Gillings Humanitarian Health Initiative
The Gillings School of Global Public Health has many long-standing and diverse public health-related activities in over 80 countries around the world. The Humanitarian Health Initiative (HHI) builds upon this deep experience, leverages existing partnerships, and creates new ones to support organizations working in humanitarian settings and situations of extreme adversity.
Message from the HHI Leads
Sheila Leatherman and Aunchalee Palmquist
Currently, two billion people live in countries where development outcomes are affected by fragility, conflict, and violence (FCV). By 2030, nearly 50% of the global poor will live in such situations. These circumstances call for attention and action worldwide. Earlier this year, the UN Office for Coordination of Humanitarian Affairs (OCHA) projected that 274 million people would need humanitarian assistance and protection, an increase from 235 million projected for 2021. Hunger is on the rise, disease outbreaks are increasing, and the impact of the COVID pandemic on essential health services could erase decades of progress in HIV, TB, and malaria, potentially doubling death tolls.
COVID-19 has triggered the deepest global recession since the 1930s with extreme poverty rising for the first time in 22 years. The UNHCR, the UN Refugee Agency, has reported that over 89 million people – or 1 in every 88 on the planet – have been forcibly displaced, the vast majority of whom are residing in the Global South.
Crises related to war, internal conflict, fragile governments unable to provide essential services, climate and water related emergencies are all an ever-present challenge, often addressed by acute crisis responses to immediate humanitarian needs for shelter, protection, medical care, and more. Humanitarian aid has been traditionally defined as “material and logistic assistance to people who need the help. It is usually short-term help until the long-term help by government and other institutions replaces it. Among the people in need are the homeless, refugees, and victims of natural disasters, wars and famine.” [Source]
However, in reality, these complex crises are often protracted and require long term solutions. A pressing question is how do we move to proactive management and mitigation of the impact of crises and more predictably build resiliency in partnership with affected populations? As global health professionals, we seek to contribute to that looming question in the pursuit of advancing health care, health outcomes and well-being for people across the world.
Our Mission
We in the Gillings Humanitarian Health Initiative, in collaboration with and support of partnering organizations and collaborators, work to address multiple and diverse humanitarian situations in ways that include;
- Evidence scanning for what works to improve health care and health outcomes in FCV and humanitarian settings
- Action research for rapid uptake of practices and interventions that can be adopted and adapted in the front lines of providing health care
- Capacity strengthening for NGOS and governments
- Strategic advising
- Monitoring and evaluation
Sheila Leatherman, CBE, Hon FRCP, Professor of Global Health in Health Policy and Management and Aunchalee Palmquist, PhD, MA, IBCLC, Assistant Professor in Maternal and Child Health
The Gillings HHI is seeking your input on developing new opportunities for students, faculty, and staff to engage in the initiative. Specifically, we want to gauge the current level of interest in a Humanitarian Health Initiative special interest group (SIG). Please contact Amy Kryston with any questions. Thank you!
Internships
The Gillings Humanitarian Health Initiative offers Gillings graduate student opportunities to engage in service projects of a year (or longer) duration, with a supporting honorarium award. Each intern works on one or more service projects focused on supporting international and national NGOs or multilateral health organizations in a specified body of work meeting the evaluation, policy, practice, and service needs specified by collaborating NGOs.
Current service projects
The Gillings Humanitarian Health Initiative operates through collaborating with both internal and external partners. If your agency or organization is interested in partnering with the Humanitarian Health Initiative, please use the link below to submit an application. Applications accepted on a rolling basis.
Where we work
Degree program: MD/MPH, Population Health for Clinicians
Santiago is an MD/MPH candidate in the Population Health for Clinicians concentration. This concentration serves as a one-year accelerated MPH track for medical students interested in expanding their public health knowledge and applying that new knowledge within a career as a physician. He plans on applying to Emergency Medicine residencies after finishing his MPH program in 2024. Before starting medical school at UNC, Santiago spent three years conducting public health research through the Duke Cancer Institute and acquiring clinical experience as an EMT, a phlebotomist, and an Emergency Department technician at Duke University Hospital. As an undergraduate student, Santiago studied Global Health and Cultural anthropology focusing on the transnational intergenerational experiences of Latinx migrant families through a senior Honors Thesis. His current research interests include Latinx migrant health along the Southern United States-Mexico borderlands, and health disparities between racial and ethnic groups. His MPH practicum focuses on assessing access to medical services in the asylum seeker community. He is currently working with a humanitarian aid project based in Tucson Arizona, Casa Alitas, and the Office of Global Health Education (OGHE) at the school of medicine to build a partnership and explore future opportunities for both medical and public health students interested in migrant health.
Degree Program: PhD in Health Policy and Management (organization and implementation science minor)
Alix is a PhD candidate in the Department of Health Policy and Management with research interests centering on effective strategies to improve vaccine distribution networks in low-resource settings and strengthen health systems. Before pursuing studies at UNC, she received an MSc at the London School of Economics and worked in program design for initiatives to tackle infectious diseases. Her doctoral dissertation research focuses on improving the quality of birth-dose vaccine distribution in the Democratic Republic of the Congo. With Professor Leatherman, Alix works to improve the quality of care in lower resourced and fragile, conflict-affected countries through the National Quality Policy and Strategy Initiative, a partnership of WHO and UNC Gillings School. To track country-level and global progress in the quality of health care, she is supporting the collection of data measuring access, safety, effectiveness, patient centeredness and facility-level performance across health systems in many countries. She provides technical support at the national and sub-national levels to improve the quality of care through a five-country initiative in West and Central Africa and contributes to developing a French version of a Fragile and Conflict-Affected and Vulnerable Settings Tools and Resources Compendium. Alix has been an HHI intern since 2021.
Degree program: MPH, global health concentration
Sara is a second year MPH student. Before entering Gillings, she worked for a refugee resettlement agency in Virginia and then entered the Peace Corps in Morocco. After being evacuated due to COVID-19, she returned to the US and worked as a COVID Contact Tracer for Partners in Health. Her interests focus on health access both domestically and abroad. For HHI, Sara worked on a domestic project in partnership with World Relief Durham, a refugee resettlement agency, where she helped develop a Health Literacy curriculum for recently resettled refugees. She is now assisting with the Al-Azhar University project (Gaza). Sara has been with HHI since 2021.
Degree program: MPH, maternal, child, and family health concentration
Clara is an MPH candidate in Maternal, Child, and Family Health. She gained an interest in humanitarian emergencies while studying the Arabic language in Jordan during the Syrian refugee crisis. She interned for International Rescue Committee and spent a semester in Nepal studying Tibetan culture in exile and reproductive health in the Himalayas. After college, she worked in sexual and reproductive health in the Philippines and breastfeeding promotion in Oregon. Her MPH practicum focuses on curriculum development for the Peace Corps' adolescent health education projects. As an HHI Intern, she is working with Dr. Aunchalee Palmquist on a repository of information about Infant and Young Child Feeding in humanitarian emergencies. Clara has been an HHI intern since 2022.
Degree program: PhD in Maternal and Child Health (epidemiology minor)
Aparna Kachoria is a doctoral student in MCH. Before joining UNC, she received her MPH in global health epidemiology from the University of Michigan and then spent five years working in quality improvement, health services research, and overseeing mental health research studies in Central Massachusetts. Her current research interests include maternal decision making and empowerment in the perinatal period, childhood vaccination in South Asia, and improving overall health equity and quality both globally and here in the US. Aparna is currently a research assistant with the WHO Collaboration Center at Gillings, working on an implementation study about hypertension in pregnancy in rural parts of North Carolina. She also works with Dr. Joanna Maselko's team on the Bachpan (childhood) study to better understand adverse childhood outcomes and perinatal depression in rural Pakistan. At HHI, Aparna provides holistic support by assisting with evaluation and evidence generation, project management and quality of care improvement across multiple projects. Aparna has been an HHI intern since 2022.
Degree program: MPH, global health concentration
Mitch is a second year MPH student and a Registered Nurse with experience in emergency care and pediatric critical care. He came to UNC with interests in humanitarian health, disaster response, and health systems strengthening. During the first year of his MPH, he continued to work clinically and teach the Public Health Nursing clinical rotation at the UNC School of Nursing. Then, he conducted his MPH practicum with UNC Project-Malawi and a Peacock Fellowship with CFK Africa in Nairobi, Kenya. Mitch supports the HHI through working with the NGO Syrian Society for Social Development with a focus to improve health and social development throughout conflict-affected Syria. His work supports quality improvement goals as the NGO increases access to needed medical service offerings. Mitch has been with HHI since 2021.
Degree program: MPH, global health concentration
Amy is a second year MPH student with interests in water, sanitation, and hygiene (WaSH) in protracted and informal settlements, climate change, community health programs, and environmental justice. Initially trained as an environmental engineer, Amy worked in the public sector and then served as a research assistant investigating cholera transmission in rural Bangladesh and climate uncertainty in transboundary water policy of the Ganges. She is also a research partner with the UNC Environmental Justice Action Research Clinic and, during her second year, will explore on-site sanitation in marginalized North Carolina communities as an Environmental Justice Graduate Research Fellow through the UNC Institute for the Environment. In her first year with HHI, Amy worked in conjunction with the UNC Water Institute to conduct an evidence review of WaSH in informal settlements and fragile, conflict-affected, and vulnerable (FCV) settings. She now continues as an organizational lead for HHI and will assist across multiple projects focused on improving community health and capacity building in humanitarian settings. Amy has been an HHI intern since 2021.
Degree program: MD/PhD in Epidemiology
Samantha is a student in the MD/PhD program at UNC. Prior to beginning the program, she worked on numerous global health research projects, from assessing glaucoma incidence in Tema, Ghana to evaluating new trichiasis surgical techniques in rural Ethiopia. She also supported two USAID-funded health systems strengthening projects based in Ghana. Her primary projects at Gillings are related to improving vaccine efficacy globally, including optimizing the Hepatitis B vaccine schedule, and investigating the impact of early life malaria exposure on measles vaccination. As an HHI intern, she is supporting a community primary healthcare NGO based in Nicaragua, AMOS Hope & Health, with a 10-year review of their activities and impact. Her primary work includes evaluating the impact of their longitudinal projects over this period and consulting on monitoring and evaluation strategy for future activities. Samantha has been an HHI intern since 2022.
Founded in 2007, this community-based Nicaraguan NGO fosters community empowerment to treat illness, prevent disease and strengthen local health leadership through training and supporting community health workers. During the past 15 years over 670 CHWs and volunteers have provided primary and preventive healthcare activities in 25 rural and urban communities in Nicaragua. AMOS focuses on improving health for pregnant women, newborns, children under 5, and people with chronic conditions. The AMOS-UNC project is focused on monitoring and evaluation, specifically to examine the impact of programs to date and to help in the redesign to optimize benefit to communities.
The State of Palestine is affected by a protracted crisis; currently, 2.5 million people, including 1.2 million children, living in the Gaza Strip and the West Bank need humanitarian assistance. Gaza has suffered from isolation causing constraints to advance capability within higher education institutions. The Gaza-based University thus requested an academic partnership with UNC Gillings to facilitate knowledge transfer to build capacity among selected Gaza-based University faculty and staff, as well as the Ministry of Health. Several Gillings professors, including HHI advisors, have begun piloting an open-university virtual lecture series.
This long-established Syrian NGO responds to the many and diverse challenges faced by marginalized groups affected by the Syrian Crisis including difficult-to-reach areas, where there are internally displaced and war-afflicted persons as well as refugees returning to their communities after many years of living outside Syria. SSSD actively intervenes at an individual person, household and community level with specialized programs to alleviate the suffering, identify and provide for unmet basic living requirements, and address medical and development needs. Programs include health, WaSH, psychosocial support, shelter, social protection, infrastructure, vocational training and livelihood generation, as well as informal educational programs for children and adults. The UNC service project is supporting the development and operations of health care programs with design of health-related records and data sets to monitor, expand and improve patient care.
Sierra Leone has the highest maternal mortality rate in the world and an expected lifespan of just 52 years. Rural Health care Initiative is an NGO that partners with the Tikonko Chiefdom in Sierra Leone to advance existing maternal and child health services through community-based solutions including two Birth Homes for Mothers for safe deliveries and a Children’s Health Program. Through outreach motorcycle clinics in rural villages, family planning and antenatal care is provided as well as care for children under age 5. Most common conditions for treatment of children include acute illness, immunizations, arranging hospital care for critically ill children as well as a comprehensive program for moderate and severe malnutrition. The UNC service project includes developing the evidence base and understanding of best practices as well as qualitative assessment to improve access and effectiveness of health services.
MSF provides medical assistance to save lives and ease the suffering of people in crisis situations in settings affected by conflict, epidemics, disasters, or exclusion from healthcare services globally. The UNC service project is focused on supporting the organization to strengthen its clinical governance framework that provides the guidance, mechanisms and accountability for health care services provided in many countries. The technical assistance specifically includes building the evidence base and practical tools for improving safety, effectiveness, and the experience of care of persons receiving health services in humanitarian settings.
This project, initiated in 2015, supports the WHO National Quality Policy and Strategy Initiative---a global program (NQPS) for which Professor Sheila Leatherman serves as the Lead Advisor. The NQPS program has developed the conceptual frameworks, evidence –based interventions and supporting tools and resources to be used by low- and middle-income countries across the world. This program provides policy guidance as well as field based technical assistance. Further research and global consultation resulted in the publication of additional WHO guidance for quality in fragile, conflict-affected and vulnerable settings which was published in 2019 and is being implemented in numerous countries. UNC is also a primary partner for developing a global country-level comparative data dashboard for quality metrics across lower resourced and fragile countries. Multiple UNC-WHO collaborative peer-reviewed publications are available describing the context, methods, and findings of this portfolio of work.
Supporting appropriate infant and young child feeding (IYCF) practices has been repeatedly identified as a critical target area necessary to globally reduce infant and young child mortality; emergencies are a particularly challenging context to deliver on this. The IFE Core Group is a global collaboration of agencies and individuals that formed in 1999 to address policy guidance and training resource gaps hampering programming on infant and young child feeding support in emergencies. The IFE Core Group develops guidance and resource materials, including training manuals and ‘stop gap’ guidance for critical gaps; documents lessons learned; and builds aspects of capacity for IFE. The IFE Core Group acts to bring challenges and issues to the collective for peer support and guidance; to facilitate rapid application of updated experiences to operations; and to connect on the ground experiences with agency and global policy guidance development. The IFE Core Group does not directly implement programs but supports those who do so. The UNC service project includes collaboration with the Carolina Global Breastfeeding Institute to make ongoing contributions to a global infant feeding in emergencies research repository. HHI interns also support various IFE Core working group activities related to emerging and protracted crises affecting the nutrition of pregnant and postpartum populations and infants and young children from 0-2 years of age.
A showing of Bending the Arc and distribution of free copies of Mountains beyond Mountains by Tracy Kidder was conducted in conjunction with the Gillings Student Global Health Committee in memory of Dr. Paul Farmer.
The Gillings Humanitarian Health Initiative Seminar Series focused on the safety and security for health care workers and facilities in humanitarian settings. Panelists include Dr. Dilshad Jaff, Gillings Humanitarian Fellow and Adjunct Associate Professor and Dr. Benjamin Meier, Professor of Global Health Policy and UNC-Chapel Hill.
UNC Gillings alumna Anna Freeman, RN, MPH, nurse and quality improvement specialist, shared her humanitarian field experiences and work to improve quality of care with Médecins Sans Frontières / Doctors Without Borders.
Dr. Dilshad Jaff, the Gillings Humanitarian Health Fellow, presented on his field experience working with the International Committee of the Red Cross in South Sudan.
