Let’s Start Now: Social Innovation as a Slow, Deliberate Process

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About two weeks into my fellowship at FHI 360, I had the opportunity to participate in an event series on innovation from FHI’s Strategy and Innovation Office. The series was designed to engage external innovation practitioners to inspire discussion about innovation culture as FHI sets out to develop an innovation strategy. Kippy Joseph, Senior Advisor to the Global Innovation Fund, spoke extensively about managing innovation for development impact. As a global public health student pursuing the Certificate in Innovation for Public Good (CIPG) at UNC, I often ask myself how social innovation in global development is held accountable. While drug trials adhere to rigorous standards, social innovation for impact often relies on guesswork, hindering progress in advancing the public good. It is imperative that managing innovation for development impact becomes a constant pursuit of excellence in designing impactful systems worldwide, even if the process may be slow or deliberate. The cost of getting it wrong is simply too high.

Sometimes, the field of global health fails to redesign systems solely because one solution has worked temporarily (often for at least 30 years), even when it does not achieve maximum impact. The innovation space for certain diseases is limited or not challenged enough.

As an FHI 360-UNC Global Health Research Fellow this year, I have the privilege of supporting the Total Quality Leadership and Accountability (TQLA) team within the West Africa and Middle East Regional Office (WAMERO). TQLA, FHI’s innovative and adaptive management approach, has demonstrated its ability to drive performance, enhance implementers’ accountability at all levels, strategically prioritize local solutions using data, and ultimately address development challenges to improve outcomes. As a research fellow, I will be responsible for documenting TQLA’s impact over the years, starting with the evidence generated from its application to the Global Fund’s National Aligned HIV/AIDS Initiative (NAHI) in 13 states in Nigeria. The evidence we gather will be instrumental in developing technical guidance for strengthening local organizations’ capacity. It will be widely disseminated to catalyze policy dialogues centered around strengthening the leadership and capacity of individuals in Nigeria and other regions. Additionally, this evidence will contribute to creating technical tools to promote social innovation and learning, transparency, and accountability, and foster local leadership and ownership in health development assistance.

As an innovation strategy, TQLA is spearheading greater accountability within social innovation to reduce guesswork in our approach to global development challenges, including global health threats like HIV/AIDS. I would like to thank my preceptor, Dr. Robert Chiegil, for the opportunity to be part of this team and to experience the importance of accountability in social innovation and policy.

-Sena Kpodzro

My Practicum with Casa Alitas in Tucson, AZ

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Hello! My name is Quintin Van Dyk and I am an MPH student in the Global Health concentration at UNC Gillings. I grew up in Northern Arizona and completed my bachelor’s degree at Lewis & Clark College, where I studied biology. One of my main interests within public health is at the intersection between migration and health. This interest is in large part motivated by my upbringing in Arizona, where I saw firsthand how migrants in my community encountered barriers to accessing health services and experienced lower quality healthcare than the general population. As I continue studying public health at UNC, I hope to further develop my understanding of migrant health and the barriers facing migrant populations in our country.

A few weeks ago, I returned to my home state where I am currently completing my MPH practicum by working with Casa Alitas in Tucson, AZ. Casa Alitas is a humanitarian aid organization dedicated to supporting and providing shelter to migrants and asylum seekers. The organization has a network of shelters and hotel spaces in the Tucson area where people can come after they have been processed and released by U.S. Customs and Border Protection (CBP). Casa Alitas’ mission is to prevent street releases of asylum seekers by CBP, something that has been a huge problem in other U.S. border communities like El Paso, TX.

In the two-and-a-half weeks that I have spent here so far, I have already learned a lot. I have been splitting my time between an ongoing research project and working on the floor in the shelters to help provide the guests with food, clothing, and to assist them with their travel arrangements. I have met people from all around the world, including folks from Mauritania, India, Brazil, Colombia, Nicaragua, Guatemala, Mexico, Ecuador, Bangladesh, and many more countries. I have unfortunately heard many sad stories of family separation and violence that our guests have experienced during their arduous journeys through the Sonoran Desert. I have also learned more about the different global factors that force people to migrate, from climate change to political unrest and violence.

Last week, I was fortunate to have the opportunity to participate in a migrant health service-learning trip that was organized by the UNC School of Medicine. I joined a group of 12 people including medical students, public health students, medical residents, and a Family Medicine physician. Together, we volunteered at Casa Alitas on projects including creating art and decorations for the newest shelter, hanging clotheslines for the guests to dry their clothes, and creating a medication catalog for the medical staff. We also volunteered with other local humanitarian aid organizations including Tucson Samaritans, Green Valley Samaritans, and Humane Borders. With these organizations, we went on trips into the desert to see the border wall, check on water-drop tanks, pick up trash and left behind migrant belongings, and offer food and water to anyone that we encountered in the desert.

Seeing the border wall in person was an intense and impactful experience, not just because of its size but because of what it represents. The wall is about 30 feet tall and stretches across 190 miles of the Arizona-Mexico border. I was struck by the contrast between the beauty of the Sonoran Desert and the inelegance of the border wall built on top of it. The wall has created a lot of trash and discarded pieces of steel that lie cast into the sand on the American side. It is a manifestation of American immigration policies, which have evolved to make crossing the border increasingly difficult and dangerous for people across the globe, especially those coming from countries like Cuba, Venezuela, Nicaragua, and Haiti. The woman who led our trip to the border wall had a powerful quote that resonated with me, describing the wall as “a scar on the environment and a scar on us as people”.

Overall, I am really enjoying living in Tucson so far and am thankful for the opportunity to work with Casa Alitas. I have already become fond of the amazing Mexican food, endless hiking trails, and incredible sunsets that make southern Arizona famous. Moving forward, I will be spending more time working on a research project to better understand the impact of immigration policies like Title 42 on migrants and asylum seekers attempting to cross the border. Thank you for reading my blog!

– Quintin

The Fight for Healthcare Access for All: Disrupting Language Barriers

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Hello! My name is Emily, and I am an incoming second-year MPH student at UNC Gillings School of Global Public Health in the global health concentration. This summer, I am doing my practicum with a non-profit organization in Carrboro, NC called Refugee Community Partnership (RCP). RCP works with local refugee and migrant communities to connect people to the resources and social connections they need and eliminate barriers to access to these resources. I have learned a lot so far and am very excited to see what this summer will hold! There is one main idea that has been prominent in my mind since beginning my practicum: The power of community.

Emily Benson

The Power of Community

The main idea that is present in every task, project, and program in this organization is community. RCP does a phenomenal job working directly with the community and ensuring that they are working to address the community’s goals. They achieve this in many ways, but one of the most prominent ways is through one of their main community-led programs called Language Navigators. Through this program, RCP members are able to request a “language navigator” to go with them to medical appointments. These language navigators are community members who go with an RCP member to help navigate the medical appointment environment from the parking lot to check-in. During the appointment with the provider, medical offices that receive federal funding (such as hospitals and clinics that receive Medicare or Medicaid payments) are federally required to provide a medical interpreter. However, often, they do not. The language navigator is there to help the patient advocate for a medical interpreter and ensure the patient understands all of the doctor’s instructions. At the end of the appointment, the language navigator is there to help with coordinating lab work, scheduling follow-up appointments, and coordinating referrals.

RCP’s direct partnership with the community in this program is beyond inspiring to me. I have learned a lot about the importance of community partnership just by watching this program take place. Their language navigator program is truly making a huge change, one medical appointment and one person at a time!

The Community-Led Research Project

During my practicum, I have been mainly working with the RCP research team on a community-led research project. The main goal of the research project is to determine the full scale of language inaccess in medical settings and the main barriers to access to healthcare among refugee and immigrant communities. The primary focus is on how language inaccess among these communities affects their ability to access quality health care.

This research project primarily aims to assess language access for six languages: Arabic, Karen, Burmese, Pashto, Dari, and Spanish. Our team is working to collect and analyze both quantitative and qualitative data to determine the availability, quality, and type of interpretation provided at medical appointments through surveys, community forums, and in-depth interviews.

Egg rolls that one of the RCP members made

Several weeks ago, the research team held a community forum for women in the Arabic-speaking community to discuss access to healthcare and language inaccess among this community. The other MPH intern and I created visual images of the main themes from this forum for the team to bring back to the women in the Arabic-speaking community to ensure that the themes the research team observed are the main problems and concerns they are actually facing. (Again, RCP does such an amazing job partnering with the community!) Along with this,  I have also been helping with the coding and analysis of the qualitative data for the research project. It has been extremely exciting and fulfilling to be able to put some of the things I’ve learned in my MPH classes into practice these past two weeks, and I am excited to continue working on this research project for the rest of the summer!

Working with RCP on this research project has been a very eye-opening experience for me. It has allowed me to see the depth and impacts of language inaccess among refugee and migrant communities in healthcare settings. While I have only been working with RCP for about two weeks, I feel as if I have experienced a whole new world within the community of Chapel Hill.

I’m extremely thankful to be able to intern at such an amazing organization with incredible people! I’m very excited to see how I will grow this summer and further discover the power of communities in creating change in the medical system. I cannot wait to see what the rest of my time at RCP will hold!

– Emily