Saturday, November 20, 2010

A special invite for World AIDS Day

I've been asked by the African Public Health Network at Hopkins to partake in a World AIDS Day panel. It is an unexpected honor given the amount of MPH students who have conducted research or worked in numerous countries on this topic.

Given the workload and upcoming finals, I will post a more proper and informative blog of the occasion during Winter break. I'm guessing a little after the New Year will do it!

Thursday, November 11, 2010

Intro to Linear Regression

I stumbled upon this video last week when I was reviewing some of the concepts we are covering in biostatistics. The video is a great introduction to linear regressions, a concept that depicts the relationship between two variables. Linear regressions are a hallmark of statistical analysis and used in multiple fields that span from economics to medical research. With the biostats midterm two weeks away, I thought it could be helpful to others.

Sunday, November 7, 2010

Economics of a Cupcake Factory

My younger sister is using it to learn algebra. My father uses it to explain the stimulus package and now I use it to supplement my Budgeting and Finance course at Hopkins. What is it? It's Khan Academy, a free library of tutorials explaining binomials to biology to banking in one central website. Salman Khan, the voice behind the magic pen, has earned the title "Bill Gate's favorite teacher" and as an introduction I have chosen to post the "Economics of a Cupcake Factory". The series covers the fundamentals of starting and running a product based business and may help supplement some of our Budgeting and Finance lectures before the midterm.

Tuesday, October 12, 2010

Final Presentation for HIV/AIDS Course

I am currently taking Epidemiology and Impact of HIV/AIDS with Dr Homayoon Farzadegan. As part of the course students present following a guest lecture.

My topic is "future issues" and in my allotted time I have chosen to present the Partner's in Health community health worker model as the future is already here. The argument is founded on my belief that addressing HIV/AIDS is based on three pillars: health, education, and jobs.

I've shadowed Partners in Health community health workers (CHW) in rural Rwanda and seen the central role they play in the community. As scholarly support for their strengths, I have relied heavily on a great journal article by JS Mukhurjee. Her study showed CHW increase access to hard to reach people, increase the social capital within the community, and act as successful referral agents.

In the face of a global recession and restructuring of PEPFAR funds, horizontal programs that integrate and strengthen health systems pose a real path forward. A leader in this field is Rwanda. They have chosen to scale up the Partner's in Health CHW model as their rural health system. Perhaps, no one explains it best then former President Bill Clinton at the 2007 TED Wish talk.

Wednesday, September 22, 2010

Follow Up to Round Table

1st Round Table Update

Although I couldn't find a round table, the hour long event was full of active discussion and back and forth open exchanges regarding human rights as a means or goal of development and the role of international funds in low and middle income countries.

One specific question posed that generated a great dialogue was what should the priority be for international funds.

Over 20 people attended the inaugural event ranging from MHS, MPH and PhD candidates from Hopkins spanning US and international physicians, former Peace Corps members, and current medical students.

Given the positive response I am in the process of planning and piecing together the next Round Table.

Sunday, September 12, 2010

1st Round Table Talk

Monday (Tomorrow) 12:15-1:15pm W4019

The JHSPH Health and Human Rights Student Group will be hosting their first Round Table talk tomorrow at 12:15pm in room W4019. Round Tables will occur at least once a month and will follow a simple pattern - a short TED style video and then discussion. No lecturing but ideas, experiences, and points of view are welcome!

We will be screening a portion of a provocative Hans Rosling Ted Talk as a launch pad into a student led open discussion on health, human rights, and development. Afterwards, you'll believe the seemingly impossible is possible.

Food won't be provided, but a thought provoking atmosphere will.

Have an idea or video to share? For now send it over at MarcoAmbrosio32(at) or @Marcoambrosio

(We showed from the 10:30 minute mark onward)

Questions to discuss:
Do you agree/disagree with the + marks?
Is Human Rights a means or a goal? What about government?
Where should donor funds and local government funds be spent? Is there a priority?

Tuesday, August 10, 2010

Dr. Mark Rosenberg - Real Collaboration

Guest Lecture from President & CEO of The Task Force for Global Health

"Collaborative partnerships have the best chance for success when members lay the foundation in the first mile for the last mile success and take mutual responsibility along the journey for leadership, management, and culture within the partnership."

Dr Mark Rosenberg MD MPP, author of Real Collaboration, guest lectured our "Making Change through Policy" course and focused on the art of collaboration. The Task Force for Global Health works with private and public sector partners to address health issues for the most vulnerable populations. Among many things, the task force currently leads the Global Polio Eradication initiative and is credited for creating "Pharmaco-Philanthropy". There were three take aways from Dr Rosenberg's lecture that can be summarized as one story, one line, and one list.

The Story
Dr. Bill Foege MD MPH, the epidemiologist who designed the global intervention strategy to eradicate smallpox, was the first head of the task force. In 1987, Merck approached Foege about donating Mectizan, a drug whose off label use reduces morbidity and transmission of river blindness. Mectizan is better known to animal lovers as Heartguard - a common medication for dogs. Merck was making enough profits on animal sales to donate large quantities for off label use. Coalition leaders fearing the partnership and backlash of working with the pharmaceutical companies advised Foege to not accept the offer. True to what I've come to learn about Dr. Bill Foege, he did it anyway; establishing what is called "Pharmaco-Philantropy". Twenty-five years later the program is responsible for treating millions and its continued efforts have made eradicating river blindness a feasible end goal.

The Line
"Collaborations are like marriages. Easy to get into and hard to make work"

The List - "The Initial Barriers: Seven Cs"

1. Culture – corporate, religion, location
2. Conflicting Goals – need to settle on the goal, a very clear goal
3. Confusion – about roles and responsibility
4. Control – no one wants to give it up (personal and organizational)
5. Capabilities – everyone has different skills, strengths and resources
6. Competition - who is going to get the credit, who is the biggest
7. Costs – people don’t factor in the costs (money and time)

Saturday, August 7, 2010

Guest Lecture by the Eradicator of Smallpox

Learning from a Living Legend

In 1796, the British Scientist Edward Jenner documented the first successful example of inoculating a person to prevent future disease. In this case, he used cowpox to protect against smallpox - an infectious diseased credibly traced back to ancient Egyptian mummies 3000 years ago. Jenner would call his work a vaccine (after the Latin word for cow - vacca), but it wasn't until 180 years later that US epidemiologist D.A Henderson led the global effort that eradicated smallpox from Earth.

A disease that plagued man all over the Earth for thousands of years was no more, surviving only in government labs in Russia and the US. The feat can be considered the golden point of science in the 20th century. D.A. Henderson's work garnered him the US Presidential Medal of Freedom, the Japan Prize, and Knighthood by the King of Thailand. Below I've listed three points that I found as takeaway messages from his guest lecture to my "Making Change through Policy Course"

1. Finding a Way
In countless examples, Dr Henderson mixed creativity or found exceptions to the rule to achieve results. After learning less than 10% of global vaccines met quality standards, Dr Henderson was told he could not mandate quality control ("it won't work"). Instead, Dr Henderson withheld World Health Organization funding unless vaccines met third party quality control standards. It wasn't a mandate, but it was one heck of an incentive.

2. Science and Evidence Trump Experts and Textbooks
There were four key examples in which Dr. Henderson and his team had to buck the stated norm or thoughts at the time. In each they set up experiments and tests to use science as their evidence against the textbooks. Each played a vital role in proving Smallpox could be eradicated. The first was proving smallpox did not spread easily meaning a vaccine campaign could work. The second was revaccination wasn't needed - a one time dose could work saving money, time, attrition, and follow up efforts. The third, smallpox wasn't stable in nature, thus eliminating it from humans could eradicate it.

3. Managing Guidelines
- Recruit good people who want a challenge
- Delegate authority and responsibility
- Adapt program to the individual country
- Get out from the desk (he mandated 1/3 time in field)
- Communicate regularly and frequently
- Harmonize practices
- Exceptions are necessary

I invite classmates to share any lessons learned or comments from the D.A. Henderson Lecture. What did you think?

Wednesday, July 21, 2010

Book Review: Polio - An American Story

Pulitzer winning book depicts the inner workings of Public Health

Within the first few weeks at Hopkins multiple lecturers have defined Public Health. Some used online dictionaries, others quoted names not yet familiar to me, and still more drew up definitions from international organizations. Whenever the slide with the bold white letters and question mark would appear, my mind would drift to our summer orientation book - Polio: An American Story.

Public Health is perhaps a field more difficult to define than others. From the molecular level of cancer mechanisms or chemical toxins to macro concepts of land degradation, sustainable development, and alternative energy, there are varying areas of concern which draw upon the medical, legal, engineering, and humanitarian aid fields (just to name a few). The picture is rather broad, but Hopkins did a service to itself by choosing David Oshinsky's Pulitzer Prize winner.

Oshinsky's book elaborately brings a reader into the moment through rich story telling while not sacrificing the proverbial meat and potatoes. He chronicles the development of the polio vaccine with all the theory and understanding of how vaccines work, the ethics of trails, and the stepping stone discoveries that produce a successful vaccine. However, he brings the story to life by focusing on the pushes, the pulls, the rivalry, the pressure, and the pieces of the puzzle that often go unnoticed.

For instance, he brilliantly captures the campaign that mobilized a nation. The first half of the book is a "how to" for creating a movement. It starts with the personal story of Franklin D Roosevelt, a victim of polio, and his creation of the National Foundation for Infantile Paralysis (Polio). The foundation had two unique factors that played mighty roles - a sitting US president as its figure head and Basil O'Connor, the visionary put in charge. O'Connor took the newly created and still young public relations and advertising fields and brought on personnel to brand and develop campaigns. Before he knew it the Foundation became a Juggernaut.

Before President Obama's heralded fund raising machine, the foundation revolutionized the concept and approach to soliciting donations. Instead of focusing attention on large sums from the wealthiest few, they shifted for the first time ever on small donations from the many. They believed it had potential to generate more funds, a deeper connection, and a broader movement. With concerted effort at "relentless optimism", the foundation made millions around the country believe they could play a role in the vaccination against a virus that plagued innocent children and kept parents in fear of summer months.

With the help of the President, the foundation was the first organization to use celebrity power to spread the word and solicit donations. For instance, Eddie Cantor, the highest paid actor/comedian of the time, is credited with coining the phrase "March of Dimes", the eventual name the Foundation would take. Through radio campaigns, people were encouraged to mail a dime right to president Roosevelt. The inaugural event, still in the midst of the Great Depression, brought in 2,680,000 dimes alone; a whooping success. With each dime mailed in there was a psychology of "Yes We Can!"

Two other interesting strategies were the creation of a "poster child" and the polio blankets. In 1946, six year old Donald Anderson was hand selected to be the face of the polio campaign. His pictures and interviews become a rally cry for donations and increased support over night. It was controversial but a successful tool. It also organized volunteer groups to sew over sized Polio blankets for victims and their families. These blankets are thought to be the "forerunner to AIDS quilts".

Polio: An American Story
pays heed to the traditional definition of public health; "the science of preventing disease, promoting health, and prolonging life with emphasis on populations rather than individuals". However, Oshinsky brings to light the wide ranging factors that affect the process and application. Science, politics, economics, culture, communications, and technology are but some of the players touched upon in this easy to read page turner. I recommend the book and I look forward to Oshinsky's upcoming visit in mid-August.

Wednesday, July 7, 2010

Revamped, Redesigned and Ready to Go

Launching The Round Table

Fourteen months ago I sent in my deferral to Johns Hopkins School of Public Health (JHSPH). I knew I wasn't ready to take advantage of the one year accelerated program. Ranked #1 in the world, with renowned faculty and over four-hundred courses, I knew the program warranted a clearer path and more focus. Considering I raised all the funds for my previous work abroad, a year delay to work and draft a half a manuscript made sense financially and personally.

Along with my deferral notice came one regret; having to wait a year to be immersed in a rich atmosphere of movers, shakers, and individuals eager to make an impact on the world around them. It was the free flow of ideas, the debating, and the unique perspectives that would have to wait another year.

This past June 28th, the fast paced journey began and I can not think of a better way to share and record the opportunity than through this blog and my website. Revamped and redesigned, this blog will be highlighting lessons learned, take away concepts, and engaging ideas from some of the best and brightest Hopkins has to offer. From guest lectures by Pulitzer Prize winners, Presidential Medal of Freedom recipients, and titans in the field of public health to guest blogs by students and general topics of discussion, I hope the blog continues to inform, challenge and inspire.

As always remember to check the side archive for titles of interest

Saturday, February 27, 2010

Museum Trip Update!!!

This is the text of an email I've sent out to individuals that donated to the Museum Trip. The reasons for the trip, which celebrates African American History and Art, can be found here. Learn more on my website.

Thank you for contributing towards the Christ the King Prep (CTK) field trip! Within four weeks of the kick off date we raised over $700 with contributions from 24 individuals. I am happy to report that donations ranged from over 50 years in age, multiple states, and varying religious denominations; including all 3 Abrahamic faiths (Islam, Christianity, and Judaism).

In the wake of Haiti's devastation, I decided many weeks ago to call the Montclair Art Museum and pro-actively approach an agreement for them to cover the remaining gap in costs. Now that it is finalized, I can fill you in on the great news! The Museum will be covering ALL costs for not only the 86 Sophomores, but has invited the entire Junior class to join as well! The Museum was eager to provide CTK students the opportunity to explore African American Art of the early 20th century and engage in an amateur studio session. Expect photos and video responses from the students following their March trips.

Your donation will be used in another meaningful art endeavors. Cristina Lewis, a young muralist, has generously accepted to volunteer and work with six students on the creation of a "multicultural" mural at CTK. The students were chosen through a submission process and each one will play an active role in the development, sketching and painting of the mural. The first meetings have already produced great ideas and acted as a new outlet for gifted students to share their talents. The raised funds will cover the cost of this mural and perhaps a second. I will be documenting the process in a short video to share with you.

Thank you again for making this possible. Your impact will certainly be felt and your support is already appreciated.

Best regards,

Marco Ambrosio

PS More can be learn at

Saturday, January 9, 2010

Cura Personalis - Educating the Whole

Christ the King Prep and a Field Trip for Black History Month

“You will be the first ever Senior class at Christ the King, excited?” – Me

“Possibly” – Chris

“Care to explain?” – Me

“Well, yes and no – all we do is work and study” - Chris

It is not the typical answer expected from a high school Junior, particularly when speaking for the collective whole. However, this is no ordinary prep school. I knew that from the beginning. What I didn’t know was how best I could help.

Christ the King (CTK) is unlike many high schools. It is one of only twenty-four schools in the national Cristo Rey Network, an innovative urban education model started by Jesuits in Chicago. It seeks to provide quality, catholic, college preparatory education to economically disadvantaged urban youth with limited educational options. It utilizes a longer school day and year, academic assistance, work skills boot camp and counseling to prepare students for college. The biggest difference, as echoed by the above dialogue, is these students are working for their education – quite literally. Once a week they partake in corporate internships that lower the cost of tuition by 80%. Besides learning the value of an education, the internships cement the end goal – college. Nationally, the network boasts a 96%
acceptance rate to 2 or 4 year colleges.

After my first meeting with Administrators, I realized there were many more needs then I could possibly provide. So, I reflected on my own high school experience at St Peter’s Prep and tried my best to pinpoint what was most formative. I soon realized the majority of my memories were not confined to the walls of the classroom. Instead, it was the hours after the final bell that the school came alive. Whether it was planning a pep rally with friends at Fr Hoag’s SJ School Spirit Committee meeting, waiting around for an Emmaus Retreat Homecoming or Arrupe Evening Lecture, or figuring out rides to soccer practice and what train or bus to take home – they rounded out the experience. I learned that you can’t control time, but you’d better learn to manage it. I learned that academics only scratches the surface of a school. I learned that each person has a talent and it should be used to help the greater good. These were all equal parts of an education. In short, I felt overwhelmed by what I wanted to offer the CTK students.

What could I do? At this juncture the school is unable to fund the majority of activities that they recognize as part of the Jesuit motto Cura Personalis. It is a dictum for educating the whole person including physical fitness and a broad based education (think your college “core”). In the end, people should have a working knowledge or appreciation for the sciences, history, math, literature and the arts. Administrators and faculty have been very creative to fill the void. There are chess tournaments, basketball teams, and workshops and presentations from college professors and community artists. With a mix of flexibility and drive the school succeeds despite a very tight budget.

Since the school does not have the resources. I am reaching out to my extended network to sponsor a student for a two hour trip to the Montclair Art Museum for Black History Month. My goal is to take all 86 sophomores, the only class yet to leave the school, over the span of four days. The first hour will be a tour of the exhibit “Forces of Change: African American Art and the Julius Rosenwald Fund” and the last hour will be a studio art session. With no arts program, I see this as a great opportunity to introduce the sophomores to a local museum’s historically relevant exhibit while exploring their own abilities.

I am asking for whatever amount you feel comfortable with. This is entirely pro bono on my part and the ChipIn widget deposits all money directly into the school’s PayPal Account via all 4 major credit cards and paypal.

You can give in any increments. Every dollar counts as this is the only fundraising for the trip. $15 covers the entrance fee, the supplies fee and transportation cost of one student.

Your $15 by FEB 5th = 1 Student going to the Art Museum

I’ve contributed the first $15.

I promise this will be a new experience and something very appreciated by the students. I will be following up with pictures and video responses after the February trip.

Ad Majorem Dei Gloriam
Marco Ambrosio