Thanks I2CRP & VCU News

Adrian Diaz, Braveen Raghunathan, and I have more in common than our internship with the WHO this past summer. The three of us are also part of the International, Inner City, Rural Preceptorship Honors Program community at the Medical College of Virginia / Virginia Commonwealth University School of Medicine.

Check out this VCU News story: Student Trio Interns with WHO.

Special thanks to Erin Lucero at the VCU SOM's Office of Development for writing and sharing this story, the Harvard Kennedy School Women and Public Policy Program Women's Leadership Board Summer Fellowship Program for making this experience possible for me, the WHO Emergency and Essential Surgical Care Program & Dr. Meena Cherian for having me as an intern, and I2CRP leaders Dr. Steve Crossman and Dr. Mark Ryan for all their support and mentorship!

Photo Courtesy of Braveen Raghunathan

WHO Intern Day 2013

It's my last week at the WHO, and I was very lucky to be here for this year's WHO Intern Day celebration! 

Set up in the main forum/hall in the center of the WHO headquarters, some of the 250-300 interns at the WHO set up tables with food and drink tasting and music from around the world. Interns showcased steps to international beats, including Nigerian Etighi, Ghananian Azonto, various Latin, Greek, and Turkish dances, Indian Bollywood, American Hip Hop, and of course, my favorite, Punjabi Bhangra.

 

My fellow WHO Emergency and Essential Surgical Care Program interns, Jimmy, Akshay, and I even convinced our lovely program director, Dr. Cherian, to dance bhangra and bollywood-style with us. 

This year, Intern Day kicked off a major fundraising event for scholarships/stipends to help subsidize expenses specifically for WHO interns from developing countries and underprivileged backgrounds. This is particularly important because all UN/WHO internships remain unpaid, making it significantly unlikely and difficult for students from non-American/Canadian/European nations or students without access to school/family/self/other -sponsorship to participate in valuable WHO intern experiences. Their voices are missing, and particularly given the nature of WHO's work, it's incredibly important to have them here. This year's Intern Day festivities raised $(-will update soon-) for scholarships.

HKSers in Geneva

It was a privilege to visit HKS classmates Dan (MCMPA'12) and Edo (MPA'14) with Subhash (MPP'14) at the World Economic Forum headquarters for lunch and a tour this week.









Earlier this week, Edo, Subhash, Barbara (MPAID'14), and I also enjoyed a dinner and stroll along Lake Geneva.

Weekend Trips -- A Series of Touristy Posts: Part 5

Paris, France

I traveled to Paris with a group of Australian law students studying in Geneva and also met up with HKS '13 classmate and friend from France, Emmanuel. 

Our group stayed in Montmartre, close to the Basilica of the Sacré Coeur (Sacred Heart), a Parisian Roman Catholic church crowning the butte Montmartre, the highest point in Paris. 









One of my favorite places visited in Paris was the Luxembourg Garden, which is in front of the French Senate palace. 

  

  

I enjoyed the fountains in the courtyard of the Louvre, as well as a fun carnival ride in the Tuileries Garden. 

 

Our group had fun biking through Paris to visit Notre Dame.

I also enjoyed seeing paintings by Monet, van Gogh, and many sculptures at the Musée d'Orsay.

And of course, it was wonderful to visit and climb the Eiffel Tower at night.

  

Weekend Trips -- A Series of Touristy Posts: Part 4

Lyon, France 

A group of interns from WHO, UN, CERN, and I traveled to France to visit the third largest city in the country, Lyon. 

Here are photos that capture just a few of the sights we saw during our time there.

Fourviere Basilica 

Roman Ruins

Lyon is known for excellent food. The best meal I had in the city was at Le Jardin Interieur. As each of our desserts featured different expressions, Wisdom was pretty much all that was left on my cherry pie plate. The food at Le Jardin Interieur was absolutely delicious, and the staff were particularly warm and friendly. The meal was certainly one of the highlights of our time in Lyon.

What do women that are victims of violence need most right now?

If you have a moment, please check out my blog post on KevinMD. 

This post provides a more concise explanation of a neglected issue that requires policy and provider attention when addressing pandemic levels of death and disability due to violence against women. I wrote it because vulnerable women experiencing violence in resource-poor settings face the greatest barriers to accessing life-saving emergency and essential surgical care. 

Special thanks to Dr. Kevin Pho and KevinMD for posting this: Violence against women: save her life and treat her injuries first. 

A tour of the Palais de Nations

After over a month of interning, my fellow interns--James Murphy (a MPH/MD student in his first year at Yale/Mt. Sinai), Farooq Khan (an emergency medicine resident in his final year at McGill)--and I took an afternoon away from the WHO Emergency and Essential Surgical Care office for a guided tour of the Palais des Nations.

The United Nations Office of Geneva (UNOG) receives about 100,000 visitors each year. Though I had traversed some of the Palais halls and meetings rooms during the 66th World Health Assembly, the UNOG guided tour included more historical context to appreciate the views.

The Palais is a beautiful art deco building in Ariana Park and overlooking Lake Geneva. Nearly one kilometer long, the Palais is a legacy of the League of Nations, the world's first global organization created to keep the world safe and at peace after WWI. Though the League failed when it was unsuccessful in countering forces that led to WWII, the United Nations succeeded it when founded in 1945 in Geneva, as a tribute to the city of peace's humanitarian history. While the meeting rooms of the Palais des Nations can seat a total of more than 8,500 people, it is also a "living museum" and home to art donated by Member States, foundations, and individuals as expressions of solidarity for improving international peace.

Source

The guided tour included the Salle des Pas Perdus (the Hall of Lost Steps), allowing for attention to the artworks that were more hidden by WHO stands/booths during the WHA. We also revisited the biggest room in the Palais, the Assembly Hall, where WHA plenary sessions were held.

The guided tour also offered some new views. Particularly breathtaking was the Human Rights and Alliance of Civilizations Room, with its domed ceiling sculpture by artist Miquel Barcelo.

I also particularly enjoyed the tour of Ariana Park, the 46-hectare park home to various species of majestic trees, and its memorable Monuments.

The iconic Celestial Sphere was donated in 1939 by the Woodrow Wilson foundation to commemorate the US President's work in creating the League of Nations.

The sphere originally featured 85 gilded constellations and 840 silvered stars and was equipped with a motor to revolve slowly around an axis turned to the Pole Star, though the motor no longer works and needs restoration.












Family by Winston Churchill's granddaughter, Edwina Sandys, was a gift from Anthony and Penny Oppenheimers to UNICEF.

The 4.6-meter high bronze sculpture uses the space between the mother and the father to depict the child.













The red brick Tower of Loneliness was a gift by the Danish artist Per Kirkeby. Standing inside the tower, one is said to experience the alternating contrasts of opening and closing, presence and absence, and light and shade.

Given to the UN for the Dialogues of Peace exhibition, Kirkeby described the themes of the tower as "an eye raised to the sky and a tear which flows." 

The Conquest of Space by Youri Neroda is a gift from the former Soviet Union and dedicated to human success in space conquest.

The two-part monument represents the projection of a spacecraft with a 28-meter tall arrow-shaped plinth, as well as a bronze statue of an astronaut with arms reaching toward the sky, symbolizing human desire for space exploration.














But of all the monuments, the Great Centaur was my absolute favorite.

The Great Centaur by Ernst Neizvestny, a gift from the Russian Federation, is a 4.5-meter high bronze sculpture.

The artist, at the inauguration of his sculpture, said, "Man must struggle to become himself."

The Great Centaur is a wounded giant--rising from a base, representing death, destruction, and chaos, and reaching upward, with his face bare, unmasked.

If you are interested in learning more, I would suggest checking out the UNOG Virtual Tour.

Save her life and treat her injuries first

According to a report on responding to violence against women released this week by the WHO Department of Reproductive Health and Research and partners[1], more than a third of women experience sexual or physical violence around the world. 

Source

At such pandemic proportions, violence against women is a serious global health threat and public policy problem. 

Violence increases women's vulnerability to many social and health problems, including depression, alcohol use disorders, unsafe abortions, pregnancy related complications, and STIs, including HIV. 

Importantly, intimate partner violence against women is a significant cause of death and injury. Particularly in resource-poor settings and low- and middle- income countries (LMICs), many factors work against women and lead to staggering rates of death, injury, and disability from violence. 

The WHO report offers detailed recommendations for health providers on what to do after a woman that has experienced violence presents to them at their clinic. 

The report's Figure 2 summarizes these recommendations, beginning by asking the health provider to assess whether the woman is presenting with injuries that require urgent treatment. If her injuries do, indeed, require urgent treatment, the report recommends the health provider's next step, which is simply: Treat injuries.

Source.

That's it. 

The WHO report just stops there. It seems to assume that women in resource-poor, often remote, settings in LMICs actually have access to trained health providers and health facilities with the capacity to treat their injuries. This is seriously problematic. 

A recent review on the "Care of the Injured Worldwide" by Sakran et al explains the realities on the ground: 

• Surgical disease, which includes traumatic injury, is among the top causes of death and disability worldwide. 
• Traumatic injury is the leading cause of death under the age of 45 in the US and worldwide.
• These traumatic injuries account for 10% of the world's deaths, more than the number of deaths from malaria, tuberculosis, and HIV/AIDS combined. 

What's most disturbing is the stark disparity in access to care for the poor -- 90% of injury deaths occur in LMICs. 

The world's poorest people, and among them, marginalized women, particularly those vulnerable women that are victims of violence, face the greatest barriers to accessing life-saving emergency and essential surgical care. 

According to Sakran et al and others, the reasons why this is the case boils down to a lack of effective political advocacy and insufficient investment in training frontline health providers and building infrastructure and capacity in primary health facilities, perhaps due to erroneous perceptions that providing emergency and essential surgical interventions are too expensive or complex by population-based measures, even though the World Bank and others have determined promoting surgery to be a cost-effective, life-saving treasure in low-income countries. 

The WHO's clinical and policy guidelines report responding to violence against women has gotten tremendous attention by mass media, health providers, and policymakers around the globe. People are feeling the urgency of addressing violence against women, as they should. 

It is just unfortunate that the WHO report neglected to offer guidelines on how health providers and policymakers in low-resource settings should actually go about treating and saving women from pandemic-levels of death and disability from violence. 

In order to protect women and prevent such astounding morbidity and mortality, clinical and policy guidelines to respond to violence against women can not just focus on prevention, mental health services, and STI management. All of these are important, of course, but equipping frontline health providers with the training and tools to detect and best treat women that experienced injuries from violence is also a critical component, particularly necessary to care for women that are becoming victims at this very minute. 

Just as treating patients with AIDS is as important as preventing the transmission of HIV, treating the acute needs of women that are victims of violence is as important as preventing violence against women. 

If 42% of women experience injuries as a result of physical or sexual violence at the hands of a partner, and 38% of all murders of women globally are reported as being committed by their intimate partners, should WHO not recommend equipping health facilities that are most accessible to women at risk with the skilled health providers, emergency equipment, and capacities necessary to save their lives? To care for their wounds, burns, life-threatening injuries? To prevent and reduce disability? 

Violence against women in many parts of the world often goes unrecognized, underreported, and neglected, particularly in low-resource settings that do not have adequate emergency and essential care capacities at primary or first-referral health centers to care for women experiencing violence, or anyone else, for that matter. Women that experience violence in these settings may not turn to law enforcement or other domestic violence-specific services or centers, whether they are near or far. 

Since victims are most likely to interact with the health system for acute health needs, health providers are in the unique position to identify abuse and intervene before serious injury or death occurs. The WHO report recommendations also acknowledge that "as much as possible should be done during first contact, in case the woman does not return. Follow-up support, care, and the negotiation of safe and accessible means for follow-up consultation should be offered." Frontline health providers, like those in the emergency room or ones at primary or first-referral health facilities in LMICs, are an important contact with the victims of domestic violence, and timely identification and intervention can save lives. 

The WHO report notes: "Ideally, women experiencing partner violence should be identified at the point of contact with health services, although these settings are not always conducive to providing such services." Perhaps it is true that these health settings are not "conducive to providing such services" right now, but it's imperative for the WHO and partners to support health ministries in building health systems that are suited to address violence against women and other emergency and primary care health issues. 

Where is the WHO recommendation to build the capacity for emergency and essential trauma, surgical, obstetric, and anesthesia/resuscitation services for these women in primary, first-referral health centers? 

Women must be able to access care and services at their most physically-accessible, first-referral health centers, where they are most likely to show up with acute needs after experiencing violence. This is why, in low-resource settings, first-referral health facilities are considered the optimal starting point for effective management of injury. These emergency or primary health centers are also more easily able to integrate care and provisions for women experiencing violence into their routine patient care and clinic services. 

If the evidence shows that it's best to integrate emergency and essential surgical care, first-line and continued supports, emergency contraception, and STI laboratory and treatment services into primary, first-referral health facilities to address violence against women, where is the WHO recommendation urging the integration of these comprehensive services into LMICs' national health plans? 

By neglecting to recommend or even note the importance of ensuring women's access to emergency and essential trauma and surgical care at first-referral health centers, the WHO missed a major opportunity to have a significant impact on policymakers interested in improving the care and lives of mothers, wives, daughters, sisters, and everyone related to them, particularly in ways that fit into their ongoing efforts to strengthen their  national health plans and systems. 

At the 66th World Health Assembly last month, I attended a panel with health ministers and representatives from Belgium, India, Mexico, Zambia, the USA, and the Netherlands on Addressing Violence Against Women. As mentioned in a previous post, each panelist briefly shared general progress and interest in addressing violence against women in their respective countries. Health ministry leaders' commitment to address violence against women is particularly important for building the momentum for real change on the ground. 

Efforts to comprehensively address violence against women must be integrated into national health plans and social policies across sectors. Building the infrastructure (such as laboratory services and essential equipment/medicines supply chain) and capacity (such as training frontline providers to manage injuries, burns, and resuscitation) to deliver accessible acute care and support services to women that have experienced violence requires political leadership and financial investment. Delivering appropriate emergency services to survivors of violence at first-referral health facilities in resource-poor areas should be an integral component of a national health ministry's health systems strengthening agenda and budget. Strengthening emergency care systems and capabilities for local health facilities to serve women that are victims of violence requires political commitment from all levels.

Perhaps it is not politically correct for me to say this, but I write from my humble intern's perspective -- I am deeply disappointed that there is not more collaboration and communication among the many WHO programs/departments/units. I'm not sure what it will take, but this report brings light to one of the most important issues of our time, one that is particularly personally important to me. It is just unfortunate because the program with which I'm interning within the WHO, the Emergency and Essential Surgical Care (EESC) Program, would have easily been able to help support and fill major gaps in the report's clinical and policy recommendations.[2]  

The Director General of the WHO, Dr. Margaret Chan, said in a recent statement, "We see that the world's health systems can and must do more for women who experience violence." Indeed, it is time we all do more to support health systems in caring for women. 



---

[1] "About the report: The report was developed by WHO, the London School of Hygiene & Tropical Medicine and the South African Medical Research Council. It is the first systematic review and synthesis of the body of scientific data on the prevalence of two forms of violence against women – violence by an intimate partner and sexual violence by someone other than an intimate partner. It shows for the first time, aggregated global and regional prevalence estimates of these two forms of violence, generated using population data from all over the world that have been compiled in a systematic way. The report documents the effects of violence on women’s physical, mental, sexual and reproductive health. This was based on systematic reviews looking at data on the association between the different forms of violence considered and specific health outcomes." Source.

[2] The WHO EESC Program works directly with ministries of health in LMICs and other partners to advocate for leaders' commitment to a cross-cutting approach rooted in national health planning. The program focuses on integration of emergency medicine and essential surgical care, which includes caring for victims of domestic violence, into first-referral level, primary health care facilities, and the WHO EESC Program's Integrated Management for EESC toolkit includes the Emergency Trauma Care workshop and other useful tools for health providers and policymakers. Reducing death and disability from domestic violence is also a priority for WHO GIEESC members. If you are interested in partnering and collaborating to achieve quality, safe emergency and surgical care for people living in low-resource settings, I'd encourage you to consider joining the WHO GIEESC community today. Also, the 5th Biennial Meeting for the WHO GIEESC will take place on October 14-15, 2013 in Trinidad and Tobago. Registration is free of charge. 

Work over the last couple weeks

Over the last couple weeks, we have been busy with a number of projects at the WHO Emergency and Essential Surgical Care (EESC) Program. 

Most recently, I've been working on putting together a couple proposals, like one on training frontline health workers in emergency obstetric surgical care in Bihar, and another one on developing innovative EESC-eLearning tools to equip more trainees with these essential skills in low-resource settings.

We have also been preparing for my supervisor, Dr. Meena Cherian's upcoming Duty Travels. Dr. Cherian, directs the WHO EESC Program, for which she often travels to partner directly with Ministry of Health officials in low- and middle- income countries (LMICs) and work on national policies and programs to build health system capacity and deliver quality, integrated EESC.

Why is this work important? 

Source: http://www.who.int/surgery/en/

Integrating emergency and  surgical care initiatives in low-resource settings is a critical and growing need to address pregnancy-related complications and injuries from road accidents, burns, and falls particularly among the aging population, which significantly contribute to death and disability. Health systems in LMICs are further strained during disasters, when communities’ acute needs add to the existing burden of obstetric and other surgical conditions. Surgically-treatable blindness, diabetes-related wound care and amputations, tropical diseases like Buruli ulcer and filariasis, and female genital mutilation also require safe surgical care.

This week, Dr. Cherian will be in Ghana with Ministry of Health officials, facilitating the WHO Emergency Trauma Care (ETC) Training of Trainers' workshop for government health providers and managers from across the country. The Emergency Trauma Care workshop is one of several important teaching tools in the WHO Integrated Management for Emergency and Essential Surgical Care (IMEESC) toolkit. 

Experts among the WHO Global Initiative for Emergency and Essential Surgical Care (GIEESC) membership have developed and reviewed the content of WHO IMEESC toolkit, which includes guidance on policy, management, research for evidence based planning (WHO EESC Situation Analysis Tool and WHO EESC Global Database), training (including instructional videos), and monitoring and evaluation in low-resource settings. Access to clinical safety protocols to protect health workers and patients from HIV and infections, functional equipment, and medicines are also vital to improving emergency surgical, obstetric, trauma, and anaesthesia service delivery. The WHO IMEESC toolkit also includes essential equipment and anesthesia supply inventory lists, quality and safety tools, and best practices and standards to support emergency and essential surgical and anesthetic interventions and management at first-referral level health-care facilities in low-resource settings. 

Preparations for the 5th Biennial Meeting for the WHO GIEESC, which will take place on October 14-15, 2013 in Trinidad and Tobago, are also in full swing here at the WHO Head Quarters. 

Making emergency and essential surgical care a political priority within primary health care and universal health coverage in LMICs requires organizing multi-disciplinary stakeholders including policymakers, health providers, and media towards investment in research and sustainable EESC services. 

Here's an excellent Global Pulse article that explains more about the WHO GIEESC, which was established in 2005 to facilitate collaborations and partnerships with health ministries, academia, NGOs, professional societies, and local and international experts to support surgical care systems in LMICs.

The WHO GIEESC Biennial Meeting brings together a global forum of stakeholders for improving basic surgical and emergency care and systems in low- and middle-income countries. This year, the WHO GIEESC Biennial Meeting will precede the World Congress of Surgery, Obstetrics, Trauma, and Anesthesia.

Dr. Cherian's Duty Travel to Ghana will also involve discussions with Ministry of Health officials on health systems strengthening and planning for comprehensive EESC. 

Integrating surgical care initiatives in national health plans in LMICs requires both public and political commitment. The WHO EESC Program and its Global Initiative for EESC works with partners on efforts to build and achieve those commitments.

If you are interested in partnering and collaborating to achieve quality, safe emergency and surgical care for people living in low-resource settings, I'd encourage you to consider joining the WHO GIEESC community today. 

Weekend Trips -- A Series of Touristy Posts: Part 3

Chamonix -- Mont Blanc

On June 15, a group of my favorite fellow interns from WHO/UN and I traveled to France to visit the beautiful town of Chamonix and Mont Blanc, the highest mountain in the European Union.

Here are some photos that capture the specialness of this place and our time there.

All of these awesome photos are courtesy of Chenxi Yu.

Chamonix is truly one of the most beautiful places I have ever visited. The day is going down as my favorite touristy adventure while interning at the WHO, to date.

Weekend Trips -- A Series of Touristy Posts: Part 2

Cailler Chocolate Factory - Charmey - Kandersteg - Oeschinen Lake - Thun

On the weekend of June 1-2, a few interns, including Braveen Ragunanthan and Adrian Diaz, who are also fellow medical students at Virginia Commonwealth University School of Medicine (Medical College of Virginia), and I were lucky to join a bus full of friendly WHO officers and staff for their HOPE Team Trip to Kandersteg.

Our first stop along the way was my favorite: the Cailler Chocolate Factory.

Photo Courtesy of Braveen Ragunanthan

After tasting the delicious chocolates, we stopped in the scenic town of Charmey. We then arrived in Kandersteg, and stayed at Kandersteg International Scout Centre (KISC).

After dinner at KISC, a group of us joined the rest of the Kandersteg townsfolk as they hosted a huge Swiss brass band music festival, where 1800 musicians and 50 bands were expected.
   
The next morning, after breakfast at the KISC, we took the cable car up to Oeschinen Lake. Though the rain and fog kept us from seeing the mountain or lake, postcards sold at the local souvenir shop (or a google image search) made it clear that we were in the midst of some of nature's finest beauty, even if we could not see it with our eyes. And as we hiked down the mountain, the fog started to lift, and we were privileged to behold some of the natural beauty all around us.

We then visited the town of Thun.

Photo Courtesy of Braveen Ragunanthan

And there, the sunshine finally joined us as we enjoyed the scenes along the boardwalk.

The first week or two, in pictures & highlights

My first view of the WHO, as I walked to work on my first day:

This board caught my eye as I walked into the building on my second day of work:

What a privilege and responsibility -- to have a mission as important as this one. We all have both the honor and duty to uphold and advance on this mission, to help all people attain the highest possible level of health, whether our position is intern or high level officer, whether the work at the center is entrenched in big bureaucracy and health politics or not.

Here's the view from my desk:

The view and Geneva, in general, are absolutely gorgeous. 

Here's my team at the WHO's Emergency and Essential Surgical Care (EESC) program for the next couple months:

From left to right: me, Dr. Farooq Khan (intern and senior emergency medicine resident from Canada), Dr. Meena Cherian (WHO EESC program director), Dr. Saptarshi Chatterjee (intern and dentist from India), and not pictured, our absolutely lovely administrator, Ms. Fiona Constable. 

Saptarshi, Farooq, and I are particularly lucky to be interning at the WHO during the 66th World Health Assembly. In the photo above, we stopped for a moment on a day of sprinting between meetings with ministers of health, advisors, and other delegates to discuss incorporating EESC in national health plans.

We also spent some time advancing EESC and other programs in our Health Systems and Innovation (HIS) department at our WHA galleria booth. One of our wonderful department administrators, Ms. Vine Maramba, found this photo of me in the WHA photo gallery on the WHO Intranet pages (credit official WHO/WHA photographers). In it, I'm telling a WHA attendee that stopped at our stand about the EESC program:

Along with free informational handouts, publications, and pens, our HIS stand featured freshly brewed cups of coffee and espresso for folks that stopped to chat. On one of the WHA days, I was lucky to become our booth's in-house coffee-brewing expert. As attendees waited for their free espresso or coffee to brew, they got to hear a lot from me about EESC and how our program supported and partnered with health ministries. A funny moment included when I sillily asked one sharply dressed man waiting for me to finish brewing his espresso whether he worked in his country's ministry of health; he responded simply, "I am the health minister." Who knew that (wo)manning the coffee at the department's WHA booth would turn out to be such a neat place to be as an intern?

I also got to attend some great WHA talks and briefings. My favorite speech of the week was delivered by one of my long-time heroes in medicine, Dr. Jim Kim:

My favorite lines from the World Bank President's speech were:

The fragmentation of global health action has led to inefficiencies that many ministers here know all too well: parallel delivery structures; multiplication of monitoring systems and reporting demands; ministry officials who spend a quarter of their time managing requests from a parade of well-meaning international partners.  

This fragmentation is literally killing people.  Together we must take action to fix it, now...  

Change will come—it’s happening now. The issue is whether we will take charge of change: become its architects, rather than its victims. The gravest danger is that we might make decisions by default, through inaction. Instead, we must make bold commitments... 

Together, let’s build health equity and economic transformation as one single structure, a citadel to shelter the human future. Now is the time to act...  

We must be the generation that breaks down the walls of poverty’s prison, and in their place builds health, dignity and prosperity for all people.   

Here's a panel on Addressing Violence Against Women: 

The panel featured, from left to right, Dr. Mercedes Juan Lopez (Secretary of Health, Mexico), Mrs. Laurette Onkelinx (Minister of Social Affairs, Belgium), Dr. Keshav Desiraju (Secretary of the Ministry of Health and Family Welfare, India), Dr. Mustapha S. Kaloko (Commissioner for Social Affairs, African Union), Dr. Flavia Bustreo (Assistant Director General of the WHO Family, Women's and Children's department), Dr. Etienne Krug (Director of the WHO Violence, Injury Prevention and Disability program), Mrs. Kathleen Sebelius (Secretary of Health and Human Services, USA), Dr. Joseph Kasonde (Minister of Health, Zambia), and Mrs. Lilianne Ploumen (Minister of Foreign Trade and Development Cooperation, Netherlands). Each distinguished panelist discussed their national health sector's response to violence against women.

All in all, it's been an interesting time, my first week or two here at the WHO in Geneva. I'm looking forward to the weeks to come!