Stories

Tag: Alan Brooks

  • Learning from Frontline Health Workers in the Climate Change Era

    Learning from Frontline Health Workers in the Climate Change Era

    By Julie Jacobson, Alan Brooks, Charlotte Mbuh, and Reda Sadki

    The escalating threats of climate change cast long shadows over global health, including increases in disease epidemics, profound impacts on mental health, disruptions to health infrastructure, and alterations in the severity and geographical distribution of diseases.

    Mitigating the impact of such shadows on communities will test the resilience of health infrastructure in low- and middle-income countries (LMICs) and especially challenge frontline health workers. The need for effective and cost-efficient public health interventions, such as immunization, will evolve and grow.

    Health workers, approximately 70% of which are women, that provide immunization and other health services will be trusted local resources to the communities they serve, further amplifying their centrality in resilient health systems.

    Listening to and building upon the experiences and insights of frontline health workers as they live with and increasingly work to address the manifestations of climate change on health is pivotal to the collective, global response today and in the years to come.

    We imagine a future of health workers connected to each other, learning directly from the successes and challenges of others by choosing to engage in digital, peer-supported, peer-learning networks regardless of the remoteness or location of their communities. Success will lie in a nimbleness and ability to quickly see new emerging patterns and respond to evolving needs of individuals and communities.

    Such a future shines a light on the importance of new ways of thinking about global health, leadership, who should have a “voice”, starting from a position of equity not hierarchy, and the value that peers ascribe to each other. The hyperlocal impact of climate change on health cannot be mitigated only through global pronouncements and national policies. It requires local knowledge and understanding.

    Recognizing this unique position of health workers, Bridges to Development and The Geneva Learning Foundation, two Swiss non-profits, are supporting this first-ever, large peer-learning event for frontline health workers to share their experiences and insights on climate change and health.

    More than 1,100 health workers have already shared their observations of changes in climate and health affecting the communities they serve in over 60 countries. They will be sharing their stories and insights at the Special Event: From community to planet: Health professionals on the frontlines of climate change, but you can already read short summaries from Guatemala; India and Mongolia; Bénin, Gambia, and Kenya.

    Starting from a Call to Action shared through the Movement for Immunization Agenda (IA2030), the call has “gone viral” through local communities and districts: over 4,500 people – most of them government workers involved in primary health care services in LMICs – registered to participate and contribute.

    Almost every health worker responding says that they are very worried about climate change, and that, for them, it is already a grave threat to the health of the communities they serve.

    Taken together, their observations, while imperfect, paint a daunting picture. This picture, consistent with global statistics and other data, helps to bring to life global pronouncements of the dire implications of climate change for health in LMICs.

    Amid this immense and dire challenge lies an opportunity to shift from a rigid, academically-dominated approach to a decentralized, democratized recognition and learning about the health impacts of climate change. This shift underscores the importance of amplifying insights from those who are bearing the brunt of the consequences of climate change, and recognizing the special role of health service workers as bridges between their communities and those working elsewhere to address similar challenges.

    This perspective requires those of us working at the global level to critically evaluate and challenge our biases and assumptions. The notion that only climate or health specialists can offer meaningful insights or credible solutions should be questioned. The understanding of climate change’s impact on epidemiology of disease, mental health and other manifestations – and the strategies employed to mitigate them – can be substantially enriched and sharpened by welcoming the voices of those on the frontlines. By doing so, we can foster a more comprehensive, inclusive, equitable and effective response to the challenges posed by climate change.

    The thousands of members of the Movement for the Immunization Agenda 2030 (IA2030) and others who have initiated this global dialogue around climate and health may be forging a new path, showing the feasibility and value of the global health community listening to and supporting the potential of frontline health workers to shine the brightest of lights into the shadow cast worldwide by climate change.

    This editorial is a contribution to the Special Event: From community to planet: Health professionals on the frontlines of climate change.

    About the authors

    Julie Jacobson and Alan Brooks are co-founders and managing partners of Bridges to Development. Jacobson was the president of the American Society for Tropical Medicine and Hygiene (ASTMH) in 2020-2021. Bridges to Development, a nonprofit founded in 2018 based in Europe and the US, strives to build on the world’s significant progress to date towards a stronger and more resilient future.

    Reda Sadki and Charlotte Mbuh lead the Geneva Learning Foundation (TGLF). The Geneva Learning Foundation (TGLF) is a non-profit implementing its vision to catalyze transformation through large scale peer and mentoring networks led by frontline actors facing critical threats to our societies. Learn more: https://doi.org/10.5281/zenodo.7316466.

    Illustration: The Geneva Learning Foundation Collection © 2023. All rights reserved.

  • Metaphors of global health: jazz improvisation ensemble or classical orchestra?

    Metaphors of global health: jazz improvisation ensemble or classical orchestra?

    In the realm of classical music, the orchestra stands as a formidable emblem of aesthetic grandeur and refinement. However, beneath the veneer of sophistication lies a deeply entrenched system that stymies the potential for creative exploration and spontaneity. As in a straitjacket, the rigidity of this system threatens to reduce the rich tapestry of human experience into a sterile hierarchy, devoid of the serendipity that breathes life into artistic expression.

    The classical orchestra is governed by a hierarchy that places the conductor at the apex, wielding an almost tyrannical authority over the musicians. It is a system that perpetuates a culture of conformity, where musicians are coerced into subsuming their individuality in the service of an imposed order. This stifling environment leaves little room for the musicians to contribute their own interpretations or creative impulses, and instead demands that they adhere strictly to the conductor’s vision, which is often based on a prescriptive reading of the composer’s intent.

    The result is a musical experience that is reductive in nature, an experience that is stripped of the chaos and unpredictability that are essential to the vitality of artistic expression. In its quest for order, the classical orchestra neglects the potential for serendipity, which can arise from the unscripted interplay of individual talents and the embrace of the unexpected. By eschewing the possibility of chance encounters and emergent beauty, the orchestra constricts the wellspring of creative potential, relegating the musicians to mere cogs in a mechanistic apparatus.

    Furthermore, the insistence on a strict adherence to the conductor’s interpretation perpetuates an illusion of coherence and stability that belies the complexities of the human experience. The orchestral structure does not allow for the acknowledgement of discord and dissonance that are inherent in life. Rather, it seeks to impose a singular vision of order, relegating the multitudes of voices and perspectives to the margins of the performance.

    In the end, the classical orchestra emerges as an antiquated institution that, in its blind pursuit of order, risks smothering the creative spirit that animates the very essence of artistic expression. It is a system that demands submission and conformity at the expense of individuality and exploration. By refusing to acknowledge the serendipity and complexity that lie at the heart of human experience, the classical orchestra risks becoming a hollow shell, a lifeless relic of a bygone era that has yet to fully grasp the true potential of the human spirit.

    Is global health more like a classical orchestra or jazz improvisation?

    In a dimly lit club, a hazy smoke fills the air, while the soft murmur of conversation weaves its way through the room. Then, the jazz ensemble erupts in a mesmerizing explosion of sound – an intoxicating mix of chaos and order, each musician adding their own unique twist to the shared melody. As their improvisation unfolds, the music becomes a living, breathing entity, transcending the boundaries of the individual instruments.

    This vibrant expression of creativity and spontaneity form the improvisational spirit. Could embracing the fluidity and adaptability inherent in jazz as a metaphor help us rise to meet the myriad challenges that crop up in our quest to improve the health of people across the globe?

    The notion of orchestrating global health initiatives like a classical ensemble, with a conductor dictating every note and movement, might be appealing at first glance. But the diverse and interdependent nature of global health demands that we adopt a more inclusive approach that values flexibility, adaptability, and collaboration. Just as a jazz ensemble thrives on its ability to respond to the unexpected, global health initiatives must be nimble enough to adjust to the constantly shifting realities on the ground.

    It’s a world where the unexpected reigns supreme, where musicians effortlessly dance between moments of chaos and harmony. In this realm of improvisation, there’s a certain magic that takes hold – a power that transcends the limits of scripted notes and carefully crafted melodies.

    The power of improvisation lies in its ability to tap into the uncharted territories of human creativity. It’s a process that relies on a deep sense of trust and vulnerability between the musicians, who must be willing to venture into the unknown, guided by nothing more than their intuition and their shared connection to the music. As they navigate this uncertain terrain, the musicians become explorers of a musical landscape that is constantly shifting and evolving, and in doing so, they discover new possibilities and pathways that would have otherwise remained hidden.

    Improvisation also fosters a unique form of communication, one that transcends the boundaries of language and culture. In the midst of a jazz jam session, the musicians engage in a conversation that is at once wordless and profound, speaking to one another through the language of their instruments. As each musician adds their own voice to the collective melody, they create a tapestry of sound that tells a story – a story that is rich in emotion and nuance, and that speaks to the universal human experience.

    Moreover, improvisation has the power to challenge and transform our understanding of what is possible. By breaking free from the constraints of traditional structures and forms, improvisation invites us to question the status quo and to reimagine the world in new and exciting ways. It teaches us to embrace uncertainty and change, and to see the beauty in the unexpected. In this sense, improvisation serves as a potent reminder of the boundless potential that lies within each of us, waiting to be unleashed.

    As the haunting strains of a saxophone solo rise and fall, and the pulse of the bass line echoes through the dimly lit club, the power of improvisation is laid bare for all to see. It’s a force that defies categorization, and yet it holds within it the capacity to move and inspire, to challenge and transform. In the ever-changing world of jazz, the power of improvisation is the lifeblood that courses through the music, and it’s a force that, if harnessed, can open up new worlds of possibility and wonder.

    In this context, the jazz ensemble emerges as the more fitting metaphor. By incorporating the principles of complexity and change found within the jazz improvisation, we can more effectively navigate the challenges that come with addressing global health issues. It is through this adaptable and collaborative approach that we can truly accelerate progress and create lasting, meaningful change.

    So, as the last notes of the saxophone linger in the air and the final beats of the drums echo through the club, we’re reminded of the power and potential of improvisation. It’s a lesson that, if taken to heart, might help transform our efforts to improve global health and the lives of those we seek to help.

    Is global health more like a classical orchestra or a jazz improvisation ensemble? Which should it be in the future?

    Reference

    Jacobson, J., Brooks, A., 2022. Reflections on “Orchestrating for Impact”: Harmonizing across Stakeholders to Accelerate Global Health Gains. The American Journal of Tropical Medicine and Hygiene. https://doi.org/10.4269/ajtmh.21-1101