June 29. 2015. Christian Connections for International Health (CCIH) 29th Annual Conference

My school for Master of Science in Public Health (MSPH) degree is finally over. When I entered the graduate school, I felt myself I was on top of the world and was ready for everything. However, as you also may know, graduation does not mean everything; another world is always waiting for me! So sad for me: my school colleagues have been scattered all over the place. We did not quite have time to say “good bye my friends,” even during the graduation ceremony, and all we can do right now is emailing to each other by saying meaninglessly that “Hey! Meet in Baltimore!... No, come to Texas!... No, come to Seattle! No, come to the Philippines!... Nono, come to Peru!...” Some are staying at school for research assistant, data analysis, or volunteering, some are doing PeaceCorps, some are entering PhD program, some are already working at the organization/ company… 

One to come, and one to go. I may meet the new people from now to form a new and more meaningful relationship. Of course, every time I meet someone, that must be the most meaningful moment. But I am just saying that I am hoping to improve myself to welcome people with a bright smile. Though I cannot avoid unintended farewell at any time, there is something that I will always be in my heart. Yes, I cannot say with confidence that “I have an unwavering faith and devotion for 24 hours!” I am also frustrated, discouraged, or too preoccupied with my own thoughts as a fragile human being, so I forget pretty often that how much I am blessed and how much love I have been given.

<Matthew 7:13-14, The Narrow and Wide Gates>

“Enter through the narrow gate. For wide is the gate and broad is the road that leads to destruction, and many enter through it. But small is the gate and narrow the road that leads to life, and only a few find it.”

I live in the confusing world where I may even have to be careful in saying “I am a Christian.” Though I do want to embrace all kinds of ideals and religion to maintain wonderful relationship without making any issues and to keep happily ever after moments with anyone, the phrase of the Bible shook my humanistic thought completely that the door of truth is so narrow. I can never ignore it and should accept it as my mission statement because I believe my calling is to look all around the place where people normally have overlooked.

Christian Connections for International Health (CCIH) 29^th Annual Conference was held during June 26-29, 2015, in Arlington, Virginia. About 190 attendees from many different countries, Benin, Cameroon, China, The Democratic Republic of the Congo, Kenya, Liberia, Nepal, Nigeria, Pakistan, the Philippines, Rwanda, Sierra Leone, Uganda, USA, and Zambia participated in the conference to discuss with each other with the theme of “Ending extreme poverty: the Challenge for Christians in Global Health.” These days, I was worn out and still never been recovered fully after leaving Africa. Driving every early in the morning for the conference was not easy, but I rendered thanks to God that I was able to see and interact with passionate and talented public health professionals around the globe in Virginia this year, just 1.5 hour far away from Baltimore, the place where I live. I realize again that I am a mere novice who have just started international health career and still needs to learn endless things from their experiences. 

Throughout this conference, I was able to become abundant with full of spiritual motivation. My forever questions, “What drives you to go to Africa?” “Why do you want to do international health?” “Why do you like NGO?” "How your belief can be connected with your career?" have been answered so naturally through many speakers’ presentations and communication with attendees. Especially, I was glad to meet a person from my country who has been working as medical missionary in Uganda for 15 years, which looked already a long-term commitment enough. So I asked him “How long will you be there more in Uganda?” He answered, “Until I was buried in that soil.” How will you explain this touched moment? It cannot be explained by human rationality. Only God is in control. I believe work, study, and faith should go forward all together, and this attitude of mind will make myself to live the life with full of patience, determination, and tireless spirit.   

Sometime, I am under a difficulty that many people are doubtful about what I have done or will have done.

“Why do you want to keep studying?”

“Do you think God whom you believe will be happy if you feel pressure to do it?”

“Don’t you think you are too greedy to do all of them?”

“Why do you go to church every single day for early morning prayer? Are you too free? Something serious happened?”

“Choose and concentrate! It must be still insufficient time for you to focus on your top priority.”

Whenever I hear these questions, I am suddenly shocked because those who ask me are the closest people to me. When I find myself that I have to put all of the energy to defend myself and impress on them, I feel so isolated because it seems that nobody, even my sincere people, do not understand me. I realize that there is no person who can listen to me and understand me 100%, but only God understands me. Even if I pour out all my troubles to somebody else, which moment seems to be cool, I know that abysmal emptiness will be followed again.

I ask God, “What is my calling that you want me to do?” I do not hear his voice directly, and I do not even know what the next destination is. But what I do know is that God has been always with me even at the painful moment and given his mind to me that “Approach people first to share God’s love.” That is why I exist. Ebola was despairing, I went to Sierra Leone with the only one reason: God loves me. Likewise, all of doubtful question towards me can be answered: God loves me so much. You hurt me with words that cut deeply before, and I am still suffering from it, but I will not give up on you because God loves you!

Apr 23. 2015. Mobile Health

“Galaxy S6?” Once I read the news article, I looked at my cell phone. I bought this Galaxy S3 in the summer of 2013, and it is still fine. I finished paying the rest of the price of this phone throughout two-year contract and revived the same U.S. number when I came back in last January. I think Samsung release the new product every single year, and now it is the S6 this year. The difference between S3 and S6? Well, I do not know. My S3 accepted every SIM card in each African country, and I was amazed by its durability. I may be an old-fashioned man whose willingness to learn the new technology has been stopped in 20^th century, so I am not that interested in the new and cool functions that only a new model of a machine has. I have to admit that I laughed at my high school teacher inwardly when he told “I don’t know how to text. I can only answer and call the phone.” during the class. For me? “I can text, answer and call the phone. But… what is the mobile application?” I realize that I am old enough who has no interest in cell phone subsidy in South Korea and satisfied with only text, answer and call.

From PewResearchCenter

While the cell phone price & charge, subsidy, new function, and comparison between Galaxy and iPhone are actively argued by people in the rich country, the cell phone is the tool of lifesaver for people in rural Africa. You cannot imagine that at least one family member in each household in rural Africa may have cell phone (of course, literally cell phone but not smartphone in most cases). The number of mobile phone has already exceeded world population.

CellPhones in Africa: Communication Lifeline

If you are under emergency – cut your finger or labor pains begin – you may call 911 and get assistance almost right away. Hospital is located nearby and doctors and nurses in the ER will help you (I heard the ER situation that patients may have to wait for the whole night to get medical treatment if the level of emergency is not fatal, but anyway, I believe patients will save their lives thanks to 911, transportation, and hospital). What about Africa? Is there 911? Is there hospital? Is the medical service 24/7? Is there a car to refer patients to hospital? Is fuel available for the car? You can see that everything that is considered as too obvious is not available in rural Africa. Many pregnant women do not receive proper antenatal care and die of birth complications only because they have no money to buy fuel, the road condition is muddy track, no one can help them in the health facility at night, and many other reasons that city people have never raised the point about.

How can the situation be solved? Medical infrastructure – hospitals, medical doctors and nurses -, transportation – vehicle and road condition -, and education – people’s awareness of healthcare – cannot be improved like magic.

GlobalHealth Facts: Physicians (Per 10,000 Population)

Ebola outbreak: Which West African countries could be next in the line of fire?

In Sierra Leone, doctor-patient-ratio (population per 1 doctor) is 1 to 45,588, which means there is only one doctor available for 45,588 populations. The total population in Sierra Leone is 6.2 million, and if you divide 45,588 by 6.2 million, you will see there are only 136 medical doctors in Sierra Leone for entire population. It is obvious that even medical device and protective gloves are not available to treat Ebola patients, so Ebola outbreak in West Africa has not still contained.

Mali mHealth Application: SNISI

I have been working on NIH R21 project, <Virtual Community Health Services- for Equity and Quality in Health Care in Mali> since the beginning of this year. The team has been thinking how mHealth intervention package will save people’s lives in the Sélingué health district, 120km south-west from the capital city of Mali. I believe mobile health (mHealth) can be the second best plan to improve maternal, neonatal and child health in Africa. Most people has the cell phone to text, take pictures or video, and some people can make or receive payments, get political news, access social network, get health info, look/apply for a job, and get consumer info. 

Community health workers in Africa have a strong sense of duty that they are responsible for visiting household to assist inhabitants to maintain their healthy lives. If people in the village can receive the text message reminders that let them know the timing of antenatal care visits or Sulfadoxmine/Pyrimethamine medication, and receive health education from community health workers regularly, they will realize the importance of healthcare during pregnancy. If the mHealth system among district hospital, vehicle driver for emergency, community health worker, village leader, and village member is systematically connected, most diseases can be prevented, and child and maternal health will be dramatically improved. Yes, mHealth is the solution for healthcare in rural Africa for the present, and I hope the health system with mobile technology will be established soon so that no one in rural area deliver their baby at home and give birth to their child without any complications.

POSTSCRIPT:

Carpe Diem, lads! Seize the day!

Feb 6. 2015. WHY Africa?

It is too cold in Baltimore. I somehow feel this coldness in my bones. This weather reminded me of the time last year that I was looking for work in Africa so madly. When I was in Africa, I often thought about this: ‘Can I go back to the U.S.? Can I see my school and friends?’ New life in Africa was struggling, and I was not even sure if I get back to the normal life. Well, I cannot say for sure which one my normal life is at this point. Gratefully, I am still alive, and I came back to school. I am just glad to be back and happy to hug schoolmates who I have not seen for a long time.

Maputo, Capital of Mozambique

People here ask me many things about Africa with their eyes wide open. Still, Africa is an unknown place to many of them.

“What food did you eat?” “Is there sushi?”

“Is there a church?”

“What do you remember most about your Africa experience?”

“Where did you stay?”

“Tell me your behind story!”

“Don’t come closer! You may have Ebola virus!”

“How did you communicate with them?”

“Your face didn’t get burnt black. Were you really in Africa?”

“Are you healthy?”

Though I was questioned the same thing, but the questions always sounded new to me. I tried to answer to the best to give them the right impression about Africa. I am still careful in talking anything about it, because people may reconceive wrong idea and have prejudice against Africa.

Somebody asked me, "What did you lose?" 

'What did I lose...?' I thought carefully and answered "My youth!" (hahaha...) It is an undeniable fact that I am getting old. 
Then she asked me again, "So then, what did you gain?" I answered, "Everything." Yes, I gained everything. It was an invaluable life lesson that will affect my entire life.

I am so happy when people are pleased to see me. I know, 8-month is not that long time for us to cry for joy, it is just the twinkle of an eye. It should be not the strange moment if someone tells me “Been a while,” and leave. However, I was a bit disappointed when person who I thought we were so close did not say anything to me and gave me a knowing glance from the distance. To me, coming back to school and church in the U.S. was awkward and unfamiliar moment enough that I was all flushed with tension for the first two weeks. I might anticipate warm greeting, “Welcome back!!!” from every single person so that I feel a real sense of being in the U.S. I reflect on myself that how much I was nice to people around me before I left. I might treat someone poorly, talk with specific person, or did not contribute anything for the group. Better late than never. I am here, and I want to be a good listener and nice person to everyone.

The question that made me struck dumb for a while was this: “WHY Africa?”

“Why do you have to go there? You can do many things for the community, even in Baltimore. Just go a few blocks away from your school. You will see the slum area.”

It is true. Baltimore is one of the highest percentage of blacks or African Americans in the U.S. More than 60% of residents are black in this city, and there should be enormous work to serve the community. Why did I leave many works that I could have done it by walking just 5 minutes and board an airplane for Africa that takes whole 24 hours? Why did I have to take every risk of getting malaria, typhoid, and all kinds of tropical disease in the choking hot area and felt so gaunt and desolate? Why did I borrow trouble and learn the hard way? Nobody asked me to do that. 

Here is the reason that I can say generally in this blog. Between hearing and experiencing, there is a world of difference. I might have heard so many times that a missionary who went Africa suffered from lack of water and electricity, and scared of snake that trespassed on the house. When I heard the story that sounds like heroic exploits, I thought ‘That’s interesting,’ and forget about it. If you do not experience, you will be indifferent in the end. I could never imagine how they actually live and what kind of trouble they are suffering. In other words, since I had everything in the U.S., I have not even realized the preciousness of bucket of water and electricity for my entire life because those necessities were always available. I did not have to worry about anything that I already had. Instead, I have always complained what I could not have. I never knew how I lucky was cause I had it all until I went to Africa. I finally have in mind that I appreciate everything that I have had. I wanted to prove it to myself: if I abandon all benefits of civilization and become the same as local people in Africa, would I still have a sense of duty of helping them? I tried hard to have the same condition that Africans have: place to live and food to eat every day. The result: typhoid was painful, mosquitoes did not make me sleep, unidentified ugly bugs offended me, and lack of cultured life made me crazily bored.

After finishing Africa life, I realize that I am never being superior to anyone. I have seen so many smart and enthusiastic African people who eagerly want to change the situation of their country. I have learnt many things from them, and I was the mere person who was fortunately born in the rich place. Studying public health was not “helping” or “saving” millions at a time, instead, it was for “being with them” to understand their life with my full heart. This enlightenment would have never come to me if I had stayed in the familiar and comfortable place. That is why. I went to Africa to feel their real nature of life. I felt head and ears, with all of my skin.

Lastly, it is not right to say “just Africa.” There are more than 50 countries in Africa, and each country has its own feature and characteristic. Since I have been to 5 African countries, I have simply said Africa, but I have should mentioned each country name, Sierra Leone, Tanzania, Zambia, Malawi, and Mozambique. If you want to remember yourself how blessed you are, I highly recommend you visit one of African countries and stay there for a while. I am not saying you will live in poor surroundings, but you will see the people who have the happiest hours of their life regardless of fancy cell phone, computer and car.

WHY Africa? Because I can say with confidence that I am alive and I can feel the real value of living, breathing, and smiling.