Nov. 3. 2016. Malaria Day in the Americas 2016

I guess no one likes mosquitoes. That’s really annoying creatures. I don’t quite understand why they exist and they are beneficial to nothing. Well… everything should have some reason for its existence, but for mosquitoes, I cannot find even a slight credit for them. At least cockroaches don’t harm you. They are just ugly… Oh, do they spread some kinds of disease from one site to another? I am not sure. I need more research, but I don’t want to know more about cockroaches at this point. When I was in Africa, I had a cockroach story. They were everywhere and they lived with me. A big giant cockroach made some sound of a footstep whenever they walk around the floor, and I was freaked out to see they even walk on the wall. 

Aug 7. 2014. Cockroach

Of course, I also had a mosquito story. I was mobbed by mosquito troops, and I was a fragile prey to them every night. Luckily, I didn’t get any disease – malaria, dengue, or chikungunya – from mosquitoes. Did Long Lasting Insecticidal Nets (LLIN) save my life? Or thanks to malaria pill? Repellent? Long sleeves and pants? I have to admit that I didn’t thoroughly use any of them. Protecting myself from mosquitoes needed a lot of dedication. LLIN disturbed my sleep because my feet or arms always touched the net, and I felt like I was a captive animal. Taking malaria pills for a long period damaged my lung slowly, so I couldn’t always rely on them. Repellent stunk and was bad for my skin. One day, I thoroughly applied repellent to my whole hand, and then began to use the computer mouse, and I was surprised that the surface of the mouse melted and it stuck to my palm. Wearing long sleeves and pants was the easiest one but you know, mosquitoes were really clever to find my area of bare skin! Do you really want to wear socks and gloves under the scorching sun? When you get a mosquito bite on the toe, it is not itchy, but strangely, it is chronic pain. Lastly, I hate to say this: mosquitoes can even bite you through your shirt… How is it possible?! I got many mosquito bites on the middle of my back, and sadly, I couldn’t scratch that itchy area. Though you have very good interventions to prevent malaria, ensuring high fidelity by implementing them as planned is a whole different story.

Aug 18. 2014. Malaria, Dengue, and Chikungunya

Mosquitoes are much more than annoying insects. Bothering your sleep in the middle of the night is not a big deal because they threaten your life in Africa and the Americas. I haven't experienced how it feels when I get malaria, but I heard how it is. I realized NGO Korean staff in Africa (needless to say for native Africans) who don’t get malaria must be so abnormal because malaria is so common, and I guess they suffer from this at least once during their lifetime. One of Koreans who I met experienced malaria and gave a talk to me graphically. “You can’t even have the energy to move your body from your room to the kitchen to drink water because you were seriously dehydrated… With an awful crashing headache, sweats, and shivering, you are able to know what the hell is…” They are still staying there, overcoming several times of malaria, to accomplish 5-year of development plan from NGOs. I feel so sorry for them because I feel like only I escaped that area and be in a malaria-free comfort zone now. What can I do for them? I pray that they always maintain good health, be safe, and be happy on the barren soil. I count on them! 

  

“Malaria Day in the Americas 2016” commemoration took place on November 3, 2016 at the PAHO/WHO Headquarters in Washington D.C. to share the malaria intervention strategy and celebrate each country’s effort to eradicate malaria. To decrease the burden of malaria in the Americas, PAHO/WHO, United Nations Foundations, the George Washington University Milken Institute School of Public Health, and the Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (CCP) have been working together to identify and implement the best malaria prevention, control, and elimination strategy. 

The forum of this year was “End Malaria for Good.” Five countries in the America experienced malaria outbreak, in Venezuela, Colombia, Dominican Republic, Ecuador, and Nicaragua. The malaria control is difficult because there are P. vivax (malaria parasite) technical challenges, the risk of emergence of drug resistance to P. falciparum (another malaria parasite), and social processes through mining, agriculture, and migration. Plan and action for malaria elimination 2016-2020 (5-year plan) in the Americas are 1) malaria core interventions (diagnosis), treatment, vector control, 2) surveillance, 3) Health systems strengthening, 4) Advocacy, communications and partnership, and 5) Tailored approaches to elimination and prevention of re-establishment. 

At the regional level: advocacy, networking, capacity building, technical groups, pilot experimentation, operational research, communication strategies, monitoring and evaluation, certification and other standardized processes, guideline development, and direct technical cooperation should be established, while at the country level: development of political and strategies platform, and technical support of control of foci should be established. The two key elements are 1) Priority foci as key interventions, and 2) Early detection, timely investigation, and prompt response to core intervention. 

USAID also shared their Latin America and Caribbean Regional Malaria Program. Their primary focus is tailoring interventions to elimination through analysis of the epidemiology of malaria to determine the most effective set of intervention, developing evidence, and strengthening capacity to implement the selected approaches and activities. Tailored approaches are through expanding passive case detection networks, private providers strategic behavior change communication strategies. For capacity and evidence, quality assurance programs, tailored guidelines for implementation of a rapid diagnostic test and quality assurance systems, therapeutic efficacy studies, and molecular surveillance have been implemented. For vector control, entomological and insecticide resistance monitoring systems, leveraging other investments in the region, prioritizing countries with high levels of transmission and significant investments in vector control for malaria are good examples. 

Malaria Champions of the Americas Award this year went to Costa Rica, El Salvador, and Suriname, and Costa Rica received the top prize. These three countries were exemplified in malaria control. Costa Rica has achieved a 100% decrease of malaria since 2000 through the robust implementation of the national Plan to Eliminate Malaria, El Salvador has achieved a 98.9% of malaria since 2000 through the National Malaria Program affiliated to the Ministry of Public Health, and Suriname has achieved to drop the Annual Parasite Index from 88 in 2004 to 1.06 in 2015 through the Ministry of Health malaria Program. 

I look forward to seeing malaria-free world in the near future! 

  

Sept. 26-30. 2016. PAHO WHO 55th Directing Council

It’s been a while. Time flies and I am back to my blog. This time, I am in Washington D.C., the capital city of the United States. I still remember the moment when I was in Sierra Leone. Yes, I think I was there with full of passion. I miss at that instant. I gave responsibility to myself of being a messenger from on-the-ground to let my people know what’s going on in Africa during the Ebola outbreak. Well, I thought I would always go back to Africa again and would resume writing my blog. But you know, our life is filled with various requirements that we have to deal with, livelihood, due dates, reports, friends, family, food, clothing, shelter… endless lists! Just doing those priorities are already overwhelming, so finding time to do extra stuff is always hard. I’ve never admitted that I might be too self-centered, which seriously conflicts with being a selfless public health professional.

The definition of “health” by World Health Organization (WHO) is:

“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.”

This is where my heart goes to. It was simply unfair to me that people in least-developed countries don’t even have access to clean water and die from diarrhea. Can you believe that? Children are dying from diarrhea… I began my public health career because I thought I could contribute to WHO’s mission, health is a fundamental human right. However, dreaming our ideal world and taking action is always a different story. During the bible study in this evening, one of the members was shocked and told me “Read the news!” Well, I didn’t catch up with the news, President Park’s leaking confidential documents to her friend in my home country fast enough. I was embarrassed and couldn’t help but to see members were so outraged by this recent news. How am I supposed to know the real-time news in South Korea while I am crazy about getting a good score at class in the United States? But think about this. Even if you are really resenting, nothing would change. It just happened, and probably it’s already been happening for a long time even before you know about that. And most importantly, you’d have never stopped that because you’ve had no connection to politics at all. I think I’d have been more comfortable if I hadn’t noticed that because I know I wouldn’t and couldn’t intervene personally in that issue to solve the problem.

Pan American Health Organization/ World Health Organization

Going back to the ambitious definition of health from WHO, why does this matter to me? Why do I try to care about the people in the rural area of Africa who I’ve never met and could be hardly going to know me? Where is my real identity in this effort, thinking about the health of unfamiliar people in an unfamiliar culture in Africa while indifferent to what’s happening in my country? It’s just nonsense. When you jump into the airplane to provide humanitarian aid and assistance to the country where suffering from Hurricane Matthew, in what sense do you do that? Is it from the humble heart of caring about the dignity of people and wishing to accomplish the Universal Declaration of Human Rights by the United Nations (UN)? Or is it from the arrogant mindset that you’re the one who is in the position to offer the necessities like an angel? Or is it for displaying your showmanship and proving you’re a nice person to people around you? It’s hard to judge. Only you know what you have in mind. You may donate a certain amount of money to support a child with the pure thought that you feel really sorry because the only thing you can do is to simply donate with one click. Or, you’re taking advantage of vulnerable people to write the paper, get a promotion, and shine your image of helping hands. Caring about people is not simple. Yes, this is public health that I’m doing.

To be honest, working at WHO was my dream. It still is. But perhaps, I should have been dazzled by the splendid image of WHO. Who would disagree that WHO is awesome because it is the only international government organization that takes responsibility for leading and guiding international health? Who wouldn’t want to look like a cool and fancy person who wears a formal suit at this UN’s specialized agency? But if you do public health just because you want to have this superficial image of the organization, you’re putting the cart before the horse. I’ve always mentioned WHO in my personal statements and say “I want to be Dr. Lee Jong-wook!” When I was a master student, my academic advisor was dubious and asked me “You’re so ambitious but too general. So what do you want to do?” Yeah… at that time, WHO seemed to be ambitious but general to me, so I was just the simple image of that. In D.C., there are so all kinds of cool buildings. Wow, White House! Wow, IMF! Wow, World Bank! Pan American Health Organization (PAHO)/ WHO building is right across the street from my home! But before being captured by that illusion, let’s think about the real purpose of the existence of these organizations. All the WHO meetings, discussions, guidelines… Are these for who? Do all countries respect and follow WHO’s soft power of regulations, guidelines, and recommendations well?

The 55^th Directing Council, 68^th Session of the Regional Committee of WHO for the Americas was held in D.C. during 26-30 September 2016. The council meets every year and I was privileged to attend this meeting. Heads of delegation from 47 countries in the Americas gathered to work on, approve, and declare the major public health issues.

What I hope is that all works from WHO would have a great impact on our societies. Getting out of its grandiose image, it’s time for WHO to prove its real functions without constraint to limited budget. I want to see that people around the world would clearly understand and know the role and importance of WHO, and appreciate their existence. The disease outbreaks, such as Ebola, Zika can be prevented under the strong surveillance system, and we don’t even have to worry about the situation to find the funding resource to respond and develop vaccine because those diseases would never occur. We can’t lose our hope to achieve our vision, everyone has the right to the highest possible level of health. Certainly, we can make the world free of needs, free of wants, and free of poverty, hunger, and diseases, if we all have true hearts that better of others.

P.S. Newsletter about PAHO/WHO Directing Council has been posted. :) 

Oct. 27. 2015. Are You Gay?

“Are you female or male? Or… both?"

“Are you homo or not?”

[To man] “Do you have wife? Or… husband?”

“Are you man or woman? Or… third sex?”

You must be insulted if someone seriously (or either way, jokingly) ask about your sexuality. So then, how about you define yourself?

“I am a man… because I have a man’s genitalia, and I am attracted to women.”

Do you think it is enough explanation to define yourself as a MALE? Then, here are some questions for you:

1.    What if your general recognition towards biological sex has an exception, “intersex”?

2.    What if you, as a man, have a sexual attraction to women, but your gender identity wants to define yourself as a woman?

3.    What if you are not attracted to anyone, regardless of sex, and have never felt sexual arousal, which is identified as “asexual”?

4.    What if you were ostracized during your school days because your gender expression was so girly?

5.    What if you’ve had crush on man just for a few seconds because he was your ideal person who has everything and that was exactly what you have always wanted to be?

6.    What if you have fantasy about ladyboy, bisexuality or pansexuality?

So then, what are you? Are you sure that you are all-about-man? Who told you that you are a man with what kinds of criteria?

Let’s talk about my case. I used to like the color, pink. The reason? I don’t know, I just liked it, all colors from red channel, including purple, violet, and powder pink. I’d never thought my color preference would be a big issue to Americans. Of course, I have to admit the fact that it was already 3 years ago (probably, men have become more open to pink now?), and people in Utah were startled (perhaps, Utahns are more conservative than others?). Anyway, this story happened when I went to Kumasi, Ghana, for global health study abroad program with a big group of public health, nursing and medical students during summer, 2012. I brought my fancy white and pink striped slipper to wear indoors to Africa! But, some strange moments occurred. When I walked around, a male colleague saw my slipper with pop-eyed and cried out in surprise, “Pink…………..???”

“Yes, my friend, it is pink, so…?”

“Oh… You should be very careful for that.”

“…….?”

He must have some fixed boundary of choosing color to make himself to be a masculine? I took a little offense at his shock and came back to my room. Another colleague, who was my roommate, also saw my slipper and showed exactly same response, “Pink…………….???”

I shocked them again when I took out my purple laptop. A female colleague saw it and asked in surprise, “Charles! Why is your laptop pink?” Well, there was some choice that I could remonstrate with her. “My friend, this is not pink, but purple!” “Okay, Okay… You’re right.” She consented reluctantly. After that, whenever I talked with her, she asked me earnestly couple of more times, “By the way, Charles! Why is your laptop pink?”

They didn’t ask me directly, “Are you gay?” However, they seemed that they wanted to hear from me directly like this, “Yes, because I like pink, I am gay.” They were so nice Utahns who didn’t cast me out even if I looked somewhat suspicious. One more moment happened when our group came back to the U.S. from Ghana. I finally took out my U.S. cell phone to turn it on. Sadly, my cell phone case was also pink. Another female colleague said in a low voice, “Pink…?” ‘Okay okay… Your response doesn’t that surprise me anymore.’ Right after this Africa trip, I threw my purple laptop into the storage, gave my fancy white and pink striped slipper to my “female” friend, and bought the new cell phone with “pure white” cover. Also, I threw all pink shirts away with tears in my wounded hearts (half in joke). It was the moment that I had to abandon my color preference to survive (Yes, I was really serious at that time).

What is your sexual orientation?
Is it the exactly same as your gender identity?

And now, I am attending half-day Gender & Sexual Diversity (GSD) Training provided by Palladium, global health consulting firm. 13 attendees from USAID, CDC, and other implementing partner join today’s training session to discuss gender & sexual diversity. I have been working with Palladium and Johns Hopkins University to research the impact of GSD training funded by PEPFAR (The U.S. President’s Emergency Plan for AIDS Relief) in 38 developing countries, and today’s training was great time for me to talk about Gender & Sexual Minority (GSM) with staff who have been working so hard to change people’s awareness towards lesbian, gay, bisexual, transgender (LGBT), men who have sex with men (MSM), and sexism.

Wait, what is GSM? Why do we make the new terminology and make ourselves confused? GSM means “People whose gender, sexual orientation, or sexual characteristics differ from what is typically expected.” It is a broader concept than LGBT and MSM that you can be also considered as GSM. If I had stuck to my pink preference ignoring whatever people think about me, I would have been called, GSM. However, I just wanted to be normal and I didn’t want to argue with anybody by saying “Pink isn’t just for girls!” Wait again, what is normal? Since when people started thinking men cannot like pink to be masculine? How much we have been suffering from this kind of social convention, not expressing yourself to the full?

Clicker for the training! 

People have complex identities. It must be impossible to express every single emotion and define themselves who they are. Even if you are confident to say who you are and what you really want to do in the future, it can always change once you sleep and get up in the next morning. If you really like to dissect the color as black and white, sex as man and woman, and weather as summer and winder, where is true diversity? How do we ensure highest attainable standard of health for LGBT and MSM? I know, God created us, either man or woman, but we are still, imperfect creatures who always need love and sincere affection from somebody else. GSM is not the existence who we blame, but we embrace. We may be locked in the cage that is defined by our society.

I was really impressed by one attendee’s self-introduction.

“I am cis-gender. I am gay. And I am from Chicago.”

I haven’t heard of “cis-gender,” but it was actually great way to explain ourselves if you are not “trans-gender.” (It reminded me cis- trans- complex molecular structures in organic chemistry class). It was also good to see that he declared himself as a gay and said he had his husband. The time is already past when coming out man dies out. To be honest, I don’t want to argue whether same-sex marriages should be banned or not. But at least, I eagerly want to see that every single person regardless of their gender identity, gender expression, biological sex, and sexual orientation has the same human right to be respected. Also, I hope to see that people can become ally, who openly support the equal treatment and human rights of gender and sexual minorities.