Guest blog post by Bobby Carney, Fulbright-Clinton Fellow.
“In Samoa, there is no individual health. There is only community health, because we are all connected. That is the Fa’asamoa (the Samoan way).” The director of my division at Samoa’s Ministry of Health advised me as we discussed the health indicator data for 2015 to plan new directions for policy in 2016. These candid moments with my colleagues teach me about the culture I’m working within, show me a bigger picture of the work I’m doing, and improve my work.
As a Fulbright-Clinton Fellow working at Samoa’s Ministry of Health (MoH), I spend a lot of time learning while simultaneously working to build capacity of my host ministry to monitor and protect population health. I am primarily assigned to the National HIV, STI, and Tuberculosis Program, but I have assisted other programs and divisions within the ministry dealing with health research, policy, monitoring and evaluation. I have worked on various projects such as drafting the Monitoring and Evaluation Framework for HIV,AIDS, STI’s, and TB, developing national hospital regulations and primary healthcare strategies, and drafting progress reports to the Global Fund to Fight AIDS, TB and Malaria.
I obtained my Master’s of Public Health in 2014 at Rutgers University, New Jersey (my home state). Previously I graduated with a B.A. in Anthropology and Ethnic Studies from the University of Colorado. My interests in global health issues, health rights, and transgender and women’s health, led me to apply to Fulbright 2015-2016 placement in Samoa.
At the Ministry of Health, I spend most of my time sifting through data, being a huge public health nerd, and assisting the implementation of national programs. All of these activities include the background scenery of the most beautiful tropical island in the world, both culturally and geographically (in my humble opinion). Samoa’s lush equatorial climate makes it easy to be biased.
STI’s and HIV are a major health challenge in Samoa. According to disease surveillance reports, HIV is low in prevalence with only 12 living cases out of an estimated population of around 194,000. However, half of those cases are mother-to-child transmissions and only 4.5% of the population was tested for HIV in 2015. This suggests that the impact of HIV in Samoa is largely un-documented, and there are more cases that we aren’t detecting. Chlamydia is also a major threat to public health (specifically maternal health) with a prevalence of 26% in 2015. Low-rates of voluntary testing compound these issues and pose challenges to promoting prevention.
Some days, my education and work experience are given a workout. My host unit and I have to work to improve the monitoring, testing and reporting systems for HIV and other STI’s, while finding ways to use the limited data we have to inform policy, program planning, and national health development efforts. The Ministry of Health is also leading some exciting new developments to improve health information, like planning implementation of an electronic medical record system.
Assisting MoH in improving health information and surveillance can be challenging, however, I love the work I’m doing. Professionally, I feel the fellowship has been a culminating experience for me, and every day I get to engage my public health training and learn something new. I am also lucky to be part of a great team. My host unit consists of very accomplished Samoan women and fa’afafine (third gender Samoans), who are talented comediennes as well as public health professionals.
My academic research projects for the fellowship are, 1) measuring the effect that Chlamydia has on birth outcomes, and 2) assessing the impact of violence on the Fa’afafine community (third gender) health. My hope is that these projects will provide the Ministry of Health with data on vulnerable populations that they can use for policy, programming, and health development planning. They’re a small attempt to give back to both a country and government ministry that have enriched me professionally and personally.
After Fulbright, I plan to continue working with Samoa and the Pacific region to improve the health of vulnerable populations through evidence based policy and interventions in the areas of maternal and child, transgender health, domestic violence, and sexual health. Until then, you can find me digging through a database, all while sneaking glances of the breath-taking Pacific Ocean through our office window.