Title: Stopping Sexual Street Harassment in Jamaica

Thesis: Street sexual harassment is a major public health problem in Jamaica and very little is done to resolve it. 

Central question: What is the prevalence of street sexual harrasment in Jamaica, what is already being done to improve this issue and what recommendations is being done to address this?

Who is the audience: Average person in the US and possibly Jamaica, english speaking 

What does the audience need to know to understand your story:

    -- Street sexual harassment , sexual harassment is repeated unwanted sexual attention and street sexual harasment is harassment between strangers or in a  public space

    -- The sexual harasment act was passed in 2021, however it only covers sexual harrasment in the workplace ( employer and employee), and not public/street sexual harrasment and may never will based on researched statement 

    -- “see n’ blind , hear n’ deaf” is a saying in Jamaica that means if it does not affect you personally, it should be left alone. 

   -- Street sexual harrasment is an endemic

CONTENT WARNING: The following podcast  will talk about  street sexual harrasment and may be triggering or disturbing to some listeners or readers. 

*soft intro music*

Interviewee: “Street harassment Sexual harassment is a major challenge in Jamaica. We've seen it well. Personally, I can give you my personal experience being someone who doesn't. Essentially, you know, you know, manifests in the typical female feminine gender with my hair that it's cut low. I often experience street sexual harassment. Hey, girl, with  your short hair. Come here. I want to do this and that with you. And then they play on it to say, Hey, are you a lesbian? Because my haircut is low. So I experience street harassment”

*soft intro music*

Narrator: Most people do not remember a time when street sexual harrasment was not an issue in Jamaica. It is seen everywhere. From as small as catcalling to as big as getting groped on public transportation.

Policy and Advocacy officer at JNplus , Kimberly Roach also shared her personal experience with this issue. 

* soft intermediate music*

Narrator: But first, what is street sexual harrasment. Sexual harassment is unwanted sexual attention and advances. It is a domination of power, usually by men. Street sexual harassment is harasment between strangers and usually in a public place, like public transportation. 

Narrator: However, there has been very little attention from academic researchers and government policy makers. It took 23 emails, 11 missed calls and 9 messages to social media before I received a response from JNPlus, an organization that was willing to talk about street sexual harrasment. JNPlus primarily deals with HIV positive women that suffer from Gender Based Violence and Intimate Partner Violence also known as GBV and IPV that are also problems in the community that stem from street sexual harrasment.  So let’s hear from Kimberly Roach on what JNplus is.  

Interviewee: OK, so Jam Plus is essentially again is an organization, an advocacy organization that essentially looks at the policies and laws that impacts persons living with HIV. Pertaining to sexual harassment, I would say that street sexual harassment is that we see that GBV and IPV which sexual harassment is a part of impacts the lives of persons living with HIV, but more so it's also a cause that, you know, plays into the whole HIV prevention because we want to tackle GBV. So it doesn't, you know, impact many other young women and other women who may experience GBV. They also, you know, are susceptible to transmitting HIV and also, you know, getting impacted by the virus.

*soft music* 

Narrator: The problem of street sexual harrasment begins in the community.  According to reports, 41% of Jamaican teen women fall victim to this crime. It is underreported however, because the culture and mentality shuns people from talking about this. It is called the “see n’ blind, hear n’ deaf” mentality. 

*haunty intermediate music* 

Interviewee:“Citizens often silenced themselves because, you know, they don't want to talk about certain issues in the public sphere. They don't want to talk about sexual harassment in the public sphere. They don't want to talk about even sex in the public sphere. And they definitely don't want to talk about HIV in the public sphere. So it's it's a it's a ingrained cultural attitude where persons generally don't talk about certain issues that they may think is taboo pertaining to sexual harassment. It often silences victims. Persons are often scared to talk about their experiences because, you know, a victim blaming, they're going to say, Oh, it's your fault because you, you should not have worn this or are anything to blame the person who is a victim of this sexual harassment? Now, It also impacts how other people view sexual harassment. Because we have this cloak of silence over sexual harassment. Persons usually don't say anything when they see it happen to other women or Vulnerable women or young women within the society. They don't talk about it. They don't go in and say, Hey, stop this, or they don't even advocate against it. And that cause, you know, the awareness when it comes down to sexual harassment, it cause the awareness to be significantly reduce where persons don't even know that they're experiencing sexual harassment because nobody really talks about it.”

Narrator: So if it is not talked about, how do we know it is a problem? Well, one of the indicators is in the music. 

* sound mimicking popular dancehall tunes* 

Interviewee: “Regarding to music, Yes there is toxic masculinity that is displayed throughout dancehall, where he talks about women in forms of inanimate objects. You know, they don't look at women as holistic beings and their project a sexual, you know, objectivity on women. They objectify women. So yes, the culture does play a major role in how, you know, we view sexuality, we view women, and it plays our role in how this generation and the generation before played into sexual harassment. Yeah. ”

Narrator: Women as objects. This definitely plays a role in its prevalence. Research states that this can cause PTSD, lack of concentration in the workplace, and other mental health issues. Mental health that is also not talked about in Jamaica.

*sad soft music*

Interviewee: “Jamaica has yet to recognize the impact sexual harassment has on a person's been both physically and mentally. We don't have a lot of access to, you know, mental health care in Jamaica, and it's also a taboo topic. So a lot of times persons who are victims of sexual harassment or even rape, they internalized what has happened to them, and they don't have much space to discuss the issue. we in Jamaica definitely need to have more spaces that, you know, look for the holistic wellness of persons, including their mental health, and particularly for persons who are experiencing sexual violence or even harassment. They need to have social services that targets this type of work, mental health and other ways to to get over trauma that they may face.”

Narrator: So you see, in public places, street sexual harrasment is a problem. But it can only start being resolved with the government's help. In 2021, the Jamaican Senate passed an act that covers sexual harrasment in certain scenarios. Like the workplace. But is that enough? 

Interviewee: “So I'm happy that Jamaica, you know, is going forward and enacted this bill in late 2021, where sexual harassment is now covered in the law and it covers both prevention and protection. It protects essentially women and men. It protects persons who may face sexual harassment in unique situations, such as the landlord and tenant in the workplace, in the church and so on. But the bill, I think what is a gap in the bill is that it doesn't really speaks to street harassment, street sexual harassment. And for me, in the Jamaican society, that's where most persons experience sexual harassment is in the streets. So what I would recommend is that we looked at innovative ways of capturing street harassment in, you know, some sort of amendment that may come later at a later time. But I'm happy that the Jamaican government enacted this bill. It's well needed. Persons here do face a lot of sexual harassment in the workplace between tenants and landlords and so on. And it's great to see that we are taking this step to to enact this bill. But there's much more to be done. We need to ensure that sexual harassment street harassment is also a major tenant in this law so that persons on the street feel safe navigating the society every day and not just in your relationship to your landlord or not just in the workplace, but more so on a societal level and not so much on the institutional level where it's protected now”

*hopeful instrumental music*

Narrator: Many steps need to be taken to resolve street sexual harrasment. Education on sexual harrasment in public schools should be introduced to the curriculum. Social issues like the bystander effect, which is when the presence of others prevents a person from intervening in an emergency situation, need to be tackled. Bystander effect is a major resolved step since street sexual harrasment is a issue that happens in the public. JN plus has also been putting in the work to better this issue. 

Interviewee: “Ok so at JN plus we primarily deal with women who are living with HIV. So some of the work that we've been doing recently is to upscale our GBV response. So part of our GBV response is ensuring that all in our community of positive women understand what GBV is, which is inclusive of sexual harassment for those who face, you know, more violent forms of sexual harassment or any form of GBV who need, you know, psychosocial help then we have, what do you  call it ,a psychologist, sorry on board at our organization, where we recommend women who are experiencing that type of thing. Well, also, we have support groups where we talk about this thing among our women, and we also educate men who are also a part, are members of our organization about umGBV and sexual harassment and why it's not OK. But also an important aspect of this is that recently we've been developing an advocacy plan specifically for positive women where um they talk about the issues that women living with HIV are facing. And one of those major issues is street harassment, community harassment and so on. So we're going to essentially ramp up advocacy to talk about this specific type of harassment  more vulnerable people face ,and how we would like to see amendments in legislation to protect them from that type of harassment. But we educate both men and women, but we put a focus on ensuring that our women have support systems as well,  in our support groups, as well as, you know, the mental health care that they need.”

*soft music* 

Narrator:What more can be done to tackle this issue? People on bus transport should be limited and public spaces should be more lit. Articles also suggest there should be stronger community leaders that will research and educate their communities on this issue. This has been done in countries such as Belize and the Bahamas that have approved laws against sexual harassment and have media campaigns that are also against it. JN plus also had recommendations on how to resolve this issue. 

Interviewee: “One of the recommendations that we we think would help is to have broad cultural sensitization about gender based violence and street sexual harassment, what it is, why it's not OK, and how it impacts the life of persons who are victims and also, you know, the persons who perpetuate this type of thing. So we definitely think a cultural shift behavior shift would happen if we have more awareness around it. But that is only useful when you also have legislation that could, you know, also put those who are doing this type of thing to the victims to ensure that they face the brunt of the law. So we also believe that even though we have a sexual harassment act, that a part of the amendments we'd like to see is persons who essentially harass persons because of their, you know, their sexual health if you're living with HIV or any other thing. So we want the law to also cover that type of stigma and discrimination as well. So those are the main  two recommendations that we have from JN Plus.”

*more hopeful instrumental music*

Narrator: Even though street sexual harrasment is a tough issue, it can be resolved. If the community and the government go hand in hand in minimizing this issue, there will be a community of peace. 

*end with faster upbeat music*

This podcast was produced by Lacey-Ann Reynolds for the Spring 2022 Global Health course at Guilford College.

References

1. Amnesty International. (2006). Sexual Violence Against Women and Girls in Jamaica:'just a Little Sex'. Amnesty International, International Secretariat.

1. Kingston, J. (2012). Sexual harassment and sexual harassment policy in Jamaica: the absence of a national sexual harassment policy, and the way forward. Asian Journal of Business Management, 4(1), 1-19.

1. Smith, D. E., McLean Cooke, W. C., & Morrison, S. S. (2020). A discussion on sexual violence against girls and women in Jamaica. Journal of Sexual Aggression, 26(3), 334–345. https://doi.org/10.1080/13552600.2019.1643505

Title: “COVID Accessibility for all”

Thesis: COVID vaccines are nearly accessible amongst specific groups of residents within

Vietnam, especially the Montagnards considering where they live and how much income they

receive, which can increase the risk of transmission of COVID amongst those who have not

been vaccinated.

Central question: [Revised questions] What should be done and provided for Montagnard

individuals to have/get access to the COVID vaccine?

Who is the audience?

- Montagnard + Vietnamese, and English-speaking individuals.

What does the audience need to know to understand your story?

- The Montagnards live amongst the Central Mainland of Vietnam’s region.

- An individual’s hesitancy in accessing the vaccine (DaDi’s *aunt* point of view/answer).

- A brief explanation of Corona Vac.

- There is an income disparity between urban and rural areas (academic research).

SCRIPT DRAFT [Revised] (2)

Narrator: In today’s segment, where we’ll be discussing, COVID vaccine accessibility and

vaccine knowledge amongst the Montagnard community in the region of Vietnam during the

COVID-19 pandemic.

Narrator: Montagnard people are a group of natives of Vietnam, and during the COVID-19

pandemic have had a high rate of transmission of the virus.

Narrator: This is due to low health education and communication programs in the rural area

where they live. COVID-19 vaccine accessibilities are related to income, self-perceived risk of

infection, and lack of knowledge and engagement in the Montagnard community. What should

be done and provided for Montagnard individuals to access the COVID vaccine while

recognizing their situation as a rural community as to provide more useful resources that benefit

them?

*Mellow/Calm music transitioning*

Narrator: A healthcare data analyst from Buon Ma Thuot, DaDi Boun Ya, is well versed in the

vaccine accessibility of the Montagnard community.

Narrator: As a healthcare data analyst, DaDi, is a frontline healthcare worker, and her job

consists of organizing, managing, and communicating amongst Buon Ma Thuot state hospital.

Interview Questions & Discussion

Narrator: On April 27th, 2021, Vietnam experienced the fourth COVID-19 wave regarded as

the first catastrophic yet "real" wave. 927,495 cases have been reported as of November 2nd,

2021. Who were the first people to receive it? Why?

DaDi: The first people who received the COVID vaccine were frontline workers in the state of

Buon Ma Thuot. For example, healthcare workers like myself were the first group of people who

were vaccinated because we worked amongst hospitals and patients. As a healthcare data analyst,

I fear so much for the safety of my family, especially my daughter and husband. Your uncle, who

works in the state as an executive officer, is always around his co-workers and other people out

of the country. This scares me because it’s a safety concern I have when it comes to rapidly

spread viruses, which can be transmitted from close contact or airborne.

Narrator: When thinking about how to receive and access the vaccine for our benefits of safety

from the risk of transmission, how would you compare the accessibility of COVID-19 vaccines

before when it was first distributed?

DaDi: Before, many people were worried about who would receive the vaccine because of safety

concerns. The spreading of COVID became a fear in everyone's minds including myself.

Vaccine distribution was only to workers on the frontline such as healthcare workers or

individuals who worked amongst the state, so it was divided from the rest of the people in

Vietnam. When looking at this situation, gave a sense of security and hope to the people of

Vietnam including the Montagnard community because it shows that time will progress through

and some protocols need to be followed and established beforehand.

*Mellow/Calm music transitioning*

Narrator: COVID-19 has created many challenges in the Montagnard community. For example,

increased job losses, lack of viable isolation areas when tested positive, and delays in accessing

critically needed care during illnesses.

Narrator: From DaDi’s point of view as a healthcare analyst, there is a high number of

Montagnard individuals living in rural areas who receive the bare minimum of acknowledgment

and preparation for prevention from COVID-19. It’s a constant fear that people within the

Montagnard community live in today, which shows there isn’t as much guidance that they’re

receiving compared to those who are getting information that they need. DaDi suggested some

resources and awareness that benefited the community.

*Mellow chime transitioning

Narrator: What challenges do you think some Montagnard individuals underwent when

accessing the vaccine? If they were some vaccine hesitancy, what might’ve been some concerns

that people may have?

DaDi: When speaking on hesitancy and challenges, our community, the Montagnards or Ede,

some people have not had much knowledge about the current (COVID-19) vaccine. Some would

wait until the effective treatment because the COVID-19 vaccine has been produced so fast.

There was some hesitancy among those who have not got vaccinated because of the lack of

knowledge and education about the various types of vaccines, which was questionable whether

or not the vaccine was preventative because of where they were produced and researched.

As the distribution of vaccines, such as Pfizer, AstraZeneca, and Moderna, began to proceed

through the community, people felt appreciated yet grateful that they were receiving them

because it provides an extra layer of protection. But as China began its production of vaccines

for COVID, it gave some concerning thoughts and opinions amongst the community because

people didn’t know much about CoronaVac and how it was created. Some assume that there’s

been less amount of research and trials that’s been done for it to be labeled as “safe” for everyone

to have access to for their safety benefit.

*Mellow/Calm music transitioning*

Narrator: Pfizer and Moderna are both produced and researched within the United States while

AstraZeneca is produced within the United Kingdom.

Narrator: When compared to CoronaVac, which was produced by Beijing-based company

Sinovac. It’s the world's most widely used COVID-19 vaccine.

On June 1st, 2021, the World Health Organization (WHO) established CoronaVac for emergency

use. The company, Sinovac, has signed purchase agreements for 380 million doses from COVAX

(COVID-19 Vaccines Global Access). As of July 2021, CoronaVac was the most widely used

COVID-19 vaccine in the world, with 943 million doses delivered.

Narrator: CoronaVac works the same way as Pfizer and Moderna. Two doses are administered

between 14 days. The effectiveness rate is 51% against symptomatic COVID-19, 100% against

severe COVID-19, and 100% against hospitalization starting 14 days after receiving the second

dose.

Narrator: The CoronaVac vaccine has been in phase 3 trials since mid-2020 in Brazil,

Indonesia, Chile, and Turkey, which brings into question whether it creates a preventative

solution for the Montagnard community when it comes to accessing and receiving them due to

the low effectiveness rate and how it may be suitable amongst each individual when it comes to

the system acceptance.

*Slight chime/ding transitioning*

Narrator: Amongst the Montagnard community, there were a few challenges when it came to

deciding to get vaccinated because of safety considerations and the fear of developing side

effects and complications from whichever vaccine is provided.

*Mellow/Calm music transitioning*

Narrator: Since you mention about lack of awareness and education, what might be some of the

solutions that should be provided for those who haven’t received the vaccine?

DaDi: Within the Montagnard community, there are different systems in providing awareness

and guidance on what COVID is and how the vaccine benefits one’s health. Each region of

Vietnam is divided into a system of “districts,” which are led by elders or medical educators,

who play an important role in explaining the benefits of the vaccine and why it's important to

receive it because if not, there may be some consequences.

DaDi: In the beginning, COVID cases have gotten worse, which then became an important issue

to be taken seriously because everyone feared spreading to one another and being around the

community.

As soon as vaccine regulation passed, such as individuals in the group of 65 or older and then

individuals who were the age group of 18 to 46, people quickly registered to get vaccinated for

the sake and benefit of their well-being and others.

When everyone got the chance to get vaccinated, it brought a sense of relief, which brought

awareness that COVID will still be around and that getting vaccinated will bring down the risk of

people getting infected.

*Slight chime/ding transitioning*

Narrator: When it came to receiving the COVID vaccine, DaDi shares her experience as a

healthcare worker when she first received the vaccine while comparing how the rest of our

community, the Montagnards, accessed it.

DaDi: When comparing my experience with our community, I see a difference in favor of getting

vaccinated with the same vaccine. For example, some considered getting vaccinated with Pfizer

for their first and second dose. Then, for their booster, they prefer the same vaccine because they

felt it would give them an easier outcome and fewer complications of experiencing side effects.

Before the vaccine distribution, the majority of people within our Montagnard community lived

with questions and doubts about what will happen next or the next step to where Vietnam will be

if COVID is still around. There were an increased number of cases because a lot of people were

around each other and being six feet apart wasn't quite helpful for anyone.

As cases got higher, Vietnam placed a mandatory lockdown that lasted up to a month for it to

dial down, which helped a lot, but the downside was that many businesses, especially small

businesses, began to struggle because there wasn’t as much income brought home since everyone

had to stay home.

As vaccines were distributed, we’ve seen a great number of our community begin to open and

accept the helpfulness of the vaccines. Many families began to spread awareness amongst other

people and help convince them that getting vaccinated will bring everyone closer and bring a

sense of safety and acknowledgment. When looking at this, it’s a big improvement that took

small steps but impacted greatly amongst others so we could see hope for the future.

*Mellow/Calm music transitioning*

Narrator: DaDi’s narrative about vaccine distribution amongst the Montagnard community of

Vietnam indicates many crucial factors. Vaccine knowledge and resources are crucial

determinants of vaccine accessibility in the context of Vietnam.

Narrator: Strategies such as social distancing and lockdown measures help maintain the

outbreaks. If the number of vaccinated Montagnard individuals increases, each of them will be

an “immune shield”, which protects them from infection and decreases the spread.

Narrator: There are some things to be advised or bring awareness of within this vaccine

distribution and accessibility. First, the knowledge and skills of healthcare professionals. When

you’re looking at public hospitals, resuscitation, and emergency care are better than those

“not-so-good” hospitals. Second, these public hospitals are well equipped. Although the

“not-so-good” hospitals can carry out emergency cases, severe cases must be referred to a better

and more equipped hospital. Third, reaching out and increasing COVID-19 programs to create

better education and knowledge for those who want to know more and expand their knowledge

to others so it benefits future outlooks.

Narrator: Health care and distribution amongst all regions of Vietnam (South, North, and

Central) is part of the grassroots health strategy and plays a vital role in primary health care.

With this, they could foresee the accessibility and affordability of available local health services

without feeling unsafe yet feel acknowledged by individuals who put them first for their

well-being and health.

Narrator: This podcast was produced by H’Neamy Mlo for the Spring 2022 Global Health

course at Guilford College.

Title: Familism in Hispanic/Latinx Daughters (Mental Health)

Thesis: Many Hispanic/Latinx daughters have struggled with their mental health due to putting

their families first.

Who is the audience?

- Spanish and English-speaking individuals

What does the audience need to know to understand your story?

- The impact of familism on mental health

- Responsibilities and tasks performed by Hispanic/Latinx daughters

- Ways to support Hispanic/Latinx daughters

Script Final

*Soft Tone Music*

Narrator: When I was focusing on the tasks and adult responsibilities that I was given at a

young age as a Hispanic/Latinx daughter, I never really realized how my mental health was

impacted by taking on adult and parental responsibilities. I had never heard of the term familism

and how it has impacted so many individuals.

Narrator: The term familism is commonly used to describe the saying “family comes first”.

Many Hispanic/Latinx parents enforce the idea of putting their family first on their children. At a

young age, the oldest daughter must take on caretaker responsibilities such as changing diapers,

feeding and providing food and raising their younger siblings. It takes a large toll on them since

they are learning to commit to all these adult and parental responsibilities at a young age. In

today’s society, women are given the opportunities to be independent by establishing their own

income. Women are able to get the same jobs as men. Although women are able to do these, in

Hispanic/Latinx culture, they are viewed as home makers who must take care of the children,

cook, clean, and many more. A cultural term for this is called marianismo since women must

sacrifice themselves to take on the role of a family caretaker. While men must become the

breadwinners of the household. The term machismo is another term used to describe men with

strong masculine pride. Because of these cultural backgrounds, daughters are automatically

viewed as a woman who should stay home and commit to being family oriented.

*Soft Tone Music Transition 1*

Narrator: Now that we have looked at the cultural background on Familism with

Hispanic/Latinx cultures, let us focus more on how it impacts daughters. Kennia is currently a

Mexican American teenager in high school, who has recently been kicked out of her household

after not wanting to deal with familism. She is currently living on her own but still has contact

with her family.

Kennia: My name is Kennia, I'm 18 and right now I just go to school.

Narrator: Lorena Del Rio-Rivera is also a Mexican American woman who has also dealt with

familism, and she reflects back on her experiences now that she is an adult. She is currently

living on her own with her husband, children, and also her youngest sibling.

Lorena Del Rio-Rivera: My name is Lorena del Rio Rivera. I am 34 years old, and I'm a realtor

in Winston Salem.

Narrator: Familism is a very important component to this family dynamic. For the first-born

sibling, this can be very difficult since you have other priorities such as school and working jobs.

In Hispanic/Latinx families, it is shown to put your family first, whereas in the United States you

are taught to become independent. Kennia had to start taking care of her 2 young brothers Santi

and Emilliano around her teenage years.

Kennia: Around the time when Emiliano was born, maybe four or five. So I was like 14 or 15

with my little brother. I just feel like there is a lot of stress on me to raise my brothers. Especially

during the pandemic since it was all on me.

Narrator: Because Familism causes daughters to have major adult and parental responsibilities,

according to research, the impact of familism on health outcomes would be intervened by the

coping and burden styles of caregivers’. When looking at this, familism is being negatively

associated with higher levels of burden, which would prevent Hispanic/Latinx daughters from

communicating and expressing their feelings. Familism causes the feeling of not wanting to

commit to a family since individuals are forced to grow up at a young age and adapt to adult

responsibilities, which they’re not able to commit to themselves mentally and emotionally. Aside

from not feeling ready to grow up soon, they must also deal with a lot of responsibilities. Some

responsibilities can include preparing bottles for younger siblings, changing diapers, bathing

younger siblings, learning how to cook for the family, cleaning bathrooms, living rooms, and

many more. They are taught to learn all these at a young age when they do not feel prepared or

ready. Both Lorena and Kennia state some of their responsibilities.

Lorena Del Rio-Rivera: Definitely cooking and cleaning, changing diapers, showering and

bathing. I didn't really get to like going outside and playing with other kids because I had the

responsibility of my other younger siblings while my mom was working. So she would do the

third shift and most of the time I had to like you know, play housewife and I was really a kid.

Kennia: I helped them with all their homework and my little brother Santi, it was on me to potty

train him and I couldn't figure out how to do it so he still doesn't know. I had to change a lot of

diapers and calm a lot of temper tantrums. And there were times where I wanted time, just alone

time but I had to take care of them.

Narrator: One of the biggest challenges of Hispanic/Latinx daughters would include translating.

Hispanic/Latinx parents are native Spanish speakers. When they came to the United States, it

was very difficult for them to adapt since most individuals speak English. Because of this, they

rely on their children to help them translate. This can complicate translating since

Hispanic/Latinx children must learn both English and Spanish. Many children must start

translating for their parents when they enter elementary school. This can be very frustrating for a

young child to do.

Lorena Del Rio-Rivera: So when I was like looking at legal papers, which you know I shouldn't

have been doing, I didn't know what it meant, so I would tell my mom like I don't know what

this means, and then you know she would say “You go to school, you should know.”

Narrator: These responsibilities take a huge toll on them because of how time consuming they

can be. Taking care of siblings or other family members takes so much effort since they are

dependent on you. As mentioned before, they have to deal with many priorities such as

education. Students who are in school and also work long hours, take longer to obtain a graduate

degree. Hispanic/Latinx parents view education as important, but expect their children to be

family oriented. This causes a daughter to not only have the pressure of family, but also

education and their job. It is very difficult for someone to try to earn their degree, while also

taking care of their family and trying to put food on the table. Lorena dropped out of school to

continue supporting their family

Lorena Del Rio-Rivera: Continuing education, I couldn't focus on me because I needed to work

so that I can help my mom and provide it wasn't until maybe my fourth sibling was old enough to

help around that I got a little bit of relief and even at that point, it wasn't like enough, I was still

like look that like wait you can't slow down on how much you bringing in. I had to work harder

to get where I am and get what I have and do what I do because it's like I had to make sure that

everybody else was good, before I could make sure that I was good.

Narrator: After listening to Lorena’s story and how hard they worked, I asked Lorena if they

had any advice for Hispanic/Latinx daughters, they said:

Lorena Del Rio-Rivera: Stay in their life gets better, you know, once you grow up and are able

to get out of that household it'll get better.

Narrator: Even though Kennia has gone through this experience, it is hard to know what to

recommend to others

Kennia: I'm not sure, because the only way for me to get out of it was to leave. I feel like it's

hard for us to speak to our parents about how we feel and whenever we do tell them how we feel,

they don't understand. Not even because of the language barrier, they don't understand because

they were raised differently. And I get it because life in their home country is different but at the

end of the day, we are not there and life is different here.

Narrator: From Kennia and Lorena’s point of view, it is clear that familism has impacted their

relationship with their families due to the fact that the responsibility of raising their siblings has

been forced upon them. In order to escape this reality to preserve her mental health, Kennia had

to move out. Meanwhile, Lorena had to put her life aside to help her family go forward. They

both had to sacrifice their time and priorities to provide for their families first.

*Soft Tone Music Transition 2*

Narrator: Many of the beliefs and values in U.S society are different from Hispanic/Latinx

society such as the view of women and mental health. Hispanic/Latinx parents were not raised to

express or understand their mental health. They were taught to work hard and do everything they

can to support their family. Due to these cultural differences, it is difficult for parents who were

born or raised in a different country to understand their children who were born or raised in the

United States.

Narrator: According to research, the Hispanic/Latinx community is the fastest growing and

largest minority group in the United States. With that being said, they are also the largest group

to not receive mental health services. This is due to lack of resources, lack of time, language

barrier, or not acknowledging mental health due to lack of education.

Narrator: In 1996, President Bill Clinton signed the Personal Responsibility and Work

Opportunity Reconciliation Act. The goal of this act would limit cash assistance for dependent

children. In other words, this act prevented Hispanic/Latinx families from receiving cash

assistance. Aside from this, most Hispanic/Latinx individuals are not able to access health care or

have many job opportunities because of their citizenship status. According to research,

discrimination policies are another factor that impacts them since it prevents them from reciveing

funds such as the Temporary Assistance for Needy Families (TANF). It is clear that

Hispanic/Latinx do not have the funds to help assist their mental health and there needs to be

more policies that will allow Hispanic/Latinx to receive the proper funds.

Narrator: Aside from providing funds or insurance to allow for mental health assistance, there

should be an increase in community mental health services. This will allow for Hispanic/Latinx

families to consider improving their mental health. According to research, Hispanic/Latinx girls

have the lowest family support and have very high conflicts with their family. This is caused due

to lack of empathy. According to research, an effective way to improve family mental health

would be Filial therapy. This is where parents are able to spend time with their children while

playing with toys. According to research, this allows families to build a better relationship and

bond since it allows parents to become more empathetic and understanding towards their

children, and children feel emotionally understood and supported. This would allow families to

communicate about the adult and parent responsibilities placed on Hispanic/Latinx daughters,

which would lead to improving the mental health of not only daughters, but parents too since

they will gain knowledge on mental health.

Narrator: Overall, it is best to educate minority groups on mental health. Some ways can

include social media, where an individual can post about the negative impacts of mental health.

Social media is constantly available to users which allows for sharing mental health resources

and mental health education. The most common social media app used for Hispanic/Latinx

communities is Facebook. Facebook would be a great source of media which would allow

individuals to communicate and also talk more about mental health.

Narrator: It is important to educate individuals about familism and help Hispanic/Latinx

daughters acknowledge and improve their mental health. Mental health impacts the way we feel,

think, and act. It determines how we handle stress and how we interact with others. Mental

health is considered an important topic in today’s society, however within Hispanic/Latinx

society it is rarely talked about. In order to spread awareness about mental health, education is

key.

*Soft Tone Music Transition 3*

Narrator: This podcast was produced by Edith Lopez for the Spring 2022 Global Health course

at Guilford College. Thank you for listening!

“Stop TRIPs”

~Music~

Narrator: While upper-income countries are handing out COVID-19 booster shots, South Africa is still trying to get vaccination rates that are similar to the majority of the world. Why is this the case during a Global Pandemic that the world has been in, for over 2 years?

~Music~

Narrator- The COVID Vaccines, to which South Africa has not had equitable access, is protected under TRIPs. 

Narrator: TRIPS stands for Trade-Related Aspects of Intellectual Property Rights. So what is Intellectual Property and what is Intellectual Property Rights? And How does it relate to South Africa’s access to the vaccine?

~Small Chime~

Narrator: Garland Grangercan give us some perspective. He is a former CPA, has a Masters in Business Administration, and is the current Accounting professor at Guilford College. He will be explaining what Intellectual Property is, as well as what Intellectual Property Rights are.

Garland Granger: If I buy a car, I buy furniture, whatever I buy in a business, I want to protect it from being stolen, you know, so I put in the controls necessary to protect my car, I lock it, I lock my house, I do all the things necessary to protect something that's physical. But how do you protect an idea? How do you protect something that your brain created is the ability to protect what you create in your mind is the ability to protect what you create in your own mind, that's intangible, you can't see it per say as a thought. But it's because of your creativity. And it should be protected. So people couldn't take it and say, Well, I came up with that idea. And that was the whole idea of what individual property rights are and why we felt it necessary to protect those rights in the United States.

Narrator: So what is a Patent and how do you get one?

Garland Granger: Okay, so a patent is I came up with an idea of how to make a product. And I want to protect that so nobody else can steal that. So I apply to the US Patent Office, and I have to get an attorney in some legal fees and application fees. And they do the research to make sure I'm not infringing on somebody else's patent, because they've got all the patents there. So they can check it out. And if they issue me a patent, and what that means is, no one else can make that product the way I created it.

~Music~

Narrator: In order to get out of this pandemic we need global herd immunity. Herd immunity can only happen if enough people have protective antibodies against infection. These protective antibodies are in the vaccine. South Africa needs access to the patented vaccine, as well as other lower-income countries, in order to reach that herd immunity. 

Fatima Hassan can speak on how TRIPS has affected South Africa’s access. 

~Small chime~

Narrator: During a roundtable discussion with health experts and activists, Fatima Hassan, the founder and director of Health Justice Initiative based in South Africa and a health/human rights lawyer explains South Africa’s COVID vaccination situation. 

Narrator: G Brindle a theatre Minor from Guilford College will be voice acting for Fatima. 

I will be voice acting as: Els Torreel and Joseph J. Amon.

Els Torreel & Joseph J. Amon (Narrator voice acting): How unprecedented is the current situation? Compared to other challenges, for example, HIV drugs, and expensive cancer therapies, what makes COVID-19 vaccine access inequities different?

Fatima (G Brindle voice acting): Let me make the point more specific, in South Africa, we are now witnessing, firsthand, vaccine apartheid. Colleagues my age in the Global North are getting vaccinated, but in South Africa, health care workers, the elderly, vulnerable workers, and others at high risk are still waiting for vaccine supplies. This is apartheid––wealth, geography, and patents matter more than people’s lives. 

~Small Chime~

Els Torreel & Joseph J. Amon (Narrator voice acting): The nature of the COVID-19 pandemic and the political context in which it is taking place is quite different from earlier access challenges. How can we find solutions to the vast inequalities that exist in terms of access to vaccines and other technologies?

Fatima (G Brindle voice acting): At the end of March 2021, South Africa––the African country most affected by COVID-19––was still waiting for its first delivery through COVAX. We ended up obtaining a clinical trial supply of the Johnson & Johnson vaccine that allowed the vaccination of 250,000 health care workers. At the end of March, we were waiting for supplies to arrive through bilateral deals and through the African Union, all of which are highly secretive, non-transparent, and not being disclosed to the public. This is shameful.

~Small Drum Chime~

Els Torreel & Joseph J. Amon (Narrator voice acting): You have all painted a pretty bleak picture of the current state of affairs concerning the world’s response to the pandemic, in particular around access to vaccines, and the failure of global institutions to foster equity and fairness in the face of nationalism, greed, the breakdown of solidarity. Are there reasons to be optimistic moving forward?

Fatima (G Brindle voice acting): Despite being extremely disheartened by the conduct and lack of transparency of some governments and vaccine manufacturers, I am encouraged by the accelerated vaccine research being done by public health scientists and researchers, the advocacy for access globally, and the solidarity among older and newer activists with the science and public health community and worker associations.

I am also inspired by the battle being waged at the WTO to once and for all show the world why treating medicines as a commodity is not normal and fuels inequality in access to lifesaving interventions.

~Small Chime~

Narrator: Through Fatima’s testimony, we can see that South Africa is not getting access to the life-saving vaccine compared to countries like the United Kingdom, the United States, Switzerland, and other higher-income countries that have had easy access. Let’s focus on when Fatima says that she is inspired by the…

Fatima (G Brindle voice acting): “Battle Being Waged at the WTO”

Narrator: The battle she is referring to is South Africa’s fight for a COVID vaccine patent waiver also called the TRIPS waiver. This waiver would allow other countries to have access to the “recipe” of the vaccine. 

~Music~

Narrator: Moderna pledged to not enforce its patents. That is unhelpful to this issue. When using this metaphor of a “recipe” to make a vaccine. This “recipe” has many steps and components that do not come from the same aisle at your local grocery store. Moderna includes other companies’ patented processes and equipment that is needed in the process to metaphorically “cook or bake” a vaccine. 

Narrator: So, when Moderna has access to outside patents but then says “Hey we will not enforce our own patents”. That doesn’t really do anything. That does not give full access to others like South Africa.

~Music~

Narrator: The issue with this is only a limited number of manufacturers have access to the intellectual property or “recipe” because of patents. And that a limited number of manufacturers can not produce enough vaccines for everyone in the world. 

So demand is high. And supply is low. Making the price of the vaccine go up. 

Allowing the path of higher-income countries to be able to buy and hoard as many doses as they please. Without regulations or specific incentives that require those higher-income countries to share with countries like South Africa.

~Small Chime~

Narrator: The TRIPS waiver would allow South Africa as well as other lower-income countries to manufacture and distribute its vaccines with the same or some of the recipes. 

Making each dose cheaper for everyone as well as accessible. We will not reach Herd Immunity without Global Access to the vaccine.

~Music (Guitar)~

Narrator: Higher-income countries have helped, somewhat, by donating doses and funds to organizations like COVAX. COVAX is a global organization in charge of distributing donated vaccines from public and private sectors to lower-income countries, like south africa, in hopes of equitable access to the vaccine.

Fatima speaks on this.

Fatima (G Brindle voice acting): COVAX and C-TAP may be critical—but at the current rate at which they can source supplies and foster cooperation, they will not be the solution for the access crisis, especially in the Global South. They are also too deferential to pharma power and influence and rely on volunteerism, which is not sustainable in my view. Our challenge is to get as many supplies to the Global South as soon as possible—and this is why the TRIPS waiver, other compulsory licensing measures, and the voluntary transfer of technology need to be vigorously pursued. It is critical to have manufacturing capacity, to dispel the myths of the implications of the TRIPS waiver, and to use other means of sharing technology fairly (especially for research funded by public sources). Most importantly, we have to remind everyone of the impact that interrupted and insufficient access in poorer and middle-income countries will have—especially as more variants are discovered.

~Music ~

Narrator: COVAX is not enough to make sure that South Africa has equitable access to the vaccine. There is evidence that the promise of a huge quantity of donated vaccines from upper-income countries, like the UK to COVAX, was not delivered. Only 14% of promised doses from upper-income countries and 12% of promised doses from the pharmaceutical companies were delivered through COVAX.

~Music (Acoustic)~

Narrator: A vaccine patent waiver, stopping TRIPS is an answer to ensure that South Africa has equitable access to the vaccine and the ability to produce their own. In a global pandemic, 

Intellectual Property and profit should not be put first, over the lives of South Africans.

~Music (Acoustic)~

Narrator: The United Kingdom, United States, Switzerland, and other high-income countries need to stand in solidarity and support the patent waiver. This is the step that is needed. To move in the direction of ending vaccine inequality in South Africa. 

~Music (Acoustic)~

Narrator: This podcast was produced by Liz Poole for the Spring 2022 Global Health course at Guilford College.

~Music (Acoustic)~

References

Aborode, AT, Olofinsao, OA, Osmond, E, et al. Equal access of COVID-19 vaccine distribution    in Africa: challenges and way forward. J Med Virol. 2021; 93: 5212- 5215. https://doi.org/10.1002/jmv.27095  

Chattu, V. K., Singh, B., Kaur, J., & Jakovljevic, M. (2021). COVID-19 Vaccine, TRIPS, and Global Health Diplomacy: India's Role at the WTO Platform. BioMed research international, 2021, 6658070. https://doi.org/10.1155/2021/6658070 

Godwell Nhamo, David Chikodzi, Hlengiwe Precious Kunene & Nthivhiseni Mashula (2021) COVID-19 vaccines and treatments nationalism: Challenges for low-income countries and the attainment of the SDGs, Global Public Health, 16:3, 319-339, DOI: 10.1080/17441692.2020.1860249 

Hein, W., & Paschke, A. (2020). Access to COVID-19 Vaccines and Medicines – a Global Public Good. German Institute of Global and Area Studies (GIGA). http://www.jstor.org/stable/resrep25695 

Iacobucci G. Covid-19: How will a waiver on vaccine patents affect global supply? BMJ 2021; 373 :n1182 doi:10.1136/bmj.n1182   

TORREELE, E., & AMON, J. J. (2021). Equitable COVID-19 Vaccine Access. Health and             

Human Rights, 23(1), 273–288. https://www.jstor.org/stable/27040053

Lindsey, B. (2022, March 9). Why intellectual property and pandemics don’t mix. Brookings.        

https://www.brookings.edu/blog/up-front/2021/06/03/why-intellectual-property-and-pand emics-dont-mix/ 

Narrator: Were you ever a car rider after school? Remember, being a car rider after school and waiting for your parents? You are in the car rider area, eagerly waiting to leave so that you can finally feel relaxed at home and safe at home. As you wait, other kids leave, so there are fewer and fewer kids waiting as time passes by. As the number of kids waiting in the car area decreases, you would start to panic and think of reasons as to why your parents are taking so long. You think maybe they're late? or maybe they forgot? And unless you're a kid with undocumented parents, you would never think your parents had to have been detained. And deported by ice. In these moments, how do you feel? Lonely, vulnerable depressed? As time passes by, you begin to feel that no one is coming for you. Although in our experiences, our parents eventually show up. But unfortunately, a group of children with undocumented parents in Forest, Mississippi in 2019, never got picked up. Kids waiting for their parents to pick them up from school, or return home after work, but never do because of deportations. This is a fear that hundreds of children of undocumented parents live with. Fear of never seeing their parents again along with various other challenges that affect their mental health. Although immigrant children in the US are more likely to have high exposure to mental health risks. They are less likely to receive mental health services. Maria Estrada who was born in Mexico and currently attends Wake Forest University, talked to me about her experience growing up as a child of undocumented parents and about her life in the US.

Student: So, I have two parents who were born in Mexico and raised there, grew up there and then I have shoulder sisters who were also born there. And then I have a younger brother who was born in the United States. So, my dad didn't have a job and where they live it was just not. It was not possible for him to raise a family of three or four. I guess it was five, including them, five people with having no job and my mom's job didn’t pay enough so they came here for like economic stability. 

Narrator: Students like her have parents that come to the US to seek you better life fleeing countries of economic instability, corruption and violence. Once they get to the US, although their life is improved, new challenges present themselves, such as understanding that their parents are undocumented and what being undocumented really means. 

Student: Yes, my parents have always been very clear with us about our legal status. I think it makes it things a lot less complicated for us if we know ahead of time like what we're allowed to do, what we're not allowed to do. And yeah, but they were always very candid and very honest with us. 

Was growing up they would tell me like not to disclose that I wasn't born in the United States so they wouldn't tell so it would tell me not to tell people I was born in Mexico even though I thought that was like super cool and I wanted to share that with other people they like they really emphasize us not sharing that because with that came other questions about like how did you get here, you know and. It was just harder to explain that and they also explained to us that you know we wouldn't be able to get drivers licenses, so we wouldn't be able to drive legally just like they weren't able to. And then you know, course we wouldn't be able to get jobs without a Social Security number, or at least high paying quality jobs we'd have to like, settle for other jobs. And in that they thought that it would be more difficult for us to like get helping came to school like financially when it came to going to college or something like that. It would be very difficult for us to get. Any help from schools like in terms of scholarships or even like it would be impossible to get financial aid from the government. 

Narrator: One particular challenge that children of undocumented parents face is having to hide their identity of being a undocumented. This means constantly dodging questions, watching what people say. And maintaining distance with all their friends, which can result in having few understand their situations. Kids constantly working to hide their identities could cause anxiety and depression among them. 

Student: When I was in first grade, I think I was sharing with my friends that I was born in Mexico and my like first grade teacher. She wasn't even my teacher. I was just in her room when we were talking about it. She approached me and then she started asking questions. So she was asking you like oh, that's cool that you like you weren’t born here. You were born in Mexican, I said yeah. And then she started asking me how did you get here and like and I was like I don't know and then she's like you should start asking your parents questions like that. Then so I had like I feel, I think I already knew. That I, you know I wasn't born here and that I was undocumented, but I decided to explicitly ask my parents like what that meant and like why she was questioning me. And then they were all like, yeah, This is why we think it's better for you to not tell people that you're not born here because people will ask the questions and some people might have bad intentions. 

Student: People finding out someone's immigration status could be really problematic as it could affect their entire lives. 

Narrator: And I could get us deported, and that would mean that we would be separated like from your younger brother potentially, and you would like lose all your friends everything that you know here everyone that we know everyone you grew up around. We would have to be. We would have to go back to Mexico and I think that was the first time that I really understood what it meant to be like undocumented. And that was when I was like in first grade. 

Narrator: The other main issue that affects his children mental health is having constant fear of deportation. 

Student: 'cause I was always like scared that my parents would get deported or that I would even get deported and living with that. It's very it's not something fun. It's not something I would wish on someone else, especially like little kids growing up living with that fear. 

Narrator: These stresses that these kids grow up with are unique experiences that many would never understand. 

Student: Grow up with a constant fear and most kids don't grow up with that. If you really think about it like most kids don't grow up thinking, hey. I could get deported or my parents could get deported, you know, and it's like. It's it's more than just a fear, it's anxiety, it's stress on little kids and growing up with that is definitely not good for your physical or mental health. I mean, like everyone has their own problems, but that's just like. It's a real life problem. I'm thinking about literally. Having to leave the place where you were raised, a place that you call home or even having to leave like your parents. The people that raised you, and I think that a lot of people don't think about that, like sometimes people will be like, yeah, in death in situations you know, like you get separated from your parents. But there are situations here where like your parents are literally taken away from you. And you won't see them again, and I think that through deportation, that's one of those ways that that happens. 

Narrator: These students, living with all the stresses that come with having undocumented parents, don't always have access to resources to deal with the stress. Students with undocumented parents sometimes only have access to resources in college, but those that do not have the privilege of going to college due to financial burden may never see a therapist because many do not qualify or unable to afford health insurance. Therefore, a session with a therapist would be paid out of pocket. 

Student: Being here at Wake, they offer so many resources that I was able to take advantage of their counseling center here and start going there. But before that, there was really no way that I could really reach someone who's like a mental health professional and like my sister, also struggled with that as well. And then we didn't have insurance at that time and I only have insurance because my scholarship offers that. So, you know trying to find some- trying to find somewhere that's affordable where we could go, and also where we could feel safe and like, feel like we're not going to like- Because I know there's confidentiality, but there's still like that sense of, you know, I don't know if I can share this because I don't know if this is gonna bite me in the butt later, or like you know, this is gonna end up hurting me more than helping me.

Narrator: Another reason kids with a undocumented parents sometimes never get help to maintain good mental health is that the stress they go through have been normalized in their community. Student: Everything was so normalized and I felt like it was normal to feel the way I did, but it wasn't until I started like- When I was here at college and I got was exposed to other people who like have that DACA and as well as like you know, to friends who don't have DACA who are citizens that I realized maybe going to therapy back then would have helped me a lot with how I cope and how I deal with my issues today. 

Narrator: The burden of hiding their identity is so difficult and traumatizing to these kids that it has lasting effects. 

Student: I think the word difficult doesn't even really match up to how hard it is. You know how all the different emotions that go with you know, not telling people information that's so valuable, so important that can really alter your life. And when you do decide to tell someone it's more like you really have to trust that person, or really hope or have good faith in people, and hope that they won’t say anything. Hope that they won't use it against you. And I think in that situation it's like, thinking the best of people, but the way I was raised and my parents and did this like with good reasoning. You know you can't trust everyone that comes around because people have different political views, have different morals, think different things and so you could tell one person and they let that slip to someone and their parent. I don't know. Maybe their parents are against you, you know illegal immigration and then they like, make a few phone calls. You know anything could happen, and so with that you know you have to be very confident in other people and you have to put a lot of faith and trust in other people, which is difficult to do in general. But with something so heavy it's almost impossible to do that. But also just growing up with that, it's very difficult. You know keeping that as an adult, I feel like it's easier to to hide that, but like when you're little, when your little kid and you're still trying to understand different things, you’re still trying to like relate to other students to other kids and you can't really do that because you feel like you're hiding a really big secret and like no one really understand you. And no one knows what you're going through. You know, like you always feel like the outcast, it feels like someone different.

Narrator: One potential reason these kids are scared to seek help is that the US government has a negative attitude towards immigrants. Using bad language to describe immigrants, while other countries are more welcoming to the immigrants and have a positive image of immigrants.

Student: This, this is a little weird to say, but I felt embarrassed at first, like I was embarrassed that I was like having to tell them that “hey look, I'm undocumented,” you know, it felt like a shame, which it isn't, but it was also like a feeling of nervousness at the same time where I was just like, OK, they can either take this in a good way or bad way and they like might hate me, or they might love me, or like I don't know.

Narrator: Although this is a complex issue that involves politics, one simple way to address the issue is educating the community. Particularly teachers so that they could provide a safe environment to these kids who spend a lot of time at school. 

Student: For one, I think better education in the school system about what it means to be undocumented, and the fear that comes with that. I know like when I went to high school and I was applying to colleges, I went to my counselor to ask like you know how do I do this? How do I do that? She had no idea how to tell me what to do and that caused me more stress and then you know, it made me feel like no one can help me and I think providing that in schools would be great, especially because I was lucky enough to know people who could help me, who know to know people who have gone through the same journey. But some students don't have that, and providing that at schools would be a lot of help for them. But I also think like. It's really important kinda just change this stigma around being undocumented as something like, not bad, you know. It- people do it for different reasons. You know, come here, but sometimes, it works out better for other people and that shouldn't be the reason why, like some students have to pay the price.

Narrator: In an article titled, ‘Mental Disorders Among ndocumented Mexican Immigrants in High Risk Neighborhoods,’ which was published in the Journal of Consulting and Clinical Psychology. Researchers reported significant data that shows undocumented Mexican immigrants are at risk for mental disorders such as depression and anxiety due to post migration challenges. This means we must work to find ways to protect this population in order to promote good health in our communities. 

This podcast was produced by Saul Rodriguez for the 2021 Spring Global Health class. 

On November 3rd 2020, hurricane ETA ripped through Central America, with

winds of up to 150 miles per hour, heavy rains, flooding, and landslides. It was

approximately 4 in the afternoon when ETA first made landfall on the east coast of

Honduras and then proceeded to bury homes along the coast and inland. Only two weeks

later Honduras was battered by another hurricane, LOTA. The disastrous hurricanes

affected over 4 million people across the nation and left more than 94 people dead and

thousands injured. Most of the people who were affected are part of the vulnerable

communities who were already struggling to get by each day as the COVID-19 pandemic

was taking a toll on their health and financial stability. People who were severely injured

by the hurricanes and in critical condition were unable to seek medical services due to the

immediate closing of health facilities as a result of the damage from the hurricanes.

People throughout Central America were and continue to struggle to survive. Honduras

is faced with a critical public health and humanitarian crisis that most of the world is

unaware of. This podcast is meant to bring attention to the current situation in Central

America, with a focus on Honduras my native land.

When hurricane ETA and LOTA hit el departamento de Cortes, the country went into a

state of emergency, everything was closed. There were many people undergoing

suffering, thousands of citizens lost their homes and lives. Yesenia who is 67 years old

speaks on the situation of her younger sister, who is 63 and the hardships her nephew and

her dealt with when their house became inundated by the rising waters from the heavy

rains of hurricane ETA

F9 [00:00:41] Mi familia si fue bastante afectada porque eh eh donde ellos viven se

inundo y perdieron todo, entonces salieron bastante afectados ellos, y han quedado pues

afectados porque psicológicamente han quedado ellos afectados.

Yesenia [00:03:10] la preocupación que tuvimos cuando ellos estuvieron, cuando estuvo

pues, estuvieron ellos en el cerro y el otro el otro sipote de Rosa estuvo en el techo de la

casa pero solo fue que vivimos la preocupacion.

Yesenia : [00:03:09] Cuando yo me comunique con ellos la primera vez ellos estaban en

el cerro y el otro muchacho estaba en el techo de la casa. La preocupación de nosotros era

que no podían rescatarlos, si no que estuvieron dos días dos noches sin comer y sin tomar

agua. Yo me preocupaba porque se podía debilitar el muchacho y se iba a caer al agua.

Yesenia : [00:04:01] A la hora que estaba comenzando las llenas yo le llame a mi

hermana y ella fue la que me contesto que están inundando, que se había inundando y que

la inundación los había rodeado.

Yesenia’s younger sister, Rosa, and her son were stranded on the rooftop of what used to

be their home for 2 days and two nights without food or water. After many phone calls

of extreme worry and pressure from Yesenia, rescue workers helped them to safety.

They lost everything that they owned. They had to leave everything behind and move in

with Yesenia. Yesenia says that her sister and nephew have not been the same ever since.

They suffered extreme psychological and physical trauma without access to any

healthcare services or any type of aid from the government.

This is just one of many extreme hardships that millions of people throughout Central

America have been experiencing through the pandemic and recent natural disasters.

According to Johns Hopkins University’s Global Health Security Index, Honduras

has one of the weakest healthcare systems in the world. In 2018 The World Bank

reported that the country only spends 7.05% of its gross domestic product on healthcare

and it operates through a private and public system. The private system is used by 10% of

the population, the economic elite, who are privately insured. The public system, The

Ministry of Health and the Social Security Institute, is open to all who have the ability to

pay and/or have medical insurance through their employer. Approximately 18% of the

population are able to utilize the public health care system. That means around 72% of

the population is left on their own to find access to medical services.

Senior citizens in Honduras are not being offered any assistance and many do not

have the help from relatives or outside sources to help with their basic needs to survive.

When the pandemic first started the government began to place restrictions on who could

leave their houses and when. People over the age of 60 were prohibited from leaving their

house and so Yesenia had to rely on her only daughter left in Honduras, who works full

time, to go and pick up her medicine and all other necessities when she was off work.

Yesenia has a history of chronic illnesses such as asthma, diabetes, arthritis and

hyperthyroidism. Given her age and her health condition it is impossible to find

employment, so she relies on the money that her children who migrated to the United

States send her to survive. For her, access to medical services and treatment has always

been a challenge, and the pandemic has only made this even more difficult. The only

option that she has for treatment is to go to a private clinic, which is extremely expensive.

F44 [00:10:39] Si me a hecho difícil porque.. porque ya para ir al médico así por una

enfermedad, el médico lo atiende.

F4 [00:10:45] Lo único que también son son en clínicas privadas. Ya en las clínicas del

Estado no mas del estado.

F6 [00:10:58] Ya no, porque como están todas ocupadas por lo de la pandemia, no

alcanza solamente de médico privado.

F10 [00:11:26] La mayoría de personas tienen dificultad, porque tal vez no hay ayuda de

alguien más. Y no, no tiene el dinero suficiente para que los atienda un médico en una

clínica privada.

F13 [00:11:41] Hay bastantes

The mismanagement of healthcare in Honduras has a history of political

corruption that has long looted the country’s most vulnerable, which is the majority of the

population. The manipulation of public funds can be traced to embezzlement, drug

trafficking, and schemes to buy overpriced medicine and equipment. Health care, a

human right, which should be a system designed by the government to take care of its

people has become a method of exploitation in Honduras.

When the COVID-19 pandemic hit, it further weakened the state of the health care

system, making it impossible for people to access medical services due to a shortage in

personnel. As reported by the CDC, in 2020 there is approximately one doctor for every

3,000 people. In addition to the lack of personnel provided, there was also a lack of

adequate protective equipment. Healthcare workers failed to receive items such as glove s

and masks that could have protected them from contracting the virus. This led to extreme

contamination and spread of the Covid-19 virus. This was the ongoing situation that the

people of Honduras underwent before the pandemic even hit. This situation worsened

throughout the pandemic and then the two hurricanes hit, destroying what little of a

healthcare system previously existed.

Today, most health facilities have been closed due to damage and injuries among

health personnel. Nine out of 18 departments (states) in Honduras have been affected by

hurricane ETA and LOTA. 61,000 people were left homeless. Due to the hurricanes and

the pandemic 95,000 are now staying in overcrowded shelters or are living on the streets.

What little access people may have had to healthcare has now become obsolete as people

are struggling just to survive. They are not only at a high risk of contracting the Covid-

19 virus, they are also in extreme danger of contracting and spreading other infectious

diseases such as cholera, dengue fever, and others. The impact of this situation will be

felt for generations to come due to governmental powers failing to address the needs of

its people.

Waiting for governmental powers to help is long overdue and no longer viable.

Solidarity and mutual aid is the only way that Central America will get through and

recover from this humanitarian crisis. That is why it is important to not only continue to

raise awareness among the people who live in larger and wealthier countries but to also

support mutual-aid organizations who are working directly with those affected to provide

food, shelter and transition relief. The Honduran Solidarity Network, Operacion ETA,

Abrassos and Operacion Frijol are some of many relief funds and organizations that are

doing grassroot work with the pueblo in Honduras. Many of these coalitions have been

started by college students with the desire of making a difference in their cou ntry.

Despite these devastating natural disasters the embracement between people has

inspired hope to those who need it. Standing in support is the only way we can help

Central America recover from this public health and humanitarian crisis.

(0.0-0.19 Audio) Bring the u.s. Approaching another Dreadful Milestone nearly, 500,000 American lives lost since the first report of death in this country just a little over a year ago half a million lives. That's more than the Americans who died in battle during World War One World War II and the Vietnam War combined.

(HANNAH) That clip is not shocking to many of us. If you live in America you know that wearing a mask, and protecting those around you has caused a political war for quote on quote “freedom”. Throughout the majority of the pandemic we had a federal government that rejected the idea of COVID-19, turned a blind eye to public health professionals and denied support for citizens With the new variants and weakened restrictions, COVID-19 in the United States seems never ending. 

RIA [ 16:03]“We have currently got the America's Cup race going on in Auckland. And there are crowds enjoying themselves on the waterfront, you know, and it's brilliant. And we have sports with actual life crowds, cheering arm and so we, we have all that normality of life”

( HANNAH ) That’s Ria. Ria is a New Zealand Native and Director of EcoQuest, .a study abroad organization that offers interdisciplinary, hands-on learning in a vibrant, sustainable learning community for students around the world to stay in New Zealand. She is talking about an annual yacht race that occurred the march of 2021. This event had a crowd of 50,000 people. New Zealand is basically COVID019 free. This seems unimaginable to me. IT is clear there are two different worlds going on. 

(HANNAH) The question is how? How is it possible to have nations so drastically different in their covid-19 response? What is New Zealand doing that the United States is not?As of March 2021, New Zealand has had only 2,350 total cases since the start of the pandemic. To put that number into perspective on February 20th, North Carolina alone had 3,234 new daily cases. 

HANNAH) One of the biggest attributes to success for New Zealand was the quick response by the government and the consistency of positive choices. Since the beginning of the Pandemic the New Zealand government implemented three key components to their success; travel restrictions, strict lockdown protocols and communicative campaigning. 

RIA [ 10:03] “I really appreciate the leadership that we had and have, because it was a science informed leadership, you know, the government was super clear about, you know, how they were making their decisions. And it was all transparent, that was communicated daily to us. And so it was also made clear as to what was our responsibility, and what was the responsibility of the government.”

(HANNAH) It is important to note the geographical makeup of New Zealand. New Zealand is an island nation, meaning it is completely surrounded by water. It comprises two different land masses making up the north and south island. Because of this it is easier to regulate who is coming in and out of the country compared to countries like the United States that share borders. New Zealand is also a rather small country. There are 5 million total residents within New zealanders.

RIA [ 9:53] “We have been super fortunate. But I don't think it was luck alone. And you know, I do believe that there are many things at play. One of course, we are an island nation, and you can actually control the borders mostly. And so. So that was an obvious tool.”

(HANNAH) The New Zealand government implemented strict travel restrictions. At the end of January 2021 Travel restrictions were lifted to a phase 1 for the first time since the start of the pandemic. New Zealanders were permitted for international travel. But U.S citizens were still not allowed to enter New Zealand. According to the New Zealand Government Travel page, all airline passengers to the United States ages two years and older must provide a negative COVID-19 viral test taken within three calendar days of travel. Travel within borders is permitted at this time as well. For those travelling within New Zealand borders it is required to conduct health screenings, and covid-19 tests. After this testing each individual would then have to do a mandatory 14 day isolation/ quarantine Quarantine is required to be done at one of the various government adhered locations.  

RIA [8:15]: ”In the first week of April, my mum passed away. And and of course, I could not travel because by then there was no global anything. You know, there are borders were close. And I actually do fully appreciate that move that our government made, you know, is that I could have left, perhaps, but it wouldn't have been very easy. And it certainly would not be easy to return.”  

(HANNAH) The New Zealand government implemented COVID-19 alert levels. These alert levels specify the public health and social measures to be taken. There are four alert levels. Level one is the least restrictive, and level four is the most. Level one is called prepare. It is where the COVID-19 is contained. This happens when there is a risk of COVID-19 in the community. Social distancing and COVID-19 testing is encouraged. And mass gatherings of 500 or more are cancelled. Face coverings are legally required in public transportation and the borders are still restricted. 

RIA [ 15:00]“Yeah, so we have a, an alert system level system is four levels. And currently the whole country is in level one. And so level one is the most relaxed mode, but it is not zero, okay, and so, so what what's being asked of us is to stay home, if you're sick, get tested, if you're sick, use the COVID tracer apps turn on your Bluetooth traces, so that we have a picture nationwide of where people are and if covid returns we can pick up who was the contact and really go hard to get people tested.” 

(HANNAH) The next level is level 2. It is the reduction phase it is done to exercise increased caution. This is when the disease is contained by the risk of community transmission has increased. “Only New Zealand citizens or residents with valid travel conditions can travel to New Zealand at this time. All New Zealand citizens and residents returning to New Zealand must complete at least 14 days of managed isolation or quarantine and test negative for COVID-19 before entering the community.” You are allowed to go to work and school, and businesses are open. But physical distancing and masks in transportation are required. Masks are encouraged in all spaces and events can only be 100 people or less. You are allowed to travel to other regions at an Alert level of 2 or lower. 

RIA [ 11:05]“We had a short period of national emergency, and everyone was just asked in order to stay home. And people did, I think we have a, you know, I think as a national trade, we may be slightly more concerned with fairness than with freedom. And so people were prepared to do this. And it wasn't easy, but people did it.” 

(HANNAH) Level 3 is next. In level three all work and school must be taught virtually. Public spaces like gyms, museums and playgrounds must close. You legally must stay home with your household bubble. Socializing outside your bubble is strongly discouraged. Social distancing is required. Masks are required in public transportation and strongly encouraged everywhere else. Traveling outside of the region is restricted.

RIA [ 12:17] “We've had two other brief periods of localized lockdown the most recent one, just a few weeks ago, in Auckland. And that was just really concentrating on you know, where, where do we see a case that's unexplained? What can we do about it? So yeah, I think not just luck, and to large degree, leadership, and definitely having a sort of science based approach really trying to understand COVID.”

(HANNAH) Level 4 is the last and most severe level. Level 4 occurs when there is a widespread outbreak and intensive community transmission. All gatherings are cancelled, businesses are closed, work and school must be done from home.All travel has stopped except for essential personnel. Individuals must stay home in their bubbles and can only move for essential personal movement. Only supermarkets, pharmacies, and gas stations can stay open. 

RIA [ 13:32]”But I think one of the things that I think I often think about is just scale, you know, like, we are a small nation, we have 5 million people. And so, you know, our Prime Minister, early on, basically pulled everyone in, for us to be a team of 5 million.” 

(HANNAH) The New Zealand Prime Minister Jacinda Ardern has made it her goal to engage her entire community within her COVID-19 response. The wording throughout the education in New Zealand surrounding COVID-19 has encouraged a community investment to keep one another healthy. There is a noticeable team based approach. Using phrases like “ what we all need to do to keep safe.” The Prime Minister prioritized public health education and frequent communication with the residents of New Zealand. 

RIA [ 24:14] “I think we were lucky that our government now freshly mentored us, they were in a way, you know, they they had a huge focus on health and well being, you know, the first budget presented by by our current government was a well being budget, you know, so, so it is it is out there, because, you know, I think we as small and actually, we are nimble, and we should be able to deal with things that matter, ” 

(HANNAH) It is evident that successful public health responses must happen at the governmental level. Not only through policy but in practice of those in political power. New Zealand is a great example of engaging your community to effectively address public health issues like COVID-19 on a mass scale. The alert level system and travel restrictions played a large role in the success in New Zealand. But more so the engagement and support from the New Zealand government to the rest of society offered trust and a willingness to adhere to public health protocols. This model is one that many countries should consider in the future. 

This podcast was created for the Spring 2021 Global Health Class at Guilford College. 

Hiroko-  

“Most of the time, especially, I think now Japan was going through a very economically hard time. And so many people, I believe, had to prioritize work over sleep.”

Anna- 

In Japan, it is common for people to be seen sleeping in public places. In Japanese there is a word that explains this: inemuri. Inemuri is the concept of ‘being present while asleep’. Some people may describe it as a precise state of unintentional napping. In Japan, sleeping on the job can be a sign of good work ethic. It can show that an employee had been staying up late the night before and putting in the extra hours to get their job done.  

To gain some insight into life in Japan and inemuri, I spoke to Professor of Japanese at Guilford College, Hiroko Hirakawa. Hiroko lived in Japan as a young woman and worked until she moved to the United States in the 1980s. 

Hiroko-  

“That's one of the reasons why I left there, because it was too much and the salary was very meager. And when I was working for other types of jobs, it was basically nine to five and then beyond five, I can do whatever I want to do. So, the salary was also very meager. And in Tokyo at that time, in the middle of eighties it was very expensive. One of the most expensive cities in the world at the time”

Anna- 

I asked Hiroko if she had experienced inemuri and what she knew about the concept, here is what she had to say.

Hiroko-

 “The first thing it came to mind was people in commuter train, because I heard that the visitors from overseas, the first thing that they noticed and then get surprised is the fact that when you get into a train, especially the morning commute train or evening commute into a subway, the vast majority of people are asleep….”

 “When I was in Japan, I thought that it's a universal phenomenon. And wherever you go, whether it is in Japan or overseas, if you go to a train and commute, you fall asleep naturally.”

Anna- 

In a New York Times article published in 2016 about inemuri, journalist Bryant Rousseau writes that in Japan, “napping in the office is often seen as a subtle sign of diligence: You must be working yourself to exhaustion.” I was curious to get Hiroko’s point of view on this, so I asked her: Is inemuri tolerated or is it something that is frowned upon by the majority of people who live and work in Japan?  

Hiroko- 

“Definitely some people look at them negatively, but not harshly judged, more like a sympathetic look”

Anna-

Typically, in the United States if any of us fell asleep on the job it could cause serious repercussions. It would not lead to praise or a “sympathetic look”. In fact, in most workplaces, it is a fireable offense. 

Sleeping on the job or in public in the United States might be considered lazy and inappropriate, but it is such a common problem in Japan that people have come to expect it and accept it— and that is bad news for sleep hygiene. Consequences of poor sleep are high and sleeping on the job is one result. Inadequate sleep affects people at individual, organizational, and societal levels. 

I am sure you can relate to what it is like to not get enough sleep. It is waking up feeling unrefreshed, groggy, and even more tired than when you first plopped down on your bed and shut your eyes….

One study published in PubMed by Kristen L. Knutson shows how a lack of sleep is directly linked to “increased risk of chronic cardiometabolic diseases such as obesity, diabetes, and hypertension.” Sleeping allows the body to restore itself. It helps the human body remain in a state of homeostasis. It would be ideal if workers in Japan could get the sleep needed to stay healthy and safe. However, there is, a cultural component to this public health issue that is difficult to untangle. Akiko Yoshida, in her article No chance for romance: Corporate culture, gendered work, and increased singlehood in Japan, notes “how normative and taken for granted it is for men to work overtime.” It is often the case that employees are viewed more as cogs in a corporate machine, and despite the fact that sufficient sleep might improve their overall productivity, their individual needs for things like sleep are not prioritized in the same way as the number of hours they work. But what’s complicated is that Japanese employers are not malicious—they don’t wish their employees harm—but the difference in priorities can ultimately lead to sleep deprivation.

Both employees and employers can be affected by inadequate sleep. One study published in 2019 explains how long work hours in Japan have serious effects on “job performance, decision-making, and safety.” The study aimed to show how employees in Japan work longer hours than those in western countries. These long work hours were measured to more than 51 hours per week within a specific industry. 

The workers who have to drive long distances into the night and work against their circadian rhythms are suggested to be at a high risk of fatigue and injury. In the same study, it was discovered that those working nighttime shifts and who had irregular work patterns were at a high risk of fatigue and injury as well. When are these workers getting their rest? 

***Lullaby Music*** 

Anna-

What can we learn from all of this? I wonder if workers in Japan could prioritize getting more sleep at night and sleep hygiene education. However, it is comforting to know that people in Japan may be more tolerant of people who may be experiencing sleep related fatigue or who may be practicing inemuri. Prioritizing sleep is important and I can conclude that no one society is getting it perfectly. But we can learn why sleep is something we should all prioritize because it will help us become healthier people. 

This podcast was produced by Anna Brown for the Spring 2021 Global Health class at Guilford College.

Maya - “ I read an article where it stated that Iceland is the third best place in the world to be a mother. Now I don't know about you but if you wanted to be a mother and heard that Iceland is probably one of the best places in the world to be one, wouldn't you look into it? Well luckily for you I decided to dive a little deeper into what is going on over there! 

Maya - “ Let's look at the fact that Iceland's maternity and paternity leave as of January 2021 will be extended to 12 months. Standard leave payments are 80% of your average income. There is also a law that requires the same benefits to the mother and father. Here in the United States maternity leave is regulated by US labor law. What this means is new mothers are required 12 weeks of unpaid leave annually and this goes for both the mother and the father, if they work for a company with 50 or more employees. If you are an employee of a company with less than 50 people there is no federal law requiring them to give you maternity leave. Okay, now just think about it, if anything happened or went wrong during your birth and the doctors said that you needed to take extra time off rest and focus on you and the baby. Although now instead of focusing on resting and your baby you have to figure out how to pay your bills because you are no longer getting paid. 

Maya - Finding out even the small differences that Iceland is doing can benefit many mothers here in the United States. As someone who is on a path to become a doctor/obgyn/midwife or doula and work with mothers information like this can easily be applied to practice in the years to come ” 

*Music*

Background info / Iceland conversation: 

Maya: What would be your first thoughts if you found out that you were having a baby in nine months? Would it be insurance or government assistance? Or if there was a possibility that the doctor recommended that you get a serious operation such as a C-section?

Now when I think of having a baby, I tend to think first about wanting to be in the best financial situation possible and just hearing about different stories with the hospital bills can be alot at some points. I also think about the time off after having a baby and the dream would be to have a year off after I give birth to just have that time with my child! 

I think that many people don't realize the major and minor flaws in our healthcare system and are willing to look at what others are doing! Especially those simple laws that could assist new mothers and the days and months after birth. 

In the U.S not many mothers or fathers have the privilege to have an entire year off with their child! 

When looking into the healthcare system in Iceland I can totally understand why Iceland is one of the top 3 places to be a mother. Wouldn't you want healthcare that covers all of the cost for pre and postnatal care?

I got to have a conversation with someone at the Iceland embassy in DC. They let me know that there are alot of measures that have been put into place to make it easier for women and men to have a successful career at the same time as raising a family. 

*Music*

Maya - Hearing about how Iceland has these things out in place to assist new parents made me want to talk to someone here in the United States about their journey and experiences during pregnancy. I was about to talk to Selena Wolf Berkeley who is a English professor here at Guilford College. She shared with me her experiences and it was interesting to hear the differences between two of her different pregnancies 

Selena - “ because I was pregnant, I lost my job and then I was out of work for almost a year, so the maternity leave thing didn't really come into play then. I just took that time off to just focus on my baby. When I was working, I took four weeks off. I think the maternity leave window was six to eight weeks and I chose four because I had to go to work. We had to pay bills. And I'm the primary breadwinner for my family. So with both even after the C-section, I only waited. I think I may have waited six, six weeks. Before I came back to work.

Maya - “The embassy also mentioned to me that free high-quality child care is also essential in Iceland which can certainly help many people out when having children and stay present in their career.”

“Things that may cause prenatal stress during pregnancy are somewhat handled in Iceland starting with the healthcare that is provided to help with the initial visits, all the way to postnatal care when a doula checks up on you at home to make sure that everything is running smoothly.”

“I even got a chance to talk to Selena about the healthcare system here in the United states”

Selena - “ I had a I've had like such a wide range of an experience. So with my first I was on Medicaid for pregnancy. And I also received WIC. 

And the process for that was really grueling to sort of go into the office and sit there for hours at a time and wait for somebody to then kind of pull your life apart and talk about how much money you make and what your plans are and how you're going to take care of your baby, which was felt really condescending in a lot of ways. But then the assistance I received was amazing. I didn't have to worry about paying for labor and delivery. I didn't have to worry about paying for my doctor's visits. It was all covered by Medicaid for pregnancy. With my private insurance that I had with my second and third. It was way more complicated and I had tons of issues with it and I was at the same doctor's office, which was another thing, so with the private insurance, they they kept trying to overbill me and I would come in for an appointment, they would say, oh, well, you owe a thousand dollars this time. And I'm like a thousand dollars! You know, it was just constant issues and money that I had to put out instead of it being covered by what I was already paying for with my private insurance. So it felt like something like universal health care would be a really beneficial thing and probably feel something more like being on Medicaid for pregnancy, except maybe without the level of paperwork to go through every time with every baby.” 

Maya - This is just some of what parents go through although this is not something that they have to go through!!!

Maya - “Now that we have heard about Iceland's way of doing things and the experience of a mother here is the United States how this can potentially affect different statistics and what can we learn from Iceland?” Statistics such as infant mortality, c-section rates and financial support are just a few that I have heard about. 

*Music*

Maya - We know that Iceland has all these amazing things such as a longer maternity leave, showing the importance of careers as well as financial support. I would want to live in a place where there are only 2 in 1,000 infant mortality births occurring. Especially when both you and your partner can take off work to care for your new born baby! 

One thing that I found interesting was in a 25 year period From 1989 to 2009 107,000 births occurred in Iceland and there are only five direct maternal deaths and 5 indirect maternal deaths nobody died from postpartum pregnancies, anesthesia complications or anything like that versus in the US those are the top leading complications towards maternal dealth. Especially with high C-section rates can factor into that. Just so you have a comparison in the United states in 1987 the maternal mortality rate was 7 per 100,000 whereas in 2017 it has increased to 19 per 100,000 live births which means that more than half of the deaths are preventable.

Many people don't really know what's happening until they have a baby in Iceland they really don't have C-sections unless it's a very high risk pregnancy but here in the United States it kind of differs depending on where you go and my conversation with Selena made it even more evident about the flaws in our system.

Selena - “ you really you don't realize how much pressure there is to have a C-section until you get into the situation. And I felt so helpless like there was nothing I couldn't convince the doctor. that this wasn't my, my baby was breached. He had only but otherwise everything was completely healthy. He was still like I was fine. He was fine. He just didn't want to move. So I had asked the doctor for more time. I was actually barely 40 weeks. And he was like, no, we need to do a C-section right now. So it's definitely like a go to here that doesn't and should be.”

Maya - I want people to know that C-sections are actually a very serious procedure and is the other option rather than giving birth vaginally. When you get a c-section you are having a procedure that goes through your abdomen and uterus to get your baby out! 

I think a huge problem and a topic for another day is realizing that c-sections are procedures that should be planned for emergencies in the United states they have been scheduled for convenience of the doctor. In the United States 31% of all deliveries are C-sections, while Iceland has a 9% procedure rate! 

Now that you have heard about Iceland and you may be more aware of what's happening I want you to just ask what we can do differently especially for women who want to be in the healthcare field ... When I go into the healthcare field I want to look out for maternal health and figure out different ways that we can lower our infant mortality rates especially maternal mortality rates as well.

Iceland makes sure that they are putting both parents in a situation where they feel comfortable having and raising a baby and I feel like nobody should have to have the financial stress or worry of where they might go next or the help that they might need. I think all those stressors can lead to unexpected pregnancy complications especially if you're not aware of the different resources that you may have, and it can possibly affect you in the long-term.

Closing:

Most places should have access to maternal care whether it be free or low cost. Some resources that people can use here in the US are planned parenthood, local health centers as well as family planning centers. You can also look at what the government can help support with in regard to financial assistance throughout the pregnancy! 

This podcast is produced by Maya Chevalier for Spring 2021 Global Health Class at Guilford College. 

*Music* 

Border Patrol found a 23 month old arm wrapped around her dad's neck, both face down, dead - cause of death: drowning. They were from El Salvador and crossing the border between Mexico and the US at the Rio Grande. The family of 3 were attempting to cross the border from Mexico. The father took the mother over to the other side and left his 23 month old baby on the other side with the plan to return to grab her and also bring her to the other side. When the father stepped into the river, the baby followed, as a natural instinct of following your parents. She jumped in the river abruptly, following her dad of which the rough current of the river swept them both away, eventually sweeping their life away also. 

Grocery store workers, farmers, electricians, mechanics from Mexico and Central America cross the border everyday in search for a better life - a life without corruption, drugs, gangs, and poverty. In the US, there is a constant debate of whether or not immigrants should be granted access into the US. With this comes misconceptions about how these individuals come over here or why they even do. What this side fails to realize is that the conditions in the home country are so bad, that immigrants are very aware of the dangers of crossing the borders, including death. The decision of coming to the US is not an easy one for these individuals, but if it means getting out of life in which they are living in now to come to a better one, then so be it. Look at it this way: you’re watching a movie in which you end up rooting for the individual that is facing hardship to ultimately come out victorious at the end. The exact same thing is happening here. People should not have to risk death for a better life because this in itself creates a public health issue of which creates larger issues down the road.

Think about a time you went hiking, and if you’ve never hiked, think about a time you went for a walk on the hottest day of the summer. You were hot, sweaty, ready for it to be over, and you knew that it would be over… maybe in a couple of minutes or at max 3 hours. Now think about walking through a desert, on days end, with one jug of water to sustain yourself. To relate this to my hiking example, one usually only takes a water bottle and a backpack that may contain an extra change of clothes, keys, and some snacks. Same thing applies here but instead of snacks, it's documentation of who they are, instead of an extra change of clothes, it's money that is supposed to sustain them throughout their travels, and instead of keys, it's a bible. This walk through the desert doesn't end in minutes nor 3 hours, it lasts for days. This is one of the examples of deadly risks immigrants face. This desert is also a place where many immigrants lose their lives because of dehydration or heat stroke. Immigrants are aware of these risks, but that's okay! Because the light at the end of the tunnel shines brighter than the sun in the desert.

I interviewed a medical interpreter who serves in the Roanoke Valley in Virginia, my hometown. For confidentiality purposes, we will call her Mary. Mary works with people from all backgrounds, including undocumented immigrants. Because of this, I knew she had come across stories of these individuals. This is what she had to share about 2 women crossing the border from Central America, one with a child and the other alone.

Interview 1:45 

“This is a single parent that she traveled from, ya know, Central America, and her message of traveling she explained to me was like in a semi truck? And they [the people] were like laid out like in pallets but they were like in rows of 4 and they traveled in this particular truck for about 15-20 hours before they were, ya know, arriving at the destination that they were to arrive.”

Mary then goes into the gruesome reality of traveling in this semi:

Interview:

“It was the summer, so it was hot and humid. They did have air coming through just the air that was coming through the truck. They were given a small bottle of water and were given instructions simply just to sip on it if they absolutely had to. But ya know, being the way that they were laid out in the rows, she told me that the worst thing was the stench, the body odors, the sweat, and also the urine because you have people stacked one above the other in these palettes, and ya know, those above, ya know, wet themselves and urine was coming to those that were below. And she said that it was just horrendous.”

She then follows with a second story of a woman found in Texas:

Interview 3:25

“I really don't want to go into much detail because it's just crushing. A woman was raped and left there to die. Obviously she was able to relate the story later on, and that's because help did come. And those two stories have always stayed with me. It was very impacting in my personal life.” 

Mary exposes the harsh realities of coming to the United States as an undocumneted immigrant. The drowning, the tractor trailer, and the rape are only 3 examples of the endless risk factors of this journey.

My family is from Honduras and most of my siblings have crossed the border undocumented. My sisters came together but my brothers on the other hand, came alone. One of whom not only walked the desert, but also traveled by train. This isn’t your typical train ride though; my brother not only had to jump on a moving train at the right time, but also tied himself to the rails on top of the train so he wouldn’t fall off if he were to sleep. It is important to note here too that when I say traveling together or traveling alone I mean traveling with someone you know versus not. Immigrants travel to the border in groups, with a coyote, or human smuggler, as the head guy in charge, directing the way. 

Misconceptions about these families are rabid, misinformation is constantly being spread about their stories or even about them as a general group. These misconceptions add fuel to the fire about the debate of immigration into the United States. Almost every single one of these immigrants come to the US with one goal: to make money in a safe and sustainable way in order to live a better life. A lot of our produce has been picked by these individuals, our grass is usually cut by these individuals, and a most notoriously, a lot of the hard, grimy labor that no one else wants to do, is done by them. 

In our interview, Mary talks about the misconceptions she believes are attached to these individuals. She discusses how these individuals are believed to be uneducated, or unworthy, simply because of the language barrier between Spanish and English:

Interview 3:56 or 4:40

“I would say one of the greatest misconceptions is that many of these people are uneducated and some may be. I may venture to say that there is a small majority that are uneducated, but I've come across those that have left medical school for one reason or another. I’ve come across several that were instructors of higher education not just in primary schools. I have come across nurses, business owners, and many of them have professional trades such as plumbing, mechanics, electricians, so I would say one of the greatest misconceptions most of these undocumented individuals are eneducated simply because there is a language barrier and they may not speak our language [English].”

Alongside this misconception, there is also the misconception that these individuals live off of the American economy, that they live off of welfare, like food stamps, which is simply not the case. While the children of these individuals may qualify for benefits like this, they only qualify if the children have been born in the US but no benefits go directly to anyone who wasn’t born in the US. There is also a misconception that these individuals don’t pay taxes, which in turn creates a stigma around these individuals that they are living off of the government. In reality though, the IRS reported that 50-75% of undocumented immigrants file taxes each year, paying federal, state, and local taxes. The grey area here though is that undocumented immigrants may work under the table due to that being their only option in recieving any type of income, in which course, they wouldn’t be paying taxes.

Immigrants do not simply wake up and decide one day that they are going to come to the US. It takes multiple encounters with hardships in their home country to finally bring them to this decision making. The journey here is hard, and they are constantly looking death right in the face. The simple fact that they acknowledge and take these risks, speaks volumes about the circumstances present in their home country. It is not a simple one, and empathy should be present when attacking the issue of immigration in the US and resolving the public health issue that is at stake here with people crossing the border in the most inhumane and dangerous ways. As a receiving country, we should attempt to make the journey to the US a safe and reliable one, as every human has the right to live a safe and happy life.

Have you ever been to a grocery store with your parents as a kid and all of a sudden you find yourself lost with them nowhere in sight? Fearing that you would never see them again, yelling their names to try to find them ? What if you weren’t reunited with them until after a long time passed or never? Imagine how children of immigrants fear of never seeing their family.

Intro…

Every year, thousands of people cross U.S state borders in order to give their children a brighter future. This is due to poverty, violence and other problems that their country has which causes them to illegally cross to other countries. It is a risky and very dangerous journey, however worth it to give their children a secure home with enough resources to live a better life. Not only is there fear when crossing the border, but there is more fear in being caught and deported once they live in the United States. Many Latinx people live with fear everyday with the thought of being separated from their family and the new life they worked hard to build. This fear not only impacts the lives of the immigrant parents but the children as well. Problems with mental health is immerged connecting to being an immigrant or being a child of one. Depression, anxiety and trauma are created when children are exposed to the mistreatment of immigrant family members and fear of separation in detention centers.

 [Music]

ICE Agents & effects (trauma) …

During the trump administration, there was one executive order that focused on immigration enforcement where there was an increase of 10,000 additional ICE agents contracted and sent out to detain many unauthorized immigrants.  

Sending out various amount of I.C.E agents highly impacted the fear for the community. Not being able to work or do daily activities due to the fear of being taken and deported caused a high level of stress for immigrants. Not only did this cause stress and fear for the immigrant community, but it also brought mental health problems for the children and family members surrounding them. In North Carolina, there were many check points surrounding the areas in rotations. This made most of the Latinx community to have anxiety and fear of losing family members. Even as citizens, they were afraid of being stereotyped as illegal for being Latin and treated wrongfully by police at the check points. 

Juan: My name is Juan, I live in North Carolina. I’m a 21 year old and me and my parents are illegal immigrants

 Juan: I have an uncle that was deported last year. Me and him were working at the same restaurant. One day a couple of cops just came in. they did not say anything, they went right through the kitchen and threw my uncle to the floor and put the hand cuffs on him. I was really scared when I had to see that. I was and still an illegal immigrant and working illegally just like him. Along with a couple friends of mine went out the door and the owner told us to wait until the cops left. They eventually took him but the cops did not treat him any good. They threw them to the floor, put force on him and I had to see that before I could actually get out. I was in fear that they would come for me and the other coworkers as well. After going home that night I had to break the news to my parents in which my mom broke into tears along with my dad.

Because of how my uncle was treated and detained that day, my family and I were scared to find any information about him in fear of also being detained and treated with violence. We ended up asking a friend who was a citizen to help us find him. After 3 weeks we found that he would be detained for a year and deported afterwards. 

Many families, like Juan’s uncle, were separated due to more surveillance and action of the ICE agents. Most families were not informed by the detainment of their loved ones until weeks after the situation occurred. Not only did this cause fear in how the detained immigrants were being treated but it also affected their family economically. Many families lost their economic providers, leaving them with no way of paying bills. Mothers who lost their husbands were left to fend for themselves and their children to move out of homes that they could no longer afford. When a family member is detained, it can cause an immensely negative outcome to family that depend on them. 

[music]

Juan: now me and my family live with fear of being separated any day at any second. I was so traumatized that day and I was really scared and I didn’t feel comfortable working at the same job I had so I eventually quit that job. Now every time we see a cop we get really nervous and scared that we may get treated the same way.

Latinx children in the United States have high risk of mental health disorders, whether they are surrounded by immigrants in their family or are immigrants as well. They are prone to discrimination, trauma and live with fear of deportation of themselves and their family. With these issues, they are most likely to develop internalized mental health problems such as stress, depression and anxiety. The unnecessary brutality of police officers used against Latinx people does not make matters better. The traumatic situation that Juan and many other Latinx people seeing the horrible ways that immigrants are treated and detained is only one of many ways that contributes to having mental health problems. This situation led him and his family to be traumatized and live with more fear than they already felt. 

[Music]

Detention centers 

Detention centers are locations where immigrants are held, in a similar way to a jail. Sadly these detention centers are in extremely poor conditions . In an article of TIME, Madeleine Joung said that “Adults and children have been held for days, weeks, or even months in cramped cells, sometimes with no access to soap, toothpaste, or places to wash their hands or shower. Some reports have emerged of children sleeping on concrete floors; others of adults having to stand for days due to lack of space. A May report from the Department of Homeland Security’s inspector general found 900 people crammed into a space designed to accommodate 125 at most.” 

In the TIME article it also brings up a grieving mothers testimony of her experience in an ICE detention center that was heard in a committee. Yazmin Juarez and daughter Mariee were held for weeks in a detention center where sick and health people were in the same area. The testimony states that within just a week of being detained, Yazmin’s daughter Mariee had “developed symptoms including a fever, cough, diarrhea, and vomiting. “I begged them to do deeper exams, but they [the detention facility’s medical staff] sent us back to our room,” she told Congress. At one point, the staff treated 19-month-old Mariee with Vicks VapoRub, which is not recommended for children under 2.”. After 10 days of being released and taken to a hospital to seek better medical care, Mariee was hospitalized for 6 weeks diagnosed with viral respiratory infection. The mother said “all of the hard work of these doctors came too late. Mariee died on what is Mother’s Day in my country. When I walked out of the hospital that day, all I had with me was a piece of paper with Mariee’s handprints in pink paint”. 

This story is only one of a million stories and testimonies where poor conditions in detention centers is a huge issue that is either covered up or ignored. When people are not informed of what actually occur in detention centers, there is no way to fix the issue. This mother, along with many others will have to live with mental health problems of losing a loved one when it could have been avoided to begin with if given the proper attention. 

[Music] 

Separation of children from parents…

Not only are detention centers given poor conditions but it causes separation of families as well. In the Obama administration, they did detain many immigrants as well, but they tried to never separate the children from their parents. However, During the trump administration, thousands of children were not allowed to be detained with their parents. This separation led to many children being missing with no real answer as to how it happened. One can only assume that the immigrant children died, were trafficked, or adopted illegally. Separation of families can lead to stress and depression. Dr. Ana Maria Lopez, the president of the American College of Physicians said in an interview with CNN that “the effect of this type of event will follow these children into adulthood and into their entire lives. Our federal government is causing a situation that is creating a host of potential health consequences for an entire category of people”. 

By keeping families together, it could help prevent separation anxiety and depression from developing in these children. Also, if family stay together then it would have been less likely for so many children to have been mysteriously lost in detention centers. When a family sticks together, they have the ability to protect and reassure their children of their safety. 

Not only should families remain together, but the treatment of ICE agents and police officers must change as well. The mistreatment and brutality towards Latinx people who are immigrants is unnecessary. Whether one refuses being handcuffed or not, they have been shoved to walls, thrown on the ground and sometimes worse. 

[Music]

Actions contributed for a solution.. 

One way that states in the United Sates have contributed to the community is by denying to allow ice agents in their areas. According to CMS many large cities, such as New York, Los Angeles, and Chicago, as well as smaller cities and communities, have chosen not to cooperate with federal authorities in enforcing immigration laws, including participation in the Secure Communities and Section 287 programs. They said that “To date, cities such as Chicago and New York have stated that they will continue to not cooperate with federal authorities on immigration enforcement because they have no legal grounds to hold apprehended person beyond a limited period and because they depend upon the cooperation of immigrant communities to “protect and serve” the public.” 

 [Music]

Fixing the issue…

A child of immigrants or being one themselves brings on many fears that negatively affect their mental health. It is not their families fault for choosing to provide their family with better opportunities. Mental health is not a common subject to speak about in the Latinx community due to seeing how hard ones parents already works and children do not want to put more on their families plate. With this said, there should be safe spaces for children that are immigrants or have immigrant families where they can talk about how they feel. As children of immigrants, it is also very helpful to have organizations that speak up for those that cannot in our community. Being a citizen or immigrant that can participate in events that give our community a voice is one of the most helpful ways to let out what non-latinx people do not know. 

Ending quote…

Informing others of the issues that a Latinx person lives and experiences is one of the only ways to open the eyes of others. So what will you do to help my community? How will you make a difference to not see children separated from their families and mysteriously go missing from detention centers? 

This podcast was produced by Jennifer Solis for the Spring 2021 Global Health class at Guilford College. 

Intro Music

Intro:[0:23] COVID-19 is a deadly pandemic that has ravaged economies, torn apart industries, and ripped apart millions of families. According to Researchers, in over a year, COVID-19   has hit poor and vulnerable countries the hardest, threatening decades of hard-won gains while exacerbating existing inequalities in the poorest countries. However,  apparently this does not apply to Haiti which only has 12,736 cases and 252 deaths. Today on A Conversation With Camari we will delve into how Haiti, a low income which lacks many prominent resources needed to contain a global pandemic in which many thought would ravage the country that has little access to healthcare has done such an amazing job in containing the virus compared to other countries. Joining us today is Moeisha Ciceron, who is of Haitian descent and was in able to provide depth answers as to what were some of the public health measures that Haiti took into place and here is what she had to say

[1:24]

Moeisha:[1:24] Haitian leaders were meeting with international health organizations such as the World Health Organization, to discuss precautions that they could take and encouraging them to shut down their borders in the beginning as well.  They didn't allow foreign visitors basically, shutting airports down because  they didn't want anybody who could possibly bring in the disease to bring in the disease. But unfortunately, their actions were a little delayed because it had already been carried into the country by tourists.

Camari:[2:05}  In 2019, Haiti averaged around 938,000 tourists with the industry bringing in an average revenue of around 703 million United States dollars. Having to close the country, effectively lost all revenue from one of the nation’s top industries, revenue that could have gone towards help with the next deadly natural disaster.

Music [2:34]

Camari:[2:47] During a Global Crisis such as COVID it is extremely important for a country to have compliance and leadership as Leadership has the power to make or break the nation and also withhold information, which is kind of sad because you'd think they'd want to express everything that is detrimental to the people of their perspective Country. Compliance is also seen as a necessity in surviving a deadly pandemic as citizens compliance can make the country look like New Zealand or the United States. Organizations such as the World Health Organization also recommend wearing masks in order to reduce transmission or further passing the virus. 2021, or the United States, which leads the world in cases. 

Moeisha: [3:10] There’s been civil unrest with the current leadership so a lot of crime a lot of looting and in these videos that I have been seeing I have not been seeing them wearing masks, I have not been seeing the being affected by COVID as much as I have seen it over here.

Music [3:32]

Camari: [3:50] The reason for this civil unrest is that according to https://reliefweb.int/report/haiti/haiti-civil-unrest-mdrht017-dref-final-report Civil unrest over corrupt government and its policies since July 2018 has severely affected Haiti and has resulted in a social, security and economic crisis which further deteriorated its precarious humanitarian situation. This crisis is such an issue in regards to the country’s response to covid due to the fact  that according to https://www.thenewhumanitarian.org/news-feature/2021/3/16/how-haitis-political-crisis-is-fanning-vaccine-fears this constitutional chaos  is overshadowing the country’s COVID-19 vaccine rollout,  thus provoking a vaccine hesitancy and  fewer immunitisations. The reason as to why Haiti having few immunisations is thai ts residents might  not be eligible for widespread vaccination until 2023 or 2024, according to estimates from the Duke Global Health Innovation Center in Durham, North Carolina, thus with so few residents being vaccinated could lead to a potential surge in cases if an individual who has the virus comes into contact with a Haitian

Moeisha: [5:13] . I really think that just because they have such low cases as well that getting the vaccine is really something that they're not pushing for. But as of right now, I feel like along as Haiti's keeping their numbers low and that they're being very mindful of who they're allowing into their country and just like screening properly and making sure that nobody is testing positive for covid is entering their country, and if they do decide to open their borders to someone who had covid in the past, comes and gets in contact with the Haitian person who hasn't received the vaccine, that might cause a spread. But I guess we're going to have to just see how that plays out.

Music: [6:04]

Outro: [6:28] Well that is our time for today   Moeisha thanks so much for joining us, we’d love to have you back and thank you to our listeners for tuning in today. A conversation with Camari is a conversation with the community. This podcast was produced by Camari Alexander for the Spring 2021 Global Health class at Guilford College.


DaSh. K. Rouse The Dominican Republic is one of the most toured countries in the world with these beautiful beaches, delicious cuisine and friendly people, how can one not want to visit? But what about the DR's water crisis? Not many people know about this. 3 of 10 people worldwide don't have access to clean water and 2 out of 5 people don't have access to basic sanitations. Now, those numbers are huge. Mariam Sherrif is from the DR and is here to discuss her country's water crisis. It's good to have you here, Mariam. Now, the DR experience is a lot of inclement weather, hurricane storms, tropical storms. These have long term effects on the country sewage system and piping, thus contaminating the water. Due to this, the people of the country simply cannot consume the water. If the water is consumed, it raises possibilities for waterborne illnesses. Studies show that poorer communities in the country are at a high risk for waterborne illnesses as they are more likely to use the island's water for drinking. Over the years, many organizations have been lending a helping hand, but the water crisis is far from over. Communities near the Haitian border are hit hard, especially by this crisis. Socio economic status plays a role in this. Depending on one's income, occupation, and even geographical location, some people may be more accessible to clean water than others. And if you're on the lower side economically or living in a poorer location, it just makes it very difficult to access clean water. Furthermore, what makes the wealthier part of the island have more access to clean water?

Mariam Sherrif It definitely has to do with geographical location. So how I mentioned earlier my family is from Athenas and Athenas we call them campos, which is more like the village side. But within the village side, you know, there is a town. And so the town is more vibrant. And that's where some people go for tourism. The town itself is very vibrant but when you start to go deeper into Athenas, you have these small campos, you the little houses and stuff. Their water system can be completely different. And so for them, their water system could be completely different, depending on on how the family is earning their money. My uncle who who lived in Athenas he his house and his plumbing system is very much advanced. So, you know, they have running water, but they can't use the water to drink. It's more so to shower and for the plumbing system. But when you go in to different parts of Dominican Republic that are more, I guess, lower income, you definitely do see the lack of of water. You go into the richer side of the world, the president lives governor, mayor or whatever. And then you, of course, have the artists, the singers, the influencers who live in bigger houses and who probably have more access to water or accessible access to water. 

DaSh. K. Rouse The water faucet is completely contaminated. Within the country, there are septic tanks that poorer communities drink from. The issue with this is that the water is contaminated with bacteria, insects and even dead birds have been reported to be found in numerous tanks in the country. Drinking from this is dangerous, this is what leads to the people of the DR to drink from the river. As for wealthier communities, there are trucks that carry clean water for the people. Within these wealthier neighborhoods, most of the population still buy store bought rather than utilizing the trucks. These trucks rarely go to the poorer communities. Is there an alternative for those people that can't afford store bought water? Is drinking water from the river their next best option? 

Mariam Sherrif You definitely cannot drink from the faucet itself, even when you look up what should I consider when traveling to Dominican Republic online? That is one of the first things that they will tell you is that the water is not safe to drink from from the tap because of bacteria and other stuff. That being said, there is a water gallon truck that comes around to the different neighborhoods. And I'm not sure if you have to pay for these water gallons. But for my family, for example, we have a water gallon and we get a few of those to last us throughout the month. And then when we run out, we basically resupply or you basically go to the grocery store and get bottled water, which is the next best thing. And so for many people, if you could afford it, then that's great. And it's not you know, for many of us who probably don't even live by a river that's close by. So we probably have to ask, like neighbors or family, friends that live closer if we can have some other water supply in which they would probably be open to sharing with you. But for many people who I do live by the river, I'm pretty sure that their next best bet is probably getting water from the river and somehow trying to purify the water. I do know that when my mom was younger, she was telling me stories about how they would always have to carry water from the river. And that was a really, really far walk and really long walk. And if you know anything about carrying water for your family, it's not just going to be one bucket, it's going to be multiple buckets and multiple trips. So for some people, that still is a reality, but it is more of a developing country. So there's a little bit more water access around the island. 

DaSh. K. Rouse OK, so we know the next best option is getting water from the river because of the dangers of consuming from septic tanks. But cholera seems to be living within the waters of the D.R. Cholera is a diarrheal infection caused by ingestion of contaminated water. It can be deadly within hours if not treated. Children are proven to be most vulnerable. Diarrhea causes half the deaths of children under age 1 in the country. Poorer neighborhoods near the Haitaian border are affected more because they are less aware of the infection. Nearly two thousand cases of cholera have been confirmed as of June last year, according to the General Directorate of Epidemiology of the Dominican Ministry of Public Health. How is cholera being informed on the island? 

Mariam Sherrif I think one of the ways that, you know, that Dominicans are being informed about it, I feel like it's kind of something that's like well duh, like we've been knowing, you know, for many of us were kind of like, well, we just don't drink from the from the tap because it's it's dangerous. It's not good. It can get you sick. And so I feel like one way that they are being informed is maybe by organizations that come into the island to volunteer their time and are eager about spreading clean water throughout the island for Dominicans. So that's one way is by having these, like nonprofit organizations come in. My mom has she drank water? I think it was either she drank water from the tap or. They got the wrong source of water from somewhere because you can't even though you do go to a store, you can't just buy any type of water. So I know that, like, whenever we go back to visit, there's a specific brand that my family gets, and that's the type of water that my mom is more used to because it's more like the water that we have here in the States. So when she had the water, with vomiting. She couldn't eat for days. She was dehydrated, much like the symptoms of cholera. But she was able to get it treated. She was able to get some antibiotics. But, for a lot of other people who can't afford that or, don't know what's happening and they just think that it's just like a common cold or something or a stomach bug, you know, it is fatal for them. I think that one way that we can improve awareness is by going into communities of lower income or of lower knowledge. I don't know about what's happening and really trying to, I guess, educate them. And it does start with the youth educating the older community. It really does start with the government trying to take a hard stance on it. I think that it really just comes up to the Dominican people to organize around that.  

DaSh. K. Rouse In 2014, Flint, Michigan dealt with a water crisis that led to lead-poisoned water into homes. We saw a massive amount of youth within the community getting involved. Should we be getting the youth involved in these affairs, could we learn something from fresher minds that are actually living through the crisis?

Mariam Sherrif Well, you know, like you said, like there's about eight hundred and forty four million people that don't have access to clean water worldwide, so it's not just international, but it's also, you know, in our own backyard. So we take Flint for example. And, you know, we saw what happened in Flint and we saw the organizing that went around that. Right with the young activists who were basically tired of having her water poisoned. So that's one way to take a stand, is by organizing and speaking out about these injustices and, you know, viewing where these injustices are happening. Right. Is it just happening in the wealthier communities or is it happening in communities of lower income? And what type of what type of people live in those communities? Right. So I definitely think that organizing around that is very, very important. And I think that that's one issue, one way that we can get that issue resolved. Obviously, Rome wasn't built within a day, but, you know, these things do take time. But it is also a time sensitive matter, as this has to say. And, you know, another way to really stay informed is, you know, being educated about that. So like I said, like, it's not necessarily just up to the youth, but, you know, the revolution has always been in the hands of the youth. So if there's an issue that the younger generation doesn't really understand, then it's really up to the youth to kind of carry that torch and to shed light on that. 

DaSh. K. Rouse Solea Water is a nonprofit organization formerly known as Water for Panama. This organization was formed in October of 2012. They work to repair and implement new water systems. One of their values is empowering local communities by including them in every decision process.What should organizations do to help with the water crisis? 

Mariam Sherrif Well, I think that their mission or their value set at best is empowering local communities by including them in every decision and in every process. And I think that's something that the world is missing, including communities in the decision making process. Right. I think that one of the things that we see and something like anthropologists have said is that people will go into these communities not knowing what the people are facing and just want to know, this is what we're going to do. We're going to add this, this and that and the third. And it's going to be very beneficial for you guys and, you know, problems solved when in reality, maybe that just made the problem even worse and it didn't even fix the problem that they actually needed. So I definitely think that when you go into communities, it's really important to listen to what it is that they're saying and not just listening to them, but try to experience what it is that they're, you know, like you don't want to go in there as the expert, even though it may seem like you are. But really just go in there as if you live in that community. Right. As if your children are drinking this water, as if your grandparents are drinking this water or trying to cook with this water for really putting yourself in their shoes. And not just, you know, coming in as I'm the expert, I know what I'm doing or we know what we're doing and kind of dissing their emotions and their experiences.

DaSh. K. Rouse To conclude, the ultimate goal for this podcast is raise awareness for the 

country’s water crisis, to give some insight of what's really happening and not what's just being reported. Awareness leads to more involvement and opportunity to change parts of the world that's in need. Potential organizations can be planned like a sanitation task force, a cholera research team, etc. Raising awareness for the country's crisis can lead to change in policy or even create new policies like creating product-based incentives like crops or water bottles for urban areas to decrease consumptions that lead to contamination. Even increasing funding for wastewater and chlorination treatments while also increasing investments in research of preventable measures for natural disasters are highly recommended when establishing a better policy. And it all starts with awareness.

It is four in the morning, still dark out and very humid. Ofelia gets up, showers outside behind her house, and gets dressed. The uniform is always the same, a knee length, pleated skirt with a button down white blouse, and a short white coat. Some mornings she has a cup of water with sugar, most mornings she doesn't have anything at all. Ofelia heads out, walking about 2 kilometers where a construction truck picks her up along with several of her neighbors. She rides in the trailer of the truck, standing and holding on. The truck drives about 20 kilometers, dropping her off at the entrance to the town. Here, she walks 6 kilometers more towards the center of town, in total about 5 miles which takes on foot over an hour. Ofelia is a medical student in Cuba, and she is part of Cuba’s most profitable export. 

Every year, the Cuban government makes around 11 billion dollars through its medical missions, more than its tourism industry, and more than exports like tobacco and sugar. In early 2020, the world watched in horror as the COVID-19 pandemic ravaged the country of Italy. Cuban doctors made headlines arriving at the height of the crisis to provide aid, carrying the Cuban flag as they came off the plane, a moving image that is haunting given the murky industry that is Cuba’s medical missions.

“[00:10:25] Now, that's basically what by that I mean why they tell everybody thinks Cuba is like a super power when it comes to matters and it's also not free. Well, they tell you the education ministry is not free because once you become a doctor, you if you leave the island, you can not come back to the island in eight years. But once you become a doctor, they can send you anywhere in the island to that remote worst places in the island. If they want to send you that, they have to have to go there because you belong to them. That’s what they tell you, that you’re a medio basico de la Revolucion.”

Cuba’s medical missions began after the 1959 Revolution, when Fidel Castro overthrew the right-wing government run by Batista and instituted a Communist regime. Healthcare and education were integral to the Castro regime. Even after Cuba lost the support of the Soviet Union, it continued its medical missions. How does the Cuban government continue to send out so many physicians each year? How does it tout one of the highest physician ratios in the world, even when many of its hospitals are in disrepair and experiencing medication shortages? What are the conditions like for doctors working international missions? It is a source of pride and altruism today, as Castro called it “the army of white robes”? Or is it something much more sinister, as the U.S. State Department has stated “a form of human trafficking and modern slavery?” (Wulfhorst). 

Cuba has one of the highest physician to population ratios in the world. Compared to the US, it has about three times more doctors per capita. Unlike the US, where medical school admissions are competitive and limited, Cuba provides scholarships, known as becas, to students hoping to study medicine. Young, academically driven students looking to have a career often feel like medicine is their only option on the island. 

“[00:00:40] Por ejemplo, eso de la potencia médica de Cuba de verdad, una potencia médica, si Cuba es una potencia médica, porque en Cuba lo los estudiantes había más facilidades, el médico seguro por decir soy un profesional, verdad? Porque en Cuba no hay vida para un periodista o una carrera de abogado, eh?”

She says, they don’t feel like there is a career as a lawyer or journalist, so they end up in medicine. That’s Vivian Alvarez, a former employee of the Health Department in Cuba where she worked regularly with doctors, coordinating care and medical missions. 

“[00:02:10] I mean, fifteen thousand medical students every year. They become doctors in Cuba.”

And that’s Vivian’s partner, Orlando. Orlando left Cuba, but still stays in regular contact with his family and friends there, including his older brother. He helps out financially as much as he can. 

Although medicine guarantees a career, in Cuba, it does not guarantee a better life. Cuban doctors spend months to years on medical missions abroad, away from family and friends. Many do not get a say in where they will be posted. They can make up to 1000 US dollars a month working abroad, but more often make much less than that, around 100 to 300 dollars depending on how long they’ve been away. This is a huge incentive, given that many stores on the island only accept US dollars for goods.

The working conditions abroad are poor. Viviane commented on the strict rules doctors are under outside of the island: 

“[00:19:15] Ellos no tienen una vida social. Ellos no pueden tener nada solo por eso mismo, porque ellos no quieren que puedan procrear algo debido a tanto tiempo que se pasan trancados un años.”

Doctors are not allowed to have any sort of social life while on missions. They are also not allowed to have sexual or romantic relationships with any doctors on the mission with them, or anyone in the community. The government wants to make sure doctors don’t have an out. If you have a kid in another country, you have a reason not to come back to Cuba. They don’t want the children of these doctors getting citizenship in a country like Brazil for example. 

“[00:15:38] Porque no, porque a ellos les importe lo que tú haces con tu vida privada, sino porque ellos están evitando el tu tener un bebé y que nazca en ese país y entonces ya tú te quieres quedar verdad? O que te van a sonalidad. Ayuda todos los beneficios que tú no tienes en Cuba, que tú no lo ves.”

It is also a form of control. The living situation is typically outside city limits. By keeping doctors isolated from the community, the government prevents escape of any sort. Doctors cannot demand better conditions when they have no access to life in the community they work. Viviane noted that many doctors don’t know there is another way of life outside Cuba, and when some have found ways to escape, they have discovered these different ways of living. But escape comes with huge fear of the repercussions if they are caught, including getting sent back to Cuba and losing their salary. 

On each mission, military personnel sometimes undercover accompany the doctors to enforce the government’s strict conditions. Some doctors have even had their passports taken from them upon arrival by military personnel. 

“[00:18:08] And that group, at least two or three people works , straight to the to the government and information, and they tell you you cannot leave if you leave we are gonna look for you, we're going to. Take away your family in Cuba, but normally it's like something like the CIA like the military and intelligence in each group.”

With poor working and living conditions, and social contact completely off-limits, doctors also experience discrimination from the very communities they are there to serve. Local doctors often view Cuban ones with disdain. Cuban doctors are like a bandaid on the huge wound that exists within these countries. The wound? The various inequities within their own healthcare systems that go unaddressed by their own governments. Governments supplement with Cuban doctors, having no real drive or incentive to address the shortcomings of healthcare and access. 

Because Cuba is able to produce so many doctors, the ones with the most experience are often sent out on the missions.

“[00:04:18] Yeah. Basically the doctors with good experience are the hospitals are the ones that they sending out and what they have on the island right now is it's, you know, like young people, they don't have the sufficient experience.”

The government invests their physicians and exports medications in medical missions because of the large profits it rakes in for the government. This comes at a huge detriment to the health of the Cuban public. Medication shortages are common. So are unsanitary conditions. In rural parts of the island, like where Orlando’s family resides, outbreaks occur with no physicians or treatments to address it. 

Because many of the physicians still on the island are fresh out of medical school, they often lack the skill or experience to treat the public. Vivianne and Orlando both spoke at length about their own personal experiences navigating care for ailing family members. It is hard and painful to know that preventable and treatable diseases end up escalating and taking away loved ones. Both Vivianne and Orlando have lost several family members this way. 

Orlando talked at length about conditions in the hospital:

“[00:27:25] Oh, yeah. I mean, the hospitals. I mean, they have no sanitation at all. They sometimes they don't. They don't even have running water. And they have the same bathroom for everybody, and they don't have that they don't have hot water, no hot water, there is no hot water in the hospitals. Thank you. If you want to take a shower, like I say, it's sometimes it's not even water in there. You have to bring your own blankets. If you're going to get surgery.You have to bring your your your blanket and your colors and anything that you need, your own soap. Because they don't have it, yeah, now most of the hospital, the room, they don't even have the AC working.”

Some Cubans are able to access medications or better care by bartering with pharmacists or befriending government officials that can get them into the better tourist hospitals. This isn’t a common experience however. 

“[00:29:02] I mean, if if you are to get in, you know, if you follow all the news that they give to the people, I mean, it's completely different. If you go to Havana to go to hospital that you mentioned, the Cimeq is completely under military control. But if you go there and you pay with dollars, I mean, do you get a different, completely different attention for the Cubans? If you don't have a good relation, somebody with power, you will. They will. You won't be able to get into the hospital.”

It is a harsh and stark reality, a country that provides so much aid, yet seemingly fails communities on the island. And even harsher, the reality that this aid exists on the backs of many Cubans wanting a better life for themselves and their families. 

On November 29, 2018, Cuban doctors working on missions in Brazil filed claims against the Pan American Health Organization, an international public agency underneath the World Health Organization. The claims stated the agency has made $73 million dollars off the missions and also supported working conditions that violate forced labor laws. 

Despite the claims, nothing has changed and the missions won’t slow down anytime soon. They will continue raking in billions of dollars annually for the Cuban government.

A: Before we get into obstetric violence, I would like to address a bit of information on this topic and define a few medical terms. Obstetric violence is physical abuse of someone being in labor or giving birth including, failure to meet their rights, lack of treatment and proper care. Women across the world have reported physical and verbal abuse during labor or giving birth. It’s typically women who are young, uneducated, or unmarried facing a higher risk. A medical screening examination is checking the health of an individual to identify whether a condition is occurring. A cesarean delivery, also known as C-section, is a surgical procedure for delivery of a baby through the mother abdomen and uterus. 

[+]

A: Maria is a mother of three who’s been a victim of obstetric violence during her first pregnancy in Chiapas, Mexico who describes how every mother would imagine having their birthing experience. However that's not always been the case. 

Interview: It was going to be my first child so I imagined that my whole labor experience would come out great, I will receive good treatment and that my baby would be healthy.  

[music clip ]

A: Chiapas, Guerrero, Mexico City, and Veracruz are a few states in Mexico to have high rates of obstetric violence. This could be from living in low-income communities, lack of knowledge between doctors, or simply because of being a woman. In 2015, worldwide, every 100,000 children born, 216 women died from the most common factor of violence which is lack of attention to pregnancy and birth.     

19:00 Interview: When I arrived at first, the doctors wouldn’t attend me and I was at the point where I was to have my baby. They didn’t want to attend me because they would say that I could still wait longer since 2 other women are in labor. But I couldn’t wait because … um.. my water already broke, I was bleeding, like I was ready to give birth but the doctors kept saying that I could wait…. Well, At that moment, my husband was getting furious, he went to talk to the doctors because I knew they didn’t have the right to not attend me. Not only that my baby could die but myself as well. 

A: Maria had just arrived at the hospital and she’s already not receiving the proper treatment. According to The American College of Obstetricians and Gynecologist, it’s hospital policy for doctors to perform a medical screening examination to determine the health condition of the mother and fetus. After the examination, the doctors can determine the next step for the mother. For example, if the examination shows symptoms of the mother going into labor, then it’s best to have a delivery room prep. Otherwise this could lead towards maternal and infant death. But if it shows that the mother still has time until her delivery date, it's best to give her proper documentation of what has been treated and when she should come back to the hospital to deliver her newborn. 

1:18 Interview: There was a small complication when people arrived wounded, and they didn’t want to attend me… like they prefer helping them and leaving me. But the doctors didn’t seem to notice that I could also die... just like the baby. I'm not wounded but in my situation, the baby was about to be born and my water had already broken.  

A: Most clinics in Mexico are full of medical students who are doing a year of service but, according to government officials and women advocates, medical students are not sufficiently trained by failing to speak the local indigenous languages, and are arrogant towards the women who they are helping. 

1:50 Interview: in the room, there were 4 beds and 4 women who also were giving birth. There was one doctor attending all of us and there were also nurses.. Like about 3 nurses. 

A: But also having lack of sufficiently trained staff can lead towards crowded rooms, not having enough beds for everyone and limited resources. Women in Mexico are forced to give birth outside of the hospital or parking lots when there’s no room inside. In 2014, news reporters from USA Today stated that women’s rights advocates sought international help for poor indigenous mexican women being forced to give birth outside of the hospital in Mexico City. The hospital received 20 cases of women giving birth outside when doctors claimed there were not enough beds.

2:55 Interview: After giving birth the next day, they lifted me up and told me that I needed to get up and start walking. At that time, I still had pain...they forced me. They were like “now, it's time so get up now to walk or to do some movement.” It’s like they never gave me time to recover, never. In that, I do see myself receiving lack of attention. Not only to myself but for the other women in the room since the doctors were forcing them as well. 

A: The most common abuse during childbirth is violence against womens’ rights. According to the WHO, women of low income or women belonging to ethnic minorities have a higher risk of receiving disrespect and abuse. Health-care professionals interviewed women experiencing health discrimnation from their characteristics such as low income, failure to understand instructions and being a woman. They reported both physical and psychological abuse such as lack of respect, being strapped onto the bed, frequently being hit or screamed at and being forced against their will. 

3:33 Interview: In my situation, the baby was ready in my womb and apparently she wasn’t going to be normal. At first, I wasn’t opening all the way, I was only a few inches dilating and my baby wasn’t going to be born naturally…. If the doctors have pushed me into a natural birth,... either one of us could’ve lost our life. One doctor earlier told me that I wasn't going to have a natural birth and that I would need a c section. 

Mexico has high rates of cesarean deliveries across the world. According to the WHo, Over 60% of first-time mothers received cesarean delivery compared to 37% of first-time women who receive vaginal delivery. Having rates that high causes concern on these cesarean deliveries since it can impact the mother, the baby and high consequences of using harmful treatment during birth. The appropriate time to perform a cesarean delivery is when the cervix isn’t wide enough and your current has strong contractions. High social class women would say that cesarean deliveries are more modern and convenient while high income women would predict an older and first-time mother to be at higher risk of cesarean delivery. 

[music clip]

(4:03) Interview: For a mother who gave birth to their first child and didn’t receive good experiences, one should be careful of which hospital they choose to give birth. I don't think all Mexico hospitals are the same. It's an experience that someone receives but never expects. One would think that I would be okay, having my child here as quickly as possible and everything is going to be fine and blessed to meet my child. I was not lucky enough to get a good experience.. 

A: As of today, women are still facing obstetric violence in Mexico as well as other countries across the world. Health providers in different cities in Mexico or different countries have provided their own set of procedures to reduce obstetric violence. A health ministry in Mexico published a set of guidelines for proper procedure of cesarean surgeries and strategies of how to reduce cesarean surgeries. This encouraged the Mexican Social Security Institute to publish their own procedures and strategies for cesareans deliveries. As of 2016, Mexico’s national policy has updated guidelines to reduce cesarean practices. In Guatemala, oncologists have created a “care navigation” to avoid the chances of receiving abusive care. Care navigators are women who are professional trained to improve care experiences. In hospitals, care navigators provide assistance in medical procedures, develop communications skills and can be used as translators. This makes it more reliable for indigenious communities. If a care navigator witnesses abuse towards the mother, they offer emotional support, companionship and privacy when in need. 

This podcast was produced by Anahy for the Spring 2021 Global Health class at Guilford College.

Annie: They line the shelves of Asian drugstores and supermarkets; they are marketed using packaging containing images of smiling, vibrant women that hide negative effects such as kidney damage; they are normalized and rampant amongst Asian media. These mysterious, hazardous substances are no other than skin whitening products, which are used by people all around the world. Every skin whitening product sold on the shelves of supermarkets and stores projects on young girls, their toxic health consequences as well as the influences of past and modern day colonialism.

[Music fades in, plays, then fades out]

Annie: Vietnam is a country in Southeast Asia that is populated by individuals with darker skin tones compared to those in East Asian countries. Similar to other Asian countries, Vietnam culture upholds lighter skin tones. However, most Vietnamese people aren’t born with these traits. I talked to Tran Nguyen, a young Vietnamese woman who is very familiar with Vietnamese culture. As members of a high school tennis team, I played tennis with Tran often over this last summer and had meaningful conversations about the difference in norms between America and Vietnam.

Tran: So, um, I grew up in Vietnam for, like, 10 years until I was in fourth grade that I moved to the US.

Annie: My mother, who grew up in Vietnam, painted a picture for me of the ideas surrounding skin tone there.

[Ambient city noises begin]

Annie: Stepping into the busy streets of cities such as Saigon, you will observe crowds of people riding motorcycles or walking. For the most part, everyone wears long, thick clothing along with a sunhat despite the beaming sun. Although Vietnam’s climate is constantly humid and can reach temperatures into the 90’s, Vietnamese people still persist in wearing heavy clothing just to preserve their skin tone.

[Ambient city noises end]

Tran: You have to wear sunscreen, you have to wear a hat, you have to cover your arms and legs everywhere you go. It's important to cover up every part of your body so sun doesn't get you.

Annie: Wearing excessive clothing is one seemingly harmless method of conserving a light skin tone. However, many Vietnamese people take this obsession to the next level by using skin whitening products. These products range from face creams to oils, and a quick search on Google can prove the prominence and popularity of these items. Skin whitening products are even more popular amongst Asian markets and websites, and are often accompanied by advertisements depicting beautiful, light-skinned models. In Vietnam, these products are so normalized that they can be found all over peoples’ homes.

[Music begins]

Tran: My house is right next to a pharmacy so I see that them selling sunscreen and other whitening products and in hospitals and clinics it's always there because the demand is so high.

[Music ends]

Annie: Moreover, it is not only through stores and physical advertisements that skin whitening products thrive. Social media’s growth over the past decade has enabled skin whitening products to be marketed in greater numbers to an audience of younger, more susceptible individuals.

Tran: And now, even now, when I scroll to Tik Tok or Facebook, I would see um the user, they are like advertising and selling their products on there.

[Music fades in and plays]

Tran: And people are buying into this, they like oh look after 10 days this person using that and they got better. I should buy it too.

Annie: As Tran mentioned, apps such as Tik Tok and Instagram promote these products through sponsored advertisements made through users’ accounts as well as posts made on the companies’ page. These applications consist of a large number of young girls and women, so they will be further exposed to skin whitening products and believe that they are safe to use. The increased access and exposure to skin whitening products leads to a large number of the Vietnamese community who use the products.

[Music fades out]

Tran: It's, it’s the norm, because everyone else is using it, their mother, their friends are using it, and so they are using it too, because to them it's normal. Like everyone is using it, so it must be safe for me to use it to.

Annie: This bandwagon mentality is partially responsible for the boom in the skin whitening industry in Vietnam. As beauty companies marketed and successfully sold their products, they became increasingly popular amongst young Vietnamese women. The more that others used these products, the more that individuals who avoided them were shunned. This growing trend is so dangerous because skin whitening products are harmful in several ways. First, there are countless dangerous health effects of skin whitening products. These range from mercury poisoning to dermatitis. One of the most dangerous is nephrotic syndrome, which is a kidney disorder that can cause swollen ankles, foamy urine, and fatigue. Finally, skin whitening creams may contain corticosteroids which can cause your skin to react negatively and produce steroid acne. Moreover, the harmful effects of skin whitening products are not only medically-related.

[Music plays]

Tran: Society in Vietnam, they like to have, um, a woman, especially for women, they want to have like this pure and innocent look, and so they need to be like white skin, no makeup and have thin body. So that's why white skin is so important because you have to be able to look like you’re pure because white skin is associated with purity while dark skin is considered dirty.

[Music fades out]

Annie: Apart from the social pressure to use the popular skin whitening products, there are other cultural reasons for why Vietnamese people feel the need to lighten their skin. This is mainly centered around the discrimination towards darker skin tones, which can be traced back to the colonialism of Vietnam by the French in World War Two.

[Music begins]

Annie: Vietnamese society also has a habit of fetishizing the appearance of young girls, which they have placed on a pedestal as the beauty standard for young women. This discrimination of darker skin tones has encouraged a racist undertone amongst the Vietnamese culture and turns Vietnamese individuals against those who look have darker skin, whether these are people from Vietnam or different countries. This encourages discrimination and hate amongst Vietnamese people, which can lead to hate crimes and systemic racism in professional settings such as workplaces and schools. Moreover, skin whitening products promote the beauty standard of the “pure” young woman, which can lead to pedophilic and predatory attitudes among Vietnamese men. This perpetuates damaging expectations amongst people all around the globe and can contribute to the negative behaviors we see in men in our society. For example, there has been an increase in sexual assault cases as well as pedophilia. Moreover, racist ideologies in Vietnam can affect other countries through all of Asia, which creates a chain of stereotypes and hate crimes around various communities. While this starts in Vietnam, it also has the potential to expand to other different countries.

[Music fades out]

Annie: Sadly, there isn’t a likelihood of people, back in Vietnam, moving away from using skin whitening products, at least for the foreseeable future. This is mostly due to the normalcy of these products as well as the heavy expectation that you should have a light skin tone.

Tran: They are like using it every day, no, because society make them to use it and so now if they don't use it, they kind of, like they an outcast.

[Music begins]

Annie: However, there is still hope. Vietnamese culture had existed without skin whitening products in the past, and before the colonialism and growth of Western influence, they weren’t as fixated on light skin tones as they are now. In figuring out methods of how to prevent and solve the skin whitening crisis in Vietnam, I reached out to an individual who was of Vietnamese descent but was more disconnected from the Vietnamese culture. I will refer to him as Thomas, which is not his real name.

[Music fades out]

Thomas: Oh hey, I am a male college student who's currently studying in his second year at college. I grew up completely in America, I was born and raised here, so I don't have any experiences of Vietnam, apart from one single visit when I was very young. I think my relation more so, is towards the Vietnamese American Community more so than Vietnam.

Annie: His ties to Vietnam are stronger towards the young, college-aged Vietnamese-American community. This particular demographic has shown signs of straying away from the deep-rooted need for skin whitening products and light skin tone. Therefore, a clever intervention method when dealing with skin whitening products would be to mirror the actions this community is taking. Thomas mentioned that, in college, he had never seen skin whitening products used among friends or family members. Moreover, many young Vietnamese individuals are rejecting skin whitening products entirely. This may be due to the normalization of Western culture amongst Vietnamese individuals living in America.

[Music plays]

Thomas: Many of us have assimilated to Western culture. Now, most of our ideals about beauty are based on what the American beauty standards are and not so much Asian ideals of beauty.

[Music ends]

Annie: Young Vietnamese college students also have less time to deal with extraneous matters such as lightening their skin. College life consists of a busy, stacked schedule--not only are you constantly taking classes, you are also working part-time, doing internships, and dealing with relationships.

Thomas: You walk into the library, walk into the dining room, not many people wouldn't be dressed. And just make up and all that for women, at least I seen in colleges it's not something that people use daily just because there's no need to.

Annie: Finally, as college students today have become more tech-savvy, they can easily use the internet to search up the negative effects of skin-whitening products. These findings, taken from certified health organizations, would likely deter them from using the products entirely. Moreover, the internet and social media allows for easy sharing among family and friends, which would spread the message of the dangers of skin whitening products.

[Music plays]

Annie: So, we know now that skin whitening products are prevalent in Vietnam, and that young Vietnamese-Americans are straying away from these products through their own strategies. Combining these two discussions can help us formulate a plan for how we can deal with the skin whitening craze in Vietnam.

Annie: Firstly, we know that social media has been instrumental in both spreading the skin whitening trend and reducing it. Therefore, we can use this tool to our advantage to spread awareness and education surrounding skin whitening products. One way to do this would be to emphasize the different shades of skin tone through social media apps, in order to normalize the idea that lighter skin tones do not define beauty.

Tran: Like social media and products from the West maybe will be good for Vietnam to kind of open up and accept. Like tourism is also good, because they will see a variety of people like Middle Eastern people, African people that have different skin like tones.

[Music fades out]

Annie: Next, implementing more recreational activities and educational opportunities in Vietnam could allow Vietnamese people to meet others from different communities. This is similar to the American college environment where you are introduced to a melting-pot of different individuals. This would open their eyes up to the color that follows diversity and the beauty of all individuals. Moreover, these educational opportunities could instruct them of the dangers surrounding skin whitening products, and discourage them from using them.

Annie: Finally, skin whitening products are known to be sold in shady environments under disguises of “brightening” creams and washes. Implementing requirements for these products in order for them to be sold would help to notify the user of any negative effects.

[Music fades in]

Thomas: They make people aware of the dangers that these whitening products may have. Many of these products may not have been approved by the governmental agencies that overlook standards for marketing, so just making people aware of the dangers of these beauty products may have on their health now and years from now, may serve as more effective.

[Music fades out]

Annie: These “standards” could be indicated as danger labels on the packages that come along with a pamphlet filled with needed information. When customers become aware of these dangers, this could discourage them from purchasing them and make their society as a whole aware that skin whitening products are not safe.

[Music plays]

Thomas: To anyone who’s listening to this podcast if you're interested in using whitening products, just don't, and neither you should use tanning beds or tanning oils or what not, because those increase one's chances of getting cancer. I mean, everyone has their own beauty standards and, you know, you can dress how you want, and you can look how you want, but if, in the end of the day, that beauty standards that you subscribe to will affect your overall health and take away years from your life, then you probably shouldn't do those things. You’re beautiful as you are.

[Music fades out]

Interested in learning about factors that influence alcohol abuse in Russia? Listen to find out more about gender and societal norms that create a problematic alcohol culture in Russia and who is facing the highest risk from alcohol use. 

Click show detail for a full episode transcript 

Hannah [00:00:12] Alcoholism and alcohol abuse do not just arise out of our biology. They also arise out of the influence of our environments. The societies that we live in can create harmful norms around drinking, exacerbating illnesses and causing premature death. Russia is an example of this. A harmful drinking culture has been created by societal and gender norms in Russia. We will discuss several reasons this is the case. But first some important definitions and background information. When a person consumes four to five drinks in one hour it is considered binge drinking. A Russian term, Zapoi is a period of at least two days in which a person is continuously drunk and is unable to function normally. Behavior like this is generally accepted in Russia. Sometimes people drink things like glass cleaner, mouthwash, everyday items that contain alcohol but are not meant for drinking. When someone consumes these for the purposes of getting drunk these products are referred to as surrogates. It is common in Russia for people who are suffering from alcohol use disorders to drink surrogates. Russia is an industrialized nation. One thing that is common for industrialized nations is to have a higher average life expectancy, but not in Russia. For Russian men the average life expectancy is sixty five years old and for women it is 76 years old. In the United States the average life expectancy for men is seventy six years old and eighty one years old for women. You might be surprised by the difference in life expectancy between Russian men and women. You might be asking why is this what made this difference? Well alcohol consumption has a lot to do with it. Russian men on average drink a lot more than Russian women and in many cases it leads to higher negative health outcomes and sometimes premature death. But why is this risk so much higher for Russian men than women? Russian gender norms, expected and acceptable behaviors and attitudes based on gender. Research suggests, that in Russia it is more socially acceptable for men to drink much more than women. Men are usually seen as the breadwinner, the provider. This can become a large source of identity and self-esteem for Russian men. It is seen as more masculine to not ask for help with issues around drinking. It is seen as masculine to use alcohol as a way to cope with problems such as job loss. For Russian women it is expected and more accepted to drink less, care for their husbands, and cope with their problems in other ways besides drinking. To learn more about this issue I interviewed Dr. In Natalya Shelkova, a professor of economics, here at Guilford College. Natalya had this to say,

Natalya [00:03:37] I think it's my personal belief, but it's also statistically true that women have more responsibilities. So, the women are generally expected to hold a job and to do most of the household work, cooking, and cleaning, and educating children and so on. I mean there are men who are doing and helping and sharing responsibilities, but statistically it's mostly women and I think women is because they're concerned about survival of the children and well-being of the children they have to be, they have to stay more focused and they're less likely to drink.

Hannah [00:04:23] Another gender norm that helps create this problem is the compliance of wives of heavy drinkers. Research suggests, that it is most socially acceptable and expected for the wives of men who are experiencing alcohol issues to allow their husbands to continue drinking. Many women end up caring for their husbands when they are experiencing health impacts from alcohol. Wives might try to convince their husbands to stay home and drink with them instead of going out, so that the drinking is potentially more controlled. If a wife is more dependent on her husband for money and labor around the house she may not be able to divorce him because of his behavior.

Natalya [00:05:07] And because of the dependence on males for household needs they just didn't have a lot of choices. You know, when the male partners were in short supply for a long time. So, I think that's partly also led to this compliance.

Hannah [00:05:41] Lastly let's look at workplace culture. Young Russian, blue collar, men face the highest risk of premature death caused by alcohol consumption. Why is this? It is very common for young men to drink together with their co-workers. It is a very important part of socializing not only to drink, but to get very drunk.

Natalya [00:06:05] It's a cultural thing, but I don't think it's purely Russian. I think it is maybe less so in the US, but I see that happen here as well. Maybe they were drinking beer and watch sports on TV, not necessarily in a group of other men, but it might still happen.

Hannah [00:06:22] This exposure to drinking can be the beginning of a harmful pattern for young men.

Natalya [00:06:28] But I also think it's a lack of growth that the job has. Career growth. I mean there is no career, basically. So a lack of self fulfillment. As well as the difficulties of the physical aspect of the job. I think that's probably the two most important factors.

Hannah [00:07:06] After the fall of the Soviet Union, in 1991, things became a lot less certain and steady for Russian people. Many parts of the economy were starting to privatise fast. Many people lost their jobs, there were wage delays, there was a lot of uncertainty moving into the future. Some men would use drinking to cope with job loss. When they got another job drinking could sometimes interfere, which would lead to job loss again, and then to more drinking. So a pattern is established.

Natalya [00:07:41] So there was a big loss of jobs, which was even more then not during the Great Depression. It was very devastating. So it was alcohol and drug addiction.

Natalya [00:08:00] So there have been since 2000, I think that's partly linked to improvement in job prospects and improvement in standard of living. And general sense of greater security and economic security. There had been a general decline in alcohol consumption.

Hannah [00:08:22] For some men when they lost their jobs and did not have enough money to buy vodka they would buy surrogates instead because it was cheaper. Some men would go on longer periods of Zapoi. Begin to spend more time with other heavy drinkers and become socially isolated from friends and family. This would begin to lead to health complications from alcohol consumption, heavy dependence on alcohol, and potentially premature death. Although the global prevalence of alcohol abuse is highest in Russia, at the time of this recording, not all cases result in death. Many people continue to live with the disease.

Natalya [00:09:12] But also I think it's a little bit of lack of opportunities for self-expression from men. And maybe lack of meaning in life. And lack of sense of responsibility for the family and. Children which I think is partly historical.

Hannah [00:09:41] Drinking problems exist all around the world. Adding to the burden of health worsening illnesses causing injuries causing deaths. This cannot be addressed with policy change alone. These harmful norms need to change to. This podcast was produced by Hannah Kaplan for the spring 2019 global health class at Guilford College.

Short Term Medical Missions In Rural Guatemala 

James [00:00:00] When you give something to someone and you say it's a gift. That may not be a gift that may again put them in a position where they're actually in a weaker position rather than a stronger position. 

Colby [00:00:25] Many people would consider medical mission trips to underserved countries a helpful asset. But what if I told you that these trips may contribute to a lack of resources and raise cultural and ethical concerns? Medical missions use many funds and resources, are volunteer trips really necessary? What is a good balance between conducting these trips and contributing to existing health care infrastructure? Short term medical missions are a form of unregulated medical service aid. These trips are usually taken by a team of medical professionals or volunteers from wealthy countries, with the United States having the highest participation in short term medical mission activity. The overall goal of these missions is to provide direct medical care to people of low and middle income countries. We will be focusing on the short term medical missions taking place in rural areas of Guatemala. I interviewed James Mulholland, executive director of Companion Community Developmental Alternatives, better known as CoCoDa. CoCoDa focuses their missions on communities in Central America, providing services such as water systems, rebuilding schools, and they work with projects geared towards public health. Kokoda strives to build strong and long lasting relationships within communities in Central America, with the overall goal being people over projects, which is particularly interesting considering that many missions fail to make building relationships a priority. 

James [00:02:10] Well, one of the things that we know from the research is that about two and a half million people from the United States travel to do international volunteering every year. We know that that's about a hundred and seventy five billion dollar industry. And we know that about 80 percent of the people who go have no recognizable or helpful skill or expertise. So, I mean, it automatically creates some some real issues. 

Colby [00:02:48] Short term medical missions are expensive and may waste valuable resources. There is evidence suggesting that short term medical missions are contributing to the lack of public health infrastructure in rural Guatemala. The real problem in these areas is not due to lack of physicians or medical personnel. It is due to lack of resources. Because of this, there are few clinics, hospitals and necessary medical supplies in these rural areas. And natives are relying on these volunteer trips instead of Guatemalan services for medical care. Global health scholar Paul Farmer has made issues like these known. 

James [00:03:32] There are some very serious risks when we do interventions. I remember Paul Farmer talking about after the Haitian earthquake, you had thousands of medical volunteers come to Haiti. Well intentioned. But what happened was if I'm a Haitian with a medical condition and suddenly everybody there is offer me free service, I'm going to go to where there's free service. Well, what it basically did over six or nine months, it completely destroyed all of the private health care system. 

Colby [00:04:15] Within medical missions and rural Guatemala, language and cultural barriers exist. A cultural and language barrier adds to the already difficult task of providing effective medical care. Short term trips also carry the risk of stereotypical views and attitudes. How can a volunteer understand a new culture in a week with the typical mission only lasting five to seven days? It is difficult, if not impossible, to get acquainted with rural Guatemalan culture, making it hard to provide effective health care. Judith Lascar, who has experience with global health volunteering and is a prominent voice in medical sociology, provides insights to these concerns. 

James [00:05:02] One of the things that we learned from the research of Judith Lasker in her book, Hoping to Help, is that short term volunteering often reinforces negative stereotypes rather than challenging them. You know, how can you possibly understand another culture if you go for a week? How do you really understand their context and that you're going to bring your assumptions to that visit and largely through confirmation bias. You're going to see what you want to see and you're not going to see what may be the real reality. So I think that's really important, is helping people understand that you you are not going to be a critic or an expert in a short term volunteering experience. When you engage in a culture, if you're doing that from a hotel or hostel and then dropping in, get the likelihood that she'll do harm is is much higher. Whereas if you're actually living in a community, living with people, there's a whole different kind of dynamic in relationships. So that becomes really, really important. 

Colby [00:06:10] There is concern volunteers are focused on seeing as many patients as possible, which could result in higher rates and misdiagnosis and complications. Since these trips are short term, there is also concern about follow up treatment of patients. Which brings into question are these trips ethical? 

James [00:06:30] I think this is especially problematic with groups wanting to do medical brigades, which we do not do. We do not do medical brigades simply because I think those have tremendous potential for doing harm. It's people who often don't speak the language. They're coming down for a very short term visit. They're probably bringing medications that aren't available in that country. They may be doing diagnosis that doesn't understand the context and they may not be connected with any continuity of care. So when they leave, whatever that person's ailment may be has not really been addressed. 

Colby [00:07:22] There are many ways current medical missions contribute to harm and may weaken an already weak system. For instance, primary care and financial resources are limited in rural Guatemala, and short term medical missions do little to address these issues. Not only are proper needs not being met, there is a potential to leave target communities dependent upon outside help. 

James [00:07:46] I think one of the questions comes and Farmer talks a lot about this and his work is, is what you're doing building capacity or dependency? And and those are a key questions. So the question is when I leave, will the people I leave behind be in a better position to take care of whatever the issue we're trying to address? Or will they be in a weaker position? 

Colby [00:08:14] When considering infrastructure, free care can be harmful.

James [00:08:19] When you give something to someone and you say it's a gift,that may not be a gift that may again put them in a position where they're actually in a weaker position rather than a stronger position after you leave. And again, I've seen so often where people come down and they say we want to give people free water so they build a water system and give it to people free. And those systems usually last less than a year. The water systems we do. There is a community fee, everybody who's connect to the water system pays a fee into a community fund that then pays for repairs, maintenance, chlorination, whatever the costs are for a water system. So the water is not free. I mean, everybody that community is going to pay to support that system. 

Colby [00:09:21] Clearly, these short term missions carry many risks, which begs the question, are these volunteer trips really necessary? 

James [00:09:30] The volunteers come and they slow it down and make it more expensive. We're very honest with the volunteers and say that's what you're doing. You're going to slow this down, make it more expensive. And if they will probably have to fix some things that you as a volunteer do. 

Colby [00:09:44] Since these ships are expensive, would the exclusion of volunteers be practical considering the ethical risks, would soliciting funds alone be a better option? Funds would certainly help, but how easy would it be to solicit funds without offering a personal experience? 

James [00:10:02] We didn't set out to be a group that use volunteers, but what we discovered is if you want to raise money, if you want to do projects, that it's very difficult to do that just by soliciting funds. That's one of the things most organizations have to do, is take people to the countries, let them see what's happening and get them excited. And then those people return to the United States and become champions for for your efforts. We also recognize that people want to help and people want to to see different parts of the world and see how they can engage. And that's that's not a negative thing. So I think all organizations, whether it's universities or nonprofits, all struggle with balancing that. How do you respond to this desire to help but do it in a way that's ethically responsible and actually doesn't do harm? 

Colby [00:11:14] There are many steps volunteers can take to ensure ethical and effective trips. 

[00:11:21] Well, in terms of short term trips, I think there might be a couple exceptions where we can be helpful. For instance, if we're going in to do specific kind of surgery, that may be rare or difficult in a region, for instance, cleft palate repairs or some kind of thing with eyesight or something like that, where there really can be a an intervention that that makes a significant difference and requires very little follow up. I think those can actually be a helpful thing. If there are physicians and nurses and volunteers in the United States who who want to to engage, they should be engaging in specific communities with specific health care providers. And then they need to make a commitment to support those endeavors, not just during their visit, but in going home and raising resources and raising support and providing medications or equipment. 

Colby [00:12:33] There are also a few things to avoid when considering a short term medical mission. 

James [00:12:40] I think what we have to stop doing is going down and doing primary care. Frankly, we just say that since to stop all over the world, that just needs to stop. What we absolutely need to stop doing is volunteer tourism, where I'm a doctor and I'm going to go to Haiti this year and do my thing in the next year, I'm going to the Dominican and then I'm going to go to Latin America. And then Asia, that's just got to stop. I mean, that that is absolutely exploitative. And we're just pretending that we're doing something for other people. It's just a way to justify or fundraise to do those kinds of trips. 

Colby [00:13:21] It's important to note that this is not just the opinion of one person, but many global health professionals as well. For instance, Judith Lasker says that if short term medical trips were the best way to handle health care, then why don't you and I rely on trips such as these? 

Colby [00:13:39] How do we avoid exploitation of those in need? What did the people of rural Guatemala and other countries ultimately need? Judith Lasker again provides helpful insight to these concerns. 

James [00:13:53] So she did a lot of work with host communities and host organizations and basically went to them and asked, do you realize that you're being exploited? And the. Almost universal response was yes. Which is very odd to think about, so we have all these these organizations in in developing countries, the North Americans come and they know they're being exploited to some extent. So the question she asked is, well, why do you keep doing it? And their response was the hope of future support. And I think that's very interesting because when I talk to people who are traveling. Develop a relationship with them and become an advocate. So I think there's a big disconnect between what people in the developed world are hoping for. And what people in North America and Europe are offering, there's this kind of huge disconnect. And I think being aware of that is really important. 

Colby [00:15:00] Avoiding the exploitation of communities is a must. Going to an underserved community and helping effectively is a wonderful thing, but not if the only takeaway is a picture that is posted to social media. There is a need for a long lasting relationship within these communities. Above all else, we need to make sure that short term medical missions to Guatemala and other countries are ethical, culturally aware and ultimately effective. My name is Colby Hinkle. This podcast was produced for the Spring 2020 Global Health Course at Guilford College. 

This is a podcast about the aging population in Japan. I will focus on factors of what's causing the elderly population to rise, for example a shift in gender roles, as well as what the government is trying to do about it. Included are interviews with exchange students from Japan attending Guilford College in the Spring of 2019. 

Click show detail for a full episode transcript

Jacquelyn: So, think about the world and what it’s gonna look like in 2050. Some might think about how geographically different it’ll be. What we should be thinking about is what the populations gonna look like. Some might think that the world will be overpopulated by the year 2050. As the popular trend right now in Japan, that’s not the case. 

Jacquelyn: The population in Japan is shifting from younger generations to aging populations. Someone might consider this to be a good thing for the world, but there are potential consequences that Japan could be facing. 

Jacquelyn: So let’s talk about what’s causing the declining birth rate in Japan. There are many social reasons that this is happening… First, there is a stronger presence of virtual dating (Rani, 2013). There’s actually a Nintendo game called LovePlus. Players basically simulate being in a relationship through their game boys. Men in Japan replace a real relationship and often treat this virtual one as if it’s real (Rani, 2013). 

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Jacquelyn: Second, the role of women is shifting in Japan. Parents that are getting older are relying more on their daughters to take care of them as opposed to a son (Boling, 2008). This doesn’t leave a woman much time to be married, raise children and work to provide family income (Boling, 2008). The bond between a daughter and her aging mother is thought of as, more special (Boling, 2008). Japanese women don’t necessarily see the role of marriage relating to happiness, whereas Japanese men do (Boling, 2008). Women are embracing a sense of self and their own independence now (Boling, 2008). 

Jacquelyn: Not surprisingly, compared to being married young and having a family, Japanese women enjoy living at home with their parents while working and they basically having more freedom. (Boling, 2008). 

Jacquelyn: I caught up with Kina, who is a Japanese exchange student from Tokyo. I asked her about traditional gender roles in Japan.

Kina: As a society, people have certain stereotypes of gender roles. So, and traditionally in Japan the society has been patriarchal. So, a lot of men say that women should stay in home and do some stuff, like um cooking and cleaning and laundry. And, and women should um give birth to childs and raise them up. So, yeah that’s the traditional gender role for women and men are supposed to do work and earn money. Um, more women are working now but still it’s difficult for women to work and at the same time keep like, house, yeah so but I think it’s changing. 

Jacquelyn: I also asked Jun, who is another exchange student from Japan, about his opinions of gender roles in Japan and how his friends might view the future, his response reflects what Kina was saying about traditional gender roles in Japan. 

Jun: Men should work and a women should, you know, take care of children, their children and like cooking the food or yeah something like that. Women tend to want to like want to have a like family in the future and so like men want to like seek the career instead of like family. 

Jacquelyn: It’s surprising, but some people out there don’t see the aging population in Japan as a problem (Davis, 2018). One professional working in Gerontology is Sarah Harper. So she basically studies the elderly (Davis, 2018). As an expert in the field, she claims that there shouldn’t be any concerns with the aging population in Japan (Davis, 2018). She says that countries with ageing populations don’t need the younger populations to sustain themselves (Davis, 2018). 

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Jacquelyn: What’s the government doing about the increase in the elderly population? Could they be helping the world by taking in refugees and immigrants to join the workforce? Historically, Japan has had really strict policies regarding it’s borders. Could opening the borders help the issue of the aging population? One big issue of the increase in elderly and aging populations is how they will be taken care of and still receive pensions from the government (BBC, 2013). They expect it right, after working their whole lives. 

Jacquelyn: I asked Kina about the shifting age of the population and how it could be sustained. 

Kina: Because younger generation are like decreasing in terms of number, like population. Um, we have to support like elderly people by paying a lot of taxes. And so, If you get a job and when for example when you retire at the age of 60 or 65 you can get money from the government in Japan. And for example my grandma is getting money from the government but I don’t know if we can get money from the government when we get older.

Jacquelyn: When I asked Jun about the aging population he also responded in a similar way and that told me that most Japanese are aware and had in depth knowledge of the subject. 

Jun: Compared to like young people the number of like you know senior people are growing up so the problem is like the young people uh is, uh, how do you say like, responsible to pay you know the tax instead of like senior people can. So, I mean, so, this is a serious problem in Japan.

Jacquelyn: An obvious problem with the aging population is those who are of age to still work and help the economy. For Japan to open up its borders does show that the government does believe there is a problem and their trying to fix it (McCurry, 2018). Therefore, there should be some kind of policy that incentivizes people to immigrate to Japan. An obvious solution to this problem would be turning to the rest of the world for help. There is a staggering statistic that the number of people working in Japan will fall from about 55 million to around 8 million by the year 2030 (McCurry, 2015). Interestingly enough, Japan does fund aid for countries in need, but still has a strict immigration policy (McCurry, 2015). One benefit of this new policy by the Japanese government is bringing over people with skills from other countries (McCurry, 2018). They will gain even more skills while in Japan but in return they’ll go back home with these skills and help their own countries’ economies (McCurry, 2018). One criticism of this policy has been that those who have valuable skills will be able to bring their families, while those with less skills will not bring their families and will have to go back home after 5 years (McCurry, 2018). Japan will also have to provide sustainable housing, health care and basic needs for these immigrant workers. 

Jacquelyn: I asked Kina if she noticed people working in Japan from other countries.

Kina: I see many um, Asian people working in convenient stores in Tokyo. Sometimes, all, um, most of employees are for example Pilipino or maybe Malaysian people. And, yeah, a lot of Asian people are coming I think. But I don’t know if their working environment is good, if the e-employers give them enough money and treat them nicely. So, yeah I am not sure and I don’t think their environment, working environment is good. So yeah but the number of foreigners working in Japan is increasing.

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Jacquelyn: If you asked anyone on the street in the United States about this issue I would guess they don’t know about it. We should be concerned with global health issues around the world. Due to global overpopulation many people wouldn’t consider the declining birth rate in Japan as a problem but in reality the research shows that is a problem. Thanks for listening.

Jacquelyn: This podcast was produced by Jacquelyn Fulk for the Spring 2019 Global Health course at Guilford College.

Kate Glenn [00:00:13] Did you know that in the United States mining is the number one most dangerous job. What about in other parts of the world? How does mining affect you and I? Why should you be concerned? 

Kate Glenn [00:00:40] Today I'm going to be discussing the public and environmental issues linked to mining in Chile South America and in southern West Virginia. Two major mining years in the world. I come from a background of coal and I am also from and grew up in a small town in West Virginia West Virginia's main economic source is coal mining. 

Kate Glenn [00:01:05] Mountaintop removal in West Virginia is very prevalent and extremely harmful research shows it leads to the development of chronic diseases and birth defects. 

Kate Glenn [00:01:25] Fortunately I didn't directly grow up in the southern part of the state but I've traveled and seen mountaintop removal take place. Mountaintop removal affects so many local communities in southern West Virginia that also struggle with food insecurity and many living under the poverty line. Even though these events may be happening far away in another country or state and may not be visual to you in real life the impacts are still affecting you every day. 

Kate Glenn [00:02:02] In many cases there are renewable resources but until it becomes less expensive and more accessible. Coal mining will remain the number one energy source in the world. You and I use coal every single day. If we turn on a light switch or turn on the TV coal power is 40 percent of the world's electricity. And mining is the number one polluter producing 39 percent of carbon dioxide emissions and 42 percent of mercury emissions. Even nitrogen oxides produce for example smog are harmful to respiratory systems and can cause chronic diseases such as pneumonia. These toxins are harming public health. 

Kate Glenn [00:02:46] This isn't just happening nationally but also on a global scale. I've also visited Chile South America. My dad's side of the family is from and my grandma was born. She grew up in a small mining town called Chuquicamata when I went to the town it is just how I imagined small and only people living there are the workers the mine I visited was huge. 

Kate Glenn [00:03:11] And just by being there a short amount of time I could see how dangerous it was working there. 

Kate Glenn [00:03:17] Alberto Cerdo is a mining engineer in Chile's south America 

Alberto Cerdo [00:03:27] I've been working for the industry since I got out of the university as a civil mine engineer. I started in in former engineer position writing into production. 

Alberto Cerdo [00:03:40] Then I moved to business professions or positions. And then to executive positions. So I mean in most all of the areas meaning production, projects, business and all of them related with the mining of copper and mining of gold. 

 [00:04:01] Mining has been a part of Chile's culture since pre colonial times. 

Alberto Cerdo [00:04:05] Just like Chiquicamata, there ae]re local communities surrounding various mines in Chile also being affected. Researchers found that outside three mining towns they had depletion of water and even an increase in prostitution and venereal diseases. Not even mentioning they are breathing in the toxins that the mines are releasing every single day. \. 

 [00:04:23] in all of my career communities have been involved in in mining. In the last ten year I would say or 15 years it's been more in the in the media and also in the news about the mining and the relationship with the community. But the truth is that communities have always been a very important part of the mining industry and in the way that the mining related to them is by first of all offering very good quality positions offering them also developing the little towns or the cities where mining are close to it. 

Kate Glenn [00:05:16] Other environmental downsides include deforestation and erosion. Erosion causes soil and sediments to run into streams rivers and contaminate waterways. Because these waterways become contaminated. This is a threat to everyone drinking from well water or even your own tap water. 

Alberto Cerdo [00:05:35] And also mining there has to be very respectful of the communities but also very respectful of nature and in an ecosystem and biodiversity because that is very important for the communities and should be important for all of the people that works in the mining industry my experience all of the all of the relationship has has been positive. The same example of stamina. It's been really positive. And the company has been able to interact with all the community interaction with community. It doesn't mean everything is is sweet and nice human relations has ups and downs. The important is that in the mid and long term the relationship continue it continues and is and is perceived as a positive relation always. 

Kate Glenn [00:06:36] Not only did environment and communities suffer the workers are hit directly. 

Kate Glenn [00:06:41] Health impacts from mining is seriously no joke. The workers go through harmful work conditions every day. Let's not forget about the incident in 2010 where 33 miners got trapped in an escape shaft in Chile. Miners also experience polluted gases even though they wear some type of protection. It does not entirely prevent harmful gases from entering their lungs. 

Alberto Cerdo [00:07:05] In my personal experience environment and communities right now are a very important area of decision making process is not only production and cost now is is safety of the people that works in the mine safety of the people of the communities due to the mining industry. Also have a really good quality of human relations human human resource relation of people relations. 

Alberto Cerdo [00:07:38] And of course social and environmental variables that any top manager should be accountable for my name needs to be more regulated and in the future we need to find a more environmentally friendly option to fuel our electricity. Mining will not go away. 

Alberto Cerdo [00:08:03] Well mining will continue to be part of the human civilization and the human model and the way to live. We love medals. 

Alberto Cerdo [00:08:15] Not only Iron. We love copper. We love lithium. We will require more lithium more copper more cobalt in the future in order to maintain the planet away from CO2.  

Alberto Cerdo [00:08:33] So mining will continue being an activity that humans will need. 

Alberto Cerdo [00:08:39] It's not something sometimes uh that that seems to be very friendly with environment. And it's also very demanding of people. 

Alberto Cerdo [00:08:48] But is there is a need for the human race if we continue. And in light to have these more than type of life that we have every equipment every unit everything that we do today in the modern world is thanks to metals that human can actually use. 

Kate Glenn [00:09:21] This podcast was produced and scripted by Kate Glenn as part of the spring 2019 Global Health course at Guilford College.