere. I now live in USA and I intend to get the highest qualifications of the land in a course of my choice. As I talk now, I am an APHA. Who knows what tomorrow holds? Yes, la luta continua.  Tom Rogers Muyunga-Mukasa, APHA.
TOM ROGERS MUYUNGA-MUKASA, APHA

Global Health and USA's expanding role

Public health in the 21st Century will be tasked with protecting us from various diseases or life threatening conditions deriving from: climate change; emerging diseases; bioterrorism; racism; stigma; prejudice; and political dilemmas. Therein lie USA's expanded roles. Therein lies the new foreign policy code. 




Public health practitioners of the 21st Century must look at public health of the globe. They must be in position to understand the complexities of cultural diversity, e.g.,different generational, economic, professional, ethnic, religious, linguistic background, gender, gender identity, sexual orientation, stereotypes, prejudices, physical status, conscious bias, unconscious bias, structural bias, enjoyment of access to resources, access to opportunities, access to options, safety from violence,  affordability of housing, civil rights, access to food, access to jobs, opportunities for job trainings, access to recreation and readiness to be  a compassionate provider.

Tom while in Kenya, 2009.


Many clients and communities face bias and discrimination when they attempt to access health and social services and , as a result, receive fewer services and services of poorer quality (Berthold, T. 2009). In order to provide public health services, government has concrete plans such as enacting laws, enforce laws, provide financial support and oversight to ensure promotion of health, prevention of diseases and instituting a preparedness mechanism.The most important new or expanded roles for public health occupations in the 21st century will include:


1. Strengthening the public health activities framework that is interlinked by a network of federal, state and local public health agencies with emphasis on referral mechanisms and oversight processes.
2. Ensure a reporting mechanism that dovetails into the overarching design where: the contribution of USA to international health-related interventions continues; the legal foundation gives gives primacy for health concerns to states; allows the federal government to promote consistency and minimum standards across the 50 diverse states; and a practical foundation of LHDs serving as the point of contact between communities and the three-tiered government.
3. Shifting mobilization tasks to advocacy entities at community level as a means of having a pulse on changing needs, resource needs and meeting public expectations.

Tom meeting with a Community Health Worker in Kisumu, Kenya circa 2009.

4. Investing in early warning mechanisms for threats from fires to bio-terrorism. There will be need to have a contingency for fire hazards now that the globe is getting warmer. This will mean wildfire-prone geographical zones like Mid-Western and California will have more established fire departments. The quarantine points at border entry points, airports and ports need to be strengthened now that there is more likelihood for bio-terrorisms, hostility and acts of sabotage against the U.S. or any other nation by terrorists and enemies (www.nytimes.com). 
5. Public health practitioners reaching out to the indigent or marginalized. This will rely on the work of local health agencies. These will in turn report to second tier government levels and different organizations that form the backbone through which the power to protect the public’s health is possible.
6. Providing training and promoting competencies for public health professionals in the 21st century mostly in these areas: conducting essential public health services; legislation; regulation; policies; and the ability to negotiate,  justify public funding for many public health initiatives. For public health to be perceived, such essential services as are relevant: monitoring the health status of the population; diagnosing and investigating problems deemed hazardous to the public’s health; educating the population on health issues; mobilizing communities to act on their own health issues; developing policies; enforcing laws and regulations that protect the public; linking people to health services; ensuring a competent healthcare workforce; evaluating the effectiveness, access and quality of health services and researching to continue progress and innovation in healthcare (Turnock, B. J. (2016). Essentials of public health (3rd ed.). Burlington, MA: Jones & Bartlett).

The Green cover needs all the care we can give it.

7. Use of Technology, which will enable complex research to be translated into action in a faster and flexible way. Technology can be used in many other forms as well. One way is establishing a centralized health management information templates that can be used to report for instance compliances to the Healthy 2020 vision and mission. Events in which equity and equality are addressed can be captured at local, state, regional and federal levels. Racial biases are shown to be a part of the social structure of medical practices at both macro and micro levels (Centre for excellence in health care journalism). Use of web-based platforms to share information can help improve on coverage of what works and who is served. Public health will be a means for America to deal with the hot topics that focus on: race, culture, ethnicity, lifestyle, health status and health care in America. This might be the great quest of technology as well. Through technology it will be possible to level the health care playing field. Socioeconomics, individual racism, and institutional racism that represent the three predominant pathways to differential treatment for diseases will be targeted and redress provided. Reporting mechanisms will provide common indicators used to gauge quality of life for women and men irrespective of their gender, sexuality, race and social status.  Compiling reports into a format that can be disseminated to all concerned is another good use of  print technology and the world-wide web. In this format the media can be relied upon to make information available or the applicability of the information by society in form of case reports/studies or any format that is reliable for dissemination. However, newsprint, radio and TV tend to tap into our anxieties focusing on trivia. “The CDC has had to contend with bogus reports of imported banana carrying flesh-eating bacteria, drug addicts placing HIV-infected needles in pay coin-return boxes, virus soaked sponges arriving with the mail,”(Drexler, M. 2010). 
8. Understanding the need for post trauma stress counseling and care arising from the link between terrorism, massacres and resultant traumas. A global nightmare envelopes the world every time wars, genocides and terrorist attacks occur anywhere in the world. The rallying call that brings together nations ready to do rescue activities is to profess solidarity with the suffering nations. Rescue efforts are made by nations. This was seen after September 11, 2001, in UK, in Uganda, in Tanzania, in Kenya and most recently in the 10th district of Paris where the most recent attacks have occurred. The San Francisco editorial has this to say, “France’s loss is our loss. Its grief is our grief. And its fight to counter the forces of inhumanity is our fight”  (San Francisco Chronicle, Editorial, November 14th, 2015). 
9. The effects of political pronouncements such as the recent debate on mass deportations sends trauma shocks to those who are  not documented yet they many have lived in USA all their life and some are employed. These people may end up not attending social services for fear of being hounded and put on hot lists.
 10. Establishing a structure of international partnership to deal with climate change, neglect, poverty and famine  at a global level which in turn make humans and in some cases livestock vulnerable to influenza, Legionnaires’ disease, Lyme disease, toxic shock syndrome, E. Coli 0157:H7, STDs, Ebola virus, AIDS, severe acute respiratory syndrome (SARS), H1N1 influenza (Drexler, M. 2010). 
11. Understanding the increasing relation of chronic low-level inflammation, wide range of common debilitating disorders, stealth infections, deadly sepsis, how to balance use of antibiotics and inflammatory-quashing steroids. Research findings recommend Mediterranean style diet for those suffering from inflammatory disorders (Sachs J.S., 2007).
In the 21st Century, stigma discrimination, bias and prejudice will be the issues that need addressing. This in turn will clear the way for addressing neglect, poverty and famine. In situations where equality, respect and dignity are promoted, proper protection of life and ensuring individual well-being will be achievable.
REFERENCES:
1. Berthold, T. 2009. Foundations For Community Health Workers. San Francisco, MA: Jossey-Bass.
Centre For Excellence in Health Care Journalism. 2006.
2. Drexler M., 2010. Emerging Epidemics: The Menace of New Infections: H1N1 Flu, SARS, Anthrax, E.Coli.Penguin Books.
3. http://www.nytimes.com/2015/11/15/world/europe/strategy-shift-for-isis-inflicting-terror-in-distant-lands.html?emc=edit_th_20151115&nl=todaysheadlines&nlid=60949333&_r=0
4. Sachs, J.S. 2007. Good germs,Bad Germs: Health and Survival in a Bacterial World. New York, NY: Hill and Wang.
6. Turnock, B. J. 2016. Essentials of public health (3rd ed.). Burlington, MA: Jones & Bartlett. 

Monday 22 February 2016

Of the crystal ball, palm reading, astrology, voodoo, sorcery, witchcraft, weather man and being a Godly infant black man!


                     My heart pumps with excitement, for I am part of the world that treats me or sees me as a human being.  A world where the immediate infrastructure allows me to work hard, read hard, rewards me well and ensures I pursue what is known as shareable happiness. Now, I have to learn to live in this city. I have to be street-wise. I have to socially adjust and speak Spanish and English like they do.

                     I am mostly informed by a christian religion and a western worldview of an African's self actualization. I have been reduced to an un questioning-brainwashed black African who shoulda/coulda/woulda understand that anything African is devilish and evil. Everything Arabic, Judaistic, Indian and everything western is white and therefore Godly.  I am led to understand that my way to heaven is to follow anything Arabic, Jewish or white. I am a subject of a system that ridicules my black skin. I am supposed to remain that way and all who give me praise do so because am staying in line. Their line! Age wise, I am 20, 30, 40, 50... years old. But as a black/negro man, I am an ethno-cultural diaper-loined toddler.

                    As a black/negro man I am aware my ancestors believed in productivity; they lived in balance with nature (well, in a way as long as the lion and leopard did not eat their livestock; and had enough space left to dig  shallow pit stops); they engaged in negotiations and tolerance rituals (with a little bit of war here and there); they produced and provided foods and ensured nutrition for all; they lived in harmony with the cosmos; and respected death as a natural stage, a passage into after life. They shared this in conversation and work. They rather talked to a snake trance-wise as they chased it away than kill it. They took time to type poisonous spiders, lizards, frogs and snakes and had antidotes for such poisons. They knew which tree to use frequently and one to avoid (like the poison oaks).


                     I was walking by a long street with beautiful Victorian houses lining the asphalt streets. On one house was the sign "your palm reader at arm's length, 8am to 9pm, Tuesday to Friday only." Before I woke up this morning the weatherman (never mind even if it was a PBS's lady presenter of the weather forecast reading into the weather's future for the next 7 days) said it would be sunny in the morning but downcast later in the afternoon. The forecast looked at the rest of the week and it got me thinking and thanking. God's gift to humanity via intellect, ingenuity and tech advance. I wondered if the rainmaker would be equally accepted were I to tell about it to my friends here.


                  I wondered about the African diviners, soothsayers, voodoo man or voodoo woman. Where have they written and kept their knowledge? Yet, the public library I frequent has tomes and more tomes on skills of stargazing, reading the stars, crystal ball consultation, astrology and palm reading. Courses and seminars are dedicated to this. Voodoo? Nada! Voodoo is evil and devilish. Voodoo is black. I am told by those who have been in heaven that even there, the angels are white and devil is black! As long as I know that, live by that I am considered mature. But, as long as I question that then I am out of line. In that heaven, the lion and sheep will play with each other's paws. The lion will open wide its mouth and the sheep will count the number of the teeth in the mouth. But, the black devil and white God will not reconcile in that heaven!

                   I wish I had the same clarity to type the grass; the trees;  the birds; the worms; the butterflies that flutter and remember the trails in the woods as my black fore-ancestors. It is amazing that the crystal ball, palm reading, astrology and weather man are symbols of western world liberty and a pedigree culture but my yearning for an indigenous African black man's culture that has witchcraft, voodoo, sorcery and other objects get in the way of my becoming more Godly. I am still the draped-in-my-diapers ethno black man!