First Person - Fall 2004

Rakesh Sarwal

Doctoral Candidate, Procter & Gamble Fellow

In arid areas of India, Rakesh Sarwal is measuring the difference a rainwater-retention effort can make in village life.

Way back in 1988, I got into the administrative service in India. One starts from the grassroots level—gets training, makes mistakes, learns. Once we were given a target of distributing 40,000 water filters in a rural district.

We could have purchased these filters from some company in a metropolitan area. But we chose a second way.

We trained local women to produce the filters. Then we bought the filters from the women and distributed them to people who needed them. This, I think, is a good example of how education, health and economic development can be rolled into one.

I am now conducting research in a series of villages in an arid region in the state of Rajasthan. A nongovernmental organization has been working with the people there on water management. What they do is help people dig out village ponds so that when the rains come the water doesn’t just flow to the sea. Instead, it recharges the groundwater, it replenishes the ecosystem.

In some of these villages, women have to travel six hours to get a bucket of water. You can imagine what happens to them and to their children when water is nearby. There has been a remarkable change in all aspects of their lives—in health, in educational status, in economic welfare. But until now there has been no formal evaluation of this project. I want to know: Just how beneficial is it? Is it cost effective? Perhaps it holds lessons for people elsewhere.

Susan G. Sherman

Assistant Research Professor, Epidemiology

Studying the social factors behind drug use and prostitution is Susan Sherman’s professional passion. Making jewelry is her hobby. She never really planned to put the two together.

I was at a high point with the jewelry thing, making jewelry in any free moment. A friend jokingly said, “Why don’t you get the women in your studies to help?”

I couldn’t do that, obviously, but it did get me to thinking. And what I came up with was a study called JEWEL—Jewelry Education for Women Empowering their Lives. Fifty-four women went through the pilot project.

Every group in the study went through six sessions. The first half was on HIV risk reduction, in terms of sexual behaviors, and in the second half the women made and marketed their own jewelry. We’d hold sales in the Outpatient Center of Hopkins Hospital, on tables we set up in a corridor.

Melanie—these aren’t real names—was a crack user with a messy, complex life. But when it came to jewelry, she was so talented! She learned these really complicated beading patterns. She probably made about $200 at the sales before Christmas. She sent most of it to her son.

Then there was Joan. She was living in a homeless shelter, using crack. Joan wasn’t the best jewelry maker, but she was a great marketer. So articulate! Whenever Joan was there, we sold a lot more jewelry. During the program, she went into outpatient treatment. Last time I saw Joan, she’d been clean for two months.

We did a follow-up survey to see how the study affected their risk behaviors: The women absolutely reduced their numbers of paid sex encounters, and they absolutely increased their condom use. Now we’re hoping to get 400 people in a randomized trial, to do this on a much larger scale.

I’ve always come to public health from the viewpoint of social justice. The behavior change outcomes are great, but helping some of these women create economic opportunity for themselves—that’d be true success to me.

Lance Price

PhD Student, Environmental Health Sciences

Lance Price’s passion for environmental science began when he witnessed the desecration of the treasured family ranch where he spent childhood summers.

When I was a kid, we spent summers on my grandparents’ ranch in the Texas hill country. Tending to cattle, building and repairing fences. They had this natural spring, and we’d catch frogs and go fishing in the pond there.

But ranches like that have become anomalies. The dairy farm next to my grandparents’ place has grown into this massive factory farm with just thousands of cattle. The density is far beyond the land’s capacity. The piles of solid waste are huge. They built lagoons for the liquid waste.

That beautiful pond on my family’s farm smells like an outhouse. It’s never coming back. The spring doesn’t even trickle anymore. That’s really been a motivating force for me.

At the Bloomberg School, I’m focusing on emerging antibiotic resistance. Did you know that upwards of 80 percent of the antibiotics used in the U.S. go toward feeding confined animals on factory farms? Not to treat sick animals—just to make the animals fatter.

I’m identifying resistant microbes and then looking at how they leave a factory chicken farm and enter the environment. The farm workers who touch these chickens, are they at a higher risk of getting sick?

And when you go to the grocery store, what’s your risk? I buy poultry products and collect the microbial pathogens on them. Then I look at resistance patterns. I’m concerned about people who have sub-optimal immune systems: old people, people with HIV, kids. If they get infected, these people might really need help from antibiotics. These lifesaving drugs are becoming useless, partly because of what’s being done on these farms.

Devra Davis

MPH Alumna and Author of When Smoke Ran Like Water

A pollution-related disaster in her hometown lies at the heart of Devra Davis’s lifelong interest in environmental health and chronic disease.

I grew up in a town that’s famous in the way that Jack the Ripper and Son of Sam are famous. A steel town—Donora, Pennsylvania. In October of 1948, a massive blanket of cold air settled over the entire Monongahela Valley. All the pollution stayed right where it was, right in Donora—it had nowhere to go. It went dark in the middle of the day. People got lost on their way home from work. Eighteen people died that week. They called it the “killer smog.”

I was just 2 years old. When I got older, I didn’t know any of this. Nobody talks about that kind of fame. We left Donora when the mill shut down, as did half the town. We went to Pittsburgh.

I was the first person in my immediate family to go to college, and that’s where I learned about the pollution. I was flabbergasted. I came home that day and I said to my mother, “Is there another Donora?” I really thought she was going to tell me there was. After all, there’s another Pittsburgh—it’s in Kansas. There are a couple of other Allentowns. We were having tea. We were sharing a tea bag. In my family, you get three cups of tea out of every bag.

She said, “Remember how we used to drive with the headlights on all day in the fall? Remember how you used to get to help clean the walls of the house?” I remember her saying, “Well, I guess today they’d call that pollution. Back then it was just a living.”

There’s a section in my book, When Smoke Ran Like Water, where I talk about how you grow up really liking the things that are familiar. Even today, when I go into factories or past places with billowing clouds of smoke and fire, there’s a kind of excitement for me. It smells like home.