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A Housecall to Help With Doctor’s Orders

By Tina Rosenberg

Doctors are very good at telling us what to do — but we are very poor at doing it. In fact, the health problems of millions of Americans are directly related to our failure to follow doctors’ orders.

Doctors tell us to take our pills, exercise, go get that C.T. scan, stop smoking, change our diets, cut out salt, quit drinking, monitor our blood sugar.  We know we should do it, but we very often don’t.  About three-quarters of patients do not keep appointments for follow-up care.  In one study of diabetes patients, only 7 percent were compliant enough with their treatment plans to control the disease.  Even people at grave and immediate risk do not always take their medicines:  a quarter of kidney transplant patients in one study did not take their medicines correctly, putting them at risk for organ rejection. Among elderly patients with congestive heart failure, 15 percent of repeat hospitalizations were linked to failure to take prescribed medicines.  And compliance with exercise and diet programs is even worse.   Poor compliance is a major reason that sick people don’t get better, and that our health care costs are so high.
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A Network of Support

By David Bornstein

In my column this week I examined the work of an organization called Youth Villages, which offers intensive in-home services to help children in the foster care system return to their families, or extended families, wherever it is possible to do so safely. My point was to highlight the fact that this approach, which is vastly underutilized and underfunded, is proving to be superior to the current practices in the child welfare system. It’s now common for youth to remain in foster care or residential treatment for years. When they age out of these systems, many are unable to live successfully as adults.
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Revolution U:  What Egypt Learned from the Students who Overthrew Milosevic

Revolution U: What Egypt Learned from the Students who Overthrew Milosevic

Originally published here, February 16, 2011
Tina Rosenberg

Early in 2008, workers at a government-owned textile factory in the Egyptian mill town of El-Mahalla el-Kubra announced that they were going on strike on the first Sunday in April to protest high food prices and low wages. They caught the attention of a group of tech-savvy young people an hour’s drive to the south in the capital city of Cairo, who started a Facebook group to organize protests and strikes on April 6 throughout Egypt in solidarity with the mill workers. To their shock, the page quickly acquired some 70,000 followers.
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About the Book

About the Book

About the Book

Join the Club is the story of an extraordinarily powerful kind of social change. It has led teens in America to rebel against cigarettes and teens in Africa to protect themselves from AIDS. It has brought worshippers into a closer relationship with God. It has led millions of people to quit drinking and drugs. It has organized a passive and fearful citizenry subjugated by a dictator into the nonviolent army that overthrew him. Through stories drawn from the affluent suburbs of Chicago to the impoverished shanties of rural India, this is a book that will not only revolutionize the way you look at the world, but give you the power to change it.

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A Families-First Approach to Foster Care

By David Bornstein

Sonja Luecke

Family Intervention Specialist Leontyne Scott, second from right, works with a young man and his family. Youth Villages counselors do much of their work in the kitchens and living rooms of families they assist.

It’s difficult to change systems even when they are widely acknowledged to be broken. That’s the situation facing the nation’s foster care system. According to the government’s most recent estimate, there were roughly 424,000 young people in foster care as of Sept. 30, 2009. Each year, about 30,000 of them turn 18 (or 21 in some states) and “age out” of foster care. What happens to them?
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What Makes Community Health Care Work?

By Tina Rosenberg

Ashim Hajra

An eye examination by a Jamkhed community health worker.

In response to Tuesday’s column about two programs in India that train relatively uneducated women as their villages’ health workers, readers provided an avalanche of information about other community health worker programs around the world. Gregory Ortiz from London (95) wrote about Operation ASHA, which has semi-literate counselors treating tuberculosis in slums in India and Cambodia.  In thefield from Alaska (109) wrote about para-dentists in rural Alaska.    Marianne Loewe (121) from Santa Ana, Calif., commented on her organization, Concern America, which works with health promoters in Colombia and Central America.
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Going to Extremes: Why Muslim Fundamentalists May Be Our Best Hope for Stopping Terror

Originally published here March/April 2011
Tina Rosenberg

courtesy of STREET

In 1996, Richard Reid, a petty criminal recently released from prison, found his way to an unassuming mosque in the rough-edged south London neighborhood of Brixton. The majority of worshippers were converts to Islam: some of them ex-convicts who had taken up the faith in prison, some immigrants. Most of the women wore the full niqab and abaya, showing only their eyes in accordance with the mosque’s strictly conservative bent.

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Villages Without Doctors

By Tina Rosenberg

For the next few weeks, I’ll be writing about an idea that can make people healthier while bringing down health care costs, both in poor countries and in the United States.

The strategy is to move beyond doctors — to take the work of health care and shift down from doctors and nurses to lay people, peers and family.  In the United States and other wealthy countries, lay people can fill in the gaps in left by doctors’ care.  In poor countries, people with no or little formal medical training are successfully substituting for doctors and nurses.
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Making the Text-to-Mom Connection

By David Bornstein

Earlier this week, I wrote about text4baby, a free service that sends text messages to pregnant women, or new mothers, to provide them with useful health tips. What struck me as most noteworthy about this program was how hundreds of different types of organizations — for-profit health care providers, nonprofit community groups, wireless carriers, government agencies, and many others — had collaborated to make it all work. Text4baby seemed to shed light on the question: How do you get a country — with all its diverse institutional strengths — to work as a team?
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Mothers-to-Be Are Getting the Message

By David Bornstein

Meredith Inman

Text4baby reaches women by many means, including billboards like this one in Martinsville, Va.

We’re used to hearing about public initiatives that get mired in politics or entangled in bureaucracy, but we rarely hear about programs that exceed expectations. So here’s one: last week marked the one-year anniversary of a program called text4baby, a service that sends free text messages to women who are pregnant or whose babies are less than a year old, providing them with information, and reminders, to improve their health and the health of their babies.
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How to Grow a Social Business

By Tina Rosenberg

In Tuesday’s column, “When Microcredit Won’t Do,” I wrote about microconsignment, a way for village entrepreneurs to sell innovative and important products for which there is no established market — such as solar lamps, water purifiers, stoves and reading glasses — without having to take on debt.  Instead, village women are given the products and the training to sell them.  Once they make the sale, they repay the supplier and keep a portion of the proceeds.  Done right, microconsignment provides new businesses for village women — and helps make life healthier and more prosperous for her neighbors.
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