by Katie Baker
ETSU College of Public Health
Appalachia Region

katie baker farmer market

Friday, July 22, 2011

Since my last post, I have been very, very busy!  First, the skin cancer prevention program I’m developing is really coming together.  At this point, I have developed two of the four modules, completed a formal recording of “Sabrina’s Story,” a local melanoma survivor’s story, with the help of ETSU’s Communications Department, and scheduled meetings with each of our region’s eight county Health Councils as a way of disseminating the program once it’s complete.   As I will be collecting baseline and posttest data from 135 students at David Crockett High School, the pilot site for the program, I will also begin the IRB (Institutional Review Board) application and approval process very soon. 

In addition to working on components of the skin cancer prevention program, I organized and conducted sun safety events at the Johnson City Farmers’ Market and Kingsport’s annual Fun Fest Splash Day and participated in the National Cancer Institute’s Research to Reality Cyber-Seminar “From the Seaside to the Slopes: Implementing Sun Safety Programs through Partnerships.”

Sun Safety at the Johnson City Farmers’ Market

July 16, 2011

Each year, the Washington County Health Council organizes a health fair/health screening event to be held during the Johnson City Farmers’ Market in Johnson City, Tennessee.  This year, the event took place on Saturday, July 16th.  Members of the Health Council invited me to set up a sun safety booth similar to the one we had at the Blue Plum Festival in June, and I gladly accepted their invitation.  For this event, I distributed educational materials donated by the American Cancer Society and Wellmont Health System describing the importance of practicing sun safety and ways to protect your skin from ultraviolet radiation (UVR).  I also distributed no-cost protective aids including foam visors from TC2 and sunscreen donated by the American Cancer Society.  Lastly, I counseled those participants that visited my table on the following topics: the dangers of UVR on a cloudy day; choosing the right sunscreen; and skin self-examinations.  One hundred participants registered (i.e., completed a survey) for the Health Fair, and the majority of participants stopped at the sun safety table.  Each participant I spoke with reported intentions to use sunscreen, and approximately 50% took a sunscreen sample from the table.  As the day was cloudy, I was able to educate participants on the importance of wearing sunscreen even in bad weather.

Research to Reality Cyber-Seminar “From the Seaside to the Slopes: Implementing Sun Safety Programs through Partnerships.”

July 19, 2011

Surprisingly, this was my first cyber-seminar, and I must say, I thought this was an excellent mechanism through which to share best practices in public health!  This particular seminar focused on large-scale dissemination of skin cancer prevention/sun safety programs.  From the Moffitt Cancer Center in Florida, the first two speakers detailed their experiences with the “Mole Patrol” program.  This community service-type program focuses on the provision of free skin cancer screenings to coincide with Major League Baseball’s (MLB) spring training.  To date, the Mole Patrol has partnered with MLB, hospitals affiliated with the Moffitt Cancer Center, local county governments, AAA, local county school boards, and the Air Force.  From 2008-2011, they hosted 59 screening events, screening 6,367 people.  Dr. Dave Buller of Klein Buendel, Inc. in Golden, Colorado presented on his experiences with sun safety programs in occupational settings, specifically ski resort employees.  He explained that to achieve maximum program dissemination and uptake, program developers must use a two-pronged strategy.  First, they must partner with the professional associations in the industry.  Benefits of partnering with professional organizations include: access; legitimacy; problem and solution identification; program development; and the facilitation of dissemination.  Second, they must partner with individual operators/employers to reduce uncertainty about the program, build trust among senior managers, and identify internal champions who will sustain the program. 

I feel as though I can apply several of the lessons I learned during this cyber-seminar to my field experience project.  I intend on partnering with a large organization, the Heath Occupations Students of America (HOSA) group, for access to students and program dissemination.  Also, I will be personally visiting each of the eight county Health Councils in our region to obtain public commitment to the initiative and create a plan for program use.

Sun Safety during Splash Day at Fun Fest’s Kids Central
July 20, 2011
Andrew Johnson Elementary School in Kingsport, Tennessee

For the last several years, the Tennessee Cancer Coalition (TC2) and its local partners have organized a sun safety booth to be held in conjunction with Splash Day at Kingsport’s annual Fun Fest.  This year, TC2 members in our region asked me to organize the booth and attend the event.  This was the largest sun safety event I’ve organized to date.  I distributed many of the same educational materials I used for the Blue Plum Festival in Johnson City and the Johnson City Farmers’ Market.  In addition, for this event, I made and gave out UV-bead bracelets from TC2 meant to teach children the importance of wearing sunscreen when the UV rays cause the beads to turn color.  I also distributed no-cost protective aids including sunglasses donated by Wellmont Health System and sunscreen from TC2.  Lastly, I counseled those participants (children and parents/caregivers) that visited our table on the following topics: the dangers of UVR on a cloudy day; the importance of wearing sunscreen to prevent skin cancer and sunglasses to protect the eyes from UVR; and proper sunscreen application (i.e., reapply after getting in the water, etc.).  Over 2,000 children and parents/caregivers attended Fun Fest’s Splash Day.  I estimate that approximately 800 children visited the sun safety table.  When asked if they were wearing sunscreen, approximately 5% reported they were, leaving 95% of children attending the event unprotected against the sun.  I gave sunscreen to each child who reported not wearing any that day; this means I distributed approximately 750 packets of TC2 sunscreen.  I asked each child who visited the table if they could tell me why it was important to wear sunscreen, and approximately 85% responded correctly (i.e., “to keep from getting skin cancer;” “to keep from getting a sunburn”).  In total, I distributed: 500 pairs of sunglasses (donated by Wellmont Health System); 300 UV-bead bracelets (sponsored by TC2); 750 TC2 sunscreen samples; and 25 sun safety pamphlets (donated by ACS).

by Megan Quinn
ETSU College of Public Health
Munsieville, South Africa

megan quinn gardens

On Thursday July 14th, 74 individuals came together and made the decision to change their lives and end hunger, malnutrition, and poverty in Munsieville , South Africa by planting gardens.  Many families in Munsieville struggle to have a well-balanced meal every day and building gardens will create a sustainable way to ensure that individuals do not have to go hungry.  Further, vegetable gardens will help to fight malnutrition in the children of Munsieville.  According to the World Health organization, malnutrition contributes to more than one third of all child deaths and can occur due to offering the wrong foods, inadequate breast feeding, and not ensuring that the child receives enough nutritious foods1.  The people of Munsieville are going back to the soil to make sure their children and families are adequately fed and nourished. 

The 74 individuals were divided into 15 groups to begin building the gardens.  Group members will assist each other in building gardens at each of their houses and training other individuals in the community as well.  The keyhole garden method will be used to build the gardens in small spaces and use recyclable materials and water.  For more information about keyhole gardens, follow this link.  http://www.sendacow.org.uk/keyhole-gardens  Community members of Munsieville are very excited to begin this endeavor! Everyone should have enough vegetables to feed their families and maybe even sell the extras.  Additionally, once they start growing vegetables, some of the women would like to open a soup kitchen for the orphaned and vulnerable children in the area.

A few of the leaders of the community garden groups met on Wednesday, July 20th to receive training about the keyhole gardens and develop plans to begin building.  These key leaders will assist us to ensure that gardens are built for all of the individuals participating in the program.  Additionally, we hope to utilize these leaders to train individuals to build gardens in other parts of Munsieville.    

We broke ground on our first garden on Friday, July 22nd.  Roughly 10 women helped the “Star Garden” group build their first garden.   The women collected materials from around the community (bricks, straw, cans, and soil) and compost and seedlings were provided through donations from the United States.  This small garden, containing spring onion, beet root, cabbage, parsley, and spinach, will feed approximately 5-10 people and will change the lives of the owner and her family.  Further, plans were made on Friday for the next set of gardens to be built.  The women continued collecting materials over the weekend and plan to build several more gardens this week.  This small effort will make a huge difference in the lives of the community; providing healthy, nutrient rich foods to the people of Munsieville.   

 

 

  1.  World Health Organization.  2011.   http://www.who.int/child_adolescent_health/topics/prevention_care/child/nutrition/malnutrition/en/  Accessed 7/22/2011. 

 

Brad Paisley talks about the importance of clean water for the 1 out of 7 people around the world who lacks access. Please join our Water=Hope campaign today at WaterEqualsHope.org. Donate $10 by texting H2O to 25383; you will receive a confirmation, reply YES. It really is that simple!

PRESS RELEASE
WASHINGTON, DC – The Clinton Bush Haiti Fund today announced a $1.8 million grant to the Boston-based nonprofit Partners In Health to support its Haitian sister organization Zanmi Lasante in a program that will make long-term, sustainable improvements in the scope and quality of Haiti’s healthcare and medical education sectors. The grant will be used to launch a residency program for family practice physicians and a certification program for auxiliary nurses at the public hospital in St. Marc supported by Partners In Health and Zanmi Lasante.

“The earthquake and cholera outbreak have only heightened the healthcare sector’s challenges,” Clinton Bush Haiti Fund CEO Gary Edson explains. “The Clinton Bush Haiti Fund’s three-year grant for Zanmi Lasante’s work is an investment in Haiti’s human capital. It will provide training for critically needed family practice physicians and auxiliary nurses at l’Ho?pital Saint Nicolas, the chronically understaffed public hospital serving 220,000 St. Marc residents and, ultimately, the 1.5 million people of the surrounding Artibonite region.”
Additionally, Zanmi Lasante will leave a lasting legacy for the nation’s public health system by upgrading and standardizing auxiliary nurse education, creating a first-ever certification program to be replicated by other medical training centers throughout Haiti.

Amplifying the impact of the Clinton Bush Haiti Fund’s grant, Partners In Health will match the funds more than one to one, and will work closely with the National Faculty of Medicine and Haiti’s Ministry of Public Health and Population.

Today’s announcement is an example of the Clinton Bush Haiti Fund’s support for projects that provide both humanitarian assistance and economic opportunity, helping Haiti “build back better.”

“This grant represents an invaluable investment in the decentralization and long-term, sustainable reconstruction of Haiti’s health system,” said Dr. Paul Farmer, co-founder of Partners In Health and chair of the Department of Global Health and Social Medicine at Harvard Medical School. “It will enable Zanmi Lasante and Partners In Health – working in partnership with Haiti’s Ministry of Health and national medical school – both to improve the quality of care for the people of St. Marc and to train a new generation of healthcare providers to deliver comprehensive, community-based care in even the poorest and most remote places.”

Clinton Bush Haiti Fund
The Clinton Bush Haiti Fund is a 501(c)(3) nonprofit organization founded after Haiti’s January 12, 2010 earthquake, when President Barack Obama asked former Presidents Bill Clinton and George W. Bush to head a fund aimed at easing the suffering of the Haitian people while laying the groundwork for “building back better.” The Clinton Bush Haiti Fund initially responded to the catastrophe with millions in humanitarian relief. By the time the Fund began independent operations in May 2010, it transitioned to primarily serving its longer-term mission of sustainable reconstruction efforts designed to promote jobs and create economic opportunity, enabling Haiti to chart its own successful future. To date, the American people have entrusted the Fund with more than $53 million from 200,000 individuals, supporting innovative programs that help Haitians to help themselves. To learn more, visit www.ClintonBushHaitiFund.org.

Partners In Health
Partners In Health (PIH) works in 12 countries around the world to provide quality healthcare to people and communities devastated by joint burdens of poverty and disease. PIH has been providing vital healthcare services in Haiti for more than 20 years, working with the Haitian Ministry of Health to deliver comprehensive health care services across the Central Plateau and Lower Artibonite Valley. For more information please visit www.pih.org.

by Karie Castle
ETSU College of Public Health
ASPIRE Scholar/Appalachia

During the past month and a half, I have been working and an intern with the Boone Watershed Partnership, Inc. (BWP) a non-profit organization currently in the process of performing restoration projects on two creeks, Sinking Creek and Gap Creek. Sinking Creek is mainly located within Johnson City, while Gap Creek is located mainly in Elizabethton. Both creeks are an essential asset to these two Appalachian communities. Both of these creeks are on the 303(d) list, meaning that they are not capable of sustaining life. Sinking Creek has been put on the list due to E.Coli pollution, while Gap Creek’s main problem is sediment.

Most of the work that I have been doing has been with Project Manager, Sarah Ketron. The main focus of the Sinking Creek project is to inform the community of the pollution in Sinking Creek and inform them on how they can help. On July 9th, Sarah, Gary Barrigar (President of BWP), and I went on a Septic Survey. On this trip, we went door to door asking people if they were connected to the sewer. Part of the grant given to the BWP from the EPA allows the BWP to assist residents in getting connected to sewer, if they are not already. The BWP pays all the costs, except for the monthly tap fee. This is a huge benefit to residents, considering this is something that could cost thousands of dollars. Also, if a resident is currently using a septic tank and is not able or does not wish to connect to sewer, BWP will assist in emptying or repairing the current septic tanks and/or field lines. BWP pays 100% of the costs. Once again, this is a huge incentive for the rural communities, considering the amount of money they would have to pay without BWP assistance. Sarah and I will be conducting another survey this weekend.

Aside from the two restoration projects that are currently up and running, the Boone Watershed Partnership, Inc. also assists in clean ups of other streams and rivers. So far, I have assisted with one clean up. BWP teamed up with Wal-Mart of Elizabethton to help clean up a portion of the Doe River in Elizabethton. We managed to clean out about four truck loads of trash and debris in about three hours. The community living along this portion of this river really appreciates what BWP is doing and even sometimes come out and assist in the clean up. It’s a really good feeling knowing that what you’re doing is helping others, especially in such rural Appalachian communities.  Thank you LoveEverybody  foundation for the ASPIRE Appalachia scholarship support.

 

by Twanda Wadlington
ETSU College of Public Health
Munsieville, South Africa

twanda blog 3a

Happy Birthday to you. Happy Birthday to you. Happy Birthday dear Tata. Happy Birthday to you. We love you Tata. We love you Tata. We love you dear Tata. Happy birthday to you. Happy Birthday Madiba!! Happy Birthday Madiba!! Happy Birthday to you!!! HIP HIP…HOORAY

Today millions of people sung Happy Birthday to Former South African President, Nelson Mandela’s 93rd birthday. Now known as Mandel Day, July 18 is an international holiday adopted by the United Nations. July 18 is more than just a day to celebrate the anti-apartheid heroic leader’s birthday; this day is a global movement to commemorate his life’s work and honor Mr. Mandela’s legacy through an act of kindness – 67minutes to be exact. Sixty-seven minutes represents the number of years Mr. Mandela dedicated to ensure equality for South Africa, from 1942 until his retirement from public service in 2009.

To celebrate Mandela Day, Megan Quinn and I had had the opportunity to volunteer our time in a small informal settlement near Randfontein, Gauteng. Along with our field supervisor, Ms. Betty Nkoana we had the opportunity to plant vegetables in a garden dedicated to the township and its people. Project Hope UK also donated soccer balls and soft toys to the local crèche (child care center) in that township.

Ms. Nkoana was also invited to speak during the program as an honored guest and representative of Project Hope UK by the Executive Mayor of the West Rand District Municipality, Councillor Mpho Nawa. Ms. Nkoana spoke about Project Hope UK’s intentions in the community, especially when dealing with orphaned and vulnerable children; and the potential changes that NGOs can contribute to the community. The program also included a campaign and demonstration of building “clean” and safe fires during the winter season.  This campaign, Winter Clean Fires, is known as the “make fire like granny” method. It was implemented because air pollution is a major problem in South Africa, especially in more dense and low income communities, where individuals depend on coal for space heating and cooking as the most affordable means of energy. The “make fire granny” method is done by putting coal first, then paper, followed by wood and then lighting the fire. When the wood catches fire, put a handful of coal on top to ignite the coal at the bottom. During the demonstration, this method was found to emit less smoke, burn longer, save coal, and is much safer for human health than the traditional method of just burning coal in a tin can. Lastly, we ended the day by distributing parcels of food and cooking materials to citizens of the informal settlement.

It was truly amazing to see an entire community and country come together for a day of giving and kindness. I feel that Mandela Day has truly represented what the Frist Global Leaders Program aims to achieve through supporting scholars, such as Megan and I. I also look forward to finishing these last few weeks in South Africa by making a lasting impact on the Munsieville community through some the projects that are scheduled, such as the waste clean-up initiative in Little Mshenguville and the homestead gardens with the local grannies.

by Megan Quinn
ETSU College of Public Health
Munsieville, South Africa

megan quinn and children

During the last two weeks, my colleague, Twanda Wadlington and I have had the opportunity to collaborate with another local non-government organization (NGO) to implement a health promotion program during the winter school break.  Legae La Bana (Home for the Children) is a local NGO focused on providing daily meals and social support to the orphaned and vulnerable (OVC) children in Munsieville.  The program centered on health related issues, while incorporating team building, arts, sports, and academics.  The program also assisted in identifying student leaders in the community that can assist with future Thoughtful Path projects. 

The second week of the program kicked off with the West Rand District’s monthly orphaned and vulnerable children (OVC) meeting.  The meeting was hosted by Legae La Bana in Munsieville.  Project Hope UK Project Manager, Betty Nkoana, Twanda, and I were invited as honored guests.  The meeting provided an opportunity for all of the governmental and non-governmental organizations that serve the OVC to meet together, discuss issues surrounding OVC, and continue implementation of programs. 

Munsieville’s Got Smarts Trivia competition took place on Wednesday, July 13th.  We had 26 children in attendance.  The game offered an opportunity to showcase the intellectual abilities of the children and for us to teach them about specific topics.  Topics included health, science, math, English, and South African history.  I was genuinely amazed at the level of some of the answers we received.  For example, one of the health questions asked participants to identify pollutants in the environment.  One extremely bright teenager mentioned that pollutants in their environment not only stem from illegal waste disposal and vehicular pollutants, but beauty products that contain certain chemicals can also pollute the environment and affect the ozone layer.  The children really enjoyed the competition, taught us a lot, and gained more information about the topics covered. 

Thursday, July 14th proved to be an extremely educational and successful day.  We conducted a sexually transmitted disease (STD)/sexually transmitted infection (STI) workshop with the OVC.  Due to the fact that some of the children may not have parents, live in foster care, or do not have parents that actively participate in their lives, early onset of sexual intercourse, teenage pregnancy, and STDs can be quite prevalent with this population.  Educating children early can aid in preventing some of the negative health effects associated with early onset of sexual intercourse.

The workshop began with a simulation of how easily and quickly STDs can be spread.  Each individual was given a piece of paper and was instructed not to look at their paper and to trade the paper with the other individuals participating in the game.  Individuals were told to remember how many people they traded with.  The number of times that an individual traded their paper illustrated the number of sexual partners.  Meanwhile, the pieces of paper either listed a common STD, pregnancy, or were blank (no STD, no pregnancy).  Following five minutes of trading papers, one by one the participants were instructed to open their paper and tell how many times they traded papers.  Twanda and I discussed the basic epidemiology of teenage pregnancy and each of the STDs.  We explained transmission, symptoms, and treatment.  Participants seemed to have a clear understanding of HIV/AIDs due to local public health campaigns, but were not familiar with many of the other common STDs (gonorrhea, chlamydia, HPV, herpes).  Prevention of STDs and pregnancy, as well as communication of STD status with partners was discussed.

The children in the Munsieville community are very aware of the health issues in their community and identified several issues and solutions on Friday June 15th.   The children were broken into two groups and asked to highlight some of the health issues in the community and identify feasible solutions.  Both groups listed crime as a major threat in the community.  Additionally, one group listed teenage pregnancy and STDs as a key issue for young females.  The other group focused on illegal dumping of waste and listed several potential solutions (additional garbage bins, changing community opinions of waste disposal, etc.).  The solutions listed will be incorporated into the waste management initiative we hope to begin next week.  Further, the other issues identified by the children will be compiled to inform future Project Hope UK/Thoughtful Path Munsieville projects.

The final day of the Winter Break Program was celebrated with a showcase of the children’s talents and skills on Saturday.  Soccer and netball served as the main events of the day.  We also had children create a banner for Legae La Bana, recite poems and perform dance routines.  These events provided the children with a safe, positive activity to participate in on Saturday.  Moreover, the events gave the children an opportunity for physical activity and increased their self-esteem.  All of the children received a certificate of achievement for completion of the Winter Break Program.

The last two weeks have not only provided an opportunity to break the cycle of poor health and change the lives of some of the most vulnerable members of the community, but they have also humbled me and taught me a great deal.  It genuinely amazes me just how smart, capable, and resilient children can be regardless of where they may live or what material items they possess.  The two weeks that we spent with the children will hopefully lay the foundation for positive change and greater overall health not only for these individuals, but for their families and the community as well.  I am extremely honored to work with this community and Project Hope UK and to represent East Tennessee State University and the Frist Global Health Leaders.  That said, I can’t wait to see what more we can accomplish in the next few weeks!  

by Bill Frist, MD

This weekend marks the celebration of the independence of a new nation, the Republic of South Sudan. A close friend, Ken Isaacs, was there to witness the joy:

"Today the Republic of South Sudan declared its independence from Sudan. Hundreds of thousands of people were present as well as dozens of dignitaries and international representatives.

There were parades of the various military units of the South. Youth groups, wounded veterans, police corps and other citizen groups also marched past the grandstand.

I have never seen or experienced such joy in Sudan. People cheered as loud as thunder. They sang and cried with tears of joy."

I'm often asked why do governmentt service? I wrote and introduced to Senate the Sudan Peace Act on Jan 25, 2001 after medical mission trips with World Medical Mission/Samaritans Purse to southern Sudan. It became law Oct 21, 2002. The Act helped pave way for Comprehensive Peace Agreement and committed the US to involvement in the peace process. Today, the culmination in INDEPENDENCE for millions of people. Politics matter. Medicine as a "currency for peace."

In celebrating this momentous occasion, I reflect upon a patient, in Lui, Sudan, on whom I operated years ago. Here is his story from my book, A Heart to Serve:

"During our last case on our final day before departure, a message came to the operating theater that a patient in the recovery room wanted to see “the American doctor.” By that time, all I wanted to do was to go back to my tukul, wash up, tumble onto the mat, and fall asleep. But I couldn’t refuse this last request. Dick, David, and I walked next door to the one-room hut that we were using as a recovery room. In the darkness, I could vaguely make out the silhouette of a man lying on a bed in the corner. Drawing closer, I saw white bandages covering the stump of what had been his left leg; a similar dressing covered his right hand.

But what drew my attention was not the man’s injuries, but his bright smile, a smile that, even in the darkness, seemed to illuminate the man’s dark brown face. I noticed a Bible beside his bed, not an unusual sight at a Samaritan’s Purse clinic. I leaned over, put my hand on the man’s shoulder, and through an inter- preter, I asked why he wanted to see the American doctor.

The man told me his story. Two years earlier, his wife and children had been murdered during the war. Even as he spoke of the atrocity, he continued to smile, and his eyes remained bright. I nodded as I listened, my own heart breaking at the thought of losing my wife, Karyn, and our three boys in a senseless, seemingly endless war. I knew there was no way I would be smiling. “Then eight days ago,” he said, “I stepped on a landmine. I lost my leg and my fingers,” he raised his hand slightly, so I could see that most of his hand was gone. And yet he continued to smile. I nodded again, trying desperately to understand. I listened as he told how he had been brought to the hospital at Lui from about twenty kilometers away, and how the American doctors had saved his life.

Finally, I couldn’t resist the obvious question. “Why are you smiling?” I asked. “Or should I say, how can you possibly be smiling?” “Two reasons,” he said through the interpreter. “One, because you come to us in the spirit of Jesus. And two, because you are an American doctor.”

“What do you mean?” I asked.

The man rose up on the bed as best he could on his mutilated limbs and uttered words that would remain indelibly impressed in my heart. “Everything I have lost,” he said, his eyes bright in the darkness, “my family, my leg, my hand—will be worth the sacrifice if my people can someday have what you have . . . in America.” He paused, then spoke as if uttering a prayer: “Free- dom. Freedom to live and worship as we please. The freedom that America represents.”

I swallowed hard. I looked up at Dick and David, and I could tell that they, too, had been moved by the man’s statement about the values that so strongly characterize the United States. Over the years, I’ve been back to Africa many times. I’ve made medical mission trips to the Congo, Uganda, Kenya, Sudan, Tanzania, and Mozambique. I’ve never seen that man again, and I probably never will. But I’ve never forgotten his smile and his heart.


Moreover, in recent years, I have become increasingly convinced that medicine can truly be a currency for peace in our world—a way for America to reach out in friendship and com- passion, creating lasting friendships with people on every conti- nent. Looking back, the awareness of that truth may have begun in that dark room, fostered by a man who had lost nearly everything but his faith in God and his hope for freedom." (A Heart to Serve, pp. 11-13)

by Katie Baker

ETSU College of Public Health

Appalachia/ASPIRE Scholar

Health eating katie baker

Having reached the midpoint of my summer field experience, I can’t help but reflect on the past seven weeks and realize that this was the most ideal placement for me.  The Tennessee Cancer Coalition (TC2), its members, and my supervisors have encouraged and supported me in my efforts to develop a comprehensive skin cancer prevention program for high school students.  I must also take the opportunity to thank Big Kenny and the Love Everybody Fund.  Without that support, I wouldn’t be able to devote the time, energy and passion necessary to complete a project of this magnitude.

Since my last post, I have made significant progress on the program.  First, I interviewed a local melanoma survivor, Sabrina Fields, who attributes her cancer to excessive sunbathing and indoor tanning during her teenage years.  Our meeting was video recorded, and I plan on integrating “Sabrina’s Story,” as I am currently calling it, into my program.  In fact, I anticipate that segments of this video will serve as prompts for each of the four modules I’m developing, modules that will be delivered in four sessions during four consecutive weeks.  Second, I met with Lori Grabner from the Department of Health Science Education at David Crockett High School here in East Tennessee.  During our call, Lori was able to share her perspective on how best to reach high school students, emphasizing the need for interactive activities and the integration of multiple teaching methods.  Lori also suggested a “vehicle” for program dissemination throughout the state.  I will soon be contacting the state consultant for Tennessee HOSA (Health Occupations Students of America) to see if the organization would be interested in adopting the program.  Tennessee HOSA is comprised of 360 health science educators and over 11,000 students.  Lori has also offered to serve as the pilot site for the program; I hope to pilot the project in August of 2011.

Healthy Eating for Cancer Survivors

June 28, 2011

Cardiovascular Associates, Kingsport, Tennessee

Of course, program development is not the only focus of my field experience.  I have also attended, assisted with, planned and executed several outreach events.  Last week, I had the opportunity to assist with and attend a healthy eating class tailored to the nutritional needs of cancer survivors here in Appalachia.  East Tennessee State University’s College of Public Health & Department of Community Health were generous enough to donate water bottles, first-aid kits and pens (see photo) to each class participant.  During the class, Kathy Visneski, a local oncology nurse, presented information on the importance of fruit and vegetable consumption, choosing lean meats and low fat dairy products, and avoiding processed foods.  She was joined by Marie Browning, a holistic nutritionist from Kingsport, TN, who prepared a menu complete with oven-“fried” chicken, a summer corn salad with a yogurt-salsa dressing, and blueberry soft-serve.  This was a very different experience for me, as I almost always find myself on the prevention side of cancer.  I was able to recognize the importance of survivorship, particularly for those impacted by melanoma, the cancer I focus on day in and day out. 

Washington County Health Council Meeting

July 6, 2011

Munsey United Methodist Church, Johnson City, Tennessee

After assisting with sun safety outreach at the Blue Plum Festival, Christen Minnick of the Washington County Health Department (Christen in now with the Northeast Tennessee Regional Health Office), invited me to speak on the topic of my choosing at an upcoming meeting of the Washington County Health Council.  I chose to present on the need to ban indoor tanning for minors in our area; I thought this to be an appropriate topic for this group, as they could potentially influence local policy.  The Council members were very receptive to my message, and several members shared their insight with me after the meeting.  I was even asked to present to the staff of the Washington County Health Department during one of their staff meetings in August (and of course, I agreed).  This experience served to drive home the fact that people truly are interested in this topic and in skin cancer prevention.  I am very much looking forward to future opportunities to share my message throughout our region.

by Twanda Wadlington
ETSU College of Public Health
Munsieville, South Africa

Twanda learning to floss

On June 30, 2011, my fellow ETSU Frist Global Health Leader, Megan Quinn and I had the opportunity to meet with the Orphan and Vulnerable Children Coordinator of a local NGO in Munsieville, Lagae La Bana (Home for the Children). This organization focuses on servicing orphaned and vulnerable children with daily meals and social support throughout the year. During that meeting, it was decided that a program for those children would be implemented during winter break from school. The program focuses on engaging children in the area of academics, arts, sports, and health issues of the community. This program also seeks to engage pensioners and non-working adults in developing a cooperative. This cooperative will seek to start a project that benefits the community through government funding.

The program began officially on July 5, 2011 with introductions of all participants and a teambuilding exercise called the Human Pretzel. During the introductions the children were given the opportunity to introduce themselves through expressive drawings without the use of words. The children seemed to enjoy these activities and they opened the lines of communication and partnership among the children. Due to the success of the team building exercise and we decided that it would be a good idea to begin every session of the program with a teambuilding exercise. These exercises would give the children and adults a sense of confidence and self-awareness.

The second day of the program was all about basic hygiene techniques such as oral health and hand washing. I led the oral health education of the session, while Megan led the hand washing education. We thought it was best to open session with one question posed to the group, “What is the smallest thing that you can think of?” This question received an array of answers from birds to germs. Of course we were looking for answers related to “germs”. I then asked the group, “What is the first thing that you do when you get out of bed?” Again I received a variety of answers from “eating breakfast” to” brushing my teeth”. These open-ended questions led to the importance of oral health. During the oral health session the group was taught the proper method of brushing their teeth in a circular motion, brushing the tongue, and the proper method of flossing. Most of the group had never seen or used floss before; so this was another new, yet exciting experience for the group to engage in. To conclude the oral health education, I asked the group, “What happens if you do not brush your teeth on a regular basis?” The group responded with tooth decay, bad breath, plaque build-up, and diseases. We then went further to discuss the types of diseases that occur from bad oral hygiene, such as gingivitis and bleeding of the gums. The oral health education ended with questioning from the group, which was very impressive. The group asked many questions ranging from sharing toothbrushes to the proper time to change a toothbrush. Each participant was given tooth brushes donated by the Thoughtful Path: Munsieville.

Megan then led the hand washing portion of the workshop. She taught the participants the importance of hand washing, the difference between using cold water and hot water, and the importance of using soap. Megan also discuss how easily germs spread from hand to mouth, person-to-person, and described the infectious diseases that can occur if hands are not washed regularly or properly with warm water and soap; especially before meals and after using the restroom.

Beginning July 7, the adults serviced by Lagae La Bana decided that they would love to begin a bakery cooperative for the community. With the help of Megan and me, it was decided that we would assist the group in developing a proposal for funding from the local government to develop the cooperative. We are also trying to establish a relationship with other businesses in the area so the cooperative may have mentors in the areas of their interests (i.e. bakery, ceramics, business development and CV building).  During this day, the children were asked to divided into to groups and list common health issues that affect their community and to suggest solutions. The children were then asked to present their ideas. This activity showed the children how to work in groups, communicate, and to serve as leaders in their respective groups.

The first week of the program ended with the children participating in “book clubs”.  With this project, the children were divided into four reading groups and four of the older children were chosen as group leaders. We selected the leaders based on their communication and writing skills, and overall confidence with being leaders.  Each child was then given an age appropriate book donated to the Thoughtful Path: Munsieville program by Project Hope UK last December.  Throughout the book club program; the children will continue to meet with their respective groups, develop their reading skills, and summarize their books to the best of their ability.

This week’s experiences have been exhilarating to say the least and we are looking forward to next weeks’ events. Next week the program will focus on teen pregnancy, sexual education and substance abuse; CV/resume’ building; and sports and art. The program will close with a showcase of the displayed projects developed by the participants of the program. Participants also will be presented a certificate of participation.

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