Tuesday, March 27, 2012

The Birth of a Movement

My love for Lady Gaga is no secret, but since the launch of her new “Born This Way Foundation,” I have even more reason to sing her praises. Last month, Lady Gaga shared the stage of Sanders Theatre at Harvard with Oprah Winfrey to launch what she calls a movement to “challenge meanness and cruelty by inspiring young people.” It is more than an anti-bullying campaign but a youth empowerment campaign that aims to change an entire culture.

The three pillars of her campaign are safety, skills, and opportunity. She aims to create a culture in which every person feels safe, has the skills to stand up for one another, and uses the opportunities that arise to spread the message of tolerance.

Probably my favorite moment from the launch event was when Alyssa, a very brave young person who was a member of the opening panel, was asked to explain what she does at school. She said, “I try to set an example...then the rest will follow.” Telling stories of success will be an important part of what the foundation does.

There has been a lot of attention paid recently to cyber-bullying because of its visibility, but statistics show that the most common type of bullying is still face-to-face. Incidentally, the foundation is partnering with Blue State Digital to use social media to spread the message of love and acceptance.

I applaud Lady Gaga’s efforts to reach out to experts, disseminate information, and begin interdisciplinary dialogues. Her partners include the MacArthur Foundation and the Berkman Center for Internet and Society at Harvard. Secretary of Health and Human Services Kathleen Sebelius, Deepak Chopra, and psychologist Susan Swearer all participated in her launch event.

This foundation intends to improve the health and well being of young people from the bottom up. Lady Gaga understands this will take time. Tell a friend and spread the message!

Watch the launch of the Born This Way Foundation and read some notes from “The Kinder and Braver World Project” from the Berkman Center.

Sunday, March 11, 2012

The International Medical Brain Drain – Are we to blame?

I read an interesting New York Times article today addressing the shortage of doctors in the developing world. There are some disturbing statistics:

- In the US, there is 1 doctor for every 416 people vs. 1 for every 23,000 in Zambia

- The median salary of a surgeon in New Jersey is $216,000 in New Jersey vs. $24,000 in Zambia

- One in 4 doctors in the US is trained overseas

Is America to blame for the shortage of doctors in sub-Saharan Africa? There is a great demand in the US for doctors, especially primary care physicians: statistics project a shortage of 200,000 doctors in this country in 10 years. With high salaries, innovative technology, and enticing immigration laws, the US attracts more foreign doctors every year than Britain, Canada, and Australia combined. Some states have legislation that allows foreign doctors to stay in the US after residency if they would practice in underserved or rural communities here. So far, more than 8,500 doctors have done so. But what is a gain to one country is a loss to another.

A 2008 article in the Lancet suggested that that the active recruitment of medical professionals from Africa be viewed as a human rights violation. It described recruitment agencies that woo medical workers through advertisements, workshops, e-mails, and even text-messages.

But for some doctors, it is the plain reality of practicing in their homeland that causes them to leave. Dr. Kunj Desai, from Zambia, now a resident in surgery in New Jersey, described repeated instances of senseless death due to lack of resources. “We were just pretending to be doctors,” he said of his time at University Teaching Hospital in Lusaka, Zambia.

There is some international funding for training and retention of local doctors but Western aid agencies often hire local talent to do research, not see patients, contributing to an “internal brain drain.”

The solution probably involves a combination of more high-quality training programs and hospital resources, higher salaries, and better working conditions for foreign physicians in the developing world. What the US can do instead of recruit foreign physicians is to contribute to the existing infrastructure for the delivery of medical care in other countries. On the issue of teaching, I am particularly interested in exchange programs for residents, which allow both parties valuable training experiences.

Check out the full article at:


Wednesday, March 7, 2012

Public Health in a Military Setting

For anyone interested in the military system of delivering medical care and offering public health interventions, here is a link to a perspective piece in the NEJM this week:


It deals with issues of protecting the health and welfare of our soldiers while they are deployed.  In fact, throughout history, many more casualties in war stem from disease and other public health concerns and do not come directly from combat itself.  We're doing better these days, but a lot of the success hinges on whether or not soldiers are compliant with the interventions recommended.  For example, as a consequence of not adhering with anti-malarial prophylaxis, a large section of a unit of marines needed to be evacuated to the states for treatment of ... malaria.

Take a moment and check out the article!