Tag: Time for Your Check-Up—Decolonizing Global Health

Observations of Mobile Health Clinics in Honduras: A Case Study on El Centro De Salud Integral Zoé

Presenter(s): Mitchell Yep—International Studies, General Science

Faculty Mentor(s): Lesley Weaver, Melissa Graboyes

Session 1: Time for Your Check-Up—Decolonizing Global Health

Visual impairment and blindness are debilitating conditions with increasing rates around the globe . The World Health Organization estimates at least 2 .2 billion people have a vision impairment or blindness, of whom at least 1 billion are preventable or remain unaddressed (Bourne et al ., 2017; World Health Organization, 2019) . El Centro de Salud Integral Zoé uses an innovative Mobile Health Clinic model to deliver cataract screenings and visual acuity exams to populations marginalized from the Honduran health care system . Zoé ́s outreach model actively removes systemic barriers that prevent individuals from seeking care such as cost, distance, logistics, and lack of knowledge . The colonial legacy and proposed neoliberal development policies have resulted in the underdevelopment of health infrastructure and widespread exclusion from these services . The expansion of accessible health care is a pressing national issue as the State›s Ministry of Health estimates 18% of the population (over 1 .5 million Hondurans) do not have access to health services (Secretary of Health, 2015) . Implementing the Right to Health under the 1948 Universal Declaration of Human Rights and achieving the 2015 United Nations Millennium Development Goals requires the foundation of accessible health care . Mobile Health Clinics present an alternative development strategy to ease disparities of access to health care by bringing medical services to communities that would not receive them .

Policy Mapping onto Bodies: The nexus between immigration policy, local community support networks, and migrant health outcomes in Tijuana

Presenter(s): Samantha Sidline—International Studies

Faculty Mentor(s): Kristin Yarris

Session 1: Time for Your Check-Up—Decolonizing Global Health

The implementation of new policy at the US-Mexico border has only exacerbated the humanitarian crisis experienced by border communities and asylum-seekers . The Migrant Protection Protocols are already affecting asylum-seekers attempting to enter the United States from Mexico . Policies like the MPP disenfranchise migrants by creating the conditions in which fleeing families are vulnerable to a system that is unsupportive of their rights, exposing them to various forms of violence and hostility . Families must now wait in Mexico for unspecified periods of time for the duration of their immigration proceedings . Inevitably, policies like this one produce environments of uncertainty and neglect the framework which recognizes immigration as a determinant of health . This thesis aims to position the current asylum-seeker experience at the US-Mexico border as one at the whim of frequent United States policy changes and how this instability may impact migrant health negatively . The reality of asylum-seekers’ experiences is detailed through my participant observation research in Tijuana, where the effects of the MPP are lived day-to-day . Interviews with community workers addressing the humanitarian crisis at the border deconstruct the embodiment of such policies in asylum-seekers while simultaneously demonstrating how community support can aim to negate the harmful impacts of policy . This research will show how policy determines the livelihood of asylum-seekers coming into the United States and recognizes community networks’ role in migrant community health and fostering solidarity .

The Correlation Between Stigma Stemming from HIV and Antiretroviral Packaging: Design Recommendations for Introducing Discrete Packaging for Adolescents in Western Kenya

Presenter(s): Arden Saravis—International Studies

Faculty Mentor(s): Clare Evans

Session 1: Time for Your Check-Up—Decolonizing Global Health

Failure to adhere to antiretroviral therapy (ART) persists in exponentially large numbers in the adolescent population in Western Kenya . The presence of stigma surrounding HIV heavily contributes to this immense prevalence in society . Adolescents living with HIV fear premature disclosure to
their peers, so many choose to not bring their ARTs in public and even hide them in their homes . We assessed perceptions of the ART pill bottle/pill to see if this contributes to non-adherence and discussed ideas on changing the bottle or developing a new, discrete pill casing . We conducted nine key informant interviews among professionals who work with adolescents and young adults living with HIV and conducted four focus group discussions with 42 adolescents living with HIV at a hospital in Western Kenya . We found that currently, because of the pill bottle, many adolescents and young adults remove their pills and place them in other items, reducing pill potency, however the results include proposed ideas and designs for an alternative pill bottle that they will use and confirmed that their adherence would increase if these such items were implemented .

Quantifying Diabetes Disparities Related to American Indian and Alaskan Native Residency on Reservations

Presenter(s): Julia Liu—Sociology

Faculty Mentor(s): Clare Evans

Session 1: Time for Your Check-Up—Decolonizing Global Health

American Indians and Alaskan Natives (AI/AN) have the highest rate of diabetes of any racial group in the United States . This disparity does not show up evenly amongst AI/AN, suggesting that environmental effects for various AI/AN can lead to health disparities . AI/AN have unique historical circumstances because many of them reside in reservations, which the government uses to segregate them from other racial groups . Due to the traumatic history of the reservation system, there are likely enduring conditions that exacerbate health disparities, including diabetes . This thesis looks at the correlation between living in a Census-designated American Indian Area (AIA) and having a diabetes diagnosis . It compares diabetes rates between American Indians and Alaskan Natives (AI/AN) living in AIAs and those living outside of these areas using data from the National Survey on Drug Use and Health . Logistic regression models determined if any subsets have a disproportionately higher rate of diabetes diagnosis . These models control for demographic factors such as age, income, gender, and education and show that AI/AN living in AIAs are anywhere between 1 .595—1 .764 times more likely to have diabetes than AI/AN outside of AIAs . This demonstrates that living in reservation- like areas is correlated with conditions that likely contribute to diabetes disparities . Potential explanations for inequalities include lack of nutritious food sources, environmental stress, and other conditions . This serves as a starting point for further qualitative research to explore social processes that create environmental inequalities and worsen health disparities .