Parallel lives - Steubenville and New Delhi

Alongside the tragic story of the Steubenville rape case here in the US, you may have noticed a spate of new stories recently about rape in India, including the horrific case of the young woman who was gang-raped on a bus in New Delhi and eventually died from her injuries. I have been intrigued by the parallels of the two situations – along with one very specific call for a solution.

I read a very interesting – and sobering - OpEd piece on CNN about rape and the broader problem of abuse of Indian women, written by Suniti Neogy, who incidentally works for CARE India (the NGO with whom I’ll be working for my Fellowship) as a community educator for gender issues and healthcare.

Neogy explains how the problem is really an epidemic – claiming many, many lives and destroying many more each year – and it stems from an underlying lack of respect for women in broader society and the tolerance of abuse as an acceptable part of life.

Her proposed solution? Start educating boys, not just girls, about gender equality from early childhood. Her piece ends optimistically, with the belief that Indian culture can change, a belief fueled by her positive experiences working with communities and seeing the change that education and the support of both men and women in the community can bring over time.

Interestingly, over the past week, two unconnected people mentioned to me that the serious issues with misogyny in India seem strange to them, given that India has had something the US has not – a female head of state – not to mention the reverence of female family members, especially mothers, in Indian society. However, I think that we can see many similarities to American culture – in a country where we have a growing list of women in powerful positions in corporations and government (yes, not growing quickly enough, but at least growing), I have been reading about the backlash about the media coverage of the Steubenville rape, and it is creating a similar tide of calls for better educating boys about respect for women (for example, see this now-viral impassioned blog from one concerned mother of three boys, Audrey Binkowski). 

The parallel is quite strong.

This should remind us that when learning about social issues in other countries, it is easy to castigate a foreign culture for the wrongs we perceive. But let us not forget that we have to look inwardly – the solutions start with each of us. As a father of three girls, I will do what I can to help prevent such a terrible crime from happening by educating them, but as both Ms. Neogy and Ms. Binkowski point out, it takes much more than the individual effort of concerned parents of girls to change things.

CARE India is dedicated to empowering women, helping create change by building up communities from the inside out. This is how we have to change things in the US as well.

Preparations are Moving Along:

I have quite a few updates this week!

More on my Fellowship Project

I had a great call last week with Dr. Drew Lewis, who is a Global Medical Affairs lead here at Pfizer, and who has worked extensively with vector-borne disease in the past. He gave me great insight into what I will probably experience in the field in India, and helped educate me on the sort of efforts that have been undertaken in the past to combat malaria. My GHF Program coordinator, Oonagh, joined in the call, and she was able to share a little more about what should be my main project in India.

I will be based in New Delhi, helping CARE India to set up a new program to eradicate Kala-Azar, or visceral leishmaniasis (VL).

VL is a disease caused by a protozoan called Leishmania donovani, and it is transmitted by Phlebotomus, a small sand fly, which bites human hosts much like a mosquito. According to the World Health Organization (WHO), it is endemic in the province of Bihar in India (where I'll be working in the field) and 60%+ of VL cases occur in the Indian subcontinent (including Bangladesh, and Nepal). VL is also prevalent in Brazil and Sudan. In 2010, in Bihar alone, over 20,000 cases of VL were reported (with likely many more unreported), and nearly 100 reported deaths due to the disease.

The disease usually first results in fever, weight loss, and enlargement of the spleen and/or the liver. The name Kala-Azar means literally "Black disease," and the form of VL found in India often results in darkening of the skin. VL is considered to be fatal if untreated, though it is actually the weakening of the immune system, leading to other (secondary) infections, that usually results in death. Because the sand fly and the protozoan are found in rural, poverty-stricken areas of the world, where the inhabitants are typically undernourished and subject to many other diseases (tuberculosis, malaria, and many others) - as well as a lack of treatment - it is easy to see the need for intervention.

There have been efforts in the past to eliminate VL in India, through what is called Residual Indoor Spraying (with insecticides like DDT) coupled with efforts to educate villagers about how to better prevent or limit sand fly bites (bed netting or some kind of screening can be very effective); these efforts have been able to reduce the incidence of the disease for some years, but a renewed effort is needed to finish the job.

My project will be working with CARE (and likely other stakeholders) to establish a new eradication program, establish goals, and determine how best to monitor and evaluate progress over time. I will be making several visits to Bihar, and by the end of my Fellowship will have started a pilot program to put everything into practice. The eradication effort will likely span many years, so key to this is setting up a sustainable system to continue monitoring progress over time.

For more information about Kala-Azar and past attempts to eradicate it in India, click here, here and here.

CARE National Conference, Washington, D.C.

On March 5th and 6th I had the honor and pleasure of attending the CARE conference in DC, joining Oonagh, as well as former GHFellows Melinda (2012), Carrianne and Crystal (2010). On the first afternoon, we attended a reception hosted by the French Ambassador, and had the chance to watch a chapter of the new film, "Girl Rising." The chapter was very moving, very inspirational, focusing on a young girl named Senna in small mining town in the Andes, and how she overcame poverty and many other obstacles to obtain an education and help her family. The film itself is made up of quite a few such chapters, and will be available for limited special viewings across the country (http://girlrising.com/). CARE helped identify several of the girls featured in the film via their local anti-poverty programs.

On the 6th, we attended CARE's program for the day, and it included sessions such as "Telling the Empowerment Story" and "Exploring CARE: Going Beyond the Mission Statement." The most eye-opening part was "Voices from the Field" - Crystal was one of the panelists who described their experiences working in the countries where CARE does most of its work. Fascinating and inspiring stuff.


Getting Visas and Planning for a trip to Dhaka:

On the logistical side, after conversations with my host organization, CARE India, and our Pfizer GHF team, I have been able to make a few more plans, and to get my visas!

The process for getting an India visa was not too tough, as I already had an active one from my business trip to Mumbai last June. I still had to get a lot of information together, including letters from CARE India and CARE USA, and submit travel plans and timing, etc. It took me a couple of weeks to get everything in line - and then I went over to Travisa (the organization to whom the India Consulate has outsourced the provision of visas and other passport-related matters) and submitted it. A couple of days later, I just walked over and picked it up.

I also made plans to go to Dhaka, Bangladesh, for a few days before the start of my Fellowship, to see my dear friend Zubayer (+zulkarin jahangir)! Very excited about this - it's been almost five years now. I bought a ticket from Delhi to Dhaka (2.5 hour flight) a couple of days after my arrival in India (so I have a little time to settle in, hopefully), and Zubayer will be taking care of all the arrangements in-country. Looking forward to it immensely!

The Bangladesh visa process was a little easier than for India (less paperwork, etc), but it actually was tough to submit the documents as they don't allow you to set up an appointment - it's walk-in service and first-come, first-served at the Consulate. Luckily, it's right across the street from my office, so I was able to find a little time to wait in line before work. Their turnaround was even faster - just one day! So I am now in good shape - after a few more vaccinations - to leave on May 24th.

The Long Prep

I tried to think of everything I must do to prepare for my Fellowship. There were so many things to do that I had to break it up into categories:

• Share with friends and family (check!) - and explain to them what I'll be doing and why the heck I thought it was important to do something that entails leaving for 5+ months (still working on that)
• Get a better understanding of India - its people, history, culture, and spirituality (all those things are tightly intertwined)
• Contact past Global Health Fellows who have worked with CARE India, to get tips on working with the organization, how to assimilate locally, and what to do while there
• Vaccinations!!!  (and other health matters)
• Visas - most importantly for India, but also for any other country I might have the occasion to visit while there (Bangladesh, maybe Nepal?)
• Talk with CARE India about the fellowship projects, and start doing some research on my own time
• Start buying and organizing the things I need for the long trip (mostly medicine-cabinet related, but also other supplies and comfort items)
• Contact people I know in India, or who might be nearby, to let them know I'll be in Delhi
• Make sure I'm able to Skype efficiently 
• Buy the plane ticket (work covers it, but I have to make the arrangements)
• And, of course, attend all trainings from work

I feel that, with 3+ months to go, I've got a good start on the list.

 Share with friends and family

After telling my immediate family and close co-workers - the people I see all the time - I posted on Facebook, and let the word trickle out. About a month ago, word also went out internal to Pfizer about the group of us who will be venturing out on Fellowships this year.

Since then, I've received a lot of great feedback from people - and of course some head scratching. The toughest, I think, is family who don't quite "get" why someone would do something like this - especially someone with a spouse and three children at home. I try to explain the best I can about the VERY long time I've been dreaming of a chance to do something like this, about why it's important to me to try to make a difference in others' lives, the excitement of being immersed in another culture, how I think this will change my life by helping clarify what my higher purpose - and maybe longer-term career will be about...and how I want to use this as an example for my children to think about their place in the world, and maybe what they can do to change it. It's not always easy to communicate all of that...

Get a better understanding of India

Can anyone ever truly understand India? I don't know. On one hand, we see the beauty, the spirit and spirituality and intelligence of its people - and on the other the poverty, health issues, the overcrowded cities. I have been seeking out a few difference sources to help me get a better grasp. On the recommendation of a friend, I watched the 6-part BBC series, "The Story of India," which turned out to be a great overview of the long history of the subcontinent from its earliest civilization through the country it has become today. It spurred me to pull out some dusty paperback versions of the Mahabharata and the Upanishads, the Rig Veda, and the Bhagavad Gita. I haven't worked my way through them all, but even at a summary level, it gives some insight into both the spiritualism and the practicality of India. I've also been doing what I usually do when I travel to someplace new - reading a guidebook. My office mate, Rockwell, gave me a great present of a Lonely Planet guide for India, and it has already been a great resource to understanding the layout of the country and the important things to see, do, and understand.

Contact Past Fellows

I had the pleasure of speaking with past CARE India Fellows Janna, Crystal, Carrianne, and Melinda, who during and after the application process gave me a HUGE amount of great information about living in India, working with the great crew at CARE, and about the types of work I might be doing. I am sure I will continue to pick their brains as May 24th (my departure date) draws near!

Medical stuff

Wow. I have never had so many shots. TDAP, Hep A, Hep B, Polio, Japanese Encephalitis vaccines so far, and (if I can get it) Rabies still to go (plus the Typhoid vaccine in pill form). I will have to start taking a malaria preventative a couple of weeks before leaving as well. I've had bloodwork done, and have another overall health check before I go. And I've also had to catch up on vision and dental visits, as I won't otherwise be able to do that until the end of the year. I've also been advised to bring lots of meds with me, including antibiotics (Cipro, Z-Packs) and anything to help combat Delhi Belly (Pepto, Immodium, etc). Fun!

Visas

I'm used to going through a passport and visa service here at work, so it will be my first time going straight to the consulates to get visas (though for India, most of it is online). I hope to have it all squared away by the end of March so that I don't have to worry about it as the departure approaches.

Meeting with CARE

I've had a first meeting, and it sounds like the project work will really be fascinating. The proimary project they've mentioned is setting up a program to eliminate Kala Azar, or visceral leishmaniasis, in India. Kala Azar is a disease caused by a protozoan (similarly to malaria) that is transmitted by the bite of a sand fly. It is indigenous to some provinces in India (especially Bihar and West Bengal) as well as Bangladesh.  I'll be spending time both in the Delhi main office as well as the Patna office in Bihar, and will take part in some field visits as well in and around Bihar. I've also started to do a little basic research on the disease itself and what has been done already to combat it and its sand fly vector. More on that later!

Gearing up

Costco is going to be very helpful here. I have to think about the healthcare needs, but also comfort items. I'm stocking up some e-books for reading material as well, and of course I'm sure I'll think of a million other things in the weeks before I leave. I've decided to wait until I arrive to purchase some climate-appropriate clothes - as I understand the prices can be a little lower there!

Contacting people in the region

I was very happy to find out that a couple of friends will be visiting India and Bangladesh while I'm going the be there! One of the stipulations of the GHF program is that we cannot take vacation during the Fellowship itself, but we are encouraged to do so on our own time. I hope to at least have a couple of weekends free that coincide with my friends' visits. In addition, my wonderful Pfizer colleagues in India have offered help and guidance while I am in-country - so I hope to take advantage of their kind offers!

Technology and communications

I am no techie whiz, that's for sure, but I do need to start making sure I'm set up to speak daily with my family through Skype. CARE is kind enough to provide me with a laptop and cell phone for use while I am in India, so I don't have to bring my own along.

Plane Ticket

Found a good deal on United - direct flight! I'm hoping beyond hope that I might be able to leverage my status and/or miles on United to upgrade to Business Class...but otherwise it should be a fun, 15-hour ride in coach. 

Work training

Oonagh and the GHF team have a terrific program set up to provide us Fellows with background in consulting, International Development, safety, and communications so that we are better able to prepare for the trip. We have already had a good part of the training sessions, with a few left to go! The program also provides Communications and Security contacts to ensure we are ready for whatever comes our way.

Global Health Fellowship - 2013

In early December of last year (2012), I learned that my company, Pfizer Inc, had selected me as one of its Global Health Fellows for 2013. For the next year or so, this blog will be dedicated to this Fellowship program.

Tuesday, Feb 12, 2013 - The Story So Far:

The story really begins back in 2006, when I first heard about the Global Health Fellowship (GHF) program, back when it was still fairly new. I spoke to a couple of colleagues who took part in the program, and it sounded like a life-changing experience for each. This especially intrigued me as I've always felt a calling to service - including considering joining the Peace Corps as a teenager - but because I had always struggled with that big question of What To Do With My Life, I never formulated a plan to put this calling into action. By the time I started business school in 1998, I was married with one child, Veronika (with my second, Josephine, born while there), and an inkling of a potential career, so that calling was put on the back burner.

But only for a while! Hearing about this program gave me hope that I would be able to get at least a taste of helping those in developing countries without having to take the huge risk of leaving my career track (especially with all those pesky student loans). The Fellowships are essentially an opportunity for Pfizer to provide pro-bono consulting to non-profit organizations in developing countries with great need - where everyone gains something (Fellows get exposure to a completely new world, and develop new skills in leading projects; NGOs get months of free time from someone with corporate leadership experience and some form of functional expertise, and Pfizer gets better-rounded employees who develop new, valuable leadership skills). I learned a lot about the GHF program back then, and followed it throughout my Pfizer career, but with multiple job changes and moves to different states (Connecticut, California, back to Connecticut, and now NY), as well as the birth of our third child, Gabriela, the time really never felt right.

But 2012 was different. My wife, Kasia, and I had spoken at length about my desire to take part in this program, and she has always voiced her strong support (despite the hardships I know it would place on her, taking care of three children while also attending to her own career). I came to realize that 2013 may be my last chance for a while to become a Fellow - all three of my daughters would be continuing in their current schools here in NYC for at least another year, but the summer of 2014 will bring college tours for Veronika; 2015 will be the start of her Freshman year, and then the process begins again in 2016 for Josephine.

So, recognizing that this is probably my last chance - at least for many years - to do this without missing these major milestones for my daughters, I watched and waited carefully for the start of the 2013 application process, in July of last summer.

The process entailed a long application, with multiple essays about my motivations for applying to become a Fellow, my experience in working across cultures and traveling to other countries, and my volunteering background. I solicited advice from friends and colleagues who had taken part in the program, and others who have lived and worked in developing countries and who had worked with not-for-profit Non-Governmental Organizations (NGOs) in the past - my officemate, Rockwell, was an especially great resource, as he had worked for Population Services, International (PSI) in Africa prior to his career at Pfizer. After a month of crafting the essays, and with a recommendation letter from my then-manager, Savitri, I finally submitted my application in August.

The almost four months of waiting for the results was gut-wrenching. Pfizer lets you apply as many times as you want to until you're accepted, but knowing I really just had this one shot to do this really had me sweating. In October, I found that I'd been selected to the final round - very exciting! - but I was still one of four candidates for a Fellowship in India, with interviews with the NGO (CARE India) and the internal GHF team still to go. My interviews were delayed thanks to Hurricane Sandy, stretching out the waiting process even further. Finally, after a great conversation (with lots of questions in both directions) with the CARE team in New Delhi and a brief interview with our GHF team leader, Oonagh, and Pfizer Global Security, I learned on December 4th - in the middle of a huge team meeting - that I was accepted into the program. I would be heading to Delhi for a five-month fellowship!

After sharing the news with my wife, family, friends, and colleagues, I gave myself a little time to celebrate before getting overwhelmed with the huge amount of preparation required for such a journey.