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About My Trip

Copenhagen, Denmark

Mental Health + Obesity

Flight to Denmark: Leave KEF 1:10 AM on 6/6, Arrive in CPH 6:20 AM on 6/6 (FI 202) — $239 - BOOKED

Planned Reporting

  • MENTAL HEALTH — Denmark is the only country in the world where a campaign against mental health stigma has been integrated into the federal health department. The program, ONE OF US, is made up of ambassadors (people with mental illness) and promotes social contact as a foundation for destigmatization. What explains the program's success over the past decade, and what can other countries learn from the Danish Model? I have already met with Anja Kare Vedelsby, the project manager of ONE OF US, and she has connected me with staff in their Capitol Region (i.e., Copenhagen) so that I can interview Ambassadors and sit-in on activities happening over my two days.

Travel Plans

June 1  - June 5

Reykjavík, Iceland

Mental Health + Obesity

Flight To Iceland: Leave SFO 7:30 AM on 5/31, Arrive in KEF 8:25 AM on 6/1 (WS 1521 + WS 38) — $426 - BOOKED

Planned Reporting

  • OBESITY — Iceland has one of the highest obesity rates in Europe, with its rates even higher than that of the United States. How have rates become so high, despite Icelandic food choices being ranked one of the healthiest in the world with fish, lean meats, and plenty of their yogurt skyr? How does the environment, with frigid winters with only few hours of sunlight, make physical activity difficult? And how is the this island nation trying to stem this rising tide of obesity? I have already connected with Sólveig Sigurðardóttir, President of the European Coalition for People Living with Obesity, and she is connecting me with patients and healthcare professionals in Iceland to interview and shadow, respectively. 

  • MENTAL HEALTH — The Together Against Stigma Conference from the World Psychiatric Association is being held at the University of Iceland from June 3-5. I am attending as a journalist because some of the world's most innovative mental health experts will be presenting. I have already met with Bernice Pescosolido and Sigrún Ólafsdóttir, co-chairs of the conference, and they've waived the registration fee for my attendance. The full conference schedule is expected to come out within the next few weeks.

June 6 - June 7

June 8 - June 15

New Delhi, India
Leprosy + Obesity

Flight to India: Leave CPH 8:45 PM on 6/7, Arrive in DEL 7:35 AM on 6/8 (AI 158) — FREE (already booked via airline points) - BOOKED

Planned Reporting

  • LEPROSY — Despite being one of the oldest stigmatized diseases, leprosy afflicts more than 200,000 new patients each year. The majority of these occur in India, partially the product of prematurely stopping the eradication campaign in 2005. I plan to spend time in the Satya Jeevan Leprosy Society, the largest leper colony in New Delhi, to meet and speak with these patients. (The colony is closely associated with a local Hindu temple, and I think there is an interesting opportunity to explore the intersection of faith healing and stigmatized diseases, with leprosy seen as a punishment for sin.) I am also planning to spend time shadowing India's leading leprosy specialist at the All India Institute of Medical Sciences. How has the healthcare system failed these patients, and how does leprosy stigma continue to preclude access to care and social services today?

  • OBESITY — India is now the most populous country and thus the most promising market for the fast food industry. Much like the world saw with the tobacco industry, when public sentiment and regulations turned against cigarettes in the United States, fast food executives are turning to emerging economies like India as demand has stalled in the West. As Hanneke Faber, the outgoing head of nutrition at Unilever, put it “India’s on fire,” saying that the nation is a “fantastic growth engine.” Correspondingly, the country's obesity rate is set to increase by 80% by 2035. I'm interested in writing a story about how hospitals are already started to be overwhelmed by spending time with the bariatric surgeons at Medanta Hospital, how the Professor Monika Arora and the Public Health Foundation of India is shaping regulations, and what it will take to turn the tide on skyrocketing obesity rates.

June 16 - June 19

Nairobi, Kenya
Mental Health + Breast Cancer

Flight to Kenya: Leave DEL 4:50 AM on 6/16, Arrive in NBO 1:15 PM on 6/16 (EY 211 + EY 767) — $292.2 - BOOKED

Round-Trip Flight to Kisumu: Leave WIL at 7 AM on 6/18, Arrive in KIS at 7:50 AM on 6/18 (Safarilink 081); Leave KIS at at 7:10 PM on 6/18, Arrive in WIL at 8 PM on 6/18 (Safarilink 090) - BOOKED

Planned Reporting

  • MENTAL HEALTH — Kenya has increased its mental health capacity by 85x between 2017 to 2020 (from 0.18 to 15.32 per 100,000), but there are still significant shortages. Given Sub-Saharan Africa's median age is 19 and the disproportionate burden of mental illness among young people, Kenya's famous Shamiri Institute has created a for-youth by-youth lay counseling program and deployed it across schools in the region. I'm planning to spend time chatting with these youth counselors and sitting in on their training and counseling sessions, with the goal of understanding how they've created a culturally appropriate program given that most existing ones are tailored for the Global North.

  • BREAST CANCER — The WHO estimates that that cancer cases are expected to surge 77% by 2050, the product of tobacco, alcohol, obesity, pollution, and various other factors. Breast cancer is the most prevalent cancer type on the African continent, but no country has a national mammogram program, which is important because early detection and treatment is the key to reducing mortality. Kenya is one of three in Africa, where the World Health Organization is piloting an effort to increase cancer screening. I have connected with the country's leading breast cancer surgeon, Miriam Mutebi at Aga Khan University, and the WHO to spend some time in the hospital and the community, understanding how the program is working. I am also curious about how these efforts are faring given well-recognized stigma against women's cancers in the country but also a recent surge in pharmaceutical company funding to roll that stigma back?

Visa: Kenyan Electronic Travel Authorization — $34

June 20 - June 22

Kigali, Rwanda
PTSD

Flight to Rwanda: Leave NBO 8:50 PM on 6/19, Arrive in KGL 9:30 PM on 6/19 (WB 403) — $291 - BOOKED

Planned Reporting

  • PTSD — This year is the 30th commemoration of the Rwandan Genocide, when nearly one million ethnic Tutsi and moderate Hutu were killed within 100 days while the international community stood by. From this horrific trauma, however, has come one of the most progressive mental health programs in the world. In 1995, just one year after the genocide, the Rwandan government established a mental health division within the National Ministry of Health; more recently, it has focused on the decentralization of care and group counseling services — to make mental health more accessible. What other countries can learn about how a country can recover from unspeakable tragedy? What does the situation look like on the ground in Rwanda today, and what are the continued challenges? I have already connected with the outgoing Director of Mental Health in the Rwandan Ministry of Health, and I am in the process of getting introductions to sit in on some group counseling sessions and speak with genocide survivors who are suffering from PTSD, as well as their children, reflecting the weight of intergenerational trauma.

Visa: Visa on Arrival — $50

June 23-25

Capetown, South Africa
Lung Cancer

Flight to Capetown: Leave KGL 10:30 PM on 6/22, Arrive in CPT 8:15 AM on 6/23 (WB 102, SA 303) — $459

Planned Reporting

  • LUNG CANCER — This disease is the most prevalent and deadliest cancer in the world, killing more people than the next two combined. However, South Africa is the only country on the continent where lung cancer is the deadliest cancer. Why are smoking and lung cancer rates uniquely high in this country, how is this linked to the legacy of colonization/Apartheid, and how is the country struggling to take care of its lung cancer patients? I plan to go to Capetown because the Western Cape has the highest lung cancer rate in the country and because I have already connected with Dr. Abba Malloum, a radiation oncologist who has offered to let me shadow him so that I may speak with patients and understand their stories. I also plan to report on South Africa's fledgling attempts to start a national lung cancer screening program, essentially going it alone because only 10 countries have established such programs and none in Africa. How is stigma playing out in terms of dedicating the societal resources for lung cancer screening, and what is the plan to ensure uptake — given that the U.S. program's uptake is only at 5%?

June 26-27

Mbabane, Eswatini
HIV/AIDS

Flight to Eswatini: Leave CPT 6:05 AM on 6/26, Arrive in SHO 10:50 AM on 6/26 (4Z 926 + 4Z 82) — $149

Planned Reporting

  • HIV/AIDS — Eswatini, formerly known as Swaziland, is a landlocked nation inside South Africa. It's also the country with the highest HIV rate in the world at 27.9% but, remarkably, one of only six countries worldwide to reach the 90-90-90 AIDS treatment target. This target refers to 90% of all people living with HIV knowing their status, 90% of people with diagnosed HIV infection receiving sustained antiretroviral therapy, and 90% of people receiving antiretroviral therapy having the virus suppressed in their bodies. It's a remarkable achievement and a reflection of the success of PEPFAR program. I want to tell the story of why Eswatini has the world's highest HIV rate, how this country has been so successful treating this disease, and what the future holds with PEPFAR not being reauthorized by Congress.​

Visa: None

June 29

Singapore, Singapore
LAYOVER

Flight to Singapore:

Leave SHO 7:25 AM on 6/28 (RN101, Eswatini Air), Arrive in JNB at 8:15 AM - NOT BOOKED

Leave JNB 11:20 AM on 6/28 (CX 748), Arrive at HKG 6 AM on 6/29

Leave HKG 8 AM on 6/29 (CX 691), Arrive at SIN at 11:55 AM - BOOKED

Lodging: Beverly Fu's Place

June 30-July 2

Taipei, Taiwan
Lung Cancer

Flight to Taiwan: Leave SIN 1:05 AM on 7/3, Arrive in TPE 5:45 AM on 7/15 (TR 898) — $109

Lodging

  • 7/15 and 7/16 Night: Stay at Hotel Riverview Taipei — $58 a night (total: $116)

Per Diem (Proportional Meals): $52 (total $156)

Planned Reporting

  • LUNG CANCER — In Taiwan, over 50% of lung cancers occur in never-smokers, with the rate even higher among women with lung cancer (93%). The country is also home to the world's first effort to screen people who have never smoked for lung cancer, the TALENT study. In U.S. for reference, you have to be a heavy smoker to be eligible for screening, leaving the 20% of Americans who get lung cancer as never-smokers behind. What does stigma against lung cancer look like in a country where most people who get it never smoked? What does this portend about the future as air pollution increases while smoking rates decrease — one where the never-smoker lung cancer rate may climb higher and higher?

Ho Chi Minh City, Vietnam
Mental Health

Flight to Vietnam: Leave MNL 6:45 AM on 7/10, Arrive in SGN 8:30 AM on 7/10 (PR 591) — $124

Lodging: Staying with research collaborator Kevin Nguyen's house - FREE

Per Diem (Proportional Meals): Free

Planned Reporting

  • Mental Health — My collaborator Nguyen is on the board of a global health program to Sóc Trăng, a rural province south of Ho Chi Minh City. One of their four projects is focused on mental health, given the significant stigmatization in the Vietnamese context — where these diseases are seen as a punishment for improper behavior in a previous life, or the possession of angry ancestral spirits. Correspondingly, many patients struggle on their own, with little support from their families and friends. With Nguyen's program, I am eager to speak to patients about their struggles navigating the healthcare system and seeking care, hoping to assess both interpersonal stigma and self-stigma. How is the WHO working to better integrate mental health into primary healthcare, and will it even matter given such cultural resistance and psychiatrists being seen only as “Bac si tam than,” or “doctors who treat madness"?

Pro Bono Interpreter: Kevin Nguyen

Visa: Vietnam eVisa — $25

Total (Flight + Lodging + Visa): $149

July 3-July 10

Philippines (Miscellaneous)
Drug Use + Obesity

Flight to Philippines: ARRIVE IN CEBU at 9:50 AM (Starlux JX 781)

Leave SIN 1:30 AM on 7/3, Arrive in MNL 5:40 AM on 7/3 (5J 804) — $99

  • Flight to Cebu: Leave MNL 6:20 AM on 7/4, Arrive in CEB 7:50 AM on 7/4 (5J 561) — $32

  • Flight to Clark: Leave CEB 8:15 PM on 7/4, Arrive in CRK 9:45 PM on 7/4 (5J 156) — $59

  • Drive from Clark to Manila: TBD

Lodging:

  • 7/3 night: Stay in Studio 89 Katipunan QC — $32 a night

  • 7/4, 7/5, 7/6, and 7/7 night: Stay in ABC's for Global Health student lodging — FREE

  • 7/8, 7/9 night: Stay in Manila Prince Hotel — $38 a night (Total $76)

Per Diem (Proportional Meals): $47 for Manila, $41 in Cebu, FREE for Clark (total $182)

Planned Reporting

  • DRUG USE — Under former President Duterte, over 6000 suspects died in anti-narcotics sting operations, although Human Rights Watch expects the number is actually double official estimates. The Philippines has had a new President (Marcos Jr) since 2023, one more "geared towards community-based treatment, rehabilitation, education, and reintegration" in his own words. It's one thing to say these things, but what's the situation on the ground? How has the country build back trust for treatment? I intend to spend some time in the slums of Manila (with the Arnold Janssen Kalinga Foundation), understanding the aftermath of the "War on Drugs" and how people perceive treatment. I also intend to make a day trip to Cebu to visit IDUCare, a harm reduction program in the Philippines. How is such a liberal approach to substance use possible in a country with one of the most violent approaches to the problem?

  • OBESITY — In the Philippines, rates of overweight and obesity have nearly doubled over the past 20 years, among both adolescents and adults. I want to understand the drivers of this rapid increase, from growing McDonaldization of the country to the impact of the Filipino diaspora on shifting cultural attitudes. I am also interested in the country's seemingly whole-of-government approach to addressing the obesity epidemic, particularly with its National Policy on Addressing Overweight and Obesity. I am also interested in how any anti-obesity programs intersect with the continued malnutrition problem in the Philippines, which is one of President Marcos Jr's key priorities. In a society where under and overnutrition are serious problems, can they be tackled simultaneously? I will spend time with Stanford professor Julieta Gabiola in Pampagna (region where Clark is) to see patients with metabolic disorder with her mobile clinic, as well as University of Philippines professor Elizabeth Paz-Pacheco to see patients at the endocrinology outpatient clinic.

Pro Bono Interpreter: Ranielle Gallego in Manila, Julieta Gabiola in Clark, TBD in Cebu

Visa: None

Total (Flight + Lodging + Meals): $480

July 11-July 14

July 15-17

Bangkok, Thailand

HIV/AIDS

Flight to Bangkok:

HIV/AIDS — Stigma in healthcare settings is one of the biggest obstacles to ending AIDS, and Thailand is a pioneer in combatting this issue. Back in 2018, Vietnam piloted a stigma and discrimination reduction program in Ho Chi Minh City, following the Thai model and translating it for the local context. I want to investigate how successful this pilot has been for destigmatization because it suggests how translatable this program might be for other contexts. Nguyen's father is a physician-leader at University Medical Center in Ho Chi Minh City, and he is helping connect me with some local AIDS physicians in the city, as well as the leaders of this destigmatization campaign. More broadly, I am curious about Vietnam's policy evolution on HIV  from punitive control measures to a more harm reduction approach, especially given the government's national strategy to end the AIDS epidemic by 2030.

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