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Google+ Hangout on How Young People are Transforming the Health World


Remarks
Zeenat Rahman
Special Adviser to the Secretary, Office of Global Youth Issues
Barbara Bush, co-founder of Global Health Corps
Washington, DC
January 8, 2014

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This video is available with captions on YouTube.

MS. RAHMAN:  Good morning, everybody, and good evening to those of you joining us from around the world.  My name is Zeenat Rahman and I am Secretary Kerry’s Special Advisor on Global Youth Issues.  I’m thrilled to be joined by a fantastic group of leaders today to discuss how young people are leading in the field of global health.

 

Now, I’ve had the privilege and opportunity of traveling in the last couple of years, and I noticed something everywhere that I went, whether it was Uganda or Zambia, India, but even in the United States, in Chicago, in Minneapolis, in New York.  I kept meeting young people who are taking the lead in addressing global health challenges.  In Chicago, I met people who are working on malaria eradication.  In Zambia, I met folks who are working on mobile payment systems to make payment for health care easier.  And so I’ve just been very taken with this movement, this groundswell that I’ve noticed of millennials, young people forging ahead in their communities to address global health challenges.

 

And as you may or may not know, the United States is one of the biggest contributors to global health around the world.  And I think this conversation, what I would love to talk about is:  How do we work better together?  How do we address some of the gaps and challenges that might exist?  And how do we highlight and support young people in the field who are leading on some of the issues that we want to talk about on some of these innovative solutions.

 

So I have a great panel with me, and with that I’d like to just begin with Barbara Bush, who is the founder and executive director of Global Health Corps.  And Barbara, I’m going to let you actually explain what Global Health Corps does.  But I really want to know:  Why did you decide to create this and why in particular a model centered on young people and on pairing young participants to tackle challenges?

 

MS. BUSH:  Sounds good.  Well, thank you, Zeenat.  Really, when we started Global Health Corps – started it about five years ago, and we started it very much based on what youth tell us around the world, based on the fact that young people are so interested in working on global health issues.  We see the United States (developing) global health programs and that they started over the past five years because students are so interested in working on these huge challenges. And I think because of this interest we see huge assets and the fact that young leaders want to work (on these global) health issues now, and they will have the rest of their careers ahead of them to solve them. 

 

So off that, our model is one that’s based on a human capital and talent approach.  And what we do at Global Health Corps is we partner with existing nonprofits and government agencies right now in six countries, and they identify gaps that they have, and then we recruit young leaders up to age 30 who will work with them for a year every day filling these positions and ensuring that they’re better serving communities.

And then on top of that we’re building a really strong network, the folks that we work with, they’re all in this or they grew up in a very global world and they’re used to working with other people and for us that means that the impact can really be magnified if there’s 322 young leaders working around the world sharing what works with them, sharing the challenges that they see, and then therefore learning from each other and implementing smarter and more effective models to solve some of the huge global health issues that exist.

 

MS. RAHMAN:  Can you maybe talk about what are the – what countries you work in?

 

MS. BUSH:  Right now, we’re working in Malawi.  We have two of our fellows on here that are working in Malawi.  And in Rwanda, Uganda, Zambia, Burundi, and in the United States in Newark, Boston, D.C., and New York on global health issues that affect the U.S.

 

MS. RAHMAN:  And everywhere that you have fellows, are they paired with one another?

 

MS. BUSH:  Yes, our fellows always work in teams of two, and that’s really important to our model.  And it’s two fellows from two different countries just working together, and that’s really important to us because as our fellows get older and as they progress in their careers, we want it to be the norm that they reach across borders and they reach across sectors to work with each other and share what works and to build a really strong coalition of other folks that want to work on these issues and then therefore solve them more effectively and work in partnership every single day.

 

MS. RAHMAN:  Fantastic.  Rebecca, I’d love to turn to you.  Rebecca is the founder of MED25.  And can you tell us a little bit about, again, why you chose to found this and what – I know you’re a nurse by training – what your work involves?

 

MS. OKELO:  Yes, thank you so much, and good morning, everyone.  My name is Rebecca Okelo and I am the founder and executive director of MED25 International.  We’re a small nonprofit organization based in Seattle that was started after my first trip working in Africa in 2006.  I had seen a lot in the media about the Gates foundation and other large organizations that were putting a lot of money into global health in certain countries, specifically Ghana at the time.  That was where I was traveling. 

 

And when I went to Ghana, I saw – I was in a very rural community and was providing outreach, care, and support specifically to HIV-positive patients, and found that they still weren’t getting the care that they needed.  So even though there had been all this media attention and we had known that there was a lot of aid going to this country, a lot of people still weren’t getting the services that they needed.  And so we founded MED25 in order to provide people with that health care, basically that last mile where they weren’t receiving it in other places through the government system.

 

Our first project was in Ghana.  Our mission is to provide quality, culturally appropriate, and affordable health care while focusing on one community at a time.  So as a small nonprofit, we know we can’t go into multiple different countries and try and do it all at the same time, but we can make sure that we are making a difference to those that need it in certain communities. 

 

And so what our focus is to go into a community, create a health care project, provide health care services, and then find a way to sustain it.  And our governmental model, and we have a wonderful partnership with the Ghanaian Government, the Ghana AIDS Commission, and the ministry of health.  And one way that they have really struggled is they had been given all of this aid but they – it took them multiple years to get to the rural communities, and so we were there to be able to provide the care every day that patients needed in order to survive.  And then by the time the government was ready to take it over, it was already in place in that community.  And so we turned that project over to the Ghana AIDS Commission, and then in 2009 began working in Kenya. 

 

And our model in Kenya is very different and our – we’re still partnering with the government, but our – the way that we’re sustaining the project is through income generation within the rural community.  We partner with the community to identify what they felt was the social need, but also to provide income generation to support the health care services we had been providing. 

 

And talking to a Western audience, sometimes you need to tell them, but we are actually opening a mortuary this month.  And the mortuary serves a cultural purpose, provides a service that is needed, and is something that they will pay for but also will be able to generate income to support 100 percent of the health care operations in the long term.  So we still are partnering with the government but in a very different way from how we did in our Ghana project.

 

MS. RAHMAN:  Thank you, Rebecca.  Now I’d like to turn to Malawi, where we have Esnatt Gondwe and Kaylyn Koberna, who are two global health care fellows, and they are working together in the Malawi ministry of health’s reproductive health directorate.  And I think – really excited to hear your perspective being on the ground because I think some of the challenge in what we’re talking about is we have all these great individual efforts of young leaders, and how do we connect them to health care systems for systems change? 

 

And I’m very interested in your perspective working in Malawi, but also you both bring just so much experience from your previous work in this space.  I’m wondering if you can speak to how have you taken the previous work you’ve done with campaigns and such and applied it to your work within the ministry to address some of the challenges that you see?

 

MS. GONDWE:  Okay.  Well, thank you again.  It’s so nice to be able to be a part of this discussion.  And previously, like my background, I’ve done a lot of awareness raising campaigns and one specific one was on cancer.  And during the process I had to work with different people from different backgrounds, people from the ministry, people – the private organizations, people that owned restaurants, people from the health education unit in the ministry of health.  So these are all people with different skillsets but also different opinions and different ways that they think that the problem can be solved. 

 

So in working in a group like that and learning how to take everyone’s point and try and come to a place where I can coordinate them, it really gave me a lot of preparation for the work we’re doing now because we work with different stakeholders all working in the field of maternal health.  And people – these are organizations that are working to solve the problem in different ways, from different routes but also using different priorities. 

 

So working with each of these people, I try to find common ground.  It’s a challenge, but I think the work that we did during our fellowship training before we came and posted on our placement, it really helped us to learn how to work with different people, because we had, like in our network we had people from the States, people from Africa, people from North Africa.  We had people from a lot of different places and working – learning how to work with all of these people and getting to a place where we discussed and solved problems together.  It really gave us the foundation that we would need to come and work in a placement in which we are working with professional people that have different backgrounds.

 

MS. RAHMAN:  Kaylyn.

 

MS. KOBERNA:  For myself, I think I was previously working in Washington, D.C., and I was easily the youngest person in the office, and so my learning curve was basically a vertical slope.  I was working at the Aspen Institute in their Global Health Development Department.  And again, it was one of those situations where I learned right away to fall back on a network because I didn’t know enough to be effective on my own to even do my job, much less be good at my job.  I really needed advice from all the people around me. 

 

And so again, coming in to Global Health Corps, it’s been like another like vertical slope learning curve, where every morning I get up and it’s kind of like, “Am I supposed to be here?  (Inaudible) to the right?”  But it’s the people around me still that’s – and especially Esnatt, particularly Esnatt who is really good at making jokes.  But my co-fellow pairing is really important, and so like, from my previous job doing policy networking type of stuff in D.C., being able to bring that here and find, like, who are those people you rely on.  And Global Health Corps helps you pinpoint them, which has been really important to me, and then it helps you keep them in your life on a day-to-day basis.  And so that’s how I’ve been able to move in this job from, like, “This is what we need to do,” to, “This is how we do it and these are the people that get it done.” 

 

MS. RAHMAN:  Great, thank you.  One of the questions that I saw several times on the hashtag – can I remind you that if you guys aren’t speaking, put your computer on mute?  It’ll help the echo effect.  One of the questions that I saw several times was if – was:  How do you hold governments accountable to their people for implementing good health care systems in different countries?  And I’m wondering what your perspective is, and maybe we can start with Barbara on that question. 

 

MS. BUSH:  Sure.  I think that’s a huge question, and I think something that we work with our fellows on all the time is ensuring that they use their voice.  Just speaking – our Global Health Corps fellows are young, they’re all 30 and under – just because they’re younger doesn’t mean that their voice needs to be equally as heard by their governments.  They’re citizens of the countries where they work, and interestingly, in many of the countries where we work, young populations are the biggest populations.  In Uganda, 50 percent of the country is under 35.  And so anyone in their age group has a powerful voice.

 

And so what we’ve seen be very effective is our fellows writing op-eds, our fellows speaking at different conferences.  One of them spoke at the TEDx in Uganda that was supposed to go to the State Department.  Writing, blogging, using any sort of formal communication opportunities to talk about the issues that they see every single day on the ground and the issues that are important for them, because people do listen.  I think we just forget – as young people, we assume our voice doesn’t matter as much as older people, and that’s a misconception.  And so I think it’s honing communication skills and using them effectively and in the – and telling stories about what you see every day, because the luxury of working in global health is that you interact with people on a daily basis who are facing challenges, and you can tell their stories for them in order to allow more stories to matter and more voices to be heard.

 

MS. RAHMAN:  And Rebecca, you’ve worked directly with the governments of Ghana and now Kenya.  Can you speak about what’s been successful, how you effectively work with governments to look at the systems change piece of this?

 

MS. OKELO:  Yeah.  So I think one thing that we’ve learned that all of us can attest to is that to make long-lasting changes, we have to focus on systems change within the government.  While that is a crucial aspect to providing healthcare internationally, there are also people that every day are dying from preventable illnesses or treatable illnesses, and things that we could – which will really make a difference.  And so one way that small nonprofits come into play is that we’re able to be on the ground and able to be in the rural communities and provide that care.  But we want to make sure that we are continuing to be a part of the systems change as well.

 

One thing that we have found is that – that’s really unique about our generation, I think, is that none of us feel like we have to go about it alone.  Exactly as Barbara was saying, is that we need to come together as a group, and the more that we can do on all fronts, we can work with governments, nonprofits, individuals, donors, and universities.  But the most important thing is strength in numbers, and that we can do far more together and make much more change if we are all tackling a different piece of something, but working together and partnering instead of trying to go about it individually and saying, “Oh, well, my nonprofit can do it this way, so that’s what we know is best.” 

 

But really, the more success we have found is in governments and other NGOs and individuals and communities that want to partner and all come together, and all be a part of that, be part of a change.  That’s what we have found is definitely successful.

 

MS. RAHMAN:  And for – in Malawi, I’m wondering if you have some examples, maybe, of successful – I’m thinking of the on-the-ground piece, using this – the asset that you have as young people to be able to communicate messages to be able to bring people together on a certain idea.  Have there been effective campaigns that you’ve done since you’ve been on the ground?

 

MS. KOBERNA:  Yes.  I think probably one of the things that we’re most proud of is our work with the Chiefs’ Council, which is a group of traditional authorities who are partnering with the government to help spread information about maternal mortality.  And they are working throughout Malawi, and we are usually working in conjunction with them.  But the difficult aspect of it – I’m sorry, I froze for a moment and I lost my train of thought – there is going to be a wide disconnect between the traditional authorities, communities out in rural areas and what’s known of their efforts in urban areas, and that there’s also a lack of recognition of the efforts that they are making to go out and change some of the perceptions and mindsets in their community. 

 

And so in working with these chiefs who are dedicated to advancing maternal health, Esnatt and I managed to form a partnership with another organization that runs a newspaper column on a weekly basis in one of the two national daily papers in Malawi, and to be able to submit that on a monthly basis and share with them some stories of – these are traditional authorities who have taken their position as a custodian of culture and want to use it to advance the health of their people, I think, is a really powerful and a very optimistic tool.  And it’s wonderful in that it shines a spotlight on some of the people we work with who don’t often get called out for the good work they’re doing.  And it also encourages other local leaders to be able to be able to become involved.

 

MS. GONDWE:  Another example of another project that we’ve been working on is we’re part of a fundraising task force under a subcommittee meeting that’s held under the RHC.  And it was a committee that was set up quite a while ago, but because everyone in the committee has responsibilities, like on a day-to-day – they’re responsible for certain projects, and partners were coming with their own projects.  So it had sort of died down a bit. 

 

So Kaylyn and I took the reins of it and tried to find the members who were in the committee in the beginning, and we managed to start a Christmas drive for Bwaila Maternity Ward, which is one of the community hospitals here in Malawi, in the capital.  And it’s – they’re – it’s – the bed capacity is 250, but they have over 300 mothers that come to this hospital.  And you see women are sleeping on the floor and are sleeping with mattresses without covers.  And as much as we’re doing projects that are catered to the general Malawi woman, but there’s that one individual woman in the hospital that doesn’t have a linen or that doesn’t have a pillow.

 

So we decided to do a drive for this, and we managed to raise quite a bit of money, and we managed to, hopefully, get a grant that will go towards a so-called longer-term plan.  So I think in using inclusion and also in, like, going into the government and seeing what was already put in place, I think it just, like, injects a little bit of energy and a little bit of excitement.  I think people want to make a difference, but they’re just looking for somebody to give them hope and help drive them forward.  So I think as young people, we have the energy, maybe because we haven’t seen as many things in life, so we still have optimism.  So I think it’s our responsibility to work with the government and with other organizations and move forward together.

 

MS. RAHMAN:  Thank you, Esnatt.  Can – Malawi, can you turn your volume down a little when you’re not talking?  That was great when you were speaking.  I want to use what Esnatt just said to jump off and ask all of you a question, which is that we have a lot of viewers who are watching this wanting to know how they can be involved.  And I’m taken that Rebecca is a medical health professional in the technical sense as a nurse, but the rest of you are not.  And so if you were giving advice to somebody just beginning in this field – we talked about a variety of traits and tools that you use and you leverage as young people – how do you get started?  What is your best advice for how a young person in Cameroon or Ghana or even here in the States in Chicago can just get started?

 

And I’ll go ahead and start with you again, Barbara.

 

MS. BUSH:  Sounds good.  Well, first of all, I’d say anyone that’s interested, we would love for them to apply to Global Health Corps.  Our applications are availableand they’re on our website.  But I think what’s been interesting for us, and one of the biggest misconceptions that we see, is that the majority of people that are interested in global health assume that they need to be a doctor or a nurse to work under this group, and that’s simply not the case.  Yes, of course we need doctors and nurses, but we have Global Health Corps fellows that are working on a wide range of issues like supplies (inaudible) drugs (inaudible). 

 

We have Global Health Corps fellows that are architects and they’re working in Rwanda right now with the Ministry of Health and an organization called MASS Design Group and Partners in Health.  And what they’re doing is they’re redesigning the way that health centers are set up because tuberculosis is a huge issue in Rwanda, and it’s airborne, so if anyone walks into a health center, they’re exposed to TB.  And our architecture fellows have been working on changing the way that air flows throughout health centers so that TB and other airborne illnesses don’t spread to anyone that walks in the door.

 

And I say that example just because I think architects would probably think that, what is their role in global health?  But by bringing different skillsets to the table, we can end up with very different solutions in solving some of these bigger problems by having new ways of thinking and new ways of dialogue and different viewpoints solving some of the same challenges that we’ve been dealing with.  And so I’m going to encourage anyone, regardless of what their skillset is, to figure out how it fits into global health, because it does.  It will fit in.  We need educators, we need communication specialists, I think (maybe every sort of background.  But to truly address the challenges, we need so many different viewpoints to build different systems and more effective ones. 

 

MS. RAHMAN:  And then Kaylyn and Esnatt?

 

MS. KOBERNA:  I think that there is a lot of willingness to work on these issues.  I think there’s a perception often that governments don’t have the willpower, but I think they do.  And I think the main issue is the scale of the problem and how many pieces need to move at once.  So in that case, I think that there’s room for people in global (health who can’t track the pathology of a disease.  And it’s better – if you can make – track a landscape, track who’s a major player and what they’re doing, and how they fit together.  And so in that way, there’s a big role for nonmedical professionals.

 

MS. RAHMAN:  Great. 

 

MS. GONDWE:  And also I would just – to the young people out there, because both Kaylyn and I don’t have any previous, like, technical knowledge, so we constantly come to work every day and are surprised and we learn new things.  So I think I would tell people if you have a passion to promote change, that’s a start.  That’s the starting point.  And every day from there is a learning process.  You have people in your life that help – that can help you, that can guide you.  I think if you’re interested, just get involved, and you will grow as you go along.

 

MS. RAHMAN:  Thank you.  That’s great advice.  And just a reminder to Malawi to just mute when you’re not speaking.

 

Rebecca?

 

MS. OKELO:  Yeah.  I think there is a common misconception that you need to be a healthcare provider in order to volunteer or work abroad, and I think that’s much more focused on the older model of bringing healthcare providers in internationally from Western communities and bringing them onto the ground to be able to provide services.  And one of the – we have more nonmedical than medical volunteers, but something that’s really important to us as an organization is about supporting the staff on the ground.  So even if you are a medical person and you’re going over, I always tell people you will most likely learn more than you will teach, and that’s really important, is that you have that mindset and that you’re willing to learn and collaborate with the people on the ground. 

 

But from the teams on the ground, we have a full-time healthcare staff on the ground.  They’re able to provide the services, but they don’t have a lot of the tools that we have here.  We have great construction volunteers that have gone over, or community activists that have gone and helped with our community health workers who have the knowledge about local diseases and other things.  But they can provide tools and assistance and how to leverage a community to get them more actively engaged. 

 

So there are a number of different roles.  The exact same way that we’re tackling issues here, we want to tackle them abroad, and we want to look at the entire community.  Health is not just about going in to the doctor.  And there are so many other things that we need to do to be able to elevate a community and to help them, that there are a lot of different roles that people can play besides just a healthcare provider. 

 

And so while I have my nursing background and I rely on that a lot, there’s also a lot of volunteers that we have that come over that bring a number of different skillsets that I couldn’t provide that they are able to provide.  So we really rely on other people to work with us.

 

MS. RAHMAN:  Thank you.  I think that’s one of my big takeaways from this conversation, is no matter what your skillset, you will find an application to be involved in this field.  And partly talking about that and talking about those stories is a way to broaden the spectrum on what people consider global health and addressing global health issues.

 

I also – I have to say that President Obama has been extremely supportive of young African leaders, and we currently have a program that’s called the Washington Fellowship for Young African Leaders.  And it’s not just for leaders in global health, but those who are focused on public leadership, citizen engagement, entrepreneurship, who can apply to this fellowship program, which would convene 500 young African leaders here in the United States over the summer for training and leadership capacity building.  And after this Google Hangout, I will – on my Twitter handle, I will put out that application link just so that for those of us – for those of you who are listening from other places in Sub-Saharan Africa, please look into it and feel free to apply.

 

There’s a question that occurs to me, being the only person really from the U.S. Government, and we have programs like PEPFAR and our contribution to the Global Fund to Fight AIDS, Tuberculosis, and Malaria where we, just last month, for example, with PEPFAR have provided 17 million people with care and support.  And I think that there is something to – there to talk about how we can work more effectively.  What can the U.S. Government, from our perspective, do to better and more effectively work with those of you who are doing programs on the ground? 

And so I throw that out to any of you who want to answer that, but I think that that’s a really important problem to solve for, is that we contribute in very large amounts.  And you all are doing work on the ground and you’re just a small kind of sliver, an example, of the hundreds of young people that I’ve met who are also doing interventions and programs on the ground.  How can we work together most effectively?

 

Rebecca, should I start with you?

 

MS. OKELO:  Sure.  I’ll take that to start.  I think one of the things that I was mentioning earlier is just the strength in partnerships.  And we do – as we’ve talked about, we have to work within the local governments and make sure that we are helping fill their gaps.  It’s not about westerners coming in and providing the solutions, but about being partners with local governments – in Africa, specifically, is where my experience is, but partnering with them and learning about what they feel their gaps are, and maybe some things that we as an outside eye can also identify and then collaborating on those together. 

 

I think one of the things that we – that has been corrected over time is that we haven’t gone in as the U.S. to save the day.  I think right now, we’re doing a really good job of trying to do that collaboration and partnering with one another, and the more that we can continue to focus on respecting everyone at the table, that everyone has an important stake in this, whether it be the local government, our U.S. Government or others on the ground, I think that’s something really important for us to continue to focus on as a younger generation. 

 

I also think that while – as people who are listening to this all over the world, the best thing we can do is continue to educate ourselves – educate ourselves on local issues within communities that we’re living in or working in, but also looking back, learning from our mistakes.  I think one thing that we, as Kaylyn was talking about with her learning curve, we’ve joked oftentimes our learning curve is a ladder.  So oftentimes, we feel like there is so much for us to learn, and the best thing we can do is to learn from others’ mistakes and not create the same ones.  And so the more we can continue to kind of engage in these conversations and to respect everyone from the different sides that they’re coming from and learning what has been working, what hasn’t been working, and how we can possibly make a difference, I think is going to help us as we continue to move forward.

 

And then lastly, I would just say I – one of the things that we always ask – people ask us all the time is:  How are you making a difference?  Well, we’re making a difference in the very rural communities where the government maybe has fallen short in the past, and we’re trying to work with that local government, with the local chiefs and kind of the tribal government, as well as the greater national government in Kenya.  And continuing those partnerships are really important, but we have to work from both ends.  We have to work from the systems change at the top to be able to provide the long-term care that we need, but we also have to make sure that our – the human right of healthcare, that we’re able to deliver that on a daily basis.  And if that means that the systems change isn’t going to take effect for five to ten years from now, we need to find a way that we can change the lives of people now who are losing their lives every day to treatable illnesses.  And the best way that we can kind of tackle both of those, then we’ll meet in the middle, to be able to create long-lasting change in communities. 

 

MS. RAHMAN:  Thank you, Rebecca.

 

Barbara?

 

MS. BUSH:  I would just echo everything Rebecca said, and I think we have – a number of our Global Health Corps fellows are working on PEPFAR-supported programs or other programs that are supported by the U.S. Government.  And I think what’s really struck us as such an important way to approach solving these huge problems like HIV or like lack of access to healthcare is listening, and it’s the partnership aspect.  And I think we see that, our fellows see that as they’re serving with other organizations who do think of the U.S. Government as their partner.

 

For us, many of our fellows have very big hopes of working on policy issues themselves.  I think we’re excited to track their careers and see which of our fellows end up being the minister of health in the country where they’re from, or working for the State Department or other organizations that are huge players in this space and can really reach scale.

 

And so what we’re excited about is this partnership approach that our fellows have now and that they use every single day, because as they progress in their careers and end up in positions with greater influence, partnership will be the norm for how they operate, and that’s really exciting for us as we think about governments working together to reach scale.

 

MS. RAHMAN:  Sorry about that.  Esnatt and Kaylyn?

 

MS. GONDWE:  I think that I’d echo what everyone has said, and I think our co-fellow relationship is testimony to the fact that for us to move forward as governments, as a global community, it’s really important for us to work together.  And I think if we can duplicate this co-fellow relationship on a grander scale, I think it will go a long way towards improving the international relationships between the U.S. and African countries.

 

MS. KOBERNA:  Yeah.  I would definitely say the same thing.  I think pretty much before any meeting that we go into with a politician, or a donor, or even our colleagues, I always come at it from one side and Esnatt always comes at it from another side, and we always kind of like do this little dance and end up somewhere in the middle that’s a lot more productive.  (Laughter.)  And I can’t tell you how many meetings I’ve been to where I think I just would have been in so much trouble if I didn’t have Esnatt and her perspective.  And (inaudible) by saying that it goes the other way, too, and --

 

MS. GONDWE:  (Inaudible.)

 

MS. KOBERNA:  -- no, but it’s really true.  It lands us both in a better place and it makes both of us a lot more effective.

 

MS. RAHMAN:  Wonderful.  There’s a lot of conversation on the feed about the lack of sexual education that a lot of young people received over the kind of course of their lifetime, and I’m wondering if you all have worked on or seen interventions that have been more – that have been successful in that space of sexual education for young adults.

 

MS. KOBERNA:  I’ll start.

 

MS. OKELO:  Can you repeat the first part again?  I didn’t hear.

 

MS. KOBERNA:  Go ahead.

 

MS. RAHMAN:  Go ahead, Malawi.

 

MS. KOBERNA:  I think on this end, in terms of sexual reproductive health, some of the most positive interventions have been at the village level where the chiefs that we mentioned earlier that we work with have set up local communities formed of people from the village who actually fill different roles during the course of a woman’s pregnancy.  So for example, wehave a woman who’s designated as a secret mother, and she will work with the expecting mother to makes sure she’s going to antenatal care.  And it’s always a confidential relationship and it’s always someone that the mother knows from within her hometown.  And then subsequently after that, they have a family planning counselor who will come visit the woman after she’s delivered and discuss whether or not she’d like to use contraceptive.  And again, it’s coming from a place of trust within the community, and that kind of system that really uses like a local strength-based approach, I think we’ve seen is really effective.

 

MS. GONDWE:  And I think there’s still – like, we still have quite a ways to go as a country to come to a place where everyone nationwide is comfortable talking about sexual reproductive health.  But I think the government – the RHD, for example has a whole department that’s dedicated to youth-friendly health services, and they’ve just recently finished an evaluation which is – which went across Malawi to try and domesticate how do youth accept messages on sexual reproductive health.  So I think as a nation, we’re making strides to address the issue on our end), but I think as Kaylyn said, on how we’re involved with on the grassroots level, I think they’re making headway because they see that it’s a necessity for us to get into, for us to move forward.

 

MS. RAHMAN:  Wonderful.  Rebecca, you were going to say something as well.

 

MS. OKELO:  Yeah.  I was just going to say that I think it’s very similar to what Kaylyn was just starting with, is that it’s really in the rural setting.  You can approach it in two different ways.  I think for long-term change, again, that needs to be – there needs to be sexual education within the schools, but if that’s something that the government is not open to, then that’s something that we really focus on through our community health worker program.  So our community health workers are out and making sure that they’re providing the education and the tools needed for young women in the community. 

 

In our community, the average age of the first pregnancy is 16 years of age, and so really trying to promote safe sex practices before they become sexually active, and that’s where our biggest gap has been.  And so really trying to work with some mothers who are even in their 30s and have 15-year-olds and have teenage girls, but really trying to help them be a part of the solution and do education at home, making sure that they have the tools that they need to talk to their children about safe sex practices, but then also being able to come into a clinic and provide that space.  That’s a very important relationship between the health care provider and the patient, but making sure that we’re able to provide that education. 

 

And a lot of it – things that we have found and been really popular specifically in terms of birth control are methods that women can technically hide from men.  So they can get the implant or the Depo-Provera shot.  Those have been much more popular than condom use or birth control has.  That brings up – without using condoms, there’s a lot of sexually transmitted diseases and other things, but that is one way that we’re at least trying to tackle the family planning side of things.  That – and that has been much more successful over the past few years and something that – one thing that the Kenyan Government has received international funding for and is something that has reached several of the rural communities.  So we partner with other agencies within the government within Kenya and other large NGOs that are able to provide that service at the rural setting now.

 

MS. RAHMAN:  Thank you very much.  I want to shift gears from that to ask each of you:  What is the single most important leadership trait that you’ve learned that’s been most helpful in your leadership?  It could be public speaking, how to run a meeting.  What is that one thing that you keep kind of referencing back, and say, “Through my experience, I’m very glad that I learned that because I apply it all the time to everything I’m doing”?  And Barbara, I’d like to start with you.

 

MS. BUSH:  Sure.  I think probably the – what’s allowed our organization and me to be most effective is really learning to listen.  We’re working on huge issues.  We chose to work on global health issues, and the scale of the issues that we work on are pretty enormous.  And for us to truly understand the root cause of the issues that we’re working on, we have to listen to people in the communities where they live, we have to listen to challenges that people face every day and what they think will work.  And so I’d say just listening and asking why and asking questions as much as possible has allowed us to learn so much, and also I think address challenges in a different – an informed way which allows us to be more effective.

 

MS. RAHMAN:  Kaylyn and Esnatt?

 

MS. GONDWE:  I think for me, it’s learning the strength of the people that you’re working with, because, like, as humans, we know – you know yourself, like, you’re pretty self-aware.  But I think when you learn the strength of other people and learn how to work with them and you learn that you’re going to a community and you’re able to take the strength of the people and help build on that strength and work with that strength so that you’re not going and saying, “I have all the answers, let’s do this,” but you’re including them in the process.  I think for me that’s my biggest lesson because I think community development is about working with the community, but not only that, but inspiring the community to know that they have the ability to work for themselves. 

 

So I think looking at people’s strengths and believing in them and using them and working together with them.

 

MS. KOBERNA:  On my part, I think it’s paradoxically, like, fail early and fail often, and then I – every day I go into work, there is something that I do not do as well as I wish I could.  There’s a new first of some type every day.  And sometimes it can feel kind of paralyzing, but once you get used to the fact that that kind of constant learning curve is a signal of success even though it’s not always, like, delivering success, it’s slowly moving you towards where you want to go – coming in peace with that, I think, which is something that I learned earlier, being one of the youngest people in the office, constantly messing things up, has been the thing that helps me bounce back every day.  And that has made the biggest difference in the long run.

 

MS. RAHMAN:  Rebecca?

 

MS. OKELO:  Sorry, just in listening to this, I can’t help but smile because those are the things that I would say as well, but then also emphasize that humility is one thing that I would say is the most important lesson that I’ve learned.  And kind of everything that I had ever thought about leadership growing up, about being out in front, about public speaking, about trying to manage those that are working for you is really the opposite of what I’ve learned from working in the sector, is that it’s more about working within your team and being a part of your team and working with one another, listening to one another, knowing that everyone has a different story to tell and everyone comes from a different perspective, but trying to bring everyone – the more you can encourage those around you and bring them all together and know that specifically as a Westerner working in this space, I don’t have all the answers. 

 

And I get flustered when people turn to me and ask for all the answers, but the best thing I can do is just kind of – try to continue the conversation, listen, and ask appropriate questions and know that, again, we’re going to fail multiple times and the best thing that we can do is partner with one another and learn from one another and just remember that, again, strength in numbers is the key to kind of our success. 

 

MS. RAHMAN:  Are there resources that any of you can point our viewers to that – to – whether it’s active listening or some of the other things that you talked about, where if they want to know more, if they want to learn more – something that’s been helpful to you?

 

MS. OKELO:  I think one thing that has been really helpful to me is finding mentors that other people that are older with – that have been in the sector longer, but finding mentors that I feel like I have seen either through the media or I have seen through some of the work that they’ve done, and I have seen the success that they’ve been able to show.  I think also, again, turning to peers and being able to accept feedback is also really important, knowing what has worked well for other people in the sector and what hasn’t, the team in Malawi being able to have each other to bounce off ideas from and kind of meet in the middle somewhere.  But the more that you’re willing to ask questions of other people and to take constructive feedback, I think you’ll go much farther in this sector.  If you can learn to kind of not take any of that personally, but continue to have your eye on the goal of making a difference or an impact in the community where you’re working.

 

MS. KOBERNA:  Yeah.  I completely agree.  I think that since this whole field is essentially one really long experiment.  It really makes a big difference to have a community of, like, peers around you that are able to (a) are interested in the same things you’re into, but can both critique you and support you.  And that’s been – as we’ve said before, I think that’s been one of the biggest bonuses of Global Health Corps, is being surrounded by that.  Even when I go home at night, I live in a house of other people who are also struggling with the same health care system.  And so to have those, like, two different perspectives mirrored back at you, that is the single thing that teaches me the most.

 

MS. GONDWE:  But I think also the challenges, like, we all come from different challenges and coming together and sharing the challenges, it sort of makes – it gives you a sense of hope that there are so many people and so many problems, but we’re all in it together, so find a common solution.  So I think, like Kaylyn said, having the network, but also having the connection with each other, I think that – it gives me hope for a future where we don’t have people not having access to health care. 

 

I think that you asked previously what – you asked whether there is, like, a place where we get information from, where we get – like, tell people to get information from.  I would say they should go to the Global Health Corps website, www.ghcorps.com.  And there are several blogs up by fellows, by people – alums.  So I think it’s a really – ‘cause learning is really important and these things provide you with the learning tasks.  So I think the website, I would say.

 

MS. RAHMAN:  Okay.  Barbara, I want to ask you a slightly different question, which is:  How have you thought about cultivating that alumni network as every class graduates and you’ve had now a network of the young leaders throughout the world, really, addressing these issues?  How do you stay in touch with them?  And then something Rebecca said about mentors, but really peer mentors – have you seen some of the alums, then, kind of face back and mentor not just other Global Health Corps members but other young people?

 

MS. BUSH:  Yes, definitely.  So as we have gotten slightly older as an organization – we’re turning five this year – we now have a very strong alumni network, and I think we see a lot of potential for impact with our alumni network.  And so during the fellowship years, as Kaylyn and Esnatt have mentioned, we invest a lot in building connections between our fellows, because we realize that this strength is numbers, as Rebecca was talking about, is so critical to making change in this field.  And so throughout the fellowship year, we bring our fellows together five times a year so that they can iterate on problems and challenges that they have and build these strong connections.  And what has been so surprising and exciting for us is that those connections carry on post-fellowship.  So we – our alums, when you poll them, they talk to other alums every single day. 

 

I’m going to Uganda tomorrow for our midyear retreat with our fellows in East Africa, so 60 of our fellows will come together there, and 40 of our alums living in East Africa are coming also, because, I think, a few reasons – that this is a really strong professional network for them, they can all navigate their careers together, but also I think they provide each other so much strength and so much opportunities to learn and iterate on ideas and challenges that they see, that this network allows them to be more effective.  And so for us as an organization, because we see so much power in this and the potential for collective action, if our fellows are going to work on an advocacy campaign and they have 322 other Global Health Corps fellows in the region that they can work with, that can allow them to reach so many people more quickly. 

 

And we’re starting to invest in that actual network and also providing our fellows and alums the tools to learn about great advocacy and learn about great collective impact so we can amplify what they’re doing.  And that now increasingly is a big focus for us as an organization as we see the potential for them but also as our fellows, as I mentioned, are starting to work for the minister of health in their country or are ending up in senior leadership positions in the organizations where they work.  They need this network for their own success, but also as you asked, they also see the power of having had great mentors and want to pay it forward and mentor other younger people in this space who are wrestling with similar questions in trying to navigate their own next steps for greater impact.

 

MS. RAHMAN:  Great.  I want to ask each of you to just – is there anything I didn’t ask you that you’d like to mention?  And again, for those who are listening to us and want to be involved, what’s the next kind of one – first, second, or third step that they can take beyond applying to a fellowship program, but what are the next three things that they can do because they’ve been excited about this conversation and want to be involved?  Rebecca, let’s start with you.

 

MS. OKELO:  I think the – just what I would leave people with is that getting involved in your local community.  I am very fortunate to live in a city like Seattle that has a number of large and small nonprofit organizations.  We have a great kind of network that has been established.  But so people all over the world, whether you are in Africa and you’re wanting to get involved in that way, trying to find either the public sector, nonprofits, other members of your community, and trying to start conversations, whether there’s a problem that you’ve been witnessing in your own community, start the conversation with people of all ages.  Get elders involved.  Get your peers involved.  Get the youth involved.  Find ways to get people actively engaged in being a part of solutions within your own community. 

 

If you’re coming from a Western community and you’re wanting to get involved in some way, so much about what we talked about is kind of on the ground, but as we’ve also mentioned is there’s a lot of work in global health right here at home, and there are ways that you can get involved. 

 

We’ve had a switch in the people interested in volunteering.  It used to be much more everyone was trying to go abroad and wanting to get that hands-on experience.  And I think that’s really important for a lot of people, but I also think there are a number of ways that you can get involved locally.  And so even though it’s an international organization, if you don’t have the money to travel abroad, find organizations within your community that you can support in different ways.  It’s not just about fundraising.  It’s about getting – volunteering your graphic design skills or your architectural skills or your computer skills, helping with websites.  There are a ton of different ways to get involved with nonprofits, helping bring more people to the table to be a part of this conversation.  And again, as we’ve emphasized over and over again, it’s all about strength in numbers.  So being able to volunteer your time and find ways to get involved in the sector, you don’t have to do it full-time to be able to make an impact.  So it doesn’t have to be your full-time job, but there are a lot of ways that all of us can make an impact that can create change at a much faster rate in some of these communities.

 

MS. RAHMAN:  Wonderful.  Thank you.  Our colleagues in Malawi?

 

MS. GONDWE:  Okay, hi.  Well, I would say when I was– when I was 17, I lost somebody that I loved very much to cancer.  And I think until that point I had known that I wanted to make a difference.  I had known that there will be a time when I’m going to solve all the issues or try and solve all the issues, but until that point, I thought I had a lot of time.  And it really just – like, losing someone like that really just wakes you up and shows you that you don’t have all the time.  And I just had to believe in myself and believe in the message that I wanted to get across and just start with – I started with something small.  Like, I just talked to some friends and said, “Hey guys, like how would you like to work with children?  Let’s start an afterschool project working with children.”  It started from there.  It doesn’t have to be a monumental project, but just I think the knowledge that you have a voice, you have a message, you can give your message, and just going from there.

 

MS. KOBERNA:  She took half of what I was going to say.  She usually does.  (Laughter.)  But I think the other half of what I was going to say is, again, that there is – every small thing for me has added up and it’s – if you keep pushing on doors, eventually one will open.  And you’re not going to get it right because no one gets international development right.  There is no right.  And there’s times when, for instance, you’re on a State Department Google Hangout, and you can’t find your mute button.  These things happen.  But if you just keep going, then eventually and actually you will get to where you want to go or somewhere that’s worth being.  So I would second everything that Esnatt has said. 

 

MS. GONDWE:  And I think, like, us working together, this just shows that – I think this is really important.  I think this is something that, like, to people watching everywhere, you can see that me and Kaylyn have very different backgrounds.  Like, she grew up in the States, I grew up in Malawi.  But then on a day-to-day, we come together, we work on issues and we try and solve problems.  Sometimes we fail; sometimes we don’t.  But then we try.  And I think that’s a message that maybe we can send out to people that --

 

MS. KOBERNA:  Just try. 

 

MS. GONDWE:  -- if you just try, you just, like, listen and try to learn from people that are different from you.

 

MS. RAHMAN:  Barbara.

 

MS. BUSH:  Well, I feel like I’m just going to repeat everything that everyone already said, but I – just to echo what everyone has said, I think realizing what you’re passionate about or what you care about and the issues that you want to work on and figuring out how to work on them.  There is really no reason not, regardless of what your day-to-day is like, not to pursue social change issues that you care about.  And unfortunately – or fortunately there is opportunities to get involved wherever you live, because these issues exist everywhere.  I’m in New York City and these same global health issues exist here.  That’s why we have Global Health Corps dollars working on huge issues like maternal health and lack of access to healthcare and HIV issues in New York, because they’re here. 

 

And I think often when we think of global health we think of “other”.  It seems like it’s something that exists elsewhere, whereas that’s not the reality and we should all be cultivating a global perspective and reaching out to communities in our communities that we care about to gain more exposure.  And I guess that’s the last thing I would say, is my career has been solely based on the exposure that I’ve had working with excellent people, having great mentors, seeing huge health interventions that have been successful, seeing ones that haven’t been successful.  And the exposure and curiosity to learn about what you’re interested in can fully shape all of your next steps, and so I’d say just cultivating curiosity and trying to gather exposure wherever you are.

 

MS. RAHMAN:  Thank you, Barbara.  I hope that – I think something that Esnatt said was really important, that there isn’t some big, monumental project that you’re going to take on and solve for some of these really big issues that millions of dollars have been spent on and many, many smart people are working on.  And so I think it’s really important to remember to the people who are listening to this conversation that you can be involved in any capacity that you want with the skillsets that you have, and that you have skillsets that apply to global health challenges.

 

When we were first taking on this topic, I thought global health is such a large spectrum that it’s going to be difficult to actually negotiate a conversation on it, but what is – what has happened is that you see all – like, all these examples of ways that you can be effective, even if you’re not an epidemiologist or you’re not a doctor, that if you have the passion and you’re exposed to certain resources, that you can be involved with very little.  And Secretary Kerry said earlier last year, more and more the important progress in this world is driven by you, the young people.  And I started this conversation out by saying I have noticed a groundswell in this area of global heath, of young people leading.  And I actually think it’s going to be transformative, not just for this generation but for all of us, but I think this generation of young people is going to be defined by this desire to and need to address and really get at some of these systemic, really intractable challenges and issues that we’ve all been working on for a very long time.

 

I mean, if you look at millennials today, almost 80 percent of millennials in the U.S. think it’s very important that their employer care about social good issues.  And if you look at Sub-Saharan Africa, one in five young Africans plan to start a business – at least one in five young Africans plan to start a business over the course of their lifetime.  So when we talk about harnessing all of this and why the U.S. Government cares, it’s because we want to be most effective.  We care about global health issues.  We care about access, giving the most people access that we can to some of these interventions, and we want to have a relationship with young leaders who are leading change in their countries to do so. 

 

And so I want to thank all of you who are listening.  I want to certainly thank all of my fellow co-panelists.  A great women-only, like, rock star panel.  And a few points on follow-up which is that you can follow up the work of Global Health Corps @GHCorps. You could follow the work of my office and what we’re doing at the State Department @Zeenat. And you can follow Rebecca’s work @Med25.  And we’ll continue the conversation and post follow-up links.  And just thank you all very much for taking the time to do this today.



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