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Map the System: Youth Suicide Crisis in India

On 15-17 June 2020, the Skoll Centre’s Map the System Competition held its Global Final virtually. The team from Amani Institute competed against 30 other finalists from institutions around the world. Team members Bhairavi Prakash, Maya Narayan, Anshul Agrawal, Neeraja Kulkarni and Tushara Ravindranath tell us how they mapped the system for addressing youth suicide crisis in India.

In February this year, when India had still not experienced the gravity of the COVID19 pandemic, five of us got together and decided to participate in the Map the System 2020 challenge. Although we come from diverse backgrounds, Bhairavi (Psychology), Anshul and Maya (Systems Thinking), Neeraja (Design Thinking) and Tushara (Academic Research), the common thread which connects us together is that we are all young professionals who have spent at least two decades of our lives, being a part of the Indian education system, and have been witness to some of the challenges it exposes students to. The situation has only gotten from bad to worse in the past decade, where roughly one Indian student dies by suicide every hour. Given the alarming rate of deaths by suicide among Indian youth, we chose to explore the various factors that contribute to this crisis.

Secondary Research

We undertook extensive literature review and realised that death by suicide is a complex biopsychosocial phenomenon, requiring a multi-sectoral approach for tackling. We particularly looked at Higher Education Institutions (HEIs) as spaces, where psychosocial determinants play out in myriad ways.

Primary Research

We created an online survey (436 student participants) across different HEIs in India to understand this issue. The survey had questions on factors that impacted student wellbeing, and on coping mechanisms that they used to deal with emotional distress. In addition to the survey, we also conducted 10 in-depth interviews of experts working in the fields of education, mental health policy and practice, funding ecosystem, etc.

Following were the findings from our research:

  1. Complex bio-psycho-social factors can contribute to emotional distress, which can lead to death by suicide.
  2. Young people are open about their struggles with mental health, however, usage of services is low.
  3. Deaths by suicide are found across the spectrum of HEIs in India, not just engineering and medical institutions.
  4. There are barriers to both seeking and providing help, which widens the treatment gap among young people.

Problem Landscape

We used system mapping tools to further analyse the data collected. We identified four major systems that interact to have an impact on one’s mental wellbeing. Interconnections between these systems, further exacerbate the challenges faced by youth, affecting their mental wellbeing.

We also classified the existing solutions in three categories: Knowledge and Awareness, Services and Skills.

Shifting the Burden Archetype

Analysing the current solutions landscape, we found an overwhelming focus on short-term remedial solutions that are easier to formulate and less expensive. This consequently, acts as a barrier to implementing restorative solutions that address the root causes and could have a long-term impact on reducing emotional distress.

Gaps & Levers

We observed multiple political, social, cultural, and economic factors, possibly acting as tipping points that contribute to suicidal ideation amongst young people. Based on these factors, we identified four overarching gaps in the system and 22 levers for systemic change.

Key Learnings from Systems Mapping

  1. Deaths by suicide are symptomatic of larger structural and systemic challenges and completely preventable.
  2. Preventive interventions for youth suicide need to be prioritised in schools, colleges, families, communities, and society at large.
  3. Contextualisation and scalability are important factors for proper understanding of the problem space, and require adequate human and financial capital.
  4. Visualisation of the system by diverse stakeholders can help build a comprehensive narrative that is key to determine the success of interventions.

Way Forward

Being one among the top 31 global finalists at Map the System 2020, was a wonderful opportunity to connect with systems thinkers across the globe, and learn about the complex problems they are working upon.

To further our study and alleviate this challenge, we have applied for a Think Tank Grant. Our goal is to organise an immersive conference and introduce contemplative practices (traditional forms including yoga and meditation, and expressive forms including art, theatre, and movement therapy) for building resilience and emotional regulation in young people.

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A Tale of Two Viruses

Dr. Diana Esther Wangari is a current 2019-20 Skoll Scholar and Oxford MBA. She is the co-founder of last mile health venture, Checkups Medical Centre in Kenya where she dedicates her work to treating those who need it most. Read more about Diana’s experience as a health professional during two viruses.

It started when I was in the queue at immigration. This was at Brussels Airport. The elegant lady looked at me, almost apologetically, then whispered to her partner. He turned and looked, decidedly less friendly, pulled her towards him and they moved forward.

They didn’t have to tell me what they were thinking. I was the only African in this queue, and it was at the height of the 2014 Ebola crisis in West Africa: they had no way of knowing what country I had come from.

And by then, global news headlines had already proclaimed the ultimate horror: a man infected with Ebola had travelled all the way to the USA, without his deadly infection being detected.

Worse still, he had interacted with various members of his friends and family – over and above his fellow passengers on the flights to the US, and the airline crew – before the truth had emerged that he had Ebola. Total panic had ensued in America, and demands were made for all flights to the US from West Africa (if not all of Africa) to be suspended immediately.

I knew they were looking at me and thinking just one thing…Ebola.

It was a time of global hysteria over this terrifying disease, and thus not really the best time for an African to be flying to Europe or North America.

So why was I there? At that airport? In that immigration queue?

I had travelled from Nairobi, Kenya to Brussels, Belgium.

My final destination was the Institute of Tropical Medicine (ITM) Antwerp, the very institution where Ebola had been discovered by Dr. Peter Piot back in 1976.

You could argue that this feeling of being dehumanised – of being seen essentially as a potential carrier of a deadly and highly contagious virus – was all in my head. But I was to have an even more disturbing encounter in the train on my way from Brussels to Antwerp.

On the train where I was seated next to the window, a child came and sat next to me only for the mother to promptly grab her hand and swiftly move with her to a distant couch. The gentleman seated opposite, noticing my facial reaction, leaned in and started speaking in French.

Now while I do know some French, it certainly didn’t prepare me for the verbal onslaught of incomprehensible French that poured forth, and so I stared at the gentleman and said, “En anglais s’il vous plait.”

“Aha, so you are not from a Francophone country,” said the gentleman, “I was simply apologizing on behalf of the lady as it is ignorance and now, I see that you are not from West Africa.”

In the conversation that followed, I explained to the kind gentleman that I was actually from Kenya. And that despite there being no cases of Ebola in Kenya, the impact of the Ebola outbreak on sectors of our economy would be notable.

Our parliament had officially decreed that Kenya Airways, our national carrier, suspend all its flights to West Africa for fear that one of the many transit passengers from West Africa would bring the dreaded disease to Kenya.

The Kenya Airways management argued in vain that they were taking precautions against any such possibility; that there were even European airlines still flying to the West African nations affected; and that flights from West Africa to Dubai or China, via the Nairobi hub, were a key profit centre for Kenya Airways.

But the parliamentarians would have none of it. One MP even declared that the next flight from West Africa landing in Nairobi, would find him – along with his supporters – lying on the runway to prevent it from landing “if that is what it would take to secure the lives of innocent Kenyans, threatened by Ebola”.

But I digress. Bruno (for that was his name) told me of his dream to go on Safari in Kenya and was considering going to the Maasai Mara to witness the annual wildebeest migration, famously, “The eighth wonder of the world”.

I was smiling and laughing by the time I got off the train.  But that night – my first night at ITM – I cried. I just could not help it.

However, that nasty experience of being an African traveling in Europe at the time of Ebola was quickly forgotten as I settled into ITM, as every day I got to interact with scientists who were travelling regularly to Liberia at the very heart of the outbreak: the kind of courageous and dedicated biomedical researchers that the world has learned to think of as heroes, since the COVID-19 pandemic descended on us all.

airplane window showing the wing of the plane in blue skies

And speaking of COVID-19, six years after the incident at Brussels Airport, I found myself in another queue. This time at the Jomo Kenyatta International Airport in Nairobi.

After completing the re-entry formalities, getting into the Uber, I noticed the undue speed with which the driver picked up my bags and flung them into the boot.

And then, once I was seated in the back of his car, ever so casually, he asked, “Where are you flying in from, my sister?”

“London,” I answered.

And I could hear the “Oh” and then a moment of silence, before he continued in a rather accusing tone of voice, “Kenya just confirmed its first case of “corona” yesterday. It was a lady coming from London as well.”

I got the impression that he felt I should have volunteered that piece of information about having flown in from London before I got into his cab; given him the opportunity to decline to drive me home.

An uneasy silence followed.

“Are you worried?” I asked despite the fact that I was in the back seat with ample space between. He quickly shook his head but did not say anything.

We drove in silence. But it was unnerving to see the occasional glances he threw back – taking his eyes away from the road for a second or two – as if he was checking for some indication that he was at risk: that a fine mist of coronavirus might be floating towards him, brought back from a contaminated London, to infect innocent people in Nairobi.

On arrival, I volunteered to take out my own bags. The driver seemed relieved.

Thanks to that great Kenyan innovation, the ubiquitous Mpesa mobile phone money transfer system, I was able to pay him without having to hand over to him, what he would no doubt have considered to be “corona”-infected cash.

There was a time when I would have been very tempted to scream at him that I refused to be treated like a leper in my own country.

But I had seen much more of the world over the past six years. I understood fear. I just paid him and thanked him. I even gave him a tip.

And that night, I did not cry.

For you see, I had learnt over the course of time, life is not black and white. I was now an MBA student at Oxford University’s Saïd Business School and I had the sinking feeling that our MBA experience, just like the rest of the world, was not going to be the same. It has been two months and I was right.

Perhaps the hardest part was being torn between answering the call to aid my country as a health professional and continuing down the path I had already embarked on at Oxford. And some days, I do find myself volunteering in the hospital because the little we can do, we must do.

And as we continue with our classes online and I think back to the classmates, the faculty, the friends and the family I made, I know it has not been easy.

I will tell you what Bruno told me as we left the train that autumn evening at Antwerpen-Central, “Take care of yourself my dear. Don’t forget to smile. It shall pass”.

This too shall pass.

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The windy road from Kenya to Oxford University

Dr. Diana Esther Wangari is a current 2019-20 Skoll Scholar and Oxford MBA. She is the co-founder of last mile health venture, Checkups Medical Centre in Kenya where she dedicates her work to treating those who need it most. Read more about what led her to Oxford.

How does a young Kenyan doctor, who through her earlier years dreamt of being a neurosurgeon, end up at Saïd Business School, University of Oxford?

The answer to this – oddly enough – is a question. And this question is, “Do you want your life to count for something – or not?”

Here’s my story.

In my fourth year of medical school, I stood in the middle of a pediatric ward, having failed to resuscitate a young boy of four years and I knew he did not have to die.

John died from a case of complicated pneumonia. We could treat pneumonia. He could have been treated from his own village; he didn’t have to travel over 300 kilometers to seek care. That time taken led to complications. He did not need to be in my ward.

On that day in the middle of the pediatric ward, I asked myself one question, “Who am I? What am I doing here?”

I was in the biggest referral hospital, but majority of our patients, consisted of those who didn’t need to be there. They had preventable and very treatable conditions that could have been handled in a facility in their towns or villages. And by the time they got to us, the case had often complicated.

But childhood dreams are not easily abandoned.

And thus, it was not until my fourth year in medical school that I was able to accept a stark fact of the health sector in a developing country like Kenya – that no matter how hard I worked, treating the patients that came to me, would not be enough. My clinical practice would not be enough.  And, specifically, if I specialized in neurosurgery, I would cut myself off from the millions of Kenyans who would never in their lives encounter a neurosurgeon.

The kind of people whom I met every day as a fourth-year medical student – people whose courage in the face of adversity and extreme neglect sometimes moved me to tears – would no longer feature in my working day.

I suppose I should also be grateful that I was not only a medical student. Beginning from my second year, I had become, out of necessity, a fulltime journalist duly accredited by the Media Council of Kenya, having worked with Radio Netherlands and Reuters Foundation.

But between what I was learning from my colleagues in the newsroom and the unforgettable exposure to what ordinary Kenyans go through in their efforts to get treatment at a public hospital, a strange change came over me.

I began to feel that I would have to regard myself as a failure in life, if, as and when, my time was up, I had not made a tangible contribution to improving the quality of healthcare available to ordinary Kenyans.

Naïve as it will sound; I want my life to count for something. Naïve as it will sound; I believe I can have an impact, which will touch on not tens of thousands, but millions of lives. And naïve as it will sound; I believe that this is an ambition that is within my reach.

Isaac Newton said, “If I have seen further than others, it is by standing upon the shoulders of giants.”

I knew that Oxford University has historically been the abode of giants; and that it is a place where I too, can hope to stand on the shoulders of giants, and expand my vision of what I can do for my country and my continent.

So “Who am I? What am I doing here?”

I am the future of the Kenyan healthcare establishment. I feel like that who have come before me, have done their best but there is a lot more that still needs to be done.

So “Who am I? And what I am doing at the Oxford University’s Saïd Business School?”

I am Dr. Diana Wangari, a doctor, a journalist and a healthcare entrepreneur. As co-founder of Checkups Medical Centre, a health tech startup that operates a network of rapid outpatient clinics to drive last mile distribution of drugs and healthcare services.  This is not just a Kenyan issue; we operate in four African countries and plan to scale across Africa through partnerships and investments.

From what I have seen this far of the Skoll Network, the Saïd Business School and Oxford University Community, I am in the right place.

How to manage business remotely

Whilst doing your Oxford MBA!

You run a growing social business and things are going well. But you soon realise that with a little extra business knowledge and global connections, your business could be so much more impactful.

So, you decide to take some time to study your MBA.

But what happens to the business? You think, ‘surely there will be plenty of time to run my business remotely, it’s the 21st Century for goodness sake, it’ll be like I’m practically in the office with all this technology at my fingertips’!

Well, sadly, most of the time this is where our Oxford MBAs can quickly get overwhelmed. In their hopes to do both, get an Oxford degree and run a successful business from 5,000 miles away, only one will prevail in the end.

So, what can we learn from those who have come before?

Mohsin Mustafa, Oxford MBA, Weidenfeld-Hoffmann Scholar, and Skoll Scholar 2018-19, offers some handy advice for any prospective MBA looking to keep their business ticking over whilst they take a year out to study. 

Some background…

I run a healthcare business in Pakistan. We have pediatrics Clinics and we run those clinics in partnership with schools where we provide preventative care services. My enterprise Clinic5 is three years old and we have a team of 15 people. One of the biggest concerns I had when I was leaving for the Oxford MBA was what would happen to the business in my absence. So, I would like to share with you my experience and what worked. For advice on this aspect I would really like to credit Sidhya Senani, MBA 2017-18 who faced a similar dilemma as I did whose advice was crucial in helping me plan my transition this past year.

What to DO:

Have a lead in place

Having one person to contact while you’re away makes it much easier for you to administratively manage affairs in your enterprise. Also having one second in command makes it easier for your other stakeholders (suppliers, clients, rest of the team) to know whom to contact in case they want an issue to be solved.

Pilot not going to the office for at least 2 weeks

This pilot helps everyone in the team see how things happen in your absence. If you’re the cofounder, its quite possible that you were always available, both in person and with your time, now that you would be gone for a year, the gap would be felt so it’s always better to first give a feeler to the team and troubleshoot the issues that come up. Trust me this will come!

Set aside dedicated time for a weekly video call.

This is very important. Face time with the team every week makes them see you still care about the work. It’s quite likely that the ownership you feel towards the business is much higher than anyone else. Feed the team with that energy every week. Additionally, during these calls, keep negative feedback to a minimum. Primarily serve as the motivational speaker or the cushion for their stressors. Let them speak. At your end reiterate the achievements during the year and how much longer the team must go before you join them and what’s waiting in store for the team after you join. Sharing the vision goes a long way.

You will get a few calls from your primary point of contact every now and then. Prioritize that call. Important for your primary point of contact (your lead) to feel that you have their back.

Also, if other team members call, try and route them through your primary lead. If there’s a call, document it immediately through an email so that everyone in the team is aware of what was discussed. This practice reduces the chance of misunderstandings. This year will be a real challenge of your business leadership skills.

Set aside cash flows so that your business operation does not suffer.

It’s possible you might get cancelled clients, it’s possible that your business development plans for this year do not work out. The cushioning of cash flows for your business should be greater than what you keep. You need not share the exact level of cushioning with your team. It’s more as a safety net for rainy days.

What NOT to do:

Don’t intervene in operational matters.

Let the team on the ground deal with them and TRUST their decision even if you think you would’ve done things differently let it be. Unless and until you think a certain decision is an existential threat, resist the temptation to intervene. This is essential to empowering your team.

Don’t get involved in office politics back home.

Some will happen inevitably. When that happens try not to take sides

Don’t give negative feedback over a group phone.

Call if you must do it, do It one on one

Don’t plan to scale your work this year.

It exerts immense pressure on the team

A year later, I could safely say, things went by quite smoothly for Clinic5. I would give this credit to my brilliant team: Dr. Taha Sabri, Dr. Selina Hasan, Muhammad Irfan and Syed Kareem. Additionally, my father kept an oversight on financial matters which took a lot of stress off me, so thank you Abbu!

This time away might have been a blessing in disguise since people took up more leadership responsibilities within my organization and now when I go back, I can really focus on scaling.

If you’re taking part in the Oxford MBA this coming year, brace yourself for an intense and exciting year.

Best,

Mohsin Mustafa, 2018-19 Skoll Scholar.

Our MIINT journey

The MBA Impact Investing Network & Training (MIINT) competition saw 31 MBA teams take part in 2019. With Yale receiving 1st place with a $50,000 investment prize, Oxford and Wharton were selected as runners up with $25,000 each, as investment for the companies they represented.  Our Oxford MBA team recall their journey through the tournament and the social enterprise they pitched for.

Image of Richard.

Meet Richard. Ugandan social entrepreneur taking on women’s empowerment. As a teacher, he noticed that many young women and girls were missing school due menstruation. In rural Uganda, menstruation is still stigmatised, often seen as something ‘unclean’. Alongside this, there is a lack of access to products to help manage menstruation with women turning to rags and even mud to cope. As a result, females are unable to fully participate in society. For example, they can miss up to 20% of school days, leaving them seriously disadvantaged when it comes to earning a livelihood.

In 2010, Richard founded Bana Pads to tackle this range of issues. Bana makes sanitary pads from agricultural banana waste. Throughout the value chain of sourcing, production and sales, Bana exclusively hires rural women to offer jobs to this underserved group.

These pads are then sold in rural areas to enable women to better manage menstruation and therefore participate more fully in society. Because menstruation is a culturally sensitive issue, Bana has come up with an innovative way of distributing their product. Bana’s sales channel is a group of women known as ‘Bana Champions’ who sell pads door to door in rural communities. This reduces the embarrassment of buying pads from (often male) shopkeepers. It also allows the champions to speak with the head of households (again often male) to raise awareness of the challenges of menstruation and the need for pads. Similar work happens in schools and churches. All in all, Bana reaches 20,000 customers per month, selling over 400,000 pads.

We found Richard while involved with the MBA Impact Investing Network and Training (MIINT) programme. MIINT simulates the impact investing process starting from writing an investment thesis, moving through to sourcing, due diligence, and drafting an investment memo. This culminates in pitching to an investment committee for up to $50,000 investment.

After shortlisting 10 companies, we decided to go with Bana for their compelling impact story. We were worried that they did not look like any of the previous winners of the MIINT competition (typically US based firms, with a range of investment already lined up) but decided to persevere.

After preparing an investment case, our first litmus test was the internal competition at Oxford’s Saïd Business School. Three judges with impact investing, venture capital, social entrepreneurship and consulting experience made up our panel.

Image of the team preparing to pitch at the internal MIINT competition.
The team prepares to pitch at the internal MIINT competition at Oxford’s Saïd Business School.

The judges’ feedback was tough. There were questions about how scalable the model was; the financial analysis and valuation; and even why Richard converted from an NGO to a social enterprise given the challenging investment thesis. All of this was summed up in one judges’ comment: that the business was ‘un-investable’ as presented. After leaving the room, we figured that was probably the end of our Bana Pads journey.

A few days later, we were pleasantly surprised to hear that the judges had selected us to represent the University of Oxford at the global finals in Wharton. The judges believed in the impact story of the organisation and the fact that they already had a viable model based on their track record. The excitement (and very audible celebration) was so euphoric that the barista at the Oxford Saïd common room came over to congratulate us on what must’ve been the news that someone was getting married.

And so, we got to work, taking on board all of the judges’ comments. We worked on the project through our examinations period and international classes in Johannesburg. Armed with a brand-new financial model, impact analysis, pitch deck and memo we assembled in Wharton.

In the morning we pitched in the Semi Finals. Only one team per thematic area would go through to the finals. Following lunch, we were thrilled to hear that not only did the judges chose us, but we also won the students award for best presentation. After the announcement we had a full 30 seconds to mentally prepare before pitching again. This time, in front of a panel of 10 judges including Bank of America Merrill Lynch, Acumen and Omidyar Network and 150 of our fellow competitors from over 30 business schools.

Image of the team pitching.
The team pitches Bana Pads for one last time at the finals

Photo courtesy of Wharton Social Impact Initiative

We gathered for the final ceremony at the end of the day. Hearts pounding, we listened to the closing speeches. And then the moment we had all been waiting for, “and the winners are…”. When we heard “University of Oxford” it took a full 5 seconds before what had happened sunk in. Cue the madness. We had just won $25,000 for Richard and membership into an incredible network of investors. Joy. Relief. Excitement. Disbelief. Sadness (that it was all over). You name it, we felt it.

This is what business school is all about. Taking on a challenge, building a team, working on something that you’re figuring out as you go along. And we managed to pull it off. Richard was so thrilled, he offered to pay us 10% of the winnings (which we had to refuse at least 5 times). It remains one of the highlights of our year at Oxford, we’ve built some amazing friendships on this team, have some unforgettable memories and (hopefully) helped Richard fulfil his dream for Bana Pads.

The next morning, still jet-lagged, a little dazed from what had just happened, we reminisced about the six-month journey that brought us here as we made our way home, taking one last photo before we left…

Image of the team winning.
One last crazy photo before leaving Wharton

We’d very much like to thank those who supported us in travelling to Wharton including MIINT, the Skoll Centre, the Saïd Business School, Green Templeton College and Kellogg College.

Nick, Alma, Alex, Aisha and Emma.

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Accelerating Global Health Delivery

Each year the Skoll Centre invites a small number of Oxford students to the annual Skoll World Forum on Social Entrepreneurship. Each year they share their unique perspectives of the sessions and events that unfold during this magical time in Oxford.

This session conducted by the leadership team of Partners in Health was scheduled for 7 am on the 10th of April. Hence by design it self-selected for individuals who were extremely motivated to learn from the experience of Partners in Health in Global Health Delivery.


Partners in Health (PIH) is a Boston-based nonprofit health care organization founded in 1987 by Paul Farmer, Ophelia Dahl, Thomas J. White, Todd McCormack, and Jim Yong Kim.

The organization’s goals are “to bring the benefits of modern medical science to those most in need of them and to serve as an antidote to despair.” It provides healthcare in the poorest areas of developing countries. It builds hospitals and other medical facilities, hires and trains local staff, and delivers a range of healthcare, from in-home consultations to cancer treatments.

The session was led by Dr. Joia Mukherjee, and was facilitated by her colleagues Dr. Gary GottliebDr. Abera Lotha

The session delved into a nuance in global health delivery which are often ignored. Dr. Mukherjee asserted that the successful delivery of healthcare ought to be reviewed through three lenses.

  1. A justice framework
  2. Human rights framework
  3. Social determinants of health framework

The first two are not given their due share of discussion since perhaps as healthcare professionals we feel this is beyond our scope of work however, they are essential to an equitable delivery of good health for all.

The justice framework requires retrospective reflection. Many of the inequities we observe as global health delivery agents are not just because people who we aim to benefit do not know better or that there is lack of will to correct the structural problems that exist. Instead, the source of these issues come from a history of colonization, practices of slavery and exploitation of certain regions by others. The damage from these unfortunate parts of our collective history is immense. While these chapters of history cannot be undone, it would not be prudent to completely forget about these issues as important causative factors towards why certain regions struggle to this day with diseases that the developed world has long overcome. Hence, keeping them in our purview as we think about global health would ensure such injustices are never repeated.

The second framework is the human rights framework. Today we live in a world where almost everything we do, any service we receive or any item we own has input from many different regions. This is especially more applicable to the socioeconomic strata attending this forum or can read this narrative that I write today. When we live in a globalized world of commerce then a question that arises is why our human rights are different depending on national borders. What would be considered exploitation in one country would be considered fair trading practices in another. The world is much more comfortable with utilitarian notions of healthcare service delivery for the poor but not the same yardstick is applied to the wealthy. These are deep-seated, class-based biases that ought to be brought out in the fore and the repercussions of these biases need to be corrected or else the inequities we wish to overcome will always plague us in some way or form. This philosophy of healthcare delivery is reflected in the work of Partners in Health throughout the world. They believe all that they interact within their ecosystems are owed a similar chance towards healthcare services.

Finally, the social determinants of health were also discussed. This is an area quite often discussed and debated on in Global Health conversations. The impact of where you are born, your gender, your education and such all impact health outcomes. This has been researched and well documented. Dr. Mukherjee added a nuance to this conversation though. She proposed that instead of calling it social determinants of health we should label this effect the social forces of health since these socioeconomic markers are not just a correlation but have vector component to them as well hence the relabeling to a “force” would more accurately depict the relationship.

One of the key takeaways from this session was that healthcare is clearly a political and a social issue. And in our respective communities, to enable meaningful healthcare change we must interact deeply with the social and political forces. Meaningful change requires mobilization and that’s only possible once we put our skin in the game by operating beyond our healthcare facilities and embed ourselves intimately with the wider community.

About the Author

Mohsin Mustafa

Mohsin Mustafa is an Oxford MBA candidate, a Skoll Scholar and Weidenfeld-Hoffmann Trust Scholar. He is also an entrepreneur who is passionate about the provision of quality primary healthcare. He sees the provision of quality healthcare as a way of enabling social justice and that’s what fuels his passion for work. Mohsin is the co-founder and managing director of Clinic5, an affordable healthcare delivery service for communities in Pakistan. He is currently a Skoll Scholar, Weidenfeld-Hoffman Scholar and MBA candidate at the Saïd Business School.