Laura Murphy

“My co-wife can borrow my mobile phone!” Gendered Geographies of Cell Phone Usage and Significance for Rural Kenyans

Abstract A unique census of cell phones in a Western Kenyan village reveals gendered dimensions of access, intensity and breadth of cell phone usage related to contemporary long-distance households and livelihoods. Women bound to marital homesteads far from their birthplace praise the freedom to communicate with family across the country; a housewife uses scarce resources to send ‘greetings’ and ensure peace of mind. Women link with community groups and distant menfolk, spanning rural/urban spaces to manage their increasingly busy and insecure lives. Older women blend these new technologies into traditional agrarian livelihoods and community activities; younger women are eager to navigate into the twenty-first century and away from farms. For cash-strapped rural housewives, their frugal, ingenious, yet constrained uses of “mobile” (stationary) cell phones help them achieve many freedoms. Findings from this village census of cell phones add to a growing body of nuanced research on the social shaping of cell phones and their uses for human development. Research reveals the intersections of adaptive uses with contemporary gendered patterns of poverty, inequality, and deagrarianization. They serve simultaneously as potentially transformative and emancipatory as well as divisive forces in sub-Saharan Africa.

Deforestation, land use, and women's agricultural activities in the Ecuadorian Amazon

Abstract Migrant womens participation in agricultural activities in the Ecuadorian Amazon frontier is examined using 1990 household survey data. A recursive model is developed to test womens participation in agriculture as a function of households land use and land area cleared (deforested), womens characteristics, use of hired labor, and household income. Results suggest that both hired labor and off-farm income “substitute” for womens labor in agriculture. Women who have more young children are more likely to be involved in agriculture. Conversely, women are less likely to work in agriculture the larger the proportion of the cleared area in pasture versus crops, partly because raising cattle requires less labor than crops. Some implications of these results for policies to develop the frontier, provide better infrastructure and services, and conserve the rainforest are discussed in the conclusion, and suggestions are provided for improved future data collection and analysis to examine the linkages between womens work, frontier agriculture and land use.

Erythropoietin promotes breast tumorigenesis through tumor-initiating cell self-renewal.

Erythropoietin (EPO) is a hormone that induces red blood cell production. In its recombinant form, EPO is the one of most prescribed drugs to treat anemia, including that arising in cancer patients. In randomized trials, EPO administration to cancer patients has been associated with decreased survival. Here, we investigated the impact of EPO modulation on tumorigenesis. Using genetically engineered mouse models of breast cancer, we found that EPO promoted tumorigenesis by activating JAK/STAT signaling in breast tumor-initiating cells (TICs) and promoted TIC self renewal. We determined that EPO was induced by hypoxia in breast cancer cell lines, but not in human mammary epithelial cells. Additionally, we demonstrated that high levels of endogenous EPO gene expression correlated with shortened relapse-free survival and that pharmacologic JAK2 inhibition was synergistic with chemotherapy for tumor growth inhibition in vivo. These data define an active role for endogenous EPO in breast cancer progression and breast TIC self-renewal and reveal a potential application of EPO pathway inhibition in breast cancer therapy.

Diagnostics barriers and innovations in rural areas: insights from junior medical doctors on the frontlines of rural care in Peru.

BackgroundWorldwide, rural communities face barriers when accessing health services. In response, numerous initiatives have focused on fostering technological innovations, new management approaches and health policies. Research suggests that the most successful innovations are those involving stakeholders at all levels. However, there is little evidence exploring the opinions of local health providers that could contribute with further innovation development and research. The aims of this study were to explore the perspectives of medical doctors (MDs) working in rural areas of Peru, regarding the barriers impacting the diagnostic process, and ideas for diagnostic innovations that could assist them.MethodsData gathered through three focus group discussions (FGG) and 18 individual semi-structured interviews (SSI) with MDs who had completed their medical service in rural areas of Peru in the last two years were analyzed using thematic analysis.ResultsThree types of barriers emerged. The first barrier was the limited access to point of care (POC) diagnostic tools. Tests were needed for: i) the differential diagnosis of malaria vs. pneumonia, ii) dengue vs. leptospirosis, iii) tuberculosis, iv) vaginal infections and cervical cancer, v) neurocysticercosis, and vi) heavy metal toxicity. Ultrasound was needed for the diagnosis of obstetric and intra-abdominal conditions. There were also health system-related barriers such as limited funding for diagnostic services, shortage of specialists, limited laboratory services and access to telecommunications, and lack of institutional support. Finally, the third type of barriers included patient related-barriers to follow through with diagnostic referrals. Ideas for innovations proposed included POC equipment and tests, and telemedicine.ConclusionsMDs at primary health facilities in rural Peru face diagnostic challenges that are difficult to overcome due to a limited access to diagnostic tools. Referrals to specialized facilities are constrained by deficiencies in the organization of health services and by barriers that impede the patients’ travel to distant health facilities.Technological innovations suggested by the participants such as POC diagnostic tools and mobile-health (m-health) applications could help address part of the problem. However, other types of innovation to address social, adaptation and policy issues should not be dismissed.

Gogo care and protection of vulnerable children in rural Malawi: changing responsibilities, capacity to provide, and implications for well-being in the era of HIV and AIDS.

The role of older women in the care and protection of vulnerable children in sub-Saharan Africa may be changing given increasing rates of orphanhood due to AIDS. Concern regarding their capacity to provide for children and implications for their health and well-being dominate the literature. However, studies have not yet examined the situation of older caregivers in comparison to their younger counterparts over time. In this study, panel data on 1,219 caregivers in rural Malawi between 2007 and 2009 is complemented by in-depth interview (N = 62) and group discussion (N = 4) data. Caregiver responsibilities, capacity to care for children, and implications for well-being are examined. Chi-square tests examine differences in these measures between older foster caregivers and younger foster caregivers, parents of orphans, and parents of non-orphans. Older women, in comparison with younger counterparts, are more stable as primary caregivers for orphans. Care by older women is particularly valued when younger family stability is threatened by burdens of orphan care. Qualitative data reveal many challenges that older caregivers face, most notably provision of food. However, survey data suggest that the capacity to provide food, schooling and other basic needs is similar among older and younger caregivers. Self-reported health status is generally poorer among older caregivers, however levels of emotional distress and social capital are similar among older and younger caregivers. Providing care for children in old age appears to entail a number of benefits. Older women committed to providing care and protection for children are important assets, particularly in the context of threats to child well-being due to HIV and AIDS. Bolstering older caregivers with material and social support to help sustain their key roles in fostering is a promising avenue for maintaining extended family responses to HIV and AIDS.

Interdisciplinary Postdoctoral Training in Global Health Through a Novel Joint Project for Trainees from Diverse Disciplines: Benefits, Risks, and Observations

Postdoctoral training programs are usually highly individualized arrangements between trainees and a limited number of senior mentors in their field, an approach that contrasts with current trends in public health education that promote interdisciplinary training to spur innovation. Herein, we describe an alternative model for postdoctoral training for a group of fellows from distinct disciplines. Fellows work with mentors from diverse fields to create a joint research project or a group of complementary projects, with the goal of developing a new device, intervention, or innovation to address a global health problem. The perceived benefits, challenges, and limitations of this team approach to interdisciplinary postdoctoral training are presented.