An OU alumnus presented the humorous and realistic side of international public health programs and research to a packed room of students and faculty yesterday at Walter Hall.
Public health programs are sometimes not based on actual benefit of evidence
said Anuraj Shankar, an OU graduate and assistant adjunct professor at Johns Hopkins Bloomberg School of Public Health.
Shanker gave the example of one group who tried to curb the high birth rate in a developing country by distributing condoms. They even followed up by asking all the people if they used them.
Shankar said the group received a very positive response. However, the birth rate remained the same, so the group went back and asked more questions. They determined that the condoms were being used as balloons.
That's the reality Shankar said. That's what's going on.
Research projects are on the opposite side of the spectrum, looking to produce only beneficial evidence. He explained that many researchers do experiments and then leave the country without any benefit from the results. Often, the people who participate in public health research will not even be told the findings.
A lot of people say 'you're just using us as test rabbits because we're poor
' Shankar said.
In 1998 Shankar started Summit, a project that would combine the aspects of a public health program with research. While working with Helen Keller International, a non-governmental public health organization based in New York, Shankar received $860,000 from the Ted Turner Foundation to develop Summit to lower pregnancy-related deaths of women.
The research side of the project would compare a group of mothers who received folic acid and iron pills with another group who received multivitamin packs. The theory is that vitamin A and others might be beneficial beyond the proven benefits of folic acid and iron to pregnant women.
It's one of the least recognized public health hazards
Shankar said of maternal mortality, which kills one woman almost every second worldwide. Only 1 percent of these deaths are in the developed world, but in Indonesia, nearly 400 women die per every 100,000 live births.
The group decided on Lombok, a small, densely populated island in Indonesia, to do their program. But working with the government, donors, other groups and local citizens proved to be problematic.
The group's logo had to be redrawn three times because the silhouette of a man with his arm around his pregnant wife was deemed pornographic by locals because it was not clear if the couple was wearing clothes.
Six years and many challenges later, Shankar reported that the program, which studied 40,000 women, decreased infant mortality and maternal mortality by 40 to 50 percent.
Junior Bryan Hornfeck said he found the presentation to be very informative.
The size of the project was very interesting
said Hornfeck, a pre-biology and pre-dentistry major.
Shankar said the group still has much to do. A guidance committee recently told Summit officials that they would have to continue their research, which they were planning to do anyway, to determine how much of their success was due to the educational aspects of the program and how much was due to the multivitamin. It is unclear now if the multivitamin is responsible at all, or to what degree, for the lower death rate among women and babies.
Still, Shankar insists, thousands of women received vitamins, folic acid and iron who would not have otherwise.
Currently, the project has run out of funding, Shankar said. Some staff have volunteered to work for free and even the Indonesian government is trying to help by raising funds. Shankar said he is hopeful the project will continue and be a successful mix of public health and medical research.
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Marshall Thompson
