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Pakistan’s Swat Valley Offensive: One Year Later (Video)

One year ago, a massive offensive by the Pakistani military against suspected Taliban strongholds in Pakistan’s swat valley resulted in over one million people displaced. At the time, this was the largest mass displacement of civilians since the Rwandan genocide.  Today, most of the civilians have returned home.  But as this video from the UN Refugee Agency shows, there are many–the UN says thousands–who have no home to which to return. 


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Michael Mann-hunt Continues

If Virginia (Professor Michael Mann’s former haunt) and Penn State (Professor Michael Mann’s current home) face off again next year, I already know who I’m cheering for. Sorry UVA , I know it’s not your fault, but your state’s Attorney General has, in one week, gone from lame to dangerous.

Earlier this week VA AG Ken Cuccinelli felt it worth his time to deliver new lapel pins to his staff with the usually exposed left breast of the state seal’s Virtus covered with a breastplate.  And now, as Dahlia Lithwick reports, he’s burdening the state’s flagship university, already considering increasing class size due to budget problems, with a witch hunt against former professor Michael Mann, creator of the controversial hockey-stick climate data.  Incoming freshmen: if you feel like you’re not getting enough access to your professors, consider joining the college democrats. 

During exams, the University will be forced to produce a decade worth of documents and correspondence, an exercise expected to cost up to half a million dollars. He justifies the action under the Virginia Fraud Against Taxpayers Act, which, in this case, if all of Professor Mann’s grants were returned, would save the taxpayers…half a million dollars. But, it won’t. 

Boy does Lithwick take him to task.   Mann’s data has been repeatedly scrutinized – by a commission created by Republican Congressman Joe Barton, a National Science Foundation panel, a National Research Council report, and a Penn State panel — and, each time, no malpractice has been found. Cuccinelli certainly knows this, and Lithwick suggests another goal, scaring those who might want do worthwhile research in the future. Limiting cutting-edge work at your flagship university? That’s a great idea.

UVA’s faculty senate agrees

His action and the potential threat of legal prosecution of scientific endeavor that has satisfied peer-review standards send a chilling message to scientists engaged in basic research involving Earth’s climate and indeed to scholars in any discipline. Such actions directly threaten academic freedom and, thus, our ability to generate the knowledge upon which informed public policy relies.

Even Mann-critic Tom Fuller has issued a letter to Cuccinelli to back off:

There are ample avenues of professional and academic recourse for people like me who think he has done something wrong. But being wrong is not a crime, and intimidating scientists not a path that this country, including I presume Virginians, should ever pursue. You may consult with colleagues in Salem to determine how long it takes to live this type of thing down.

I would be letting Cuccinelli off the hook if I simply called his actions irresponsible. It’s pretty hard to see his repeated actions (see Lithwick) as anything but an attempt to pander to a small minority for his own political benefit and to the general detriment of all Virginians. 



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Hunger in Niger

Ten million people in Niger face food insecurity right now. It’s a complicated situation. There is no one defined cause for the food insecurity, just a range of destructive factors that are adding up into something ugly. It’s being defined as a chronic food crisis at this point, and no one has a clear sense of how to resolve it.

The World Food Programme has stepped up emergency food aid to Niger. WFP is targeting small children, pregnant women, and nursing mothers for food distribution. They’re asking for $182 million to support the operation, which will stave off the worst impact of hunger in the short term. Food aid, however, can’t resolve long-term chronic insecurity. The Wanderlust blog has an excellent introductory post on the situation in Niger, outlining the causes of that insecurity. It covers the whole range of basics, from what to call the people of Niger – Nigeriens – to defining the difference between famine and chronic food insecurity. One especially shocking data point:

“nearly 170 out of every 1,000 children born in Niger die before they reach the age of five. That’s almost 17%, or more than 1 in 6. Given that the average woman gives birth to 7 children, that means that on average, every woman in Niger will lose at least one child.”

Reuters has a piece up that focuses on expert recommendations on how to improve food security in Niger for the future. According to Boureima Alpha Gado, an expert in droughts and food shortages in the Sahel at Niamey’s Abdou Moumouni University,

“poverty among people whose incomes don’t permit them to afford their food needs in the case of sudden shocks – including droughts, locust attacks, floods – is the other most important cause of the food crises in the country.”

He recommends better agricultural policy, to increase farmers’ output as a solution to the hunger problem. Other experts call for promotion of family planning, better irrigation, and a campaign against polygamy. One thing is for sure – children are dying while the world tries to figure out the solution.

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Making mHealth a Reality

Special to Dispatch from Hima Batavia

Last fall, under the direction of Dr. Patricia Mechael at The Earth Institute at Columbia University, our team of mHealth interns conducted a review of evidence-based studies on mobile health, or mHealth.  The product of that work is being released today as part of the mHealth Alliance thought leadership series, and tied to the USAID, mHealth Alliance and SHOPS eConference on mobile health, family planning and maternal and child health.

mHealth is the use of mobile and wireless technologies to support the achievement of public health and health service delivery activities. This includes the use and capitalization of mobile phones’ core utility of voice and text as well as more complex mobile and wireless remote patient monitoring systems. The purpose of the review was to improve our understanding of the policy barriers and research gaps that inhibit the scaling and sustainability of mHealth in low and middle-income countries (LMICs).

After reviewing nearly 2,994 peer-reviewed publications and secondary sources, the consensus was that there was no shortage of mHealth literature. It was only after digging deeper to identify studies assessing mHealth’s impact on health outcomes in LMICs that a gap in the literature became evident.

Surprisingly, for an emerging field focused on the use of mobile technologies to address public health challenges, measuring health outcomes was the exception rather than the rule. Conversely, studies (mostly from the field of computer science) concentrated on the usability and adoption of mobile technologies in healthcare settings, and the feasibility of implementing a program given contextual nuances and patient and provider attitudes. While important, the evidence required to advance mHealth beyond small-scale pilot projects is missing.

As a result, we reassessed our criteria and expanded the scope to include examples of mHealth interventions in high-income countries with transferable lessons for LMICs. Interestingly, we found that high-income countries were using mHealth as a monitoring and treatment compliance tool for chronic diseases. As some LMICs begin to experience an epidemiological shift, lessons and examples of these mHealth implementations will be valuable.

Understanding the reasons for the gaps in the literature became more apparent during our round-table discussion held at Columbia University in March 2010. Holly Ladd of AED-SATELLIFE reasoned that often before mHealth studies go through the process of execution, aggregation, analysis, writing and publication, the technology environment has changed. We found this to be accurate, as many studies available in the mHealth literature related to LMICs focused on mobile technologies such as PDAs. Given the pace of mobile technology advancement, discussions suggesting alternative means to traditional long-term randomized control trials (standard in public health for new interventions) for building the mHealth evidence base are needed. 

mHealth is a disruptive innovation and has great potential to strengthen health systems. Electronic health records and point-of-care support tools on mobile phones  can help improve quality of care and health outcomes with the capacity to capture data that when aggregated can inform district-level health programming.

This type of macro-solution demands the assembly of governments, policy makers, practitioners, researchers, funders, medical professionals, and users to find common ground and realize the real potential of mHealth.  Consortiums such as the mHealth Alliance and Digital Health Initiative are critical forces helping to set an agenda that will mobilize stakeholders for collaborative discussions and strategies to progress mHealth within both eHealth and mServices forward.

Perhaps the most glaring finding of our targeted review was the sector’s inclination to operate in silos. Divisions were found among the types of professionals working in the field (i.e. public health researchers, practitioners, computer scientists), the types of mHealth interventions (i.e. treatment compliance, disease surveillance, data collection) and the types of diseases (i.e. HIV/AIDS, diabetes, malaria).

The fragmentation within the mHealth and broader eHealth field is the greatest barrier for implementations to reach scale and sustainability.   For this, an enabling policy environment that links technology to health priorities and defines information and communication system architecture elements and standards, will help to guide and drive donor, industry, and NGO activities in an additive fashion that truly leverages the power and potential of mobile technologies and supporting infrastructures.


Hima Batavia is an mHealth intern at The Earth Institute at Columbia University and a Research Officer at the Mclaughlin-Rotman Centre for Global Health

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“Congo on the Wire”

On Monday evening, about 70 people ensconced themselves in a windowless conference room on the 3rd floor of the CBC building in downtown Toronto for “Congo on the Wire”, an event that focused on the continuing humanitarian crisis in the eastern Democratic Republic of Congo.
The event, sponsored by Médecins Sans Frontières and Reuters, offered an opportunity to hear from Finbarr O’Reilly, a Reuters photographer who has worked extensively in the Great Lakes region and whose photo exhibit opened last night, and Banu Altunbas, the MSF head of mission in the DRC.
As someone who follows the news out of the DRC closely, I wasn’t surprised that I didn’t learn anything new about the conflict during yesterday’s event. But that wasn’t the point. What the launch event for the “Congo on the Wire” photo exhibit sought to accomplish was to provide new and different perspectives on the conflict, as told by people whose work brings them close to the heart of it.
For me, the highlight of the evening was listening to O’Reilly talk about his photos. Many of the images he discussed last night depicted very brutal scenes on the front lines – blurry, spontaneous shots that underscored the banality of evil in conflict. Violent exchanges on the front lines, never-before-seen photos of Hutu militants in their jungle hideouts, artisanal miners in gold mines in Ituri: O’Reilly’s photos aren’t necessarily elegant, but they capture reality faithfully. When asked about why he seemed to focus so much on fighters and soldiers, he explained that these are the people who are driving the conflict, and he wanted to depict their lives as realistically as possible.
Not all his photos, however, focus on the actors of the conflict. One of his most beautiful shots – which is unfortunately not part of the curated photo exhibit at the CBC building – was of a tailor named Boniface and his son. O’Reilly explained that he was in one of the displaced camps around Goma when gunfire erupted. At that moment, Boniface invited him to hide in his makeshift house – made of banana leaves and a plastic tarp – to wait for the threat to subside.
In the photo, Boniface and his son are lying down next to O’Reilly, who recorded the sounds of the attack. The combined impact of the photo and audio was unusual and very powerful. Like with many of his other photos, O’Reilly does a great job at humanizing the conflict and its survivors. His intention of showing various facets of life and conflict in the DRC, including the “Congolese love for life” and the “bit of glamour that lurks in the shadow of the war” was a testament to the vibrancy and spirit of the people of the DRC.
After O’Reilly’s presentation, he and Altunbas discussed the continued involvement of the international community in the DRC, namely the presence of MONUC, the UN peacekeeping mission that has been in place since 1999.
Both O’Reilly and Altunbas expressed their disappointment with MONUC. O’Reilly spoke of a “failed mission,” that fails to provide adequate protection to civilians. He noted that violence was ongoing, despite the presence of a “heavy, bureaucratic, and expensive international mission.”
Altunbas echoed this sentiment, acknowledging that MSF maintains only minimal relations with MONUC, given their contentious role in the conflict. Both speakers agreed that they did not – and could not – know what the effects of a UN withdrawal would be (MONUC is slated to leave the country in 2011).
Last night’s event was an interesting opportunity to hear about how MSF – bound by a principle of neutrality – can support advocacy efforts. By helping out writers and photographers with logistics and providing them with access to remote locations where the media rarely ventures, MSF facilitates the journalist’s role.
As a joint venture between MSF and Reuters, “Congo on the Wire” represents an innovative approach to raising awareness and levels of understanding about one of the world’s most intractable conflicts.
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UN Approval Rating Hits 60% in the United States

A new poll finds that Americans’ support for the United Nations has reached its highest point in five years.  The research, conducted last month by pollsters Bill McInturf, Liz Harrington and Geoff Garin, finds that 60% of the survey respondents had a positive attitude about the UN.   This marks a fairly rapid rise in the UN’s favorability ratings. In October, a similar poll found that the UN’s image was 50% favorable/36% unfavorable.  The poll also found that 2/3rds of Americans believe that the United Nations is still needed today– this includes majorities of Democrats, Republicans and Independents.

What is to account for Americans’ warming attitudes toward UN? The survey credits a “very positive news environment around the UN providing humanitarian relief during natural disasters around the world.” In other words, when a crisis hits and people’s attention is drawn to the UN’s humanitarian response, they generally like what they see. It would seem the earthquake in Haiti provided the American public with a glimpse into how the UN works –  and Americans overwhelmingly approved.  

The poll also surveyed Americans’ attitudes toward the Millennium Development Goals. Not surprisingly, nine out of ten Americans have never heard of them. But according to the poll, “after hearing a brief description of the eight goals, 87% of Americans believe the United States should be very (43%) or somewhat (44%) involved in a worldwide effort to accomplish the MDGs by 2015.”  A majority of those surveyed said that seven of the eight MDGs should be a top priority for the United States..  Americans’ strongest preference was for increasing access to safe drinking water, followed closely by decreasing child mortality, cutting in half the number of people who live in extreme poverty and face hunger and increasing girls’ access to education. 

The poll was commissioned by the UN Foundation, which supports this blog. The full results will be available at the UN Foundation’s website at 10 am. Stay tuned!

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