Written by guest author Kathryn Kaplan who is a graduate student at Tulane School of Public Health and Tropical Medicine.

Over winter break I spent 10 days in Haiti for the first time since I left in late 2009, before the earthquake, Hurricane Tomas and the cholera epidemic ravaged the country.  From 2007-2009, I worked in Jeremie, Haiti the capitol of the Grand Anse department in the Southwest of the country as a program coordinator for an adolescent girls wellness program within a larger MCH community-based program.  While I desperately wanted to return to Haiti pretty much since the day I left, especially in the midst of all the turmoil that 2010 brought, it took to just this December for me to finally be able to go back and visit the friends, coworkers, and the country that I so missed.  It was emotional to say the least arriving in Port-au-Prince, seeing the rubble, the instability, and feeling the general despair of the population. 

            I stayed for the first few days with my friend Jude-Marie who lives in one of the “tent cities” close to the National Palace, which is now split in two.  Staying in Jude’s makeshift neighborhood was such a paradox in many ways.  On the one hand, I saw how terrible the living conditions are and how frustrated and angry the people who live there are.  There is no available clean water.  There is a pump with a sign that said “clean water”, but Jude told me that although people from the ministry had come to take pictures of it to show the “great” conditions of the tents cities, it has never really had clean water, and now there is no water at all.  There is no sanitary (or even unsanitary) place to defecate.  While there are two port-o-potties outside of the encampment Jude told me they have been unusable for quite some time.  Cholera is a huge fear for everyone and a main topic of conversation. 

            The day I left there was a huge commotion in the front of the camp.   I found out that an NGO was distributing new tents, but only for the lucky individuals that lived in the front of the encampment – just in time for a press conference with members of the international community showing the high quality tents in which people are living in the encampment.  Meanwhile, my friends in the back are living in tents with holes in the top that let in the rain at night and provides no safety or security for anyone’s possessions or for their own bodies.  In late December a Human Rights Watch report (http://www.hrw.org/en/news/2010/12/17/sexual-violence-haiti-s-camps) pointed to the high numbers of rapes and sexual assaults occurring in the tent cities- I’m sure the true numbers will never be known.

            At the same time, despite the fact that many of the people living in such close quarters had not known each other before the earthquake, there is also such a strong sense of community.  I only had the experience of spending time with one friend in one tent city so I certainly can’t generalize but at least where I was I can say that this sense of community had everything to do with the strong women who cooked for not just their families, but anyone who couldn’t find food that day; the women who made sure that their tents with holes in the roof, with no doors, with rats and roaches, was as clean and tidy as possible and resembled a real home for their families; the women who despite being hungry, tired, stressed and sad themselves sang, told jokes, told stories and welcomed an unknown American to sit and eat with them and become part of their family even just for a few days.  My guess is that these women that I met are the norm and not the exception.

            I left Port-au-Prince to go south to Jeremie with a heavy heart thinking of the hopelessness that many of the people I spoke with in Port expressed to me, and myself too feeling slightly hopeless.  I took the bus from Port-au-Prince to Jeremie, which was overcrowded, terrifying at times (imagine speeding down one-lane rocky roads on cliffs with no guardrails- terrifying!), and took 14 hours.  Fittingly the name painted on front of the colorful bus is Dieu décide- God decides.  While I’m not a particularly religious person I did feel like my life was in God’s hands for most of those 14 hours!  Although I had considered (and attempted) a few other modes of transportation to reach Jeremie, I feel like I was almost fated to ride the bus because it gave me the chance to meet Tamarie.  Tamarie is 12 and was on her way to Jeremie with her cousin after spending the holiday in Port-au-Prince with family.  Not only did Tamarie share her package of cookies with me, update me on the synopsis of every Haitian movie that I had not seen yet, and pretty much entertained me with stories the whole trip, in that one day she restored all my hope in future of the country that Port-au-Prince had taken away. 

 As we were driving through the majestic mountains, I looked out the window and remarked to Tamarie, “Your country is just so beautiful!”  Tamarie looked out the window too and reflected for a moment before turning to me and saying, “It’s true.  It is a beautiful country but it really lacks evolution”.   She then went on to explain to me her plan to open a research library so that people can read and research what programs and policies have worked in other countries and apply it to Haiti so the country can progress.  Needless to say, I was shocked to hear this coming from a little girl.  She was so determined, so sure of herself and so committed to improving her country. 

            I then thought back on the women in the tent cities who I had spent time with and saw in them too that same determination in Tamarie.  Maybe they didn’t have the same ideas and intricate plan as Tamarie to improve their country, but their strength each day to care for their families and the people around them is slowly improving their country by providing a future for their children, who like Tamarie, will go on to make a difference.

            I didn’t see Tamarie again after I got off the bus, but I hope that one day in the future I will meet her again.  She will be running her research center and advising her country on how to advance and progress.  I will be proud to have said that I sat next to her for those 14 hours and was able to see the future of the country in her hands and in the hands of the many young women and girls like Tamarie who have the strength and determination to fight for their rights, the rights of their children and their families to create a better tomorrow.


One of the hardest things to understand about the obesity problem in our country is how poverty and obesity go hand in hand.  We often imagine that being overweight or obese is simply a result of eating too much.  So, what does it mean when the segments of the population who have the highest rates of obesity (and the related health problems) also tend to be the poorest?

It means that it’s not just a problem of how much we eat, but also of what we eat. We think of obesity as being a “lifestyle” problem, reflecting people’s choices about what to eat and how much exercise to get.  It’s more than that, though. It’s also a problem with the physical environment people live in. In neighborhoods with no grocery stores, fast food chains seem to be on every other corner.  Although they are easy to access, these foods are full of fat and salt, and it’s almost impossible to meet the recommendation of five servings of fruits and vegetables at them.

vegetablesSo here’s the old solution: growing your own vegetables, right there in your neighborhood. I’m sure you can think of lots of reasons not to give gardening a try, but it might be a bit easier than you think.  The biggest obstacle, of course, is space.  I’ve got two solutions for that one: community gardens and container gardens.

Currently there are 31 active community gardens in New Orleans.  Neighbors in these communities are taking back some of the 66,000 vacant lots left after Katrina to grow their own vegetables and herbs. It only takes a handful of neighbors and a willingness to get your hands dirty to start one.  It’s a great way to bring the community together and  to keep kids active and interested in nutrition. Here in New Orleans, Parkways Partners and The New Orleans Food and Farm Network both provide great information, training and resources (even seeds!) to help get your community garden started.

You can also start a garden in a small space, even if it’s all pavement.Various kinds of containers, from plastic kiddie pools to large sacks can be used to make gardens.  When I lived overseas, we taught families without land to make “sack gardens” that don’t take up more than about a square yard of space on the ground.  There’s a great description and pictures from a sack garden project in Rwanda here. I also found a great article on Urban Agriculture that gives all the how-to’s of container gardening.  Check it out here.

If your new year’s resolution had to do with eating more vegetables, maybe it’s time to think about growing your own!

Written by guest author, Elisabeth Bradner, Student Intern Tulane Breastfeeding Program

For years, multiple medical organizations have sung this mantra: exclusively breastfeeding your infant for 6 months is best. However, recently the University of London’s Childhood Nutrition Research Centre released a different suggestion: exclusively breastfeeding past 4 months is harmful to your baby’s health. The media grabbed on and with a plethora of sensational headlines, there was an uproar from the breastfeeding community. Breastfeeding mothers, who want the best for their baby, are confused; health care professionals aren’t sure what to tell mothers.

To break it down, no professional medical organization has changed their recommendation. Even the authors of the controversial article do not call for an immediate change in recommendation. They simply suggest we review the 6 month recommendation, and in the end, isn’t that what we want from our scientists? To continually challenge and review the status quo?

It is interesting to note that 3 of the 4 authors have received funds from baby food companies, perhaps biasing their research?  In addition, Unicef points out the foods usually used when weaning would not solve the problems the authors claim are created by exclusively breastfeeding past 4 months (higher risk of iron deficiency anemia, higher incidence of food allergies, higher risk of celiac disease). It is also important to mention that very few babies are breastfed exclusively for 6 months. When the recommendation that infants breastfeed exclusively for 6 months originally came out, it drastically reduced the number of infants receiving complementary food before 4 months (which is especially not recommended).

Even the authors of the study agree, breastfeeding your baby is the best, preferred, and natural way to ensure your infant is fed nutritiously and many studies show that at 6 months breastfeeding continues to be the perfect nourishment. If you succeed in exclusively breastfeeding your baby for 6 months, you deserve congratulations, not any feelings of guilt. In the end, you, your family, and your health care provider must make the best decision for you and your baby. Most important is that you make the best decision you can, work hard to reach your goal and enjoy life with your new family.

How do you sort through all the information to formulate your decisions? Does this new study change your ideas about how long you should to breastfeed? How long do you want to breastfeed your baby?

Surgeon General Dr. Regina Benjamin

A great stride forward in the support for breastfeeding occurred yesterday with U.S. Surgeon General, Dr. Regina Benjamin’s Call to Action to Support Breastfeeding.  The Call to Action indicates that women are not receiving the support they need to succeed with breastfeeding (which is certainly the case here in Louisiana!).  It calls for America to support the removal of barriers to breastfeeding in all the various environmental settings, from hospitals to workplaces to homes.

Specifically, the Surgeon General calls on health care providers, employers, insurers, policymakers, researchers, and the community at large to take 20 concrete action steps to support mothers in reaching this personal breastfeeding goals.  I am very excited that 4 of these steps are actions surrounding employment.

The 2nd of these employment action steps is exactly what we’ve been working on with the NOLA Breastfeeding Support Program – to “ensure that employers establish and maintain comprehensive, high-quality lactation support programs for their employees.”  It’s wonderful to have not only the support of the law behind this initiative, but now the support of the Surgeon General as well.

The Louisiana Department of Health and Hospitals sent out a press release yesterday, in conjunction with the Call to Action, that talks about the state of breastfeeding in Louisiana and the initiatives that are currently underway to improve breastfeeding rates and support.  The press release highlights the Nurse Family Partnership, the Guided Infant Feeding Techniques program, and Louisiana WIC (Women, Infants, and Children Program), which are all succeeding in helping moms beat the “booby traps” of breastfeeding.  Hopefully we will continue to see positive change in the support breastfeeding moms receive in our state!

You can see the Call to Action and the webcast of the launch event here.

Market Watch just published an article,  Family-friendly policies? In the U.S., not so much by Ruth Mantell that,  in the wake of  an attempted repeal of the health-care reform law by a newly Republican-lead House of Representatives, broadly reviews U.S. policy impacts on our country’s “family friendliness”  (i.e. breastfeeding laws, maternity leave, etc).    In short, new breastfeeding laws mandate that employers provide time and space for breastfeeding mothers to pump breastmilk.  In terms of family friendliness, this is a small step in the right direction; however, we have yet to establish federal laws that mandate paid maternity leave or family leave.  Such laws or lack thereof disproportionately effect women as we often take on a greater domestic roles  in comparison to men.

Policies such as these weigh heavily on the “gender wage gap”.  An article entitled, The Anti-Mommy Bias by Nancy Folbre, a professor of economics at the University of Massachusetts Amherst, states that, “…family responsibilities still weigh more heavily on women than on men, accounting for much of the pay gap between the sexes“.  She illustrates this point by telling the following story:

In a telling episode last December, Gov. Ed Rendell of Pennsylvania praised the appointment of Gov. Janet Napolitano of Arizona as secretary of Homeland Security, “because for that job you have to have no life. Janet has no family. Perfect. She can devote, literally, 19-20 hours a day to it.” Governor Rendell did not realize his microphone was on. He later explained that he has no life either.

Gov. Wendell is not alone in his thinking and this type of  thinking presents a conflict.  How can we overcome gender wage gaps if our policies are outdated and employers still favor those who can work around the clock?  Women, how will we balance the demands of career ambitions/employment and family? If evidence shows that women carry a greater burden of domestic responsibilities, why do U.S. policy makers not inact policies that are more woman and family friendly?  Under our current system, what sacrifices are women FORCED to make in order to support our families? 

 Let’s dialogue about this…comments?

If Hurricane Katrina and its rebuilding aftermath taught me anything, it’s that city change is possible if there are organized and dedicated people who want to help change the things that are not working!  One of my ideals (though I admit that I’ve been very lax in acting on it) is that I want to be a part of making good changes in my neighborhood, including creating a more healthy environment.  I’m not sure what that “healthy environment” will look like, however, until I get involved and learn what the people in my neighborhood need.  One thing I do realize is that I can’t help to bring about good changes if I don’t participate in community meetings.

So my new years’ resolution this year is to become more involved in my community by going to neighborhood meetings and events.  Specifically, my goal is to attend at least 1 meeting or event per month.  After making this decision, the first question I had to consider was, “What do I consider my neighborhood to be?”  Since I live near S. Claiborne and S. Carrollton, I decided that my immediate neighborhood was the Fontainebleau area.  So it was absolutely perfect that when I got home yesterday, I had received an e-mail announcing the Fontainebleau Improvement Association’s (FIA) annual meeting on January 18th.  I now know what I’m doing for January.

When I investigated it a little more, however, I realized that the FIA does not have an event or meeting every month.  I am therefore expanding my neighborhood boundaries to include all of uptown, mid-city, and downtown (where I work).  Every month, I will pick a meeting or event that seems pertinent to my life that takes place in one of these New Orleans areas.  By the end of 2011, I would not only like to know my community better, but I want to help my community create needed change.

Your Point of View

My New Year’s resolution is to not make one.  To me, a resolution is a serious strong commitment of firmness and resolve for which I will put other things on the sideline; whereas a goal is something I’ll do my best to achieve as I follow the rhythms of each day. My goal this year, as it has been in the past, is to gradually get healthier by eating out less and moving around more. 

My goals are broken down into short term periods of time, a week or month, rather than a year at a time.  This seems to work best for me.  Each period of time I will have accomplished something.  Should something side track me during the year at least I’ll have these earlier accomplishments.  So I will continue to make small personal life corrections all year long and celebrate at year’s end instead of worrying about what isn’t perfect.

My method will be to follow the spiritual rhythm of the day, which is basically getting in tune with nature, spirit, and the universe.  If I do, all other good things will naturally follow.  I’ll remind myself to live in the moment and to see a challenge as an opportunity for good.

I’ll continue to greet people with love and compassion and be a good listener.  I believe it helps me and those who come into my life each day.  I sincerely hope that you all find peace and happiness in the New Year.