Harvard Without Borders

In arguably the world’s poorest country, on an island four times the size of Manhattan, exists a population of 250,000 people invisible to society and, in a sense, forgotten.

This island—Idjwi—is a six-hour boat ride from the mainland of the Democratic Republic of the Congo, in the middle of Lake Kivu.

Many Harvard students travel the globe to pursue their own projects each summer, but in this project, a team of seven students from the Graduate School of Design, the School of Public Health, and the Kennedy School joined forces and traveled to Idjwi to conduct a comprehensive assessment of the island and to design a preliminary framework for a healthcare facility. They hoped their efforts would also raise awareness of the island’s needs and gain international support.  This collaborative effort between the schools at Harvard is a great way to foster innovation and amplify impact; hopefully, other Harvard students will follow suit.

In the fall of 2009, Dr. Jacques Sebisaho, a native of Idjwi and now the Executive Director of Amani Global Works, approached the Student Alliance for Global Health at Harvard (SAGHAH) about doing research on the island. Together they began planning the trip to Idjwi that would provide the first thorough and comprehensive description of the island and its inhabitants.  Each student would be responsible for designing their own research agenda as part of this project.

After arriving on the island this past June, the team became familiar with the local customs. The more educated on the island spoke French and Swahili, but the common language was Kihavu. The islanders are devout Christians and find religious meaning in even the smallest daily occurrences. Social life centers on church and the biweekly markets. Groups have come and gone before, and the people of the island don’t want to be given false hope. “Please come back and do something, don’t just ask questions and leave,” they would say. The team reassured the Bany’Idjwi that if they could secure funding for the project, this would be the first of many trips to work with the local community to plan and deliver a better healthcare system.

Traders take vegetables and fruits to sell on the mainland, but most residents never leave the island. Poverty is extreme and most families have 10 to 12 mouths to feed. Kwashiorkor (protein malnutrition in children) is common, and there are an estimated 3,000 preventable deaths per year.  Though there are schools on the island, many of them cost money to attend—money that most families don’t have (islanders usually use barter, rather than currency).  The few children who get a good education leave, as there are few opportunities for them on Idjwi.

Michael B. Hadley, a HSPH student, designed and conducted a health survey, while fellow HSPH student Thomas A. McHale conducted a qualitative survey on men and women about gender-based violence and access to healthcare and education. Dana R. Thomson used satellite imagery to map infrastructure across the island and come up with randomized areas for the survey team to visit; Shu-Chuan Tseng collected data from existing healthcare providers.  Sunkyo Im at HKS assessed the how the healthcare system fits into the healthcare policies of the country. Marika Shioiri-Clark and Daniel S. Sullivan at the GSD assessed the island’s infrastructure—the designs of the buildings, waterways, and land use practices.

By the time the team was done with its initial assessment, they had over 44,000 pages of data. And although they are just beginning the data analysis, there are already some interesting findings. Gender-based violence is a common problem, most likely due to mens’ joblessness. The total fertility rate is 9 -10 children per family, higher than Sub-Saharan Africa’s average of 7-8 children per family. Health data from this region does not yet exist.  This assessment should shed light on more specifics of the health and medical status of the residents.

The identification of the needs on the island may be helpful in attracting more NGO and international support to Idjwi. Dr. Sebisaho’s organization that supports the SAGHAH Idjwi project, Amani Global Works, was able to achieve 501(c)(3) status this year.  This will be the first health-focused NGO to establish a lasting presence on Idjwi. Though there is still much to be done, SAGHAH is very excited about the headway it has made in collecting data and establishing ties in Idjwi. This is only the beginning. The group is planning a trip next summer to continue the next round of data collection and to begin preliminary planning of health care interventions. As global health is such a popular subject among undergraduates (I’m talking to you, Societies of the World 25), those brave enough to venture into this uncharted territory, or help from afar, can join SAGHAH to get involved in this exciting project that, as Hadley puts it, “uses the lens of health to connect other disciplines.”

Meredith C. Baker ’13, a Crimson editorial writer, is a social studies concentrator in Currier House. Her column appears on alternate Thursdays.

This article has been revised to reflect the following correction:

CORRECTION: OCTOBER 18, 2010

An earlier version of the Oct. 14 article "Harvard Without Borders" incorrectly referred to Jacques Sebisaho as an Earth Institute Official. In fact, he is now the Executive Director of Amani Global Works. The same article misspelled the name of a student at the Graduate School of Design. It is Marika Shioiri-Clark, not Marika Shiori-Clark. The Crimson regrets the errors.