Tuesday, June 19, 2012

Education for New Mothers

This past quarter, I took a Public Health Nutrition and Biology class, in which we focused on various subjects related to nutrition and its association with public health, as well as how it could affect our biology over the course of a lifetime. One of the lectures dealt with pregnancy, breastfeeding, and nutrition. We spent three hours talking about mother and baby issues. Many new mothers (and not-so-new mothers) are not in the loop about information pertinent to the health of their newborns. What a mother does (and doesn’t do) can have an effect on multiple generations. For this reason, it is important to provide education to mothers. For example, many assume that breastfeeding is instinctive, but the reality is that mothers need training on properly feeding their babies.

This particular lecture reminded me of some of the traditional practices that my mother was taught about how a newborn should be treated during the first few months. I want to mention each oral tradition and talk about its relevance to modern science.

1) When you are pregnant, eat a variety of foods.

In this particular class, we learned that there should be an increase in body weight during a normal pregnancy. Pregnancy is not the time to go on a diet. Even before getting pregnant, folic acid from dark, green leafy vegetables (think: spinach) are a must. While you are pregnant, you should be eating nutrient-dense foods and getting your nutrients from a mixed source of vegetables, fruits, and grains.

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Interesting fact: Did you know that the habits, behaviors, and health of the mom during pregnancy has the potential to influence health for generations to come? Children born to a mother while she was pregnant during a period of starvation will have a higher chance of becoming obese in their adult years. Similarly, mothers that are either overweight or obese when they are pregnant increase the chance that their baby will be overweight in his/her life as well.

2) Keep your bundle of joy bundled up.

I think my grandmother aggressively emphasized the importance of keeping the baby warm and it is definitely something to keep in mind. However, make sure that you are not overheating the baby. I read somewhere recently that the baby’s temperature should be between 16 and 20 degrees Celsius. You should buy a thermometer and diligently check if your baby might be overheated. Apart from warm clothes, it might be good to invest in cute baby hats.

3) Breast milk is the best milk.

I think we might have spent close to an hour or so talking about the benefits of breastfeeding. Our professor pointed out that breast milk is the cheapest, eco-friendliest, and most nutritious milk for babies. It provides the necessary nutrients as well as antibodies. I had a friend that decided to go the baby formula route because she said that her baby looked too thin. She was only 19 at the time so she did not have much education on baby basics. Breast milk provides the right amount of nutrients and energy for the baby. There is no need to use formula milk and it could in fact hurt the baby in the long-term.

It can be a daunting task to be a new mother, but a rewarding experience as well. Make sure you consult with your doctor or nurse about practices that are safe as well as healthy for your baby. If you have friends that are pregnant or new mothers, share well-researched information with them and encourage them to visit their primary care practitioner.

 

Monday, May 21, 2012

Is Torture Ever Acceptable?

This quarter, I am taking a class called Public Health Ethics, in which we discuss the moral and ethical justifications of actions taken by public health professionals, governments, or any other entity in the name of protecting society as a whole. During our first class, the professor posed an interesting question. He handed us the Universal Declaration of Human Rights (compiled by the United Nations) and asked us this: Which one of these rights would you be willing to put boots on the ground and fight for? Which one of these would you think are ideal to have, but maybe not worth fighting for? He proceeded by reading some of these ‘rights’ outlined in the handout. All was well until we got to the part about torture. The comments made by a woman in class have been forever embedded in my memory.

Article 5 of the Universal Declaration of Human Rights reads:

No one shall be subjugated to torture or to cruel, inhumane or degrading treatment or punishment.

He asked again: Is this something that you would advocate for? No one should be tortured no matter what? What about prisoners of war?

At this point, a woman in her 40s, dressed in a nurse’s uniform, raised her hand. She said that she had a son who was fighting in the United States Army and that the topic of torture by the American soldiers has been on the news quite often. She was referring to the torture of prisoners at Abu Ghraib. The justification she used for the torture of the prisoners was what bothered me. Her conclusion was that the American soldiers were justified because if they had been the ones captured, the “others” would have inflicted a more cruel form of torture on them.

I know where she is coming from in her thinking. She has a son that has been through a lot with the military service and obviously she will be more sympathetic to the soldiers. However, I think this notion of “they” is problematic. When we start differentiating in this way, it is easy to justify inhumane actions on others, whether it’s killing, torture, or something else. Her answer prompted me to think about this subject more and I decided to do my presentation on “War and Public Health”. My partner is talking about the needs of those that are stuck in the middle of a war (and after the war) in terms of food, water, shelter, mental health, and the like. I will be focusing more on the subject of torture and if this is something that we can justify as public health professionals.

Unfortunately, the U.S. Department of Justice sanctions torture to an extent that it deems appropriate. The Bybee Memo redefined torture and concluded (among other things) that there needs to be a ‘ specific intent’ for torture to be considered as such (1).  It is easy to justify these actions when they are being done to terror suspects, but the reality is that many of these suspects are actually innocent. Over 80% of the prisoners at Abu Ghraib were innocent (2). Furthermore, the confessions taken from these prisoners (even from those that were rightly detained) have been incorrect or fabricated, which has led to even more drastic and unnecessary measures by the U.S. government (1).

The next issue that arises is the role of the public health professionals, including nurses and medical doctors. Do they have a moral responsibility to protest against this? Unfortunately, a loyalty conflict arises where a physician is torn between providing care for the patient and working for the military (3). In this case, should the physician ensure that the prisoner’s medical needs are being met, or be a silent observer? It’s known that clinicians have been complacent in these activities and they have reached to the point that they are aiding in the exact science of the torture techniques. For example, physicians might fabricate reports that state that the detainee is healthy enough to go through the ‘interrogation’ process or not treat the appropriate medical conditions of the detainees(3).

I feel that it is an obligation for public health professionals to advocate that governments provide a torture-free environment for the detainees. Torture is plain bad policy, with few (if any) positive outcomes. It would send a strong message to governments if public health workers united against the atrocity of torture, wherever it may happen.

References:

1.    Iacopino V, Allen SA, Keller AS. Bad Science Used to Support Torture and Human Experimentation. Science. 2011;331(6013):34-5.

2.    Lenzer J. Oath Betrayed: Torture, Medical Complicity, and the War on Terror. BMJ: British Medical Journal (International Edition). [Book Review]. 2006;333(7564):401-.

3.    Singh JA. Treating War Detainees and Terror Suspects: Legal and Ethical Responsibilities of Military Physicians. Military Medicine. [Article]. 2007;172:15-21.

Side Note: Here’s a video that I found, but I haven’t watched all of it. It goes into the details of how medical complicity is present in many cases of torture:

Saturday, May 19, 2012

A New Chapter

A new chapter has begun in my educational journey and from now on, you will be reading a lot about my time at this new graduate program. I am pursuing a Masters in Public Health (MPH) with a concentration in Global Health. Don’t ask me what I want to do with this degree! I say that not because I randomly picked a degree program to get myself busy, but because there is so much I want to do! I think this degree will open many doors for me, but it will not be the end of my educational journey. I will definitely pursue my studies beyond my MPH.

I moved into my dorm on April 2nd and am still adjusting to living on my own without family. My parents wanted to visualize the place so I made them a short video. I have edited it (mostly by cutting out the part where you can see me) so I can share it here. Please excuse the choppy editing.

*Lota= Urdu/Hindi term; I’ve had to deal with awkward stares during my bathroom visits. I take this ‘watering can’ with me so that I can clean myself with water once I have finished using the restroom. It’s a religious thing. As a public health student, I think I should start advocating for the use of the lota.

In case you are wondering, I wanted to show my parents that I have lots of space (more than I need). That’s the reason you had to go through the torture of looking through all those empty drawers and cabinets.

Here are videos of the study rooms on my floor:

Here is the gym on my floor:

I have used the gym at the dorm maybe twice because I prefer taking fitness classes at the main university gym.

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