Reflection of Justice and Health Conference, 2019, Sydney

I was glad to have attended the Sydney Justice and Health conference at the start of this week.

What were the key take away messages from this conference?

First of all, on a fundamental level, the conference brought me back to the first impulse I had towards epidemiology – understanding the health issues of prisoners, notably HIV, in my country. Back in 2009, I wanted to apply for what was known as a Sach’s fellowship to undertake research in the field, just before graduation from undergrad. The fellowship would have given me a year of funding. After the conference, I understood that was perhaps a far too ambitious aim for a 23 year old undergraduate student. Just obtaining authorization to enter the prisons could have taken a year, let alone conduct the necessary survey and take the samples.

Even as a PhD project, obtaining information regarding the distribution of health states and their change over time, among those imprisoned, is far from an easy undertaking.

It was indeed humbling to learn this.

Now, I did learn something about young people in Australia. On the opening day, a professor spoke about the clear link between childhood neglect or abuse, mental health and the justice system. An infant that is neglected – ignored – by the parents is most likely to have arrested development of certain regions of the brain. The result – mental illness later in childhood and adolescence. Yet perhaps the term “illness” is not appropriate, as the young person is not infirm in the mind per se, just neglected, so mental neglect could be the term.

Now what happens to such a young person? They end up being suspended from school and may end up committing a crime that brings them into the criminal justice system. And all of this is because their brains were neglected during the first years of life. Yet it seems this story could be broken. Would it be germane to investigate then the link between mental health and the criminal justice system for young people?

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More on young people on Sydney’s trains

Out of breath, running to catch the train, I tap my card, the beep registers that I have passed, I dash down the stairs behind a youth in a red shirt ,he manages to cut inside just before the sirens before the “doors closing, please stand clear” sounds and my fate is sealed, I am too late, the doors are closing before my eyes. But then his reaches his arm through the narrowing space and they open wide once more. And I “alight” the train, as they say.
Another instance of young person violating the laws of the train network. I speak to him inside and he scoffs, stating that nothing will happen. His mate and him were smoking once, “but we were the only ones on the train” he insists. I explain how these trains were bran new, made up something about the “smoke clogging the AC vents” – I think he saw through that one – before referring to the real danger of burnt and ashy seats (they are a upholstery!), not to mention the disrespect he would be causing anyone who entered a smoky train.
From what he said, there were no repercussions to that incident, although the conductor threatened them with arrest.

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Sydney

Since I became a Sydneysider, trains have been my mainstay.Here you have to ‘tap o and tap off’ to access it.
I once a young person jump the barrier. No judgement here,I have evaded the fare once myself, in fact today, merely because I was in a rush.
But I had no idea a large swathw of young people in Sydney are in juvenille justice for fare evasion. I wonder about the loss to society, through the adverse experiences that being in a youth holding faciciliy brings, and I ask: could a developed country not find a better way of dealing with youth who jump barriers?

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Pride Month Events @AmericanCulturalCentre, Windhoek

 

Now, I hereby invite you, dear reader, do join us for the LGBT events at the American Cultural Centre, Windhoek, for the LGBT community events and film festival:

Wednesday, June 20 – Live #PrideMonth Webchat @ 17:00

Featuring community leaders discussing way to encourage dialogue and promote #LGBTI inclusion. 

Speaker biographies (make no assumptions about their gender, except for Father O’Brien who is clearly a man since he is part of the Roman Catholic Church).

Father Kevin O’Brien, SJ is currently the dean of the Jesuit School of Theology at Santa Clara University.  He frequently gives talks around the country.  Prior to joining Santa Clara, O’Brien taught at Georgetown University’s Department of Theology.  There he also held the position of vice president of Mission and Ministry where he headed inter-faith campus ministry programs. He received “internet fame” for his take on the Merry Christmas v Happy Holidays controversy where he takes a very inclusive view.  He is a lawyer by training.

Sabrina Kent recently moved up to chief of staff at the National Gay and Lesbian Chamber of Commerce.  She works with leadership to advocate for economic empowerment of LGBT- owned businesses both within the U.S. and globally.  Kent also leads the organization’s internship program, mentoring youth.  Recent work includes participation on the Global Team with a focus on India.

Braden Schrag is a sergeant with the Las Vegas Metropolitan Police Department assigned to the Office of Community Engagement. This unit works in every religious and cultural community in Las Vegas and focuses on prevention, intervention, and outreach in all sectors with a focus on gangs, human trafficking, countering violent extremism, refugee integration and connection, and proactive jail programming.  His law enforcement experience includes supervision, instruction, intergovernmental services, homeland security, and program development.

Friday, June 22 – Movie & Discussion: “Pariah” @ 17:30

A Brooklyn teenager juggles conflicting identities and risks friendship, heartbreak, and family in a desperate search for sexual expression.

Friday, June 29 – Movie & Discussion: “Moonlight” @ 17:30

A chronicle of the childhood, adolescence and burgeoning adulthood of a young, African-American, gay man growing up in a rough neighborhood of Miami.

 

Should you have any questions, please don’t hesitate to contact me on writinghealth@gmail.com

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How do we address the HIV prevention needs of transgender women?

This is a live blog from the Global Fund Concept note writing process. I am wondering, when considering how to include transgender women (TG) in the proposal for funding. As we know, transgender women also comprise of adolescent trans girls and young trans women. In this vein, there is reason to cover them under the priority group known as adolescent girls and young women. Yet they are also a key population, and the Global Fund Modular Framework Handbook, they are part of key populations. Herein lies the rub – in which group to include them. And this is not a mere existential question. It has to do with access to funding, including access to the new catalytic funds for the priority population.

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Fantastic time

A party for the LGBT+ community is a rare occasion in Windhoek and tonight’s party, which is still kicking, was refreshing for me.

I am grateful to OutRight Namibia for Organising it. I look forward to the Church service tomorrow morning, at Holtel Pension Alexander at 10h00.

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Brief reflection on health seeking

Indeed, one of the healthcare workers I know came to see me. All I have is a strep throat and she told me which medications to get for that. I detected it early, which is great. Afterwards, she ended up chatting with another healthcare worker, who happened to be in the vicinity.

State health care may not be as bad as we believe it is. She said that in public health care facilities they have certain preparation of clorhexidine mouthwash that, according to her, is more effective than the brand name mouthwash from the pharmacy. Then she share about her own experience "My daughter was diagnosed with a specific condition [omitted here] at the state, after seeing many private doctors".
The problem, according to her, and the healthcare worker who saw me was the immense wastage of health care materials. Nurses, according to her, do not use the materials sparingly. In contrast, in the private sector everything is charged for, from the cotton swab needed to disinfect the skin, the needle for a drip and of course, the drip itself. For this reason, she commented that "in the private sector, you are sometimes scared to put on gloves to touch a patient’s blood".

They both concluded that healthcare workers appreciate the state a great deal, because use of products is not billed to the nurse, in the event a patient is not billed for it.
Yet they acknowledged that the health care services are overburdened: "imagine 90% of the population sees the state [health care facilities]".

Clearly, the state health care facilities are struggling both with patient volumes and prudent – rational – use of materials.

Pancho Mulongeni,MPH

University of Cape Town (2016)

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