Day 13(1/15/18) *Copenhagen/WHO Euro*

WHO Euro

WHO flags

Welcome to day 13! This morning we boarded a plane to Copenhagen, and I'm not sure if it was the 4am wakeup or the airline, but the coffee they served on the flight was lovely:) Once arriving in windy and quaint Copenhagen, we checked into the hostel ("The steel house"...it's super new to the city, and it is so cute...there are 6 beds in our room which allows for some more group bonding, though each bed is its own pod within the larger room-so it's like a cozy little nest…kinda like beds on a cruise ship I’d imagine-I like the hostel😊). Then, we were off to the WHO Euro headquarters to meet with our hosts! There, I had another moment of "wow, I can't believe I'm actually here in this situation!" (that seems to be happening with more and more frequency!). We walked to our assigned room, the "VIP room", which by the way has a lovely view of the river, and met with Claudia Stein, Omid(who's a Canadian from Toronto too!🍁). All of them are very welcoming people, and I look forward to working with them further tomorrow, on the "Gateway" project-I'll tell you more about this tomorrow and even more on day 15 when we get to present our project to Dr.Stein and her colleagues! The Gateways website is a platform that the WHO Euro created in order to have health data on each member state(there are 53) in one place, and our job as students will be to work on a project using the Gateway for our own learning and in order to evaluate how user-friendly the datasets are. More on this tomorrow:)

Dr.Stein, the director of WHO Euro, is quite an impressive woman(the director of this centre spoke with us, how generous is that?? I'm sure she has so much to do, and yet she chose to spend significant parts of the next three days with us...I'm very touched that she was nice enough to do this😊)--she gave a great talk to my class before we broke for the evening. Dr.Stein holds MD, MSc, PhD, and FFPH degrees, all relating to public health and medicine. She has studied/worked in several countries, including Switzerland, England, Germany, parts of Africa, and France. She talked to us about the WHO Euro specifically, but on day 15, she will be talking with us about general career advice(as she calls it, “Quo Vadis”), in which I expect she’ll talk about her work outside of the WHO as well! In outlining Dr.Stein’s talk, I know that it is going to be a very long journal post—so fair warning:)

So first we learned that evidence is the backbone to policy (which also explains why the CDC was so research and data-gathering-focused!), and that the WHO acted as a connection between evidence and policy. It does this through four official languages: English, French, Russian, and German; all functions/publications must be presented in all of those languages. The reason for involving so many languages has to do with accessibility, but also with politics. Dr.Stein emphasised that politics are the greatest barrier to the work of the WHO Euro because really they cannot impact countries without having good relationships with each and also because the politics determine which projects move forward and which do not. Therefore, by having the potential to communicate in multiple languages, the political barrier sometimes is a bit less!

Another interesting part of the presentation had to do with language: the term “disparity” is unacceptable in this organisation because the definition of “health disparity” is “something that’s considered a natural and acceptable difference in health”. Dr.Stein emphasised that there’s nothing acceptable about differences in health, and that it is only ever considered “natural” because the country has been accustomed to it. Therefore, it is much better to use the terms “inequality”(same types of resources are given to everyone, yet some still have poor health) and “inequity”(differing types/intensities of resources given to those who are most in need of them in order to improve their health). I find it interesting that we don’t really use the word “inequity” in the US, but rather we use the word “disparity”…perhaps it’s because our system is not really social, and therefore we just consider some people to be better off than others due to their own wrongdoings/responsibility? Is it possible that people just have been using the word “disparity” and don’t really consider its definition to mean anything beyond “different”? I wonder if other WHO branches are as insistent on the use of “inequity” instead of disparity!

Dr.Stein then went on to discuss the health2020 initiative, a project in which the organisation was using the whole of society/teamwork approach to address determinants of health by 2020 with the following targets: 

1) Reduce premature mortality

2) Increase life expectancy

3) Reduce inequities 

4) Enhance wellbeing in EURO member states

5) Achieve universal health coverage 

6) Establish national targets for member states

*notice that all of these goals require good surveillance to see their progress, so this gives an initiative for the Gateway project to take place in order to have accurate, accessible statistics

She said that while these are large goals, she believes that “We can achieve this as long as we have a good roadmap as a team and as individual member states, and we know the rules of the game.” That was very moving to hear….and applies to so much more than just the health2020 initiative—having a good plan and knowing how to follow it is the key to achievement usually, and I will expand on this when I reflect on Dr.Stein’s “career advice” talk on day 15!

A few other interesting points from Dr.Stein’s talk:

-She said very few political comments about the US or any other country. In fact, she only made one note about the US health system in which she praised Obamacare, noting that at the WHO Euro, the debate on Obama care is a “non-debate”😂. This differed from the WHO headquarters in that the spokesperson there immediately commented our idiot president’s recent press release about the “sh*thole countries”. I’m very glad that he did call out trump in saying this, but I found it interesting that Dr.Stein stayed away from such comments…I have a hypothesis as to why: perhaps it’s similar to the reason that a teacher tells a student with irresponsible parents that the student is smart and capable and kind…in saying this to the student, the student comes to believe that he/she does not have to be the person that his/her parents are, because the teacher believes in him/her. Perhaps Dr.Stein told us only positive things about our country because she wants us to become better than our leader, and believes in our ability to do so. It’s just a hypothesis, but maybe it had something to do with it.

-There exist only 2 laws that the WHO Euro put in place: 1) that all countries must adhere to the WHO definitions/regulations of diseases, so as to not allow any interpretation of what constitutes each identified disease, and 2) that all member states who have signed up for the anti-smoking program through WHO Euro (for countries who have signed up) must adhere to the strict no-smoking rule

-The WHO Euro doesn’t ever rank countries based on their statistics (ex. say something like “X ranked as #1 in infant mortality) so as to keep the peace politically. Interestingly, other organisations are allowed to do what they want with data that WHO Euro publishes, so often countries are ranked against each other, just not by the WHO Euro.

-She talked about well-being, which is what I decided to study in my individual major!! She said that wellbeing occurs when many factors all are taken care of and work together properly. So, health perspectives all working together to create wellbeing…..it’s exactly my major’s title, I was so excited when she talked about this, and about it being one of the 4 goals of the health2020 initiative!

After that great discussion/presentation, I went with some group members to dinner downtown, and afterwards we walked around a little bit--we stumbled across a very fancy-looking movie theatre and didn't actually see anything but it was so fun to have run into!

I then spent some time in the cozy lobby at this hostel writing my journal, and now I am very tired after a very busy and unique day(well, they're all unique, come to think of it...😁)-but I'm definitely looking forward to the next few days we get to spend in Copenhagen :)

Goodnight,

-Anna

The fancy movie theatre we found!