An exciting development co-operation instrument is being applied by the Finnish government. First and second generation Somali diaspora health professionals trained in Finland or in other Western countries are facilitated to return for 6-24 months to transfer knowledge and skills to local health workers in hospitals, ministries of health, and training institutes around Somalia. Returnees are ready to sacrifice a lot as they are highly motivated to “help our land”. But… Are the local health workers so ready to be trained by the ones who had a chance to leave in difficult times? How could knowledge and skills actually be transferred from one expert to another? These are traditional questions when Western expatriates have been sent to Africa. It is any easier and more successful when a trainer and trainee share the culture and language? Or is their culture the same? How about mechanisms required to support learning, such as human resource management? We started to ask more questions and ended up beginning a study to find out some answers with the ultimate aim to find ways to enhance brain gain in Somalia. Our study aims to shed light on how temporary return of diaspora health professionals can be used as a development modality that has a convincing positive influence on strengthening health systems through skills and knowledge transfer. In December 2016, we travelled to Hargeisa in the north-western part of Somalia, to carry out interviews.In December, when our plane was landing to Hargeisa, the vast dryness was the first thing one could see. Sand everywhere, no trees or water were visible to a human eye. The view from the plane was truly astounding. By now, one could realize that drought is a severe issue challenging all life in this environment. Despite of the dryness, Hargeisa is a lively city with buzzing atmosphere. The street life in Hargeisa is truly diverse. At the same second, you can witness honking cars moving from one place to another, donkeys pulling water canisters, people exchanging piles of Somaliland shillings to dollars at the money market, goats running around, and ladies selling oranges from wheelbarrows. Although the environment in Hargeisa was definitely different from what we are used to in Finland, our trip was a success. Our time in Hargeisa was filled with warmth and friendly smiles, and we were encountered by such hospitality and helpfulness of the local people. Our local team member, who was a UK trained health expert, had many roles during our trip, which illustrates the complex reality of life in Hargeisa. He was a specialist in an area of health services and at the same time an expert in Somali culture, a driver, a caring father of children suffering from “winter” flu, an expert in on-the-job training, a son of a respected religious scholar with a huge and helpful network including 30 children and 200 grandchildren, a husband of locally trained medical doctor, a certified guard carrying a gun, as it is required to accompany foreigners, and many more. Without the help of our local team member our trip would have not been as successful! Now we are all excited to analyse the first data and gain better understanding on how this kind of development strategies, based on brain gain, can be utilized in order to provide the best possible results in strengthening healthcare systems.
|Infectious disease||Country and Statistics|
|Measles||Syria: UNICEF reported 594 cases by end of 2014, other sources claim 7000 to 10000 cases Lebanon: 13% increase.* Jordan: From 24 cases to over 200 in one year.*|
|TB||Syria: 6% new cases and 31% re-treatment cases Lebanon: 27% increase in cases * Jordan: 22% increase in cases due to Syrian refugees (of the total 40% increase).|
|CL||Syria: More than 41,000 cases in 2013 ** Turkey: 1843 cases in refugee camps in 2014 * Lebanon: 97% of all cases involve Syrian refugees in 2013|
|Polio||Syria: 7,600 cases. No new cases from 2015 until April 2016|
- Ozaras R, Leblebicioglu H, Sunbul M, Tabak F, Balkan I, Yemisen M et al. The Syrian conflict and infectious diseases. Expert Review of Anti-infective Therapy [Internet]. 2016 [cited 13 December 2016];14(6):547-555. Available from: http://dx.doi.org/10.1080/14787210.2016.11774572.
- Sharara SKanj S. War and Infectious Diseases: Challenges of the Syrian Civil War. PLoS Pathogens [Internet]. 2014 [cited 1 December 2016];10(11):e1004438. Available from: http://dx.doi.org/10.1371/journal.ppat.1004438
- Syria crisis: humanitarian situation, needs and response [Internet]. International Committee of the Red Cross. 2016 [cited 13 December 2016]. Available from: https://www.icrc.org/en/document/syria-crisis-humanitarian-situation-needs-andresponse
- Murthy SChristian M. Infectious Diseases Following Disasters. Disaster Medicine and Public Health Preparedness [Internet]. 2010 [cited 2 December 2016];4(03):232-238.Available from: http://dx.doi.org/10.1001/dmp.2010.hcn10005
- Ismail S, Abbara A, Collin S, Orcutt M, Coutts A, Maziak W et al. Communicable disease surveillance and control in the context of conflict and mass displacement in Syria. International Journal of Infectious Diseases [Internet]. 2016 [cited 6 December 2016];47:15-22. Available from: http://dx.doi.org/10.1016/j.ijid.2016.05.011
BLOG: By Annariina Koivu: From Darfur to Liberia - Heidi Isohanni's lecture on humanitarian emergencies was a success
A new kind of cross-sectoral forum, GainStorm, was held in Tampere Hall on Thursday 15th September. 7-minute talks, conversation and networking took place between members of the business community, the City of Tampere and Tampere’s universities. Nearly 100 took part in the event. Informal networking forums are important for scientists, business people, engineers and public sector experts and enable them to brainstorm. Having TV-person Simo Frangén as the “moderator” ensured that the event was also fun. These kinds of encounters have longer term effects, according to the "godfather" of the idea, University teacher Mikko Perkiö, from the Programme for Global Health and Development, at the University of Tampere. The Mayor of Tampere, Anna-Kaisa Ikonen envisions the city as a “Smart City” in which civil servants are more facilitators than producers of services. Tampere as a campus city would be known as a facilitator and testing ground for new innovations such as IT applications and digitalization linked to new urban culture and new forms of community, including the sharing economy. The business leaders; Aarne Actan, the CEO of Pihlajalinna and independent innovator Jari Pasanen; welcomed the collaboration of academics and researchers and mentioned their concern at how from the business viewpoint, it often takes too long for collaborative results to be utilized. Following on from this, senior expert Oras Tynkkynen from SITRA voiced a need for sectoral boundaries to be more fluid, which would mean freer movement of human resources between academia, business and administration. On the other hand, students and researchers can provide businesses with critical observations on product development as is the case in the "Demola" project. Professor Jyrki Nummenmaa and Janne Eskola Demola introduced Demola as a platform for developing projects or practices, i.e. creating demos, between students and business or public sectors. The famous Demola, a “made in Tampere” innovation, now operates through 17 offices world-wide. Demola network includes over 600 company partners and over 40 universities. The most challenging problems, such as global warming require transcending sectoral boundaries. To face future challenges, Oras Tynkkynen introduced new branches of "green business", many of which relate to practical solutions to everyday needs such a turnkey-version of solar panels. A global perspective offers Tampere-3 University a way to internationalize its research and staff, which is likely to improve its outcome, as outlined by Rector, Liisa Laakso. The speakers identified concrete global problems and how global partnerships could function optimally. Teacher training, water and sanitation issues along with various social innovations were seen as potentially being the most beneficial collaborations from a low income partner’s angle. Fortunately, the innovative Tampere-3 University will have strong capabilities in these areas. Furthermore, a GainStorm participant Dr. Antti Kasvio published an informative blog on global wellbeing (in Finnish) http://anttijuhanikasvio.puheenvuoro.uusisuomi.fi/222915-globaalia-hyvinvointia The University of Tampere is developing a new profile in Global governance and responsibility, which consolidates and updates its historical mandate as a "grand” school of management, social science and health to global level. It is important that the city of Tampere steadfastly stands by the university and assumes the role of facilitator when needed.
The world’s coldest capital Ulaanbaatar (1,4 Million people) in Mongolia, suffers wide wellbeing losses due to air pollution. The city’s outskirts are growing with internal migrants, often herders, who have lost a large share of their animals and life-stock because of tough winters. Contrasting realities of housing in Ulaanbaatar. Pictures: Mikko Perkiö The downtown of Ulaanbaatar is surrounded by ger districts, where a newcomer may occupy a small portion of land where to settle family’s home. Large part of the city’s 200.000 outskirt dwellings are gers, which are mobile and light constructions. These can not be connected to the heating grid of the world’s coldest capital. The air pollution causes health problems. The heating of a ger is based the stove in the middle of the ger. During cold months and cool nights, the latter met throughout the year, the stove burns coal or wood (even tyres and trash), which produces smoke and small particles in the air. Air pollution in the Ulaanbaatar ger-districts crosses several time the alarm rate of Peking. One of the most alarming health danger includes fetal abnormalities and miscarriages. Amount of those have increased substantially due to air pollution. Fortunately, there is a simple and affordable solution available: housing policy. The state of Mongolia and the city of Ulaanbaatar just have to replace ger dwellings and wooden houses by apartment buildings. Connection to heating grid and piped water would mean giant health improvements for the city’s people. A flying start would find new tenants to the city’s 20.000 empty apartments. If needed and requested cold latitude countries like Finland and wellbeing research oriented universities such as Tampere-3 would be ideal partners in transforming life of Mongolia‘s people. -------- The insights on Ulaanbaatar were gained through the participation in an evaluation project on Mongolian Red Cross Society's Community Based Health and First Aid Programme. The consultancy was carried out as a training project by the University of Tampere, Global Health and Development, and it was funded by Finland's Red Cross. Link: UNICEF video; Ulaanbaatar (UB) Mongolia: Air Pollution & Human Health Impacts: https://www.youtube.com/watch?v=ge70BlPN6_s
Overweight and obesity are the fifth leading cause of death globally. Poverty and socioeconomic status (SES) determine child weight. The global burden of underweight associated with absolute poverty is reducing and the issue of overweight dramatically growing. Prevalence of overweight and obesity in developed countries is higher than in developing countries, although, in absolute values there are more overweight and obese children in developing countries. Predominantly, higher SES in developing countries and lower SES in developed countries lead to increased risk of overweight and obesity. These trends are complex and not always unidirectional and linear, there are many intertwining influencing factors. Neighbourhood SES and individual demographics determine weight status. Parental income and education determine weight status as well as stress, negative life events and ethnicity. Place of residence effects weight status also; urban poor in developing countries and rural poor in developed countries have higher risk of overweight than their counterparts, the rural poor in developing countries and urban poor in developed countries. Generally, how SES effects weight depends on the equity and socioeconomic development of the country. In developing countries, the rich lavish their children with the novel westernised diet and may be naïve of the dangers of the newly adapted sedentary lifestyle. The developing country poor are catching up with the lifestyle behaviours of the rich as they urbanise and lose the capacity to farm their own healthy and natural food and remain the physically active lifestyle of traditional rural life. The developed country poor struggle to afford healthy diets and expensive sport hobbies and are uneducated in the requirements of a healthy lifestyle. It is only those of high SES in developed countries who have the awareness and means to keep their children physically active with a nutritional and balanced diet and so reduce their risk of overweight. Unsurprisingly, as developing countries progress, their trends in weight status see a transition towards the trends of developed countries. Action in the form of promoting healthy eating and physical activity are required to reduce such inequalities in health, education and lifestyle to decrease the global burden of overweight and obesity.
BLOG: Needs and Wants – Do the UN Sustainable Development Goals know the difference? By Aada Vihanta
We all have needs and wants, but when it comes to sustainable development, making difference between these two terms is crucial. Abraham Maslow (1954, 80-92) says people have deficiency needs and growth-needs. Deficiency needs are things inevitable for living (food, water, protection etc.). After fulfilling those needs we can move to growth-needs which respond to human’s need for self-actualization. (Maslow 1954). The UN’s Sustainable Development Goals define new millennium development goals. The basic targets are eradicating poverty, achieving equality and making sure everyone has access to basic needs in accordance to sustainable, sustain and inclusive development. The contradiction in SDGs is that they don’t properly define what are basic needs. Without defining them, SDGs allow that everyone can define their own basic needs. The problem is that what people define as needs varies a lot depending on the area and the standard of living there. It leads to situation where rich can be rich and poor will stay poor. The western consumer culture has obscured our understanding of needs and wants. That means we easily include more things to our basic needs than people in the poorer areas. What we think as needs, are somewhere else wants. The SDGs take into account the boundaries set by the environment. They admit the environmental problems are caused mostly because of over-consumption and we have to change our lifestyle. Environment should be taken seriously into account because it can be classified as basic need. That’s because it’s something we can’t live without and it’s inevitable to our lives. However, SDGs target to development which allows the continue of growth. On the contrary, it seems we have to keep on consuming because SDGs aim at increasing economic productivity. But how is it possible to keep on consuming and at the same time protect the environment? If we go on like this, we can’t meet the environmental limits. And if we fail to protect the environment, we can’t eradicate poverty or achieve any other targets described. The consequences of environmental destruction impinge most badly to the poor. (Woodward 2015). The SDGs are trying to find a compromise between our consumer culture and protecting of the environment. It’s hard to change our lifestyle because our whole society is based on growth and consumerism. The SDGs suggest we have to create green jobs and green economy which remain in the boundaries of environment. The new goals are optimistic and maybe even impossible to achieve. We have to be prepared for the possibility that trying to achieve sustainable, sustain and inclusive growth and society isn’t going to be enough to protect our planet (Gough 2013, 199-200). References Gough, Ian (2013). Climate change, social policy, and global governance. Journal of International and Comparative Social Policy, 29, 185-203. Maslow, Abraham H. (1954). Motivation and personality. New York, NY: Harpers&Brothers. Woodward, David (2015). “Incrementum and Absurdum: Global Growth, Inequality and Poverty Eradication in a Carbon-constrained World.” World Economic Review. Sustainable Development Goals. Retrieved from http://www.un.org/sustainabledevelopment/sustainable-development-goals/
At the present time, we cannot think anymore about poverty as an isolated problem. Poverty is not related to the absolute scarcity of goods but to an unequal distribution. At the global and at the national level. Indeed, a system is maintaining, in a plutocratic way, a power relationship between a small number of owners and the “marginalized majorities“. Marginalized because devoid of any incentives over their own lives. Devoid of any ability to do or to be, meaning of any ‘capability’, an idea on which Sen and Freire merge. Worse! These majorities are in a way owned by the wealthy people : they are dehumanized. This statement sounds “old fashioned“, ones would argue, “déjà vu“ others would shout, “Still relevant“ I will defend.
In his Pedagogy of the Oppressed (1968), Paolo Freire presented a guide for oppressed people and oppressors ready to join them in their fight to free the whole world. In his view that I share, not only the oppressed people but also the oppressors need to be freed in order to restore the humanity of both of them. The freirian pedagogy requires a concientization of the oppressed people helped by some humanist educators in a very subtle way. It should be oriented to the praxis (dealing with the reality) and avoiding the trap of reproducing the same system. “Nobody frees anybody else; nobody is freed alone; people free themselves together”.
Utopian? His ideas have been implemented by the Worker’s Party in Brazil. The city of Porto Alegre gives a very successful example of it. Through the practice of participatory budgeting, meaning that the population has a voice over the management of the municipal budget. Porto Alegre with 1.3 Million inhabitants and a budget of $7 Billion has seen its service of water reach 98%, its children enrollment in school doubled and even the revenues growing because of the transparency of the model playing a motivational role to pay taxes. This happened in less than 10 years (from 1989 to 1996).
Still irrelevant today? It is up to you!