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Reporting on Global Health: A Conversation With the International Reporting Project Fellows
›“The story is the story, the information is the information, but you can frame it in very different ways,” said freelance journalist Annie Murphy at a roundtable discussion on the current state of global health reporting. Fresh off their five-week assignments, Murphy and three other fellows from the International Reporting Project (IRP) – Jenny Asarnow, Jill Braden Balderas, and Ann S. Kim – spoke at an event at the Woodrow Wilson Center on April 28 about their experiences researching underreported health issues in Haiti, Botswana, Mozambique, and Uganda. [Video Below]
Taking the Temperature of Global Health Reporting
Global health reporting, like many other forms of journalism, has felt the pinch from the global financial crisis, said Balderas, who edited a recent Kaiser Foundation report on the issue, “Taking the Temperature: The Future of Global Health Journalism.” Other challenges that have led to less global health coverage in mainstream media include an increased focus on “hyper-local” news; “story fatigue” from years of HIV/AIDS coverage; greater focus on epidemics and disasters; and the increasing number of advocacy groups starting their own news services.
Placing global health stories is a big challenge, agreed all four panelists. Who will want to run the story? What form – radio, documentary, print, online – will the story take? According to Murphy, some creative thinking may be needed: “It is global health, but that doesn’t mean we always have to frame it in this box of global health. It will be global health no matter what we do, so I think it’s also important for us to feed it into other events and issues that are important.”
(Re)building Maternal Healthcare in Haiti
With the worst maternal and infant mortality rates in the Western Hemisphere, Haiti needs medical providers of all kinds, said Asarnow, but especially skilled birth attendants. The devastating earthquake in 2010 destroyed Haiti’s only midwifery school, located in Port-au-Prince, killing many students and instructors. The school is still struggling to graduate a class of 15 people, she said.
In the rural town of Hinche, located in Haiti’s Central Plateau region, Asarnow frequently visited a public hospital that provided pregnant women with free obstetric care. Yet, she said, “even with free care, there [were] still a lot of barriers for women coming to the hospital to get care.” For example, the family members of expectant mothers had to provide sheets, clothing, food, and a bucket for personal needs. In addition, some women were too poor to afford transportation to and from the hospital.
Most women in Haiti, though, give birth at home with the help of traditional birth attendants, called matrones, Asarnow said. These matrones, popular in rural areas, are not formally educated in midwifery, but the government, along with non-profits such as Midwives for Haiti, have provided the matrones with training in basic health care and emergency situations.
Simply reporting on childbirth turned out to be a challenge, said Asarnow. “It’s hard to get people interested in something that just happens to most women,” she said; other more unusual health problems, such as infectious diseases, tend to garner more interest.
Finding Health Sovereignty in Mozambique
Health sovereignty, explained Murphy, is “the idea that nations have the right to make decisions about health and about how people are going to be treated” – an issue that is particularly pointed in Mozambique, where 50 percent of the national budget and 70 percent of the annual health budget is tied to international aid.
Mozambique, said Murphy, has only 1,000 doctors to serve a population of 22 million. By contrast, the country has an estimated 50,000 traditional healers. As a result, she said, most Mozambicans use traditional healing for at least part of their regular health care.
While researching traditional healers in the northern province of Tete, Murphy investigated a large Brazilian-owned coal mine that had displaced 5,000 local people when it was built. Mining is a major economic activity in Mozambique, yet mining companies are taxed a mere three percent by the government, said Murphy.
Health reporting doesn’t have to only cover traditional health issues, said Murphy. “The environment, natural resources, and how a country earns its money very much have to do with the health of the people who are living there,” she said. “How can you talk about being sovereign and providing health to your citizens if you don’t have the money to do that?”
Treating the Over-Treatment of Malaria in Uganda
“Malaria is quite over-treated” in Uganda, said Balderas. There’s the “idea that if you have a fever, you have malaria.” Consequently, the rate of misdiagnosis can reach alarming rates in some areas, she said.
Balderas said an estimated 50 percent of Ugandans get free treatment through the public sector. However, only donor-funded facilities are equipped with the rapid diagnosis test (or RDT), which takes only 20 minutes to determine the presence of malaria in a blood sample, she said. If these facilities were more widespread, misdiagnoses rates could easily be lowered.
Other challenges to the accurate diagnosis and treatment of malaria include faulty equipment, shortages of electricity and lab technicians, human error, corruption, bureaucratic entanglements, and presumptive diagnoses. For example, sometimes health workers do not know what is causing a patient’s fever, Balderas said, but they prescribe malaria treatments anyway because “they want to be able to give someone a treatment; they want to feel like they’re helping people.”
“There are certainly a ton of issues that relate to health,” Balderas said, such as poverty and corruption. Everyone she interviewed in Uganda – with the exception of government officials – identified the corruption in the country’s drug sector as a key problem.
Helping “Africa” One Small Story at a Time
Inspired by a World Health Organization study, which found “at least a 60 percent reduction in HIV infection among men who were circumcised,” Kim went to Botswana to investigate infant circumcision, a practice that is gaining popularity but is still alien. “I would meet people in the course of my day and they would ask me what I was doing there and I would talk about circumcision. They’d say, ‘Oh, I really want to get my baby circumcised. How do I do that?’” she reported.
The most powerful moment of her trip, said Kim, came when she was researching cervical cancer – the number one cancer among women in Botswana. As she waited with a woman to receive her lab results, Kim asked her if she was nervous. The woman, who was HIV-positive, said, “Yeah, I’m really worried. To me, it would be worse to get cervical cancer than to have HIV.” Even though Botswana is a middle-income country, said Kim, there are far more resources available to treat HIV than cancer.
Kim said that when presenting her work it was important for her to bring in the human element and not just the statistics: “I hope that, in whatever small way, even these small stories will help get issues in various countries on the map, especially in Africa where we tend to think of it as ‘Africa’ and not so much as different countries with different personalities and different situations.”
Sources: Malaria Journal, UNFPA, World Health Organization.
Image Credit: David Hawxhurst/Woodrow Wilson Center. -
Youth Bulge, Demography-Security Dialogue, and NATO
PRB Discussion on Population and National Security
›April 14, 2011 // By Schuyler NullThe Population Reference Bureau (PRB) held an online discussion this week with demographer Jennifer Dabbs Sciubba of Rhodes College on the topic of “Population and National Security.” On tap were questions on sex ratios, youth bulge, the definition of “national security,” whether the United States should be giving population and health-related advice, and other demographic security topics. Click through to PRB for the full transcript, or check out some select questions from ECSPers Richard Cincotta, Geoff Dabelko, and Schuyler Null below:
Richard Cincotta: Jennifer, my concern is with the lack of specificity that seems inherent in the youth bulge model in terms of civil and ethnic conflict. In other words, the highest probability of civil conflict (often protracted) is associated with very young populations – the Afghanistan, Iraq, sub-Saharan African situations. But, there is also a situation that arises among populations that are demographically somewhat older that is associated with democratization (i.e., the North African situation). These seem to have been conflated by the press and political scientists, yet they are demographically and politically very different cases. Any thoughts on how to recognize these and separate them?Jennifer Dabbs Sciubba: Rich, I think that until we have a stronger theoretical foundation for understanding the conditions under which a “youthful” population leads to civil conflict (very young pop) or democracy (slightly older pop) it will be hard to relay the difference in these two structures to non-experts. The democratization connection, in particular, needs to be refined to move firmly away from correlation and into causation. Right now, it seems to me that we give the same theoretical reasoning to both conflict and democratization (motive, cohort crowding). Do you agree?
Geoff Dabelko: Is the security community, so accustomed to framing issues as threats, internalize your messages about opportunity? Is there a recognition that low cost interventions such as provision of voluntary family planning services could be part of a holistic sustainable security approach? What are the steps that would need to happen to gain more adherents to this perspective?
(Editor: Read more discussion between Cincotta and Sciubba here and here)Sciubba: I’m sorry to say, but no, not really. The positive perspective does not resonate much because most in defense and intelligence are tasked with imagining the worst-case scenario. Opportunities and happy stories just do not fit in this paradigm (or even most of their job descriptions). I’ve tried to figure out what needs to happen to get them to pay attention to prevention, and the only place I see some chance of breaking through is in discussing Afghanistan. Many realize the challenges posed by Afghanistan’s young and growing population and there is some recognition that family planning may be relevant there. I think that for a paradigmatic shift to occur, it would have to be top-down – the vision of the President, Secretary of Defense, etc.
Dabelko: What would be the benefits of demographers and population experts taking more seriously a dialogue with the security community? Your book shows why security sector actors should pay attention to demography. Why should demographers pay attention to security?Sciubba: Some in the security community don’t necessarily understand the assumptions behind demographic projections or other aspects of the data, which means they sometimes misuse the info or distrust it and discard it all together. I also think that scholars of any discipline have a responsibility to understand how their work is being used.
Dabelko: What will be the subject of your next book?Sciubba: I’ll be returning to the politics of population aging. I’m particularly interested in comparing how different regime types have dealt with these issues, including not just Western European states, but also states like Singapore and Russia.
Schuyler Null: There’s been a lot of talk about how aging populations in Europe will affect defense sectors there, in terms of shifting budget priorities. But there’s also the aspect of how aging might affect European decision-making processes when it comes to foreign intervention (perhaps less willing put boots on the ground, stay for long, etc.).
Can you speak to how aging might affect the decision-making process and behavior of European countries when it comes to conflict in the future? How might aging affect the operation of NATO or the UN?Sciubba: Isn’t France a puzzle right now given your question? France, a low fertility country with an aging population and HUGE challenges ahead in terms of paying for entitlements to seniors, has recently shown a greater willingness to contribute to military missions. There is no doubt that aging states in Europe will be under strain trying to meet their promises to seniors and also maintain defense. But, European states still feel that there are sufficient threats in the world to warrant maintaining a military. They are trying to reduce redundancies among themselves and increase their efficiency – great cost-saving measures. Technology can compensate a bit as well. I think European states are willing to use their militaries when the threat is sufficient. Aging, however, may raise the threshold for what qualifies as “sufficient” and US-European opinions on what qualifies may increasingly diverge.
See the full transcript of questions and Sciubba’s responses at the Population Reference Bureau. -
What’s the Link Between Population and Nuclear Energy?
›The popular Big Green Purse blog, written by best-selling author Diane MacEachern, recently asked the Worldwatch Institute’s Robert Engelman, “What’s the Link between Population and Nuclear Energy?” The blog, which encourages women to use the “power of the purse” to improve the environment, wanted to know: “Why aren’t we talking about reducing population as part of our global strategy to minimize dependence on power sources [like nuclear energy] that pollute the environment and threaten people’s health?”
While “reducing population” is not possible, slowing population growth may be, if fertility rates continue to fall. As always, Engelman answered the tough question with thoughtful aplomb, offering three core values as a starting point:One: see the global environmental dilemma not as a problem to be solved but as a predicament to be responded to. We can’t control our future, but we can act with integrity as we aspire to build just societies in an environmentally-sound world. Addressing our numbers can become part of that.
But I’m wondering how the readers of Big Green Purse – which is replete with media-friendly lists like “Top Ten Eco-Tricks” – can translate population and its messy intersection of human rights, health care, and consumption levels into an individual purchasing decision.
Two, embrace human rights as a foundation for our actions. All people – even if too many or consuming too much – have dignity and a right to be here. As it happens, population policies based on the right of all women to choose whether and when to bear a child actually slow the growth of population. …
Three, acknowledge that no one can claim a greater right than anyone else to use energy and natural resources. This is called equity. We cannot object if the poorest people living today and yet to be born succeed in gaining the means to consume as much as Americans do.
As Engelman writes, “The idea that we can easily trim our individual consumption to come into balance with nature – worthy as that effort is – looks increasingly naïve. If people in the developed world slash their per capita greenhouse emissions by half, their effort could be counterbalanced by people in developing countries boosting theirs by just 11 percent.”
Photo Credit: “Trojan Nuclear Power Plant,” courtesy of flickr user tobo. -
‘Dialogue’ Interviews International Reporting Project Fellows on Liberia
›Since 1998, the International Reporting Project has been a pioneer in the “non-profit journalism” movement that seeks to fill the gap left by much of the mainstream media’s reduction in international news coverage. IRP has provided opportunities to more than 300 U.S. journalists to travel to more than 85 countries to produce award-winning reports. This month on the Wilson Center’s Dialogue program, host John Milewski speaks with guests Sunni Khalid, Ed Robbins, and Teresa Wiltz. They recently participated in an intensive fact-finding visit to Liberia under the auspices of the International Reporting Project where they produced stories on the country’s ongoing development and women’s empowerment efforts (among other topics).
Sunni Khalid is managing news editor for WYPR in Baltimore, Maryland. Previously, he worked for Time, The Washington Times, USA Today, Voice of America, and NPR.
Ed Robbins is an independent, multi-award winning director, writer, producer, and videographer. Outlets for his work have included PBS, The Discovery Channel, National Geographic Channel, ABC, and the BBC.
Teresa Wiltz is a senior editor for The Root, where she helps oversee the production of the African-American web-magazine. She previously served as a staff writer for The Washington Post’s style section.
The full 30 minute interview is available at the Wilson Center.
To hear more about their projects, see The New Security Beat’s “A Lens Into Liberia: Experiences from IRP Gatekeepers.” -
Food Price Shocks and Instability Highlight Weaknesses in Governance and Markets
›Unrest across the Middle East has been front-page news for weeks, with commentators searching for explanations to account for the shifting political winds. Many, such as Thomas Friedman and Kevin Hall, have drawn connections between food prices and instability. But, as they point out, high food prices do not deterministically lead to unrest. Instead, rising prices highlight the degree to which governments and governance processes provide and ensure sustainable livelihoods for their people. What these and other commentators point to is that recognizing the role of government in providing food and security is vital: high food prices, they argue, don’t directly cause unrest, but high food prices in poorly managed countries creates a dangerous environment in which unrest may be more likely.
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Portraits of Women From Afghanistan to the DRC
A Conversation on Art and Social Change
›“At the core of human rights and artistic behavior is respect for human dignity. It is this that unites art and justice,” said Jane M. Saks, executive director of the Institute for the Study of Women and Gender in the Arts and Media, speaking at an event cosponsored by the Environmental Change and Security Program and the Africa Program at the Woodrow Wilson Center. Lynsey Addario, MacArthur-winning photographer and former Institute fellow, joined Saks to share striking photographs highlighting the effects of conflict on women and girls around the world. [Video Below]
The Power of Art
“Art is inherently political because it has the power to really engage in social justice,” Saks said. The Institute that she helped found promotes art that pushes boundaries and creates conversations about peace and war, so as to “add to the accepted canon of understanding of conflict.” As part of this effort, the Institute created the exhibition, “Congo Women: Portraits of War,” composed of photographs by Addario and others about violence against women in the eastern Democratic Republic of Congo (DRC).
Saks hopes that these “photographs saturated with human dignity” will create awareness and, ultimately, influence policy about the conflict in the DRC. The exhibition has traveled to more than 20 locations since its opening. In May 2009 it was installed at the Senate Rotunda during the Senate Foreign Relations Committee hearings on violence against women in conflict.
Addario, who said her work is drive by a desire to “give the people a voice,” has spent 15 years traveling deep into conflict zones all over the world, including Iraq, Sudan, and Afghanistan.
Women and Childbirth
Addario’s images reveal the often shocking conditions in which women around the world give birth. In Sierra Leone, she documented 18-year old Mamma Seesay, “one of thousands of women who die in childbirth.” Due to a shortage of doctors, lack of transportation, and high rates of child marriage, one in eight women in Sierra Leone die in childbirth. Afghanistan has the second highest rate of maternal mortality in the world, partly because “an Afghan woman will be pregnant up to 15 times in her life,” she said. “When you watch someone who in most other developed nations would survive without question, it’s just not fair.”
Throughout a decade of covering women in Afghanistan, Addario has sought to provide a “balanced picture” of their lives to American audiences. Her photographs show the milestones women have achieved since the fall of the Taliban: graduating college; driving cars; becoming actors, producers, or police officers; getting married; and giving birth.But her coverage of Afghanistan also contains stories like that of Fariba, an 11-year-old girl who doused herself with petrol and set herself on fire after being abused by her parents. The burn ward at the hospital in Kabul is full of such women who commit self-immolation “to escape their lives,” said Addario. An Afghan woman’s life “is worse than a donkey…there is no release for these women.”
“Give Us Your Guns”
In 2009, she went to the tribal areas of Pakistan to meet the Taliban. “Wrapped up like a cigar,” she posed as the wife of former New York Times correspondent Dexter Filkins and went into a room of 30 Taliban fighters “armed to the teeth.” The two spent the day with the Taliban and “by the end, they loved us,” she said. “The whole time they just laughed at us: ‘You Americans, you give money to the Pakistani government and they give it to us!”
While covering the conflict in Darfur, Addario had to convince UN peacekeepers to drive into a Janjaweed-occupied village so that she could verify how many people had been killed. “Every time we would go towards the village, the Janjaweed would shoot at us and so [the peacekeepers] would turn the cars around and go,” Addario said. To convince the peacekeepers to go in anyway, she said to the commander: “Just give us your guns. We’re gonna go in ourselves if you don’t.” When they finally drove towards the village, “the Janjaweed set it on fire right in front of us, and we just kept driving, and when we got there they had left,” she said.
Addario has spent years as a single woman traveling around the world and throughout conflict zones. “Women in Afghanistan think I’m insane,” she said. “They think I have a lonely, miserable life.” But she believes that as a woman working in conflict zones, she has a unique ability to access places that a man could not and a mission to tell the stories that she hears. “For me it’s about showing the greater American public what’s happening.”
Sources: Institute for the Study of Women and Gender in the Arts and Media, National Geographic, The New York Times, Public Radio International, Slate, UNICEF, and the U.S. Senate Committee on Foreign Relations.
Photo Credit: Woman in labor with her mother on the way to the hospital in Afghanistan and a U.S. Marine in Afghanistan, used with permission courtesy of Lynsey Addario and the VII Network. -
‘Blood in the Mobile’ Documents the Conflict Minerals of Eastern Congo
›With Blood in the Mobile, Danish director Frank Poulsen dives into the eastern Democratic Republic of Congo (DRC) to document a vicious cycle of conflict that has claimed millions of lives, produced rampant humanitarian abuses, and is driven in part (though not entirely, it should be noted) by the area’s rich mineral resources – all under the noses of the world’s largest peacekeeping operation.
The minerals extracted in the eastern DRC – tin, tantalum, tungsten, and gold, mainly from North and South Kivu provinces – are used in cell phones around the world. The trailer shows Poulsen gaining access to an enormous tin mine in the area – the biggest illegal mine in the Congo, he says – capturing powerful footage of the squalid and dangerous conditions that thousands of often-teenage workers labor under for days at a time.
“Four years ago this place was nothing but jungle,” narrates Poulsen. “Today, 15,000-20,000 people are working here [and] different armed groups are fighting to gain control over the mine.”
Though Poulsen is pictured making dramatic phone calls to Nokia (the largest cell phone manufacturer in the world), the issue of conflict minerals from the DRC and places like it is in fact more than just a blip on the radar screens of most leading technology companies. The NGO the Enough Project in particular has been championing the cause and bringing it to tech companies’ doorsteps for quite some time. Their efforts have helped produce an action plan for certifying conflict-free supply chains (complete with company rankings) and also helped lead to passage of the United States’ first law addressing conflict minerals this fall.
However, Poulsen’s message of the developed world taking responsibility for sourcing is commendable. Efforts like this that have led to the adoption of corporate responsibility initiatives like the Cardin-Lugar amendment, a similar measure in the works for the European Union, the Extractive Industries Transparency Initiative, and the Kimberley Process for diamonds.
Blood in the Mobile premiered this fall at the International Documentary Film Festival and the producers are “in dialogue with different U.S. distributors,” according to their Facebook page, where those interested are advised to stay tuned.
Sources: BloodintheMobile.org, Enough Project, EurActiv.
Video Credit: Blood in the Mobile Official Trailer. -
A Lens Into Liberia: Experiences from IRP Gatekeepers
›The International Reporting Project (IRP) gives “editors – the ‘gatekeepers’ – a chance to get out of the newsrooms and to see for themselves the importance of international affairs,” said John Schidlovsky, director of IRP, at a Wilson Center event about the independent journalism organization’s recent two-week trip to Liberia with 11 U.S. news editors. [Video Below]
Schidlovsky stressed the importance of providing international opportunities for journalists in the face of news industry budget cuts. IRP fills the gap by sending gatekeepers, who help determine what news items will be selected for publication or broadcast, to countries that are often underrepresented and neglected in mainstream media.
Three of the gatekeepers, Sunni Khalid, managing news editor at WYPR Baltimore; Ed Robbins, a video journalist; and Teresa Wiltza, senior editor for The Root, shared their observations from their Liberia trip, as well as their insights into the challenges of international reporting.
Economic Challenges and Opportunities
Liberia is slowly beginning to rebuild its economy after a 14-year civil war with more than 200,000 casualties, but there are still “tremendous challenges,” said Khalid. “How do people survive? What kind of jobs do they have? How do they feed their families?”
According to World Bank figures, 84 percent of Liberians earn less than $1 a day, and more than 94 percent earn less than $2 a day. The government’s annual budget is only $369 million, the official unemployment rate is 85 percent, and corruption and lack of infrastructure remain major concerns.
Despite these problems, “Liberia has a lot of good points going for it,” said Khalid. Investment in the country’s raw materials is growing; most recently, the country signed a $7 billion deal with China and a European consortium to continue iron-ore mining.
Initially expecting to “write an obituary for Liberia,” Khalid said he “came out of this trip fairly optimistic about Liberia’s future.” With its “small population, great location, and mineral wealth,” as well as “competent political leadership,” Liberia can take advantage of its potential, he said.
“Capturing the Flavor” of Liberia
Robbins hopes to paint a multidimensional picture of Liberia and “capture the flavor of the country beyond Monrovia,” with his series of short films, which will be available on the websites of both Time and the International Reporting Project,
Robbins previewed one of these films, a profile of the chair of the Liberian Women’s Initiative, Etweda “Sugars” Cooper, who he says “embodies a certain power of a lot of Liberian women in her dedication and also her love for the country.”
At the local level, “the problems of recovery and development are all there in miniature,” said Robbins. But with dedicated leadership from people like Cooper, communities are slowly beginning to rebuild the schools, roads, hospitals, and other infrastructure that was destroyed in the civil wars.
“When you read books and articles, it tends to be really focused on the war and the devastation,” said Robbins. But there is also a sense of optimism among Liberians: “you can see hope in these people, a sense there is something there,” he said.
Empowering Women and Ending Rape
Wiltz pointed out that, “there is a prevailing sense of hope,” particularly among the older generation of women. After years of violence, these female “peace warriors” led the movement that ended Liberia’s civil war. But seven year later, “for women there, the biggest issue is that of economic empowerment,” said Wiltz. “They’re feeling empowered, but they’re broke.”
Sexual violence has become “part of the national psyche,” Wiltz said. During the civil war in Liberia, it has been estimated that more than 60 percent of the female population was raped. Today, “everyone seems sensitized to the issue, and yet it’s still a huge problem,” she said. Sexual violence is still common despite the prevention efforts of radio campaigns, NGOs, and Liberian President Ellen Johnson-Sirleaf.
“You’re in a country where families were destroyed by war,” Wiltz said. In the process of rebuilding Liberia, the new challenge is to engage and empower a new generation of young women and girls. “Underneath the surface there is all this pain and this legacy of extreme cruelty, but they very much want to overcome this.”
Much of the gatekeepers’ coverage is available online: Sunni Khalid produced a week-long series of radio pieces for WYPR, an NPR affiliate; Ed Robbins produced a series of short films for Time; and Teresa Wiltz published several articles on The Root.
Sources: CIA World Factbook, U.S. State Department, World Bank, World Health Organization, WYPR.
Photo Credit: “Liberia Will Rise Again,” courtesy of flickr user Jason Judy.
