MPH Cupid

Heart and Blade

My name is Karel and I am an Internet dating failure.   Yes, I have met a few nice men on OK Cupid for the requisite coffees, drinks or dinners and “nice meeting you, good-bye.”  There of course have been the fascinating respondents who live in “New York, New York” but only write back at 2:00 AM and have no idea where the George Washington Bridge is.  The men who live in suburban apartments who had very lavish life styles and were very financially successful, but “lost everything in the divorce.”  (I don’t know which planet these men are from since, having been divorced myself, I happen to know first hand that wives definitely do not “get everything” as these men claim was their judicial fate.)   There was the very attractive somewhat familiar looking man who was wearing an Eddie Bauer shirt with the logo prominently displayed in every photo; nicely scanned from the catalogue.

My profile remains on OK C and I check in from time to time approximately once a month because though not an enthusiast, I am sort of academically interested in the process, maybe even a little bit hopeful.  And recently to refresh my memory, I checked in few times before writing this blog.

Of course I have heard the various urban legends of a cousin of a friend of someone’s sister-in-law who found true love, got married and had five children and lived happily ever after with a man she met on eHarmony. Or the neighbor of a woman in yoga class who is engaged to a man she met on Match.  There was even an article in the New York Times “Weddings” about two people who met on OK Cupid.  Read it, Believe it!  If it is in the New York Times it must be true. http://www.nytimes.com/2013/06/09/fashion/weddings/malini-sur-arpan-jhaveri-weddings.html

Alas, I have not even come close to this experience, although I suppose it would help if I updated my profile from time to time (I went to St Petersburg, Russia two years ago.)  Maybe I need to add something really compelling like my broken ankle last winter with a photo of my scar.  Kind of makes me think of Ben Stiller’s Walter Mitty trying to get a wink on eHarmony, although I actually have been to the Himalayas and Iceland.

In spite of this failure to find true love on my computer, two years ago I met David and since then we have exchanged I am sure hundreds of emails, photos, ideas, feelings, thoughts, plans.  We have written sometimes several times in one day.  About year ago when I wanted to set up a meeting, he disappeared for over a month and I thought it was over.  I was pretty angry.  And there have been times when he has been angry and critical and seemingly very demanding.  But still we continue and in fact I just received an email from him this morning.  “Good morning,” he wrote.  “Thank you for your humble reply.  We have much work to do.”  David lives in Uganda and I live in New York.

David and I didn’t meet on a dating site.  We met on the Global Health Forum of LinkedIn when I posted my MPH thesis in 2011.  Over the two years we have been working together to establish Holistic Care for Mothers, a project of the Makindye Rotary and soon to be an independent not for profit registered with the Ugandan government.  I am more than academically interested; I am hopeful that we can make some positive change for women and girls.

This is not my only Internet relationship.   Early in my thesis process at New York Medical College, probably around 2008, I found the Birthing Kit Foundation and Dr. Joy O’Hazy.  Joy and I have written to each other over the years about the distribution and efficacy of birthing kits,, but also about her travel, her singing and dancing; her wisdom and experiences.  There are often long gaps in our correspondence, but I always feel a connection to her and every day I look at the beautiful appointment book she sent me last year with her photographs and poems.  It was Joy who was my contact to the Foundation that yielded the donation of birthing kits to Holistic Care for Mothers that David has distributed in rural Uganda. http://www.birthingkitfoundation.org.au/

I met Kirtiman Tumbahangphe in Nepal, the director of  MIRA, Mother and Infant Research Activities http://www.mira.org.np/mira/ and after many emails and exchange of phone numbers, Kirti and I did meet in Hetauda where I visited several women’s projects out in the beautiful lush mountains of southern Nepal.  We talked about maternal mortality in Nepal and the very successful MIRA project using women’s empowerment, peer health education and community leadership.  Kirti and I even had dinner together at the Hotel Avocado and Orchid Resort where I stayed.  We said goodbye in the parking lot and he rode off on his motorcycle.

Diana Nabiruma is a health writer for the Ugandan newspaper The Observer.  I was researching health in Uganda when I found one her articles about violence against women and girls.  Thinking she might be interested in Holistic Care for Mothers I sent an email to the address in her by-line; an arrow shot into the cyber dark for sure, but she wrote back.  She was interested and interesting and funny and smart.  And, she interviewed David and Dr. Sarah Nkonge.  And….she did indeed write an article about maternal mortality in Uganda, about the Holistic Care for Mothers. The%20Observer%20-%20No%20more%20%E2%80%98labour%20suites%E2%80%99%20in%20banana%20plantation.html

And then there is Mike Cook who is one of the most amazing Internet contacts I have ever had.  I was thinking about how razor blades in birthing kits might be replaced with natural, local sustainable materials.  I thought about repurposing broken glass bottles; could blades be made from glass? So I searched “GLASS BLADES.”  And there was Mike Cook.  His website states, “Hi I am Mike Cook and I was born to be a flintknapper.”  Mike lives in Portland, Michigan and has a company called Art of Ishi www.artofishi.com He in fact makes blades from glass and stone, but not the kind of glass I was thinking of.  He uses natural volcanic glass, obsidian, flint, chert.  Take a look at his website and you will be totally astonished.  You can watch his videos about how he makes these blades.  For those of you who are not faint of heart, watch him shave with a blade he strikes off of a hunk of  obsidian http://www.youtube.com/watch?v=QWSTE6WLB0Y  All I can say is “DON”T TRY THIS AT HOME.”  So I wrote to Mike.  Generous, thoughtful and expressing interest in birthing kits, Mike sent me a few of his blades.   I have them on my desk (although I have not used them on my legs,) and there is the possibility of natural blades to cut umbilical cords safely, cleanly, sustainably.  Thanks, Mike.

These are some of my Internet relationships.  I don’t think any of them will lead to a date for New Years Eve, dinner on Valentines Day, not even the cup of coffee or drink.  I have not found my one true love, but I have found passion.

As I, a la Joseph Campbell follow my (Internet) bliss, I think of a web perhaps not so different from our www in Walt Whitman’s “A Noiseless Patient Spider”:

A noiseless patient spider,

I mark’d where on a little promontory it stood isolated,

Mark’d how to explore the vacant vast surrounding,

It launch’d forth filament, filament, filament, out of itself,

Ever unreeling them, ever tirelessly speeding them.

And you O my soul where you stand,

Surrounded, detached, in measureless oceans of space,

Ceaselessly musing, venturing, throwing, seeking the spheres to connect them,

Till the bridge you will need be form’d, till the ductile anchor hold,

Till the gossamer thread you fling catch somewhere, O my soul.

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Beautiful to the Bone

The fine black line that diagonaled through the bright white shaft against the dark background was the reason we were looking at this picture.  It was cause for concern, for necessary interventions, for my fear.  And yet my attention was also drawn to the lower area of this study in black and white where delicate lines and sensual little spheres connected, designed like an intricate and elegant piece of jewelry.   These were the bones of my right ankle and foot.

I soon came to have a great appreciation for my ankles, the right one in particular.  I have of course enjoyed them and they have held me up in ever so many of my endeavors:  running on my pier out into the Hudson River; climbing along a precipice in the foothills of the Himalayas; standing in Proud Warrior; kicking away the blue and green and aqua of oceans and rivers and swimming pools; holding me steady as I bounced a baby (mine or anyone’s else’s I could get my hands on;)  dancing and leaping into a silly pirouette; rocking forward on a tennis serve, sloshing through the Mumbai Monsoon; supporting me as I sauté-ed and fried and roasted and peeled and mashed and whipped in my kitchen.

But I never learned to really appreciate my ankles until my right foot slipped from a wet stair onto a wet tiled floor and slid sharply (much too sharply) to the left on a wet San Diego morning.  Snap.  Alas, the ominous black diagonal line running through my lovely fibula poised above the delicate bones of my foot.  Despite the diagnosis, the picture of my ankle and foot was quite beautiful.  Perhaps if I ever decided to take online dating seriously I would post, instead of the requisite head shot, this foot shot with the caption, “Not just another pretty face.”

So while I have certainly enjoyed the structure and support of my bones, I haven’t really thought about them all that much, as is probably true of most of us.  Sure, I am pretty compulsive about getting my calcium; cheese is after all one of the great pleasures of life.  And then there is all of that low fat yogurt:  plain, Greek, frozen, and in smoothies.  Ice cream.  Zero Percent Over the Moon Milk (with Oreos, of course.)  Pizza with fresh mozzarella and anchovies.    I haven’t exactly indulged in all of these calcium rich foods for purely medicinal purposes.  I do also love all those green leafies: broccoli, Brussells sprouts (an odd early acquired taste during my childhood,)  spinach (preferably creamed. ) I have done exceedingly well on my bone density tests with very little advance study.

Now I think about my bones all the time; now that the thin black line has resulted in my right ankle being permanently adorned with some titanium.

I have also been thinking about why we don’t typically think too much about our bones.  In fact bones actually get kind of a bad rap.  Halloween: scary skeletons.  One annually adorns my front door kept company by the Jack O’Lanterns.  Pirate ships:  Skull and Cross Bones.  The dangling marionette of bones in a medical lab in a science fiction thriller.  Malicious King Richard found under a parking lot.  Creepy, but bones intact.  The pejorative terms:  bag of bones, bad to the bone,  bare bones and bone head.

I looked through a few magazines to do some research on the fashion value of bones.  More seemed age appropriate for me.  Here are the survey results of attention to body parts  beautiful as depicted in advertisements:

Skin:  18

Hair: 8

Eye lashes: 4

Lips:  3

Nails (fingers and toes):  2

Bones:  0 (except for a minor mention among heart, joints, muscles, digestive tract, immune system in an ad for Shiff vitamins.  Not very glamorous. )

Of course there were lots of ads for beautiful clothes, and shoes (I long to wear two matching shoes; high heels are yet a dream for the future…although mostly I would love to be wearing my tennis sneakers on the courts.)

Where would those clear unwrinkled skins, exotic eye lashes, lavish hair styles, luscious lips, and sassy finger and toe nails be without the beautiful bones holding everything up.

I was thinking that maybe to attain beautiful bones it just doesn’t take a lot of chemical research (certainly not like what it takes to have those exotic eye lashes.)

Here’s what the NIH has to say:

Get enough calcium and vitamin D in your diet at every age.

Be physically active.

Reduce hazards in your home that could increase your risk of falling and breaking bones.

Talk with your doctor about medicines you are taking that could weaken bones, like medicine for thyroid problems or arthritis. Also talk about ways to take medicines that are safe for bones. Discuss ways to protect bones while treating other problems.

Maintain a healthy weight. Being underweight raises the risk of fracture and bone loss.  (hmmmm here’s something those fashion models might need to know.)

Don’t smoke. Smoking can reduce bone mass and increase your risks for a broken bone.

Limit alcohol use. Heavy alcohol use reduces bone mass and increases your risk for broken bones.

Surgeon General’s Report on Bones

http://www.niams.nih.gov/Health_Info/Bone/SGR/surgeon_generals_report.asp

I thought it was interesting that it didn’t say anything about don’t do crazy stuff like skiing, playing tennis, skate boarding, bike riding,  bungie jumping, mountain climbing, running Marathons. Take it from me, done a lot of those things and never broke a bone.

Most of these recommendations are pretty easy for us here in the United States, but may be more difficult in developing countries.  In some countries dairy products are either expensive, difficult to acquire or in places like India and Nepal not a dietary desire.  When I was planning my trip to Nepal, I asked the Director at the US Embassy what he might like for me to bring him from home.  He didn’t hesitate for a nano second:  “Cheese.  Please bring me cheese. “ And it was true there was no cheese in Nepal.  There are other ways of getting calcium.  It is in those green leafy vegetables, nuts, herbs, soy and seeds (including, yes, Amaranth!!!!!)  But 4 cups a day of that zero fat milk will give you 100% vitamin D, 120% of your calcium, at only 360 calories.

So get your exercise, don’t smoke or drink too much, definitely don’t be underweight, be careful at home, and get your calcium and vitamin D.

But here is something a little tricky and it’s about the vitamin D.  Would you ever think that being out in the sun without sunscreen and eating sausages would be good for you.  Seems a little counter intuitive.  And yet one of the most important ways we get our vitamin D is why it is called the “sunshine vitamin.”   Yes, we get it from sunshine.  It’s also in some things we might find kind of odd:  Cod Liver Oil (ick!:) Fish (yum;) Fortified Cereals (think Cocoa Krispies;) Oysters (sexy;) Fortified Soy (meh!) Eggs (: ) Mushrooms (exotic;) Fortified Dairy (there’s that milk again:) and!!!!!! Salami, Ham, Sausage (get down and make yourself a good hoagie!)

As we know, sunshine is much maligned and for some good reasons like skin cancer.  But we do need some.  An editorial in the Indian Journal of Medical Research by Sarath Gopalan and Prema Ramachanandran (March, 2008) states:

Adequate exposure to sunlight can provide

sufficient vitamin D to children and adults. It is therefore

imperative that nutrition and health education to

improve exposure to sun gets due attention. These

efforts will also result in increase in physical activity

(play in schools and walks for adults) which will reduce

risk of overnutrition and associated risk of non

communicable diseases and improve muscle and bone

health.

The article also notes that the preference for light skin in Indian and Asian cultures can keep people particularly women out of the sun, increasing the possibility of vitamin D deficiency.

If you want to read the whole (very interesting) article here’s the link: http://icmr.nic.in/ijmr/2008/march/editorial.pdf

So these are just some ideas about bone health.  Mostly, we all need to think about our bones more, love them, honor them, respect them.  I have been assured that my right ankle will once again be strong.  I will walk (without crutches,) swim, run, dance, balance, pick up and cradle babies, wrestle with my grandchildren.  I will climb mountains again.

And for this I have many people to thank:  My daughter Kierra who rescued me from Newark Airport and the hospital and nurtured, fed me and kept me smiling; my daughter Alex who will stay with me next week and get me off to my new job, I am sure with her typical sweetness; my grandchildren Nico and Sonoma who love me even in a cast; daughter Kristin who has cheered from the sidelines; Lauren who was able to make me laugh even when I was about to be wheeled into the hospital for surgery; Julie who kept me calm and brought me sushi the night before; Pat who is adopting me for (hopefully) almost the last of my days on crutches; Deb, Purna, Carol, Rochelle, Dan, Jon, Terry who have kept me company; Enrique who is always an Epic; and San Diego Steve who was there.

I am thankful to the health professionals at Englewood Medical Center and Englewood Orthopedics who are the finest and kindest I have ever known in any health facilities; Dr. Perlman who put me to sleep (and made sure I woke up;) and Dr. Adam Becker of Englewood Orthopedics who expertly put my lovely fibula back together (and called me “Princess” when I was wearing a shower cap, hospital gown and my glasses.  Sometimes it’s the little things that get us through.)

To all of the above, who have truly healed me, bones and soul, and to all of you, I raise a glass of Zero Percent Over the Moon Milk in a toast:

“To Our Beautiful Bones.”

shoes

50 Shades of Designer Bags

My children could tell you just how nerdy I am since they have experienced my crazy obsession with their school projects (“Oh, no, not foam core again, Mommy!”) and my over-preparedness for classes I have taken (at least half the text book read and HIGHLIGHTED before the semester started).  My  friends, fortunately for me, welcomed me back after I had spent months in the cocoon of writing my MPH thesis. My reading material tends to be the daily New York Times, The New Yorker and the American Journal of Public Health. (I actually have a once a week date night with The New Yorker; I have found it some mornings stuck to my face.)  I have been known (or hopefully unknown) to steal copies of Journal of the American Medical Association from my doctor’s office.  The most recent book I read is Classified Woman by Sibel Edmunds.  Although I do have to confess to having read……no actually I am going to take the 5th on the 50 Shades books.   When I fly I do totally indulge in something like Vogue or Glamour, but that is in response to my suppressed fear of flying and is for purely medicinal purposes.  So when 4 times a year The New York Times has a fashion supplement I feel completely justified in wallowing through those pages of luscious, colorful, crazy expensive designer clothes and accessories because after all, it’s The New York Times.  The Fall 2012 issue arrived last weekend.  I continue to wallow.

It seems that darling little designer clutch bags are very much in style for the Fall.  There’s a page of them in yummy colors and another section called Grab Bags:  Know when to hold ‘em and when to fold ‘em, with no apparent apologies to Kenny Rogers.   Somehow I did not fashion forecast well when I bought that big red Prada knock off in Hong Kong for $15.  These little bags are of course very pricey.  They are designed by Celine ($2,100,) Phillip Lim ($625,) Victoria Beckham ($650,) Marc Jacobs ($550,) and Coach (only $148,) among others.  My guess is they are just big enough for a credit card, a lipstick, a cell phone and a couple of condoms…maybe a box of Tic Tacs.   Just the basics for survival at some soignée soirée.

Of course I know what little bags can carry and the impact on health outcomes they can have because I spent about two years of my life studying the contents of little bags about 6” by 4”.  These darling little bags, not so pricey, not so pretty, carry things like a razor blade, string, a piece of soap, a sheet of black plastic: not really contents for a fun evening out, but pretty useful if you are going to have a baby at home in a rural region of Nepal or India or Uganda or Ghana or Rwanda or Afghanistan. At least 350,000 women a year die in childbirth internationally.   One of the leading causes of death is infection which can result from unsanitary delivery conditions.  So these little bags of useful items, called birthing kits, have been developed by several organizations including Zonta International, the World Health Organization and UNICEF. More than a million of these kits are distributed annually, especially in developing countries where maternal deaths are the highest in the world.

The kits have been designed by medical providers and organizations.   They are standardized and able to be mass produced, inexpensive and extremely compact.  Dr. Joy O’Hazy who works with Doctors Without Borders and Zonta told me that, “While quantifiable data is difficult to acquire what we have received is a large amount of anecdotal evidence from our partners about reduced infections and deaths in places like Kenya and Afghanistan.”  (Joy by the way is an amazing person and I have been fortunate to be able to stay in touch with her since completing my thesis.  “Hello, Joy!!!!”)

So here’s the thing I just can’t stop wondering about.  We know that birthing kits save lives, but to save lives they not only have to be available, they have to be used.  If rather than having a pretty little clutch bag, the only thing you could carry your evening supplies for a party in was a plain plastic baggie would want to do that or would you just leave your stuff home? Do you want someone to pick out that plastic bag for you or would you want to shop for something you like or you feel expresses who you are?  Do these seem like silly questions in relation to clean birthing supplies?  I don’t think so.

Social design is based on the understanding that for products to be effective they must include user end participation in the design, i.e., if you are going to design something ask the people who are going to use it to be involved with the design of that product.  How do I know this? I have a brilliant neighbor named Dan Formosa, Ph.D., who is one of the founders of Smart Design, and he told me about social design and he helped me with my thesis.  So I know this is true.  For birthing kits to be truly effective in saving the lives of women and babies, the design of the kits has to include the women who will use them.  They need to be social designer bags.  Not mass produced but in at least 50 shades.   The bags that women use in Uganda need to be Ugandan.  The bags that women use in Afghanistan need to be Afghan.  The bags that women use in Nepal need to be Nepali.  Not only is this social design, it is beautiful design.  All of these countries have wonderful traditional designs, colorful crafts, amazing creativity.

So here’s the challenge for designers.  Design beautiful, inexpensive, small birthing kits that can be distributed and used and can save lives.  You can include women from their countries, you can use some of the proceeds from your $600 pouches, you can engage the design community in saving women’s lives.  You can make preventing maternal mortality sexy and cool.  That’s what designers do.

Here are some direct challenges:

Hey, Prabal Gurung, do it for Nepalese women.

Mimi Plange, for women in Ghana.

Georgio Armani, Louis Vuitton, Channel, Estee Lauder, Gucci, Calvin Klein, Hermes, Prada, Marc Jacobs, Tod’s, Salvatore Ferragamo,  Celine, MaxMara, Michael Kors, Balenciaga, Missioni, Chloe………pick a country and get to know the women there.  And design with them.

And Kenneth Cole, how about some really cool compelling billboards.  You are so very clever.

Perhaps Tyler Brule, the editor of the hip international travel, design, political magazine Monocle would take on the coordination.

So I guess it is just my inherent nerdiness that got me from those darling little clutch bags to preventing maternal deaths.  Or maybe it was the women I met in Nepal and India and Brazil and my friend David in Uganda and Joy O’Hazy , who constantly inspire me and make me think, actually believe, that “it only seems impossible until it is done.”

PS…Hey, Prada, so sorry about buying the knock off.  I promise never to do it again.

There is No Finish Line

 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