gOttawaNotes
aNormal200907.dotm; ; ;
MoliehiKH@gmail.com
mChopra@unicef.org
Smita spakhale@ohri.ca
Carys Carrington rys_11@hotmail.com
"Co-H 20100919
CC Fran & John Tanner
Attendees:
Equity & associate members
Jane
Mary-Ann&Steve from 1st time
Stephen facilitator
John,Julia&Jamie
Diana
Tess
Steve&Laurie
Roger&Stephanie
Patrick&Kathleen
Dawn&Liz
Dave&Lauren
Mtg: common house activities
Diana to work with Ronnaye on web.
Prioritize rooms & activities.
Almost unanimous for common kitchen & dr; also for all individual washer hookups plus common - m'be in
mudroom.
Adjacent to common space, fire-pit, bbq, ourdoor cooking & eating area.
Q: computer networking, natural foods - homemade wine, hot tub/sauna, pool. Enough meeting rooms,
greenhouses / coldframes.
Atrium, possible waterproof roof allowing dry access to common room.
Quiet areas, youth, mags.",
"Shops $=buy
Lond drugs ipod charger
Bus pass
Milk
Marg
Meds
Sierra mix
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Powd milk?
Bread, $eggs, $camemb
Spinach
Edam
Ice cream
Grapes
Marg
Chock
$sierra trail mix
$tamsulosin
HCl thiazide
$Oat bran
Fish oil
Apples
$Nect,ine
Jam
P-nut but
Bread
Rolls
'Sprouts
$MIlk
Froz peas
$Coleslaw
$gravy
Asian confection
crispy dried fruit
$green onions
Mint moose track ice cream
Fruit
$Granola
Sliv almonds
Brazil nuts
Pecan fragments
Peach cider
Powd milk
Financial"
"5 min to-do
60 30 Finast
70 20 Rabep
50 40 tamsu
87 3 metf
10 80 HCl thiazide
83 7 venlafax
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Paul Pollock design for other 90%
Pater noste cape
Val 2pc I'd 1pix
Cantaloupe
Matthais zeller memento
Susie & @@ & Robert
Lawn
Wifi
Cable TV
Mud
Insurance
Lease
Conveyancing & invoices
Warranties
Strata permit
EMAIL
Dale Rhodes",
"Bring to Seabeck",,
90040 vigilance 9004
$75k
To Seabeck:
Bedside light*
Granola spoon
Doormat
Large clock
Food consolidation container
Hand towel for drying bowls
Ice chest",
"Available TV channels
To 59, 64-68, 83-96, 106, 118(vsn) -121, 133, 135, 138, 143 (144-159 sports), 165, 175 (Alj), 179 (RT Anal),
180,",
"5th Dimension
Imagine a universe that makes sense
No logical inconsistencies (like action at a distance, uncaused events, entities that neither exist nor don't) nor
singularities, like the limit to the speed of light.
There never was nothing. No such thing as empty space, nothing happens between events. No time passes, no
distance is traversed. No such thing as solid matter, only repulsive forces.
Electromagnetic and gravitational forces cause different trajectories for magnetic vs non-magnetic materials to
follow in the same space-time coordinates. For each entity there is a unified field within which it travels in a
straight line at constant TIME-UNIFIED FIELD. Spherical curvature for gravity vs hyperbolic curvature for E-M
document1 2010-11-06: svd 2/8/2016 3:06:00 AM, prtd 2/8/2016 3:06:00 AM
3/13/
in an orthogonal dimension. Think of them as refraction - non-instantiating interactions, not observable events for
the interacting particles.
The observed behaviour, as revealed at the level of the ultramicroscopic, and galactic levels, including special &
general relativity, emerge logically and naturally from the underlying structure of reality.
What we observe arises naturally from the structure of reality, and the limitations of our sensory and data
processing structures.
The structure of the reality, behind what we perceive, has a convincing and elegant simplicity.
CC Fran & John Tanner
"Books and movies
BOOKS
Little bee (Nigerian)
Idiot Dostoevsky
MOVIES
Winter's bone
Secrets in eyes - inability to cope with tragedy cements a life-long disaster
Antonio das Mortes
Toy story 3 (downsizing moving on, growing, letting go)
Up
Avatar - theology, panenthism
Eat love pray shallow & self-serving luxury as path to enlightenment. Compare destructiveness of inability to
forgive self in inception
TV Friday nights lights - football
MUSIC
Steve Earl's CD",
"Songs
Sweet forget me nots
Manzanar
Providence ferry Joe vharron
Sleepless sailor
Logdrivers waltz
Chestnut tree
Dreaming my dreams of you
Augustus & Cathrine
The idea of north
Swimming to the other side
Song for a winters night
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Love comes to th simple heart
Early snow
Chestnut tree
Bramble and the rose
Song for a winter's night
Belle of Broughton
Coming home
Deep peace
Mendocino
New year's eve
Who will watch the home place
Crossing the bar
One small star",
"CCGH20101031AM",
We WILL get there. NAm consortium of universities for global health globalhealth@mcgill.ca
Noon in capitol room
James Orbinski Dignitas Intl. Trains non-medical informal health workers for community care - nb in Malawi.
Need to define problem accurately!!! Suffering occurs in a political context. Dignity is never granted, but can be
recognized. Sameness of self in the other.
Genocide: France, Belgiun & US chose to pursue foreign policy through genocide against Tsutsis. Al Basheer
was arrested but since then 300,000 have been killed in Dafur.
Neglected diseases. Pharm companies it's not profitable to provide drugs for 1b people.
MDGs: Most ambitious drive in history. More than half people in the world live on < $2 /d. Solidarity can be
rooted in compassion. Regecting the unacceptable.
AIDS15 m aids orphans in SA. Competition for water fuels conflict. Humanitarian acts have profound political
impacts. In risking nothing, we risk everything. Orbininski said we will get there. G20 is now the locus of
power. We would need 4 planets for all to live as North Am.
Kevin Pottie we are short 3m health practitioners worldwide. We need to listen to our students.
In the current environment we may be building a house of cards Like the suffragettes!!- nailing jello to the wall.
GHEC core competencies CANMEDS for GH. GH scholar or diploma. Sharing in health.ca ehealth edutainment
Barry Pakes GHEInst at UofT
Initial experience may not give much at the time but may create a lifelong change in perspective!!!
"Social advocacy through narrative" book!!
Questions: Prevention of genocide? Informal training? Students teaching students case studies. Need a path to
GH starting early. Eur & Jap model.",
CCGH20101031PM
Telehealth in the developing world IDRC
GHMP Global health mentorship program kcanderson@gmail.com Chapter in resident's guide compilation
U of Ottawa has identified global nutrition as a curriculum component!!!
Action global health network: Seny funding to cover cost of their own satellite student PLUS that of a local
student at a place of their choice.
Focus on advocacy. Doctors & universities are supposed to be apolitical.
There's a need to coordinate activities & resources across universities.
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Montreal Nov 10 to 12th 2011
Nicholas White Elimination of malaria - feasible or futile
Toronto malaria conference. Guy's Hosp. Artemesinin against plasmodium falciparum. Adult is sequestered in
capillaries, and this causes problems. 2.5k kids die / d or 1m pa.
WHO attempt to eradicate malaria ignored Africa, but worked in rich countries. Sri Lanka down to 16 cases
rebounded to 12m in 1 y. Failure to set realistic goals eradicated malariologists!!
Malaria deaths rose with drug resistance. Then $1.5 b/y. 1st (1) vaccine for any parasitic disease is 30% effective.
(2) Insecticide tereated bednets.
(3) Artemesinin administered early decr mortality by 33%. With mefloquine (ACT) or its like it's very effective.
Strong leadership is needed, but WHO is a weak political organizn. Has put almost no funding into it. Malaria
areas are in conflict ridden areas.
P. vivax is much trickier, but responds to primaquine.
Death by fake drugs is taken less seriously than MJ.
There is tremendous competition for funds in GH.",
CCGH20101101AM
Minister Oda!!
Speak outside the box, Equity means avoidable inequalities..
Equity and efficiency: are at odds. Govts allocate fewest resources to nost needy
Availability: Coverage: not well distributed after Acheh. Haiti 90% odf resources are in10% of camps.
Risks
Outcomes
300 organization – who is doin what where? Health srvices checklist
Shown where there's no TB treatment despite 80 agencies! Etc. Phakista after floods 7000 admissions for 14 beds
Fragile states!!
After tea:
Zacharia
Health cluster coordination to increase efficiency
1. WHO Cluster coordination
2. Country level
3. Partners - many share task
Responsible who is answerable & pays the bill
Application of standards
Checklists
Paul Spiegel
Av refugee is a refugee for 13y; "guests" so they can be deported more easily
MSF can speakout freely - no government funding!! UN is conservative!! Internally displaced persons are
complicated - govt may not allow access.
Fragile states; conflict torn; persons of concern; reource-limited environment. Disposable income. Social
behavioural component is huge.
There's no clear path to job in GH!! Dilemmas are part of territory - politics
Robert Fox Oxfam International Rights-based approach. Power imbalances in crises.
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Poor are already suffering as a result of climate change.
WASH water sanitation health
Urbanization of informal settlements - water supply sanitation health may (should) become better than previous
location. (Telegenic disasters address the disaster response cowboys in shorts from 100 outside agencies. Hatians
pulled 500 x as many from the ruins as NGOs. Scope of many disasters exceeds global capacity to respond.
Military have unrivalled resources, but complicated by population's attitude to, say, NATO. However, they mix
in our foreign policy objectives.",
"CCGH20101101PM
Food security
Access, adequacy, accumulation!!
Mplus for path analysis
Anwar Islam (dean) & Enamul Hasib (lecturer) James P Grant Sch PH BRAC Univ. Bangladesh
164.4 M 46% below poverty line 40% stunted.",
CCGH20101102AM
Evidence vs action in areas of humanitarian need Andrew Padmos, Royal College CA
Mickey Chopra SA MRC!!
Get his graphs!!
Infant mortality is measured in relative numbers, but underweight can be absolute.
Averages hide inequaliries, but variance reveals it. Growth quintiles show new knowledge is better incorporated.
Among countries that decreased inequalities 20 increased ineq but 9 decr them.
New ineq. Community heqlth workers wirh diagnostic kits outperform doctors - cos rthey follow directions.
We're starting to disagregate data. Allows us to see who to focus on. MNCH !!! And xheck to see that erichest
don't capture most resources. Idwntify misallocations of budget among kinss of service. Eg in N Nigeria
contraceptice delicvery would be cost effective. Many services can be packaged along with immunization
campaigns - eg micronutrient delivery & many others.
Advances in education take 10 y tobe translated into benefits in health or decr birth rates.
Werner Lambert represents UNICEF. Chopra: $4b pa mostly on health. Needs to amplify voiced from the
ground so the come to the attention of govt.
Disaggregating cause & effect. What can we do wirhout economic growth.
After tea
Equity 101 the rich are getting richer and the poor are getting poorer, but in the end it all averages out. BMJ 2010
Equity methodology. Study design needs to match the question. ""Process evaluation"" .
In Canada 5% of 5-12 deaths are sore throat related
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Pick a country: high prevalence, try to get one where incidence is high. Calcutta vs Delhi.
Equity
Incidence of longstanding symptoms from rheumatic fever: Role of equity, and implications for selection of
intervention strategies
Nicole: latin Am!!
Susan Erickson!!
David Orr!
Everybody loves a good drought1",
"GHEC20101102PM
CO-H 20100919
MoliehiKH@gmail.com
mChopra@unicef.org
Smita spakhale@ohri.ca
Carys Carrington rys_11@hotmail.com
Aspen ideas festival
Berkeley lectures webcast.com courses
Itunes univ
Why do people get involved in GH? Azad Mashari
How do we form healing relationships across disparate communities. NB with communities in danger.
Sometimes from our own community's activities. Heal from ethnocide?
A kind relationship can be leaving a person / community alone!! Solidarity. In charity we may lose when we
succeed, since we need to find a new way to be kind!!
Blessed are the cracked for they shall let in the light!! Groucho Marx
Jane Philpott & Harry Pakes
Wade Davis Achebe latest book: "When we are comfortable & relaxed, we are most at risk of doing damage
absent-mindedly"!! Also ""things fall apart"".
Motivation - sense of moral obligation to help!!
What do our international neighbours perceive are our motivations?
Motivations I'd rather suppress
Motivations to which I aspire
Residents without borders!!
MoliehiKH@gmail.com
mChopra@unicef.org
Smita spakhale@ohri.ca
Beware of temptation to sensationalize
Said ""Orientalism""!!
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Anna Siefried IDRC there is no monitoring of Canada's committments to GH. Bamako ministerial agreement!!
Call for action in 2008 to administer 2%. 5% to health res. Canada's DAH devel assist to health $758m of which
research was 3%. So we need to double this. Devel innovation fund DIF.
Are our expenditures demand driven. Needs driven?
We need a tracking system NEHSI Nigerian evidence- based health res evaluatn.
More commitments from CA to global fund
Catherine Muldoon UBC ""TASO""!!; Southern-led research in Uganda!! Like student-directed education.
OCAP ownership, control, a, possession
Construct validated tool: "Is research working for you?"
N-S geopolitical & economic rift.
Locally directed research has more credibility with (say) local MOH.
Local participants are volunteers; distant are ""experts""
CCGHR partnership assessment toolkit
Prof Olagoke Akanitola!! Kwazulu Natal Impact of 2008 meltdown on home-based care organizations in SA
Job losses: mining, manufacture, domestic labour -> more demand for services
Funding agents reduce new grants & renewals. Incr community self-sufficiency eg seeds & gardening.
CCGH20101030AM
ccarry@naho.ca Catherine learning objects email rw NIM etc
We know what we need to do in the situation (Srinath Reddy)
Keith Martin MP Juan de Fuca
www.keithmartin.org
Translating knowledge to action
Worked in Africa as physician. Zinc for pneumonia gastro
2b < $2 / d 1.4 b with tropical diseases. Leishmaniasis second to malaria. Vet medicine -> poverty. Common
pathway - primary care. 2.4 m health care workers needed. Build & retain capacity. ""Low-resource settings.
Consortium of universities for GH in Seattle. ALARM initiative. Pennies from heaven = initiative. CIHD
database is needed!!!
Univ Govt NGO & use WFP infratructure. Rexipient driven, sustainable. Once the war acute is over people walk
away! Together 9m lives can be saved.
KM doesn't tell constituents, cos there's a political penalty to promoting GH!
Colleen Davison midwifery, tobacco, food securitym cdavison@uottawa.com Knowledge based programs.
Using knowledge for prog implementn. ""Critical realism"" non material consideration - who bears the cost, who
benefits. Precede-proceed model for implementation. Ultimate vision - improve QoL.
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PHIRNET. PHIRC, PHIRN. PHIRIC, NREPP (reviewed interventions).
Web (PPT) blunders pictures as metaphors!!!
Western models are outcome driven. ""Outcome mapping"".
Deworming person Tracey - how do we avoid reinventing the wheel? We need process / organization people
""knowledge brokers""!! Q: Much knowledge is in English. Computer translation - google?!!! Program
evaluation & funding broker!! Needs assessment as undervalued. Pharmacy UBC. CCGHR Mali, Zambia.
Phillipines eHealth!!
Harriet + Uganda
Linda Moore writes res grants
Colleen again ""Know-do"" gap.
CIHR end of grant KT disemmination. Integrative KT involve input from consumers into future research.
Meetings & dissemination grants. Plain language summaries, results into action. Translation from english.
Reationships can reult in future projects. Ethics requires publication.
KT toolkit at www.idrc.com!! REACH Regional East Africa ... $ed0k for regional hub. Male circumcission decr
AIDS transmission by 40%.
""Engaged scholarship-measuring the impact"". Ethics - nondisemmination of negative results. When do you
know you've done enough.
Most research in underfunded situations is drug company funded. Intent! Do participants hear what was found.
Manuela Allen, Luis, stakeholder engagement, forming partnerships. Identify systems issues of the community
stakeholders. Small group meetings, mix oh high middle and low level stakeholders. Prioity setting to ensure
update, novel small ways to build trust.
Building partnerships - need to change the way we speak. How much can you simplify. Be aware of power
differentials ans local sources of knowledge. How urgent is the need on both sides. Follow-up is an ethical
imperative. Research is cv driven - lots of cheap solutions, eg social networks to create partnerships.
Linda grantwriter.
CCGH20101030PM
Katerina Plamondon Mt Royal. Where are we at? Hoe did we , what did we learn
Most signif change
After action review
Rapid appraisal
Impact log
Appreciative enquiry, surveys horiz eval
Performance indicators
Assessment tool checks:
Support a learning envir - leadership
Concrete learning process
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Harriet
SURE comprises 8 work packages, incl AAR.
Policymakers can get research brief by rapid response. Ability to push or pull knowledge. Prefer 1, 3, 25 page
report?
Informal workers & backlash. Role expansion = task shifting.
CHSRF
What happened; why did it happen, how could we do better?
Certain points were addressed, or left out. Backgrounds differedm how could we do better.
Most signif change: g20. Little coverage of content.
Evaluation must be ongoing.
Ross Kemp documentary
Cultural ownership
Robert Sauder Knowledge systems perspective
Be precise re what works where. Where is our knowledge. Hundreds of millions of CIDA $40b goes to food
security 5 staff.
Knowledge brokers & K networks. Social networking is not part of the plan, but IS the plan.
Emphasize solution-oriented results-driven research. Implementation science.
Objective success vs learning.
Lisa Schwartz epi & biostats",
CCGH20101103
Susan Johnson!! Ntl Dir Red Cross.
Reln with Red Cres?
Kenya partnership - anti malaria. Speaker hasa choice btw advertizing and giving fresh info & surprizes
John Yates: Haiti - The good, the bad, & the ugly!!
NGO responds rto donors stakeholders, govt, recipients. There's a tension. Golden rule & who has the gold rules.
197 NGOs collected billions.
Factors hobbling NGO collaboration - see slides!!
Aid problems:
Inflation from UD$
Widening gap
Destrn of public ctr
Leslie Shanks Med Dir MSF Lead poisoning in N Nigeria
Differential diagnosis.
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Vaccination teams can do quick needs assessment eg?!!",
"Global
My background is far from uniqie
But pts of view are not
2008 recession
We never promised 0.7%
I hope I can just remind everyone that the program is eminently solvable - china cuba
I don't want to rain on your parade - at 1st overview slide
Relief aid isn't designed to give long term results
At worst it's given to make the donor feel better. TV cameras tun elsewhere. Us too + not just govts.",
"Transfer to P5000
90040 vigilance 9004
$75k
To Seabeck:
Bedside light*
Granola spoon
Doormat
Large clock
Food consolidation container
Hand towel for drying bowls
Ice chest",
"Available TV channels
To 59, 64-68, 83-96, 106, 118(vsn) -121, 133, 135, 138, 143 (144-159 sports), 165, 175 (Alj), 179 (RT Anal),
180,",
"5th Dimension
Imagine a universe that makes sense
No logical inconsistencies (like action at a distance, uncaused events, entities that neither exist nor don't) nor
singularities, like the limit to the speed of light.
There never was nothing. No such thing as empty space, nothing happens between events. No time passes, no
distance is traversed. No such thing as solid matter, only repulsive forces.
Electromagnetic and gravitational forces cause different trajectories for magnetic vs non-magnetic materials to
follow in the same space-time coordinates. For each entity there is a unified field within which it travels in a
straight line at constant TIME-UNIFIED FIELD. Spherical curvature for gravity vs hyperbolic curvature for E-M
in an orthogonal dimension. Think of them as refraction - non-intantiating interactions, not observable events for
the interacting particles.
document1 2010-11-06: svd 2/8/2016 3:06:00 AM, prtd 2/8/2016 3:06:00 AM
12/13/
The observed behaviour, as revealed at the level of the ultramicroscopic, and galactic levels, including special &
general relativity, emerge logically and naturally from the underlying structure of reality.
What we observe arises naturally from the structure of reality, and the limitations of our sensory and data
processing structures.
The structure of the reality, behind what we perceive, has a convincing and elegant simplicity.",
document1 2010-11-06: svd 2/8/2016 3:06:00 AM, prtd 2/8/2016 3:06:00 AM
13/13/