Look at the person, not the disease: A model for holistic health

22 01 2013

By Caroline Hope Griffith
Research Analyst, Duke Global Health Institute

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Dr. Sam Orach speaking to Institute participants.

Dr. Sam Orach, Director of the Uganda Catholic Medical Bureau (and Thursday’s plenary speaker), was trained to treat the whole person, not the disease. Diseases are influenced by a community’s economic, social, political, and religious context and to truly understand the cause of an illness, doctors must always examine this context.

Dr. Sabina Mtweve, our seminar moderator, introduced a model that helped us frame Dr. Orach’s approach. The model captures all of the different dimensions of a truly healthy community. First, there must be a balance between the mental, physical, emotional, and social health of individuals within a community. Second, spiritual life and the physical environment of the community also must be in harmony. Next, the community must practice equitable distribution of resources, offer access to education, and promote gender equity. Lastly, the community must embrace moral values, provide good leaders and equitable policies, and respect the environment. If all of these requirements are met, then the community will not only be healthy, but it will be peaceful.

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Dr. Sabina Mtweve showing us a model of a health community in Swahili.

Cathy Groenendijk, Executive Director of Confident Children in South Sudan, gave a poignant, yet bleak, example showing the interconnectedness of these elements. The poverty in the slums where she works causes depression among many parents. These parents often resort to alcoholism and can’t care for their children. The children fall sick from poor hygiene, malaria, and cholera. They are also exposed to sexual exploitation and abuse and live in a polluted environment full of sewage and waste. All of these factors contribute to a breakdown of cultural norms and traditional ways of life, and the community loses its direction and hope.

These conversations make me think more deeply about the term “global health.” It is important to remember that global health refers not only to geographic diversity, but also to a global perspective that includes context and community.

Thanks to all of you for following along with my blog. After an exhilarating week, I’m headed back to the US. I am grateful for the time I spent in Uganda with these leaders and for the insightful dialogue and experiences we had together.

See my earlier posts from the conference:

Health is Greater Focus of 2013 Peace & Reconciliation Conference in Uganda
Building Healthy Communities in East Africa
Don’t give up, don’t ever give up
The gift of language: A little French goes a long way





The gift of language: a little French goes a long way

16 01 2013

By Caroline Hope Griffith
Research Analyst, Duke Global Health Institute

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Dr. Philemon and Sister Marie-Bernard from the Democratic Republic of the Congo, two leaders who asked me to interpret for them in our community health seminar.

One of the many things I enjoy about this Institute on peace and reconciliation taking place in Uganda this week is hearing so many different languages spoken all around me. All of the participants either speak French or English, but many also speak other local languages. When the Institute first started, the dominant language for all presentations and communications was English. Over time, the conference organizers realized the importance of having interpretation between English and French to ensure that all of the French-speaking participants were able to fully participate.

Now, during all of the plenary sessions, an interpreter stands beside the speakers, who are free to speak in either French or English. I still marvel at the skill and talent of these interpreters. Being a French-speaker myself, I know how difficult it is to stand in front of a room and communicate an English lecture in French to an audience on the spot.

During this conference, I have had the opportunity to serve as an unofficial interpreter for members of my seminar group. Several of the members come from the Democratic Republic of the Congo and Rwanda, and while their English comprehension is high, they are more comfortable expressing themselves in French.

Over the past few days, I translated for these leaders so that they could share their reflections with the group. It is a humbling experience to be able to serve my colleagues in this way (especially because it has been a long time since I have spoken French!), and I have enjoyed the opportunity immensely. It is powerful to be able to offer this gift – albeit a small one – of communication to these leaders who have shared and taught me so much.

See my earlier posts from the conference:

– Health is Greater Focus of 2013 Peace & Reconciliation Conference in Uganda
– Building Healthy Communities in East Africa
– Don’t give up, don’t ever give up





Don’t give up, don’t ever give up

15 01 2013

By Caroline Hope Griffith
Research Analyst, Duke Global Health Institute

Today’s theme of the Great Lakes Leadership Institute was lament, which is the ability to see and truthfully name the brokenness in the world.

IMG_7739-croppedIn our community health seminar session, we heard the laments of women and men who have witnessed incredible brokenness. Participants talked about corruption, the vicious cycle of war, HIV/AIDS, the consequences of genocide, rape and sexual violence among women, and the abject poverty of too many communities.We don’t like to think too much about the brokenness in our lives; instead we constantly seek superficial quick and easy fixes. However, it is important to dwell in this brokenness for a time in order to understand and prepare ourselves to create a space for reconciliation and peace.

I thought about some of the laments we have in our communities in the US: so many people go hungry and are homeless, too many people are out of work, political and religious divisions impede the growth of our society, and there are so many fatal shootings in our schools.

Even among all of the brokenness, these leaders continue to rebuild lives and search for hope. My inspirational thought for the day came from our plenary speaker, a Congolese theologian who led efforts to reconstruct homes, hospitals, and lives in his hometown in eastern Congo after 2000 were killed there (the legendary Jimmy Valvano also lived his life this way): “Don’t give up, don’t ever give up, no matter how difficult the challenges are that you face.” If these men and women can continue to press on in the face of such great violence and sadness, then who am I to quit when the going gets tough?

See my earlier posts from the conference:

– Health is Greater Focus of 2013 Peace & Reconciliation Conference in Uganda
– Building Healthy Communities in East Africa





Building Healthy Communities in East Africa

14 01 2013

By Caroline Hope Griffith
Research Analyst, Duke Global Health Institute

Today was the first meeting of our seminar, Community Health, Trauma and Reconciliation.  The goal of the seminar is to understand the relationship between trauma – which can manifest itself in afflictions of the body (e.g., HIV/AIDS), the mind (e.g., post-traumatic stress) and the spirit – the practices of reconciliation, and the health of communities in the face of this trauma.

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The Community Health, Trauma, and Reconciliation seminar is co-led by Dr. Sabina Mtweve (pictured in forefront), a doctor and community health promotion specialist at Kilimanjaro Christian Medical University College (KCMC) in Tanzania and Dr. Peter Morris (back right), a doctor and Executive Director of Urban Ministries in North Carolina.

Participants of our group come from many backgrounds and include a doctor caring for HIV patients in Uganda, a palliative care chaplain in Tanzania, a medically trained doctor helping children in the slums of South Sudan, a Bishop in Rwanda training Congolese refugees in trauma counseling, and an advocate helping women who are victims of sexual abuse in Kenya.

Today, we centered our discussion around 2 questions:

What kind of healthy community would you like to belong to?

We all agreed that we would like to belong to a community that is holistically healthy. The community would not only have access to basic health services and work to reduce illness, but it also would have security, good schools, and respect for the environment. Community members would be peaceful, caring, accepting, trusting, loving and faithful and embody justice, peace, and equal opportunity.

Can a healthy community help to prevent conflict?

A healthy community can certainly help to prevent conflict. The opportunities and the future promise offered by such a community invite the younger generation to invest in their futures and resist conflict. However, without peace it is difficult to establish all of the components of a healthy community. One participant shared his experience working for the United Nations. He said that when his organization came into a conflict zone and asked the people what they needed most, the people said peace. Not food or shelter or schools, but they first asked for peace. So, if the community is in conflict, then efforts to build good schools, health centers, and establish trust and security – all important parts of a healthy community – will be very difficult.

So where should we start to help a community become healthy again? For me, it’s clear that a comprehensive response is necessary – providing food, clothing, and health care must be accompanied by peace-building, and reconciliation needs to be integrated with efforts to build housing, health care, and education.

See my first post from the conference:

– Health is Greater Focus of 2013 Peace & Reconciliation Conference in Uganda





Health is Greater Focus of 2013 Peace & Reconciliation Conference in Uganda

13 01 2013

IMG_7739-croppedBy Caroline Hope Griffith
Research Analyst, Duke Global Health Institute

Hello from Uganda! I am here to attend the annual Great Lakes Leadership Institute organized by the Center for Reconciliation at the Duke Divinity School and its African partners. I will be blogging about the five-day conference, which brings together Christian leaders from East Africa (and a select few from the U.S.) working to promote peace and reconciliation in their communities. The week will be full of plenary sessions, discussion seminars, and time for worship and reflection.

I attended the 2012 Institute and came away inspired and awed by the work of these amazing leaders. (See last year’s blog posts compiled here.)

My three goals for this year’s Institute are to:
1. Learn,
2. Connect, and
3. Be present

Learn: This year, for the first time, we will have a seminar on reconciliation, trauma, and community health, which I helped to organize. In this seminar, we will hear directly from leaders working in the trenches about how they address health – physical, mental, and spiritual – in their communities and the role reconciliation plays in building healthy communities.

Connect: At Duke I manage research projects that connect faculty and students in global health, theology, business, and environmental studies to address difficult global health challenges. Over the next week, I will continue to serve as a bridge-builder, looking for ways to connect participants with each other (and possibly with my colleagues back at Duke) so they can support one another in their work.

Be present: One of the wonderful things about this Institute is that it takes the participants away from their daily routines and struggles. It is a place of rest, reflection, and rejuvenation and provides space to build and nurture relationships. I also plan to use this time to be present; to stop rushing from place to place and task to task and to focus on the conversations, the relationships, and the insights that the week is sure to bring.





Improving Health Care in the Faith Community

23 01 2012

By Caroline Hope Griffith
DGHI Associate in Research

How can spiritual leaders and faith-based institutions use reconciliation to help health care providers work together, improve quality and accessibility of care, and improve the well-being of individuals, families, and communities?

On Friday, we asked seven health professionals from Uganda, Tanzania, Kenya, and the U.S. who gathered this year at the GLI Institute to share examples of the ways in which the faith community could use reconciliation to improve health care in this region.

Health leaders at the GLI Institute: Caroline Hope Griffith (Duke), Peter Asiimwe (Uganda), Dr. Edith Namulema, (Uganda), Rev. Deogratius Msanya (Tanzania), David Toole (Duke), Dr. Peter Morris (U.S.), Dr. Sabina Mtweve (Tanzania), Darriel Harris (U.S., working in South Sudan), Dr. Jean Kagia (Kenya) I’d like to thank Duke alumnus Darriel Harris for providing the photos for my blog posts.

An educator and former nurse from the Congo explained a situation in her town that rendered doctors and nurses powerless in serving a criminal in their hospital. A man suspected of murder was taken to the hospital, but the army wouldn’t allow the doctors and nurses to take care of him. Community members came into the hospital to torture the man, and he was eventually taken outside and killed. She believes that the faith community could help to empower hospital staff so they could better protect patients’ rights.

A Reverend from Tanzania noted that there is a tension between doctors and nurses in his country. Doctors consider themselves superior to nurses and stigmatize the nurses (this tension exists in the U.S. as well). He believes that the church can help different health care providers learn to respect one another so quality of care does not suffer.

An HIV/AIDS doctor from Kenya discussed the many challenges faced by children of discordant couples (when one parent is HIV positive and the other is negative). The child is stuck in the middle and becomes the victim of his parents’ struggles. She believes that spiritual leaders can help the parents to reconcile with one another and provide a safe place for these children.

A member of the Ugandan Catholic Medical Bureau noted that church leaders are increasingly separating themselves from health care because they see health care as the concern of medical professionals. However, spiritual and physical needs are intertwined and faith-based facilities in Africa provide much of the region’s health care. He believes that church leaders have a responsibility to re-engage and provide support to health leaders and facilities.

While faith communities do not have all the answers, these stories demonstrate that there is an important role for faith communities to play in addressing the conflicts faced by health professionals and their patients, families, and communities.

The GLI Institute came to an end on Saturday. Over the next year, we hope to work with these seven health leaders to develop a new seminar series for the 2013 Institute where health and faith leaders can more deeply explore the connections between health and reconciliation.





A Powerful Tool to Improve Ugandan Health Care

19 01 2012

By Caroline Hope Griffith
DGHI Associate in Research

What are the most important attributes of a leader in the African Great Lakes region? One quality stands out above the rest: the ability to lead by serving, instead of leading by being served, a concept known as “servant leadership.” Many leaders (all over the world) see their position as a privileged one, and expect to be served. Leaders hold their position until they die and often forget the real reason they are elected to lead, which is to care for and serve their people. This problem is especially prevalent in this region.

Dr. Celestin Musekura, Founder and President of ALARM (African Leadership and Reconciliation Ministries), teaches GLI participants about servant leadership.

Robert Greenleaf writes that a servant leader makes sure that other peoples’ highest priority needs are being served. A servant leader measures success by asking: do those who I serve grow as persons, become healthier, freer, and more likely to become servants themselves? What is the effect of my leadership on the least privileged in society? Will they benefit, or at least not be more deprived?

I see servant leadership not only as a powerful tool for bringing church leaders back to their roots to serve God and others, but as a powerful tool for improving health care in Uganda. Through a joint Duke-Uganda project to improve management and leadership of health facilities in western Uganda, we’ve learned that many problems in health facilities (unclean facilities, corruption, etc.) arise because managers do not practice the principles of servant leadership. What if our project could train these leaders to put the growth, freedom, and health of the people they lead and manage above all else? I am confident that the least privileged in society would benefit.

Note: In my last blog, I wrote that Dr. Sabina Mtweve had started an initiative to reduce unsafe abortions and reconcile families in Tanzania. It is actually Dr. Jean Kagia who is an ObGyn in Kenya who started this initiative. I’ve had rich conversations with so many people here, that I confused the work of the two women when I was writing the blog late the other night.








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