There is No Finish Line

08 Aug 2012 4 Comments

by privatelifeinpublichealth in Uncategorized Tags: , , , , , , , , , , , , , , , , ,

 Who could not be absolutely in love with Gabby Douglas? With Alex Raisman, Jordyn Wieber, McKayla Maroney, and Kyla Ross…the Fab Five who won our hearts and medals at the Olympics?  Along with so many athletes we are watching intently, cheering for, sighing for, disappointed with and celebrating with, they are paragons of health, of beauty, of achievement, of competitiveness, of winning.  Even when they fall short (literally off of a balance beam) we know they are at the Olympics because they are the best in the world.

As I watch night after night in my bed, my bedroom being the only place I have a television (very small) and air conditioner (very noisy), I find myself wondering what it is that these young women and the other athletes at the Olympics have that has made them the great athletes they are.  Is it exceptional physical abilities, a drive and commitment to their sport, parents who devoted themselves and their children to rigorous training, some unknown Higgs Boson-like God particle that they were born with? (http://news.nationalgeographic.com/news/2012/07/120704-god-particle-higgs-boson-new-cern-science/)

I did a little very non-scientific research on “what makes athletes great?”  Here are a couple of results.  The first is from a New York Times blog for junior high students. This is an answer from a 13 year old:

 Okay a lot of things make athlete storng and those things can be by eatting good and also by trying there best.but most importantly is when they never give up  http://learning.blogs.nytimes.com/2010/02/08/what-makes-an-athlete-great/

This one is from an article in Shape magazine from a couple of days ago:

In my opinion, it’s not just the amount of medals you win or how many events you compete in. There is definitely a lot more to being an Olympian than that. I believe athletes like Wilma Rudolph and Jesse Owens epitomize what it means to be an exceptional athlete. Rudolph was born prematurely and spent the bulk of her childhood in bed. She suffered from double pneumonia, scarlet fever, and later she contacted polio. After losing the use of her left leg, she was fitted with metal leg braces when she was only six. However, years of treatment and determination to be a “normal kid” worked, and Rudolph was out of her leg braces at age nine. She went on to become a basketball star before taking the track and field world by storm and ultimately went on to win three golds and one bronze at the 1960 Olympics in Rome. From there, she became the fastest woman in the world and the first American woman to win three gold medals in one Olympics.  http://www.shape.com/blogs/london-2012-summer-olympics/what-makes-olympic-athlete-great

Never giving up and overcoming difficulties seem to be favored ingredients, and certainly we have seen that night after night.  Gabby Douglas actually did fall off the balance beam and got back on; she didn’t win a medal in that competition and she knew she wouldn’t win, but she got back on that narrow strip of hard wood and jumped and tumbled and vaulted off.

Two things were going on in my head as I was watching event after event and pondering the question of what makes these athletes great: they were perhaps more subliminal than rational thoughts.  One was the often-played snippet from the Phillip Phillips song, Home.

Just know you’re not alone, Cause I’m going to make this place your home

And there they were accompanied by the song: the women’s gymnastics team, the audience cheering, the parents, the coaches.  The Karolyis and Liang Chow literally going to the mats and challenging Alex Raisman’s score to secure her bronze medal on the beam. Win or a fall, you are not alone.

The other had nothing to do with the Olympics.  It was an article in the Sunday New York Times Magazine section from July 29 that I kept getting distracted from and kept being pulled back to.  The picture on the first page of the article, titled Hope in the Wreckage, was of two women who could not look less like Olympic athletes.  Claudia Cox, a visiting nurse is pictured kneeling on one knee at the bed of a women dying of bone cancer at home.  “Just know you’re not alone,” the lyrics seeped into my head.  But it wasn’t just the photo. Claudia Cox works in Jackson, Mississippi a place with some of the worst health outcomes in the country.  Sixty-nine percent of adult Mississippians are obese or overweight: at least 25% of the state’s households do not have access to healthy foods, adequate grocery stores being up to 30 miles away.  The article notes that many of these families buy their groceries at gas station convenience stores. Mississippi has the highest teen birth rate and Human Rights Watch calls the state “the epicenter of the H.I.V. epidemic in the United States.”  Tragic human wreckage indeed. So where was the Hope?  The Hope is Claudia Cox working for an organization called HealthConnect which was founded by Dr. Aaron Shirley and Mohammad Shahbazi, a professor at Jackson State University, based on the community outreach and very personal home care in a program in Iran. The Iranians founded “health houses,” local huts that contain exam rooms and sleeping quarters for community health workers in rural areas to reach the population living in more than 60,000 villages outside the urban areas of Iran.  The community health workers who are all from the villages themselves, “advise on nutrition and family planning, take blood pressure, keep track of who needs prenatal care, provide immunizations and monitor environmental conditions like water quality.”  The services of the health houses lowered rural infant mortality by 75% and substantially lowered the birth rate, two benchmarks of overall improvements in the health of a population.  Dr. Shirley, impressed with the positive impact on health outcomes in Iran, adopted many of the same services, mostly local community members/health workers establishing close personal relationships with patients, encouraging them, counseling them, advocating for them. In one year the services of HealthConnect cut the rate of admissions to Central Mississippi Medical Center by 15%. http://www.nytimes.com/interactive/2012/07/27/magazine/mississippi-health-care.html#

I have seen these same health strategies and relationships in the home visiting programs in Costa Rica, in Resource Mother projects in Norfolk, Virginia, in the MIRA project in Nepal.  Community health workers, peer educators, home visitors teaching, supporting and advocating which all comes down to what the best coaches do for the best athletes.

The positive differences in any of our lives are often the results of coaching.  I will never play tennis at the Olympics, I am not even seeded and I don’t play at an exclusive club, but I do have a coach.  Bill is the best; he knows just how to keep me improving and “playing up,” without my getting frustrated (although he occasionally slams one past me just to keep me humble.)  He is also a person who has been there most weekends through many of my life’s changes over the past 7 years.  I missed the opening ceremonies for the Olympics because I was out with two of my other coaches, my yoga buddies Lauren and Julie who have also coached me as friends and guides.  My daughters Kristin, Kierra and Alex keep me balanced and let me fall and are there to get me back up or just sit on the floor with me for a while.  Carol has been coaching me since I was 5. Heller An who is a triathaloner knows good coaching.  I am fortunate to have many wonderful coaches.

Sure we all have our gifts, we all have our challenges, our abilities and disabilities, and some very exceptional people to dazzle and inspire us in Olympic events.  They show us what can be.  So does Claudia Cox.  So do each of us when we refuse to give up, when we open ourselves to being coached and when we assure others that “you are not alone.”

Home Phillip Phillips

or

http://www.youtube.com/watch?v=7dfTURAhrTY

Hold on, to me as we go

As we roll down this unfamiliar road

And although this wave is stringing us along

Just know you’re not alone

Cause I’m going to make this place your home

Settle down, it’ll all be clear

Don’t pay no mind to the demons

They fill you with fear

The trouble it might drag you down

If you get lost, you can always be found

Just know you’re not alone

Cause I’m going to make this place your home

Settle down, it’ll all be clear

Don’t pay no mind to the demons

They fill you with fear

The trouble it might drag you down

If you get lost, you can always be found

Just know you’re not alone

Cause I’m going to make this place your home

Of Health and War

04 Jun 2012 Leave a comment

by privatelifeinpublichealth in Uncategorized Tags: , , , , , , , , , , ,

Last Monday was Memorial Day, the day that extends a weekend to three days, celebrates the beginning of summer and commemorates those who have died in wars with ceremonies, parades and poppies sold at grocery stores.  In my small town USA village of Piermont, New York, there was the annual parade through our little town to the Veterans Monument.  I had played tennis early in the morning and was returning just as our Piermont Police Department was starting to close the main street with saw horse barricades diverting cars through the pier parking lot.  After a quick handshake through my car window with my favorite Piermont cop, I took the detour, arrived up the hill at my house and grabbed my bicycle (oh, yes, got out of my sweaty tennis clothes and slipped into biking shorts.)  I cycled down to the Veteran’s Monument and got a good spot for the parade which consisted of the Fire Department volunteers in their uniforms, the very impressive Piermont (“on-the-Hudson”) fire trucks, our Mayor, and the Yonkers Pipe and Drums Band wearing kilts.  And, there were several veterans of wars marching, elderly gentleman who I would guess had been in WWII.  There were a few speeches and prayers, the band played “God Bless America,” it was over, and the crowd dispersed.

There was also another Memorial Day event that was taking place out at the end of the pier.  Every year on Memorial Day a huge bonfire constructed with enormous tree trunks is built right on the river.  It is lit at midnight and burns through Memorial Day until midnight and then is bulldozed into the river.  It’s a pretty impressive site for our little town.  It’s called a Watchfire, a homecoming fire.  It is a blazing light in the dark night to welcome back all of the souls lost far away and to bring them back home.

While all this was going on, and people were stoking their barbeques, I was thinking about all of those wars, all of the lost and damaged lives.  In fact I Googled “US in Wars” and opened up a chart that you can access on Wikipedia.  There was much more information than I expected.   In the meantime I couldn’t help thinking about other “wars.”  The war on poverty…who and what are we exactly fighting?  Was there a beginning?  Will we win or will poverty win?  The war on drugs.  The war on crime.

The war on cancer was declared 40 years ago by Richard Nixon.   Here is an interesting commentary. http://odewire.com/52324/the-end-of-the-war-against-cancer.html

And in an updated report from 2010:

Declaring a “war on cancer,” President Richard Nixon signed the National Cancer Act on Dec. 23, 1971, in a White House room full of happy scientists and proud politicians. The bellicose metaphor implied that cancer was one enemy and that victory was possible. Nobody believes that anymore. It would have been no less naive if Nixon had declared a “war on bad government” that day, ignoring the fact that there are a hundred ways to govern poorly and no single way to do it right.   For the full article: http://www.washingtonpost.com/wpdyn/content/article/2010/04/26/AR2010042603361.html

There of course has been a war on AIDS: http://www.nytimes.com/2010/05/14/opinion/14fri2.html

Brian Lehrer on WNYC has been conducting a survey called “End of War” asking the question “Is War Inevitable?”   http://www.wnyc.org/shows/bl/series/end-war/

Many responses indicated that if more women were in power that more wars would be prevented because women are more inclined to negotiation, conflict resolution, and a focus on health and well-being for themselves and their families.

Former Chilean President Michelle Bachelet, the first Under-Secretary-General and Executive Director of UN Women, discussed the role of women and war–and the importance of having more women in power to lessen conflicts around the world.

An interesting connection, or perhaps it is the disconnection, of war and health is in the little Central American country of Costa Rica.  In 1991, after having researched the substantial decrease in infant and maternal mortality and increased health and well being of children and families based on the Costa Rican home visiting program, I traveled to San Jose and had a meeting with Dr. Lenin Saenz, one of the architects of the government-funded health care program.  The program included visits to every family in Costa Rica four times a year to assure that all children had their vaccinations, that pregnant women were receiving prenatal care, that the family had clean running water and everyone was in good health.  The visits were done by community health workers who had been soldiers in the war against mosquitoes.  Yes, the war against mosquitoes was mounted by a collaboration between the United Fruit Company and the Costa Rican government.  So many farm workers were dying of malaria that the fruit export business was suffering.  Literally armies of mosquito eradicators were employed in the joint effort.  By the late 1960’s, the mosquito was defeated and Costa Rica was free of the tyranny of malaria.  But now what to do with all of these people who had visited every part of the country spraying and removing breeding areas?  Dr. Saenz and his colleagues in the Costa Rican government decided to fight on…this time against infant mortality, maternal mortality, water borne diseases, and just for good measure, illiteracy.  They retained the army of workers and re-educated them to be home health visitors.  Within 10 years between 1970 and 1980, the health status of Costa Rica dramatically improved as indicated by the drop infant mortality by 69 percent from 61.5/1,000 to 18.6/1,000. How did they finance this one might ask?  All those health workers fighting disease.  Well, they used money that other countries use to pay for their military.  Costa Rica in 1948 had decided not to fight their own people or other countries; they disbanded their army.  Since the mid 1980’s there have been financial challenges that have impacted the success of the Costa Rican war against disease, but there is still no military and the health status far exceeds that of most countries in the world.

So Is War Inevitable?

This post does not have neat clever ending or political message or even health prescription.  I just find myself wondering if the question needs to be shifted from “Is War Inevitable?” to “Who or What Are We Fighting?” or more importantly,  “Who Are We Fighting For?”

As for Memorial Day, I continue to think about the Watchfires bringing everyone home.