Wednesday, January 31, 2018

Five Steps to End Malnutrition in Africa

Photo credit: Dietmar Temps/

Africa has seen steady growth over the past 20 years. This trend can only be sustained through continuous investment in its young and dynamic population. Malnutrition, however, is undermining progress on the continent and remains unacceptably high. About 59 million children in Africa are stunted, and 14 million are acutely malnourished. Malnutrition is one of the major obstacles to health, economic growth and development in Africa.
I applaud the African Heads of State for strengthening their commitment to nutrition by formally endorsing the African Leaders for Nutrition (ALN) initiative at the African Union Summit in Addis Ababa. I am pleased to continue to support this effort for improved nutrition as an eminent member of the ALN.
I believe the following priorities are critical in our fight against malnutrition in Africa and I am confident that we can catalyse appropriate actions on these fronts:  
  1. First, both the public and private sector need to champion nutrition and mobilise more financial commitments on nutrition to deliver socio-economic and health returns. This will save millions of lives every year and contribute to sustained economic growth. A particular focus has to be put on infants, children and mothers, as adequate nutrition during the first 1,000 days of life – from the moment of conception until age two – is the most critical time in a child’s development. 
  2. Second, governments have to adopt a nutrition-sensitive lens to new policies. Nutrition is not just a health issue, but one that cuts across multiple sectors and essential parts of life – from agriculture to education. For example, in sub-Saharan Africa, millions lack the nutrients needed for proper health and development. One way of tackling malnutrition is by making crops and diets more diverse and nutritious. We have to put a much bigger emphasis on the quality of our diets, rather than just focusing on quantity. 
  3. Third, we need to create new partnerships and promote solutions that come from all sectors – governments, the private sector, and civil society. By pooling our resources and efforts, we can accelerate progress towards the WHO Global Nutrition Targets and the 2030 Sustainable Development Goal to end malnutrition. 
  4. Fourth, we need to make sure that we put in place a nutrition accountability mechanism. Building on the successes of similar tools, the ALN is establishing a Nutrition Accountability Scorecard to drive performance, track progress on implementation, and identify good policies and strategies. 
  5. Finally, a focus on data is critical to helping countries reduce malnutrition. Timely, relevant, and reliable data are essential to defining problems, diagnosing root causes, and making informed policy decisions.
Africa is facing a serious nutrition crisis, but ending malnutrition is possible if sustained and bold leadership from every sector can be ensured. Let us all live up to this collective responsibility so that African people, communities and nations can reach their full potential.

By: Kofi Annan


Somalia to conduct second round of focused polio vaccination activity in Banadir and Lower and Middle Shabelle regions

Dr Ghulam Popal, WHO Representative to Somalia, and Minister of Health Dr Fawziya Abikar Nor vaccinate a child against polio during the second focused campaign in Banadir, Lower and Middle Shabelle regions

Mogadishu, 29 January 2018 |A second round of polio vaccination was launched at a ceremony today chaired by the Somali Federal Ministry of Health, with the participation of WHO and UNICEF. The campaign will run up until 4 February and aims to reach more than 726,000 children under five years of age in accessible areas of Banadir, Lower and Middle Shabelle regions.
Somalia has not reported a case of wild poliovirus since August 2014, however the country remains at high risk of resurgence. An initial immunization round was successfully carried out in December 2017. A second high quality round will help ensure all children under five receive the necessary vaccine to protect them against this preventable disease. Surveillance efforts have also been bolstered in the region.
During the launch of the round the Federal Minister of Health Dr Fawziya Abiikar praised vaccinators, health workers and volunteers for their ongoing commitment to ensure Somalia stays polio-free, at times risking their own lives. She reiterated the leadership of the government for Polio free Somalia and expressed her gratitude to the partners for their continuous support.
The round will be supported by around 3,500 personnel including vaccinators, social mobilizers, monitors and supervisors. To help provide accurate, timely, and comprehensive information about vaccination activities, Open Data Kit (ODK) mobile data collection tools have been developed and will be put to use. More than 200 supervisors and monitors have been trained on the data collection platform.
Conflict and insecurity has continued to hinder access to children in Somalia during polio immunization campaigns, with approximately 240,000 children under five years of age reported as not accessible for more than a year.
WHO Representative to Somalia Dr Ghulam Popal said the commitment and leadership of the government in responding to the ongoing risks to polio reemerging and ensuring no child is denied the right to be vaccinated, should be commended.
“This is the second vaccination round being in Somalia in as many months. It is critical to ensure we close any immunity gaps,” said Dr Popal, at the event.
 “It is important that all children under five in these areas, regardless of immunization status, are vaccinated to protect them [against polio], and we urge all families to ensure vaccination of their children,” he added.


Sunday, January 28, 2018

US Travel Ban Leads Major and Dead Consequence on Refugees Health

FILE - A Somali refugee holds a toddler at a hospital in the Dadaab refugee camp, Kenya, December 19, 2017.
At Dadaab, the world's largest refugee camp in northeast Kenya near the Somali border, they were the lucky ones. They had tickets to American destinations like St Louis, Missouri; Buffalo, New York; Fargo, North Dakota, and others.
But all the euphoria and preparations died at the stroke of a pen when U.S. President Donald Trump signed an executive order temporarily halting settlement of refugees from seven mostly-Muslim countries.
A year later, hundreds of Somali refugees are still in Dadaab waiting to grab a chance to live in the U.S. For some, it is a matter of life and death.
Five-year-old Nimo Mohamed Nur Salan is nursing an old wound from surgery to remove her kidney two years ago.
"When she is walking outside and sees other kids she says, ‘Mum what if they stumble on me? What if they touch me? Push me and hurt my stomach?'" says Timiro Hassan Baraki, Salan's mother.
Not only is Salan suffering from kidney problems, she faces a far more serious challenge; she has been diagnosed with Nephroblastoma or Wilms tumor, a type of cancer. The cancer is treatable. Her former doctor Aden Hassan says Salan had one cycle of chemotherapy but she needs more extensive medical treatment.
Dr. Hassan says treatment in Kenya is too expensive which is why the child was referred for resettlement. "If untreated, she won't make it, her system will shut down," he told VOA Somali. His interview and the others in this story were conducted by telephone.
Baraki's worry permeates her face. "She will die, I don't know what to say."
Somali refugee boys recite the Koran at a Madrassa, or Islamic religious school, at Dadaab refugee camp, Dec. 19, 2017.
Somali refugee boys recite the Koran at a Madrassa, or Islamic religious school, at Dadaab refugee camp, Dec. 19, 2017.
Relying on Allah
Salan is the youngest of nine siblings. She and her family were looking forward to living in Fargo. The family was only waiting for a flight; they had gone through a full screening process that started years ago. That dream has now been revoked.
Refugees were stripped from the travel ban in October and became the subject of their own presidential order, which imposed additional screening requirements on 11 countries. The countries were not specified, but are thought to include Somalia.
"What am I going to tell Trump, he is not listening to other big countries, some of his compatriots appealed to him, and if he resisted to listen to them he is not going to listen to me," Baraki laments.
"If I just add my appeal, I would tell him that we have been refugees here for almost 30 years, we have been waiting our luck for resettlement for a long time, which you [U.S.] have offered to us. We didn't know even what resettlement mean, you said you will take us to your country, and now you are blocking that. This has been painful to us and shocking what the president is doing. You have extended the carpet now you are folding it."
Baraki falls back on her faith. "Nimo was brought to this world by Allah; her health and fate is up to Allah."
U.N. refugee chief Filippo Grandi, center-right, visits a hospital as he tours Dadaab refugee camp, Dec. 19, 2017.
U.N. refugee chief Filippo Grandi, center-right, visits a hospital as he tours Dadaab refugee camp, Dec. 19, 2017.
If the door closes...
Salan is not alone in desperately needing health care. Dr. Hassan says at the top of the list are children with congenital heart disease that requires open heart surgery, most of them under five years of age. He knows of a three-year-old boy, who died while waiting to go to the U.S.
"Literally their heart is not working normally, and the more they stay in the camp, the higher the chance of heart failure and the three-year-old is just a case of heart disease that was waiting for resettlement," he told VOA Somali.
Ahmed Noor Hussein, 6, also has serious health problems. He is suffering from nephrotic syndrome, causing his kidneys to fail. Diagnosed with the disease when he was only 18 months old, Hussein has been evacuated to Nairobi's Kenyatta Hospital for medical emergencies more than 12 times; the last time he spent 65 days in the hospital.
Referred for emergency resettlement, Hussein's case was submitted to the U.S. government in October 2015 for consideration. In September 2017, the family was interviewed at the Refugee Support Center, which comes under the State Department's Refugee Admissions Program, and is a first stop for applicants.
Four months later, he still has not heard. His father, Noor Hussein, believes the case has dragged on because of the new restrictions.
"It's very clear it's stagnant because of the Trump decision, it affected everything, including people like me, other countries that were accepting these cases were influenced by Trump's decision," Hussein said.
"The doctors said if he gets treatment in one of the developed countries, it's a possibility he could live. If not, he is likely to die," Hussein says.
Baraki is unsure if her daughter will get the opportunity again. "If the man closes the door to you, you knock the door and he does not open, you get around and still can't get in, then you accept it and go back," she said.
FILE - An aerial view shows makeshift shelters at the Dagahaley camp in Dadaab, Kenya, April 3, 2011.
FILE - An aerial view shows makeshift shelters at the Dagahaley camp in Dadaab, Kenya, April 3, 2011.
So close, yet so far
On January 23, 2017, Liban Aden Omar arrived in Nairobi to prepare for his flight to the U.S., scheduled for six days later. His itinerary shows a flight via London Heathrow and Newark, New Jersey where he would catch a plane to Buffalo, New York.
This was the break he was looking for. He was being resettled because he was an orphan. In the U.S., he would be able to help his grandmother who raised him from a young age. But then, two days before his flight, came the travel ban.
‘I was sent back to Dadaab, but just two days later we heard a judge blocked the ban, and we came back to Nairobi for a flight on February 12," says Omar.
Then his situation took a disastrous turn. Omar says he was called up by doctors at the International Organization of Migration before the flight.
"They said, ‘We'll take you to the hospital for a checkup again. (You) will have to miss the flight on February 12 and will be put on another flight on February 21."
Omar says he was taken to a hospital and X-rayed. He was told he would have to have back surgery, as they had diagnosed an injury to his spine.
"I went into surgery, and the next thing I know my legs are paralyzed," he said.
Doctors told him he would need physical therapy; he was put a Nairobi hospital and then moved to a second hospital, but did not regain his walking ability. Last week, almost a year later, he was returned to Dadaab, with his American dream in tatters and worse, his life turned upside down.
"Imagine leaving your friends healthy and to come back like this, unable to walk," he said. He had a wheelchair to move around in hospital, but that did not come with him to Dadaab. "I was carried from a car and then thrown on to a mat."
Omar says he was told many times he would be resettled to the U.S. He was also told by refugee representatives who visited him in the hospital that they would also try other countries, to no avail.
"I need care all the time; I have none," he said. His aged grandma is blind, unable to care for another person. He says a trip to the U.S. on January 29 last year would have made his life completely different.
Even now with his spinal injury, he can't understand why he was not resettled, a gesture he says would have benefited him.
VOA Somali spoke to IOM doctors in Nairobi, and they refused to discuss his case.
FILE - The sun sets over the Ifo extension refugee camp in Dadaab, near the Kenya-Somalia border, in Garissa County, Kenya, July 31, 2011.
FILE - The sun sets over the Ifo extension refugee camp in Dadaab, near the Kenya-Somalia border, in Garissa County, Kenya, July 31, 2011.
A 'need to resettle'
"There is a need to resettle these people." says Mohamed Abdi Affey, the special envoy of the UNHCR High Commissioner for Somali Refugees. 
"We have identified them as cases that deserve resettlement, and we hope that the quota or the number that essentially have been allocated to Somalia comes back, because as special envoy I believe that the Somali refugee situation is not out of the woods."
Affey told VOA that the U.N.'s refugee resettlement agency has processed the cases of about 20,000 refugees in the Horn of Africa for resettlement, of which more than 15,000 are in Kenya.
He says U.S. resettled about 2,000 Somalis last year compared to nearly 10,000 in 2016 and just over 7,000 the year before.
Even the larger numbers are a small drop in the refugee population. Affey says resettlement cases, the most vulnerable, generally account for less than 1 percent of the overall refugee population.

"They have gone through security background checks, including processes that U.S. has put in place in order to ensure that anybody who is coming into the country is well screened," he said.
Affey urges the U.S. government to reverse the travel decision. "The U.S. …is a country that has been known and it continues to be known as a champion of refugee protection, and we hope that that spirit, we hope that fantastic name is maintained and maintained for the protection of humanity," Affey said.

By: Harun Maruf


Thursday, January 25, 2018

Hard Cases: A Neonatologist’s Worst Nightmare and Biggest Blessing: Walking the tightrope of viability

Normally when I say to someone that I’m a neonatologist they look at me with a blank stare … unless of course they have had a premature baby or a very sick term baby. I usually follow the sentence.
 “I’m a neonatologist” with the words: “I’m a pediatrician who cares for premature babies, you know -- the ones who can fit in the palms of your hands or the term babies who are very sick and may require surgery.” I can literally bet my entire life savings (which isn’t much) on the next words to leave their lips: “Wow, how sad. I couldn’t do that. God Bless you.”
            It always gives me great pause when I hear those words. I don’t think of my job as sad at all. I consider it a great blessing and a huge privilege to hold the hands of those parents who have a baby that must be admitted to a neonatal intensive care nursery. I get to see a miracle every day and often I meet angels. It’s a place so few will ever visit, and it’s so much bigger than the miracle babies that you see on television. I’ve wanted to be a neonatologist, aka preemie doctor, since I was a very little girl and realized that my sister had been premature. That she was small enough to fit in the palm of your hands. That she spent her first months of life in a plastic box known as an incubator. And that the doctors who cared for those babies were called neonatologists…and the rest, as they say, is history.
But Neonatology is a relatively new branch of pediatrics; I am constantly amazed at the state of the art of the field today and a tad bit frightened. We are saving babies today that we were not able to save 15 or 20 years ago, babies that during my training we did not have the equipment to offer a so-called “trial of life.” Even 50 years ago, the field of neonatology was just beginning; it has not escaped me that my sister a micro preemie born at 1lb in 1968 and 26 weeks was born just five years after President Kennedy lost his son to prematurity… a son who was 4 pounds 10 ounces and 34.5weeks or almost six weeks early. But he was born when neonatal intensive care nurseries were just beginning and unfortunately could not be saved despite a heroic transport. I carry both of their legacies with me every time I enter a delivery room and every time I hold a tiny human in my hand. The feeling always leaves me mystified even now, 20 years into my training.

But this issue of the viability of a human life has grown because technology has gotten pretty good at saving little humans but at what cost? We now have the capacity in many cases to offer a trial of resuscitation to 22 week infants … infants almost 4.5 months early. Most of whom who do not survive, and some of whom survive but with significant neurologic handicap. It’s a slippery slope and a very perilous tightrope and I have no idea what the right answer is, and I dare say that no neonatologist does. This push has largely been in response to parental desires…and in my view very understandable. I don’t know the right answer for every family, but I do know I’m in this profession for a reason and I try to support the life that’s presented to me for the time being that the life is here. Sometimes the support is warmth, human touch, soft words, a prayer; other times the support is machines, tubes, wires, and more prayers…sometimes you just don’t know.

About a year ago I was forced to walk that tightrope and the power of the human spirit wrapped in one little 1lb body has continued to both haunt and encourage me. I started my shift like so many shifts hearing a report about how many sick babies were in the ICU nursery and how many more sick babies were coming. I was told about a baby whose mother desperately wanted her to survive but unfortunately the mother had gone into preterm labor at only 22 weeks. At this hospital, and many hospitals, fetuses who are less than 23 weeks are considered to be non-viable. But what does that mean? It means that despite heroic measures, the infant is more likely to not survive than survive and that if the infant does survive he or she would do so very likely with grave handicap. To intervene in this scenario is often perceived as cruel to the infant. This mother was going to be 23 weeks at midnight. 

The current time was 7pm. What a choice. It’s actually no choice at all. If the baby were to be born before midnight, we would not intervene but provide comfort care. If the baby were to be born after midnight we would try to resuscitate the baby. Again, this is no choice. This the tightrope that I hate. This is the slippery slope that has you questioning your life choices in a matter of seconds. When I spoke with the mother, she shared she understood the risk...but what she really wanted to know was that if her child was born before midnight and she held her child until midnight would I come then and try to resuscitate the baby if the baby was still alive. She cried. I cried. We both prayed that her child would not be born before midnight but her labor was progressing and the child was indeed coming. I really hated those arbitrary lines around viability. I remember every baby I’ve left and so many more that I tried to save and they all leave me wishing that no one ever went into preterm labor. It is the epitome of being between a rock and a hard place…no easy answers.

The child was delivered in bed at exactly 11:30 pm …. 30 minutes before the arbitrary cut off time for the coveted trial of life. And guess what the child was actively crying…and moving. Yep, a 22 week infant crying, moving, daring me to leave her in her mother’s room. What to do? Leave? Stay? Do no harm? But life in the NICU is unfortunately filled with harm in the name of saving lives. Most babies will recover from this harm…but not all of them.

 I picked the baby up and brought her to the warmer. She was giving it her all and the minutes were ticking. I knew the mom understood that her life could very well include blindness, cerebral palsy, handicap…but so could any other life. So we proceeded with a trial of life. Which included placement of a breathing tube, oxygen therapy and a respirator. Her first several days were very rocky and she was very unstable. Her mother made her DNR or do not resuscitate but her heart never stopped. Her lungs got stronger. She got stronger. She never had another rough day after 2 weeks of age. She went home without any equipment. With no brain injury. No eye injury and actually breastfeeding. In 20 years I had never seen that…and I don’t know if I will ever see it again….but I am blessed to have witnessed a rare miracle. A rare moment where the art of medicine superseded the science of medicine and one little human spirit literally dared me to leave her in the delivery room.

By: Dr. Terri MD                


Monday, January 22, 2018

Breaking All The Stereotypes: Super Mom and Trauma Surgeon Dr. Qaali Hussein, MD

  When you hear the words Muslim, female, and mother of six, the image of a trauma surgeon probably is not the first thing that comes to mind, but this next guest is breaking all the stereotypes! This week, we have the absolute pleasure of learning from the amazing Dr. Qaali Hussein, MD, a Muslim mother of six who has overcome all the challenges that have stood in her way.
"Don’t let anybody define your limitations. You define what limits you"
 Learn about the inspirational and amazing story of a child caught in a Civil War in Somalia, who got her first glimpses of trauma trying to protect her grandmother; a child who ultimately fulfilled a dream of becoming a doctor. Learn about the resident who was told she couldn’t be a mother in residency but did so anyway. Learn about the Muslim who respects her religion and wears a hijab, in spite of the challenges this can bring to the workplace. Please listen and learn from Dr. Qaali Hussein!

A glimpse into the Conversation:

Why Trauma:
In Somalia when we were leaving, there was a Civil War. On our way out, we had a trauma occur within our family. I was in a car with my grandmother… we got shot at. My grandmother ended up getting shot in the legs and the bullet went through both of them. We had to get off the road to help control and stop the bleeding. At the age of seven, as I was putting my hands on her bloody legs, that was my first exposure to trauma.
Throughout my studying and training I never planned on doing trauma, but when I started doing it, it was an automatic connection. I don’t know if it was from that initial exposure to experiencing trauma, but it was it something that automatically made me feel, you know, someone is hurt and you can do something, you can do something significant to save their lives. That’s been one of the things that pushed me towards trauma. It was just an instant affinity as soon as I started doing it.

Following The Plan:
I’ve always wanted to say my plan was to be a doctor. Plan “A” was to be a doctor, plan “B” was to be a doctor, and plan “C” was to be a doctor. Plan D was to stay at home and have a bunch of babies.

How do you know you chose the right path:
[There] are days that are absolutely exciting and even if [you’ve] been up for 24 hours, 30 hours straight, by the end of it is very exhilarating. If you have a passion for something like that, I don’t think any limitations should exist with your pursuit!
The Struggles of appearances, and overcoming them:
I’ve literally been called a terrorist by a patient of mine. I’ve been given religious lectures about which book is the true book, and you know, those things happen. But the good thing is, I take care of patients that are very very sick. So when they see that I’m trying to help them, all those things fall by the wayside and we don’t have to talk about that.

Sunday, January 21, 2018

A Minnesota health advocate’s crusade brings harmful skin lightening out of the dark

Amira Adawe inside Karmel Square, unofficially known as the Somali Mall, in Minneapolis.
MINNEAPOLIS — Karmel Square is a hub of the Somali community here, a colorful, cheerfully noisy hodgepodge of vendors and restaurants unofficially known as the Somali Mall. Amira Adawe stops by often to buy tea and chat in Somali with friends and relatives wearing hijabs and flowing, floor-length skirts. They greet her with smiles and hugs, and she calls them “auntie.”
Her visits are more than social, however. The public health advocate scans market shelves for skin lightening creams that may contain harmful toxins — tubes and jars sold under names such as Fair & Lovely, Prime White, and Miss Beauty 7 Days White.
Some women use the creams in hopes of erasing dark spots, but many rub them over their entire bodies multiple times a day in hopes of whitening their brown skin. The practice pervades many cultures in Africa, Asia, the Middle East — and many immigrant communities in the U.S. — and Adawe has made it her mission to end it.
She began her crusade as a graduate student, after she discovered that creams sold in many Twin Cities ethnic markets contained levels of mercury thousands of times higher than the amounts considered safe by the U.S. government. But her concerns go beyond the physical harm to women. She worries as much about the damage to their self-esteem.
In Somali and other cultures, the lighter-skinned daughter is often seen as more beautiful, Adawe explained recently; in fact, the Somali term for light-skinned — cadey — is considered a compliment. “It’s used as a term of endearment,” she said, “but I think it’s so wrong to say it.”
Public health agencies in several major cities have launched their own investigations of tainted skin creams, occasionally getting advice from Adawe along the way. And now Adawe has created The Beautywell Project, to combat the stigma faced by women with darker skin and take on the industry that promises them beauty in a jar.
By day, Adawe is now a manager for the Children’s Cabinet of Minnesota Gov. Mark Dayton. In her “spare time,” she hosts a weekly radio show in Somali that reaches 80,000 people worldwide. She holds educational outreach sessions in Minneapolis and Kenya, talks with imams, and presents at national and international conferences. Sooner or later, most anyone connected with the skin-lightening issue seeks out Adawe. She fields personal pleas for help from Somali men in Minneapolis worried about their pregnant wives rubbing cream on their skin, as well as calls for help from Kenya, Canada, and Australia.
“We can’t address this issue without discussing beauty, what it means and ways to redefine beauty, as well as discussing and educating individuals about wellness,” she said in an interview.
She admits her goal is ambitious. The stigma runs deep, and skin-lightening creams are a multibillion-dollar business overseas, despite bans and public campaigns against the products in many African countries. In the U.S., creams are often smuggled in and sold in small, ethnic markets like at Karmel Square or purchased on the internet. They have been found in Somali, Hmong, Mexican, Dominican, and West Indies communities from California to Minnesota to New York. Users, and even sellers of the creams, are often unaware that they are harmful or illegal.
“We can’t address this issue without discussing beauty, what it means and ways to redefine beauty, as well as discussing and educating individuals about wellness.” Amira Adawe
Somali women are reluctant to speak openly about skin lightening, and Adawe faced resistance when she began her research seven years ago. Her persistence impressed Jim Koppel, who was deputy commissioner of the Minnesota Department of Public Health at the time.
“It’s a very tight-knit community, and this put her in a tough place,” he said. “It could have had a negative impact on the businesses [that sell the creams], both financially and potentially for legal problems, and was of great concern to her personal reputation. And she went ahead and did it and continues to speak out.”
“I had to be brave enough, and, fortunately, the community saw it as an issue” and supported her, Adawe said. “That means a lot to me.”
Fair & Lovely Cream
Skin whitening creams displayed for sale at Karmel

A topic few wanted to talk about

One recent afternoon, Adawe was 35 minutes into her radio show, broadcast from the studio of KALY, 101.7 FM, a Somali-American station tucked into a corner of the International Bazaar in Minneapolis. She had been talking nonstop about skin lightening, peppering her fluent Somali with a few English words — endocrine system, mercury, hydroquinone, prescription.
Then she turned to the phones, murmuring in understanding as she listened to a female caller from a Minneapolis suburb. Do you have any more feedback, Adawe asked in Somali.
“Women who practice skin lightening and who have experienced skin damage or illness should come to the radio and discuss their experience without disclosing their names,” the caller said in Somali.
Adawe nodded. The topic of skin lightening is a delicate one, both overseas and in immigrant communities in the U.S. While the stigma associated with dark skin is deep, admitting to using skin-lightening creams is also taboo, thwarting efforts to track the prevalence of the practice. As adept as Adawe is at navigating the delicate social norms and customs of the Somali-American community she’s part of, when she began her research in 2011, she could find only seven women who would talk about their use of skin creams.
It was in those interviews that women told her that they apply the creams to their entire bodies three times a day, sometimes while pregnant or breastfeeding. Most mixed several creams together and stored them in the refrigerator.
Adawe had been suspicious of the creams since her childhood. Growing up in Mogadishu and Minneapolis in a health-minded family (her mother was the head of the maternal and child health bureau in Somalia), she watched with concern when friends’ and relatives’ skin reddened or grew discolored from using skin lighteners. Adawe is grateful for the message she received growing up with the darkest skin of three daughters: “I’m so fortunate I came from a family who embraced me for who I am,” she said.
When Adawe became a county public health educator and a graduate student at the University of Minnesota School of Public Health, she was finally in a position to act on her concerns. She purchased 27 samples of creams to test for the toxins she suspected were present.
The tests confirmed Adawe’s fears, revealing that 11 of the products contained mercury, a known neurotoxin. Mercury has been banned in skin-lightening products by the Food and Drug Administration since 1973; the legal limit is 1 part per million. Adawe still remembers the shock she and the pollution control agency specialists who did the testing felt when they saw the results reaching 33,000 parts per million.
FDA spokeswoman Lauren Sucher said mercury is on a short list of prohibited ingredients in cosmetics. “The FDA has been aware of mercury as a potential allergen, skin irritant and neurotoxin for decades,” she said in an email.
Poisonous to the nervous, digestive, and immune systems, it is often found in unlabeled or mislabeled creams; sometimes it’s listed as “mercurous chloride,” “calomel,” “mercuric,” or “mercurio.” Just touching a washcloth or a mother’s cheek that has been rubbed with the products could be harmful to a baby, the FDA notes, interfering with brain and nervous system development.
Yet the agency was able to inspect only 0.3 percent of 3 million cosmetics shipments last year, and it tested just 364 products even though “adverse findings” are discovered in 15 percent to 20 percent of the products tested, the FDA said last June in a letter to New Jersey Congressman Frank Pallone Jr.
Even skin-lightening products sold legally in the U.S. often contain ingredients other countries recognize as potential health hazards, Adawe said. Hydroquinone, a potential carcinogen that is banned in Europe, Japan, and elsewhere, is often found in the creams, as are steroids, which can cause acne, thinning of the skin, and hypertension.
Adawe’s testing in 2011 triggered immediate action: The Minnesota Pollution Control Agency cracked down on suppliers (in a raid on one popular store, inspectors found about 20 boxes full of products that contained mercury); the FDA investigated; and the Minnesota Department of Health warned of the danger.
Elsewhere in the country, similar scenarios were playing out. Alerted through data from local and national surveys, health departments embargoed products, conducted home visits, and notified manufacturers and health agencies in other countries. In New York, for example, after finding eight skin creams with mercury after inspecting products from 22 stores, city health workers now visit stores incognito to identify products of concern, said Wendy McKelvey, executive director of environmental health surveillance and policy.
Once notified of the dangers, there’s “pretty good compliance,” McKelvey said. “They’re not wanting to sell hazardous products.”
Adawe is often consulted because she understands and is trusted by the affected community.
“I think it’s extraordinary what she’s doing,” said Lori Copan, a research scientist for the California Department of Public Health. “A person from the community is a much better spokesperson than someone working in a public health department in terms of motivating and speaking the language and being one of them. It would be fantastic for all of us in public health if we had a community leader like Amira.”
The value of that cross-cultural competence is often in the details. Inspired by Adawe’s study, an ongoing biomonitoring project in Minnesota looking at chemical exposure in pregnant women and babies now tracks urinary mercury. With Adawe’s input, the program has fine-tuned details such as how to phrase questions in surveys about use of creams.
“If you ask directly, ‘Do you use it?’ they will never, ever answer,” Adawe said. To get at the truth, she said, it’s better to start by asking what kind of moisturizer they use.
Initial results of the yet-to-be-published study show that more than 30 percent of pregnant Asian women who spoke Hmong in their interviews had high levels of mercury and received special follow-up to help them reduce their exposures. “The higher levels were likely from using skin-lightening creams and eating certain kinds of fish higher in mercury,” said Jessica Nelson, an epidemiologist and program manager at the Minnesota Department of Health, where Adawe works as a legislative liaison. (The Somali portion of the study isn’t finished yet.)
Adawe isn’t resting: She’s happy that skin lightening has been established as a public health issue. Still, Adawe said there’s plenty more to be done. Next up, she said, is trying to reframe what it means to be beautiful. She’s developing a curriculum for schoolgirls and outreach sessions focused on men, teenagers, and new teachers, which will revolve around the question: How do we change the narrative of what is beauty?
“My dream is that every woman stops using skin-lightening creams and trying to change their color,” she said, “and that they are happy for who they are.”
By: Sheila Mulrooney Eldred

Sister Lionella Sgorbati: her slogan was “tender loving care for pregnant women and lactating mothers”.

Sister Lionella Sgorbati,
Sister Lionella Sgorbati, who worked in Kenya for many years. She was killed in Somalia in 2006 and is considered a martyr by the church. PHOTO | COURTESY
In Summary
An Italian Catholic church nun who worked in Kenya as a midwife is set to be made a saint by Pope Francis in May.
Sister Lionella Sgorbati, who worked in Kenya, was killed in Somalia in 2006 and is considered a martyr by the church.
She is the second Consolata nun with Kenyan roots on the course to sainthood after Sister Irene Stefani (Nyaatha), whose process of canonisation is on-going. Born in 1940 in Italy, she came to Kenya in 1970.
“For 13 years she worked in Consolata Hospital at Mathari and Nazareth Hospital in Kiambu, mainly as a midwife. She was also the head of Consolata Nursing School, Nkubu, until 1993 when she was elected the regional superior of Consolata Sisters in Kenya, a task she undertook until 1999.  Under her care, about 4,000 babies were born,” says Father Joseph Mwaniki, a lecturer at Tangaza University College and an expert in the “Processes of Beatification and Canonisation”. While working at Mathari Consolata Hospital in Nyeri, her slogan was “tender loving care for pregnant women and lactating mothers”.
She would repeatedly remind nurses to give TLC (tender loving care) to mothers so that a new-born brings happiness to the mother and her family.

Sr Lucy Karweru recalls how the former principal tutor at Nkubu Hospital would give special care to first-time mothers and ensure they went through labour with ease.
“First-time mothers are usually very scared, especially because they have heard all sorts of things that happen during labour. But Sr Sgorbati worked to reduce the tension by showing them care,” she said in an interview at the hospital.
For those that experienced severe pain, she would massage their back to ease the pressure while uttering reassuring and comforting words.
She ensured that mothers-to-be didn’t go through discouraging or traumatic delivery in her bid to make childbirth memorable to them.
This was anchored on offering emotional support and physical comfort during labour and after delivery, advising mothers on how to breastfeed and hold the baby.
Since there were not many qualified nurses in Nyeri, the sister would respond to midnight calls without complaining.

“It did not matter to her that she had spent the entire day working. If woken up in the middle of the night, she would rush to the maternity wing,” Sr Lucy recalled.
As the principal tutor at Consolata Mission Hospital, Nkubu Nursing School, between 1985 and 1993, she is remembered for the high standards she set at the institution.
The Meru-based mission hospital administrator, Father Silas Mwiti, said Sister Leonella was keen on high standards of training, valued skills and knowledge and emphasised on integrity and moral uprightness. 
“She was very hard working and laid a strong foundation for the nursing school,” Fr Mwiti said.
Sister Catherine Joan, the current principal tutor and a student of Sister Leonella, has fond memories of her.
“She taught us midwifery and was very social and intelligent. Sister Leonella was very keen on imparting skills on students and was very careful not to release half-baked nurses,” Sister Catherine said.
She said the students were very fond of Sister Leonella, who treated them as her daughters.

 “Any time she came from leave, the students would abandon whatever they were doing to welcome her. I have never seen a teacher so close to her students,” the principal said.
In November 1993, she was elected as the regional superior of Consolata Missionary Sisters in Kenya and retained the position until 1999. She then went on sabbatical in 2000 and in
2001 she spent several months in Mogadishu, Somalia, looking at the potential for a new nursing school.
The Hermann Gmeiner School of Registered Community Nursing opened in 2002 with Sr Sgorbati in charge. The first 34 nurses graduated from the school in 2002, with the World Health Organisation awarding them certificates and diplomas since Somalia has had no substantive government since 1991. Sr Sgorbati was a fluent Somali-speaker.
According to Fr Mwaniki, on Sunday, September 17, 2006, barely four days after her arrival back in Somalia where she had gone to give classes in the medical school, two men hiding between vehicles shot her seven times. Her guard, Mohamed Mahmud, a Muslim father of four children, tried to fire back but he was shot dead, too.

“She was taken to hospital and helped by her own students; she had already lost a lot of blood and even breathing was difficult. Sr Marzia Feurra, a fellow sister, clearly heard Sr Lionella utter her last words in Italian before she died: “perdono, perdono, perdono” (I forgive, I forgive, I forgive). And this way, she offered her life for the sake of poor Somalis,” says Fr Mwaniki.
“At the imitation of Christ, Sr Lionella’s last words were forgiveness for those who killed her. This is the most authentic Christian testimony that a real martyr can give, showing the victory of love over hatred and evil.”
Her body was airlifted to Kenya where she was buried on September 21, 2006, in the cemetery of Nazareth Hospital.
Fr Mwaniki, who is in Rome to conclude his PhD in the History of the Church, says that at her death and later at her funeral, there was a widespread opinion, both in Kenya and Somalia, that she was killed because she was a Christian.
Her process of beatification officially started in 2013, and everything concluded in 2017, with the decree of Pope Francis of November 2017.
Before the Pope’s decree is promulgated, the Church requires that the servant of God be exhumed. This was done on September 30, 2017, under Bishop David Kamau of Nairobi at Nazareth Hospital cemetery. Her remains are now in the Chapel of Flora Hostels which, after the beatification, will become another centre for devotion by the faithful.

Sister Joan Agnes Matimu, the regional superior for Consolata Sisters, says it is an honour for Consolata Sisters to have two saints from their congregation in Kenya.
“We may not have been there when Sister Stefani was here, but Sister Lionella was one of us. When I joined Consolata Nursing School in Nkubu, she welcomed me. And when I took my first vows as sister, she received me. We ate and cried together, we agreed and disagreed. But in the end, she taught us to work for humanity and spread the word of Jesus Christ. We are proud of this achievement,” she said.
The beatification comes after that of Sister Irene “Nyaatha” who was declared “Blessed” in May 2015 at a big ceremony in Nyeri. Nyaatha took her vows on January 12, 1912, where she became Sr Irene Stefani.
After completing her novitiate on January 29, 1914, she became a full Consolata missionary. With three other young sisters, she left for Kenya on December 28, 1914, arriving in January during the First World War. She was posted to Gikondi, Nyeri.
Later, she joined other missionaries as a Red Cross volunteer in Voi. Inevitably, she succumbed to plague at 39 years on August 31, 1930.


Thursday, January 18, 2018

An Inspirational Message: My Journey to Kellogg College

Hamse Abdilahi is a Somali community activist and writer. He is a postgraduate student at Kellogg College, University of Oxford, studying for an MSc in Sustainable Urban Development. Here he tells us about his childhood in Somaliland and he shares ten lessons which he learnt on his way to being accepted to study at the University of Oxford. Hamse is also former Mandela Washington Fellow at the University of Delaware and a former Chevening Scholar at Bristol University.
I watched the majestic sight of sunrise from my half-empty Oxford-bound train window. Trying to figure out how my long educational journey culminated to that very dawn, I had a deep sense of appreciation for the great people who helped me along the way.  The train’s automatic voice kept calling out the various stops it made along the Bristol-Oxford route. Even the cold October morning couldn’t dent my excitement to report to Oxford University for my course registration. As the train reached my destination, I grabbed my luggage and headed out of the small but otherwise packed train station. I patiently waited for a taxi at the parking space outside and it didn’t take long when a black taxi arrived. ‘Where?’ asked the taxi driver. ‘Kellogg College’ I answered.’ ‘Oh Kellogg’ smiled the taxi driver implying his familiarity with my destination.
At Kellogg College, I grabbed a cup of coffee and a biscuit. Students, dressed in black gown and hat, a white shirt and bow tie, continued to gather at the college for the matriculation day. Matriculation is an elaborate ceremony and an old Oxford tradition which is normally done in the first week of the Michaelmas Term – the first term according to the Oxford language. It is the last step of the University’s long and rigorous admission process where students are formally admitted to the various colleges they were accepted to. We marched to the Sheldonian Theatre where the Vice Chancellor read a centuries-old brief speech in Latin and English welcoming students to the university and wishing them a successful life. We then marched back to Kellogg for a group photo, lunch and conversations with students and college staff over tea. Despite the long day, it was a sigh of relief for me, for I was finally and officially an Oxford University student and a proud member of Kellogg College. But my pride was tempered by humility because of my very humble background.
Kellogg College is Oxford University’s largest college by student size and the most international of all of Oxford University’s 38 colleges. A college does not mean a department or a faculty as many would expect, but rather an autonomous and self-governing corporation within the university. It is like a government within a government. The collegiate system entails that all teaching staff and students must belong to one of the colleges. Colleges have substantial amount of responsibilities which include administering houses of residence and tutorials. A typical Oxford college would comprise of a dining hall, a chapel, a library, a college bar, postgraduate and junior common rooms, lodgings for the dons etc. However, the university departments run the traditional tasks such as organising lectures, examinations, laboratories and central libraries.
My long journey to Kellogg College wasn’t all rosy. Raised by my maternal grandmother, I started school in a roofless building in Hargeisa in the early nineties. The city suffered a complete and spectacular devastation in the Somalia civil war. Occasionally, on my way back from school, I would come across people bleeding profusely after their legs were blown off by mines. I watched them helplessly as they were carried away on to the back of truck to be transferred to the nearest hospital which had little or no medical supplies. ‘Maybe I would help them when I grow up’ I would console myself and head home. The roofless school was short-lived as another civil war broke out forcing us to leave the town. Luckily, in several months, the war stopped, and my schooling was never interrupted again. This, however, was not the case in southern Somalia, where the conflict has endured and lasted to date.
The secessionist agenda which Somaliland pursued following the seemingly irreversible state collapse in Somalia has had the most dramatic effect on me and my generation. In one way, it spared us from the violence that consumed the rest of Somalia, but it also left us in an awkward situation. The idea of living in an internationally unrecognised state is unusual. There are only a little over a dozen unrecognised or de facto states in the world. Lacking official international recognition means that there are no diplomatic missions in the country, you can’t travel outside the country since you lack a valid and recognised passport, the government cannot go into formal trade deal nor binding international agreements with other nations and international organisations. In other words, you are stuck, the country is stuck, and everybody is stuck. And ever since, the country grappled with poverty and painstaking state building in the face of international diplomatic isolation. Lacking in infrastructure and near non-existent public services compounded the austere life in Somaliland. Working hard in school was the key to escaping not only the poverty but also breaking free from the shackles of that diplomatic ‘cage’. Despite such circumstances, I feel fortunate that both my undergrad and postgrad studies came through a merit-based scholarship all of which were competed nationally.
How did you end up at Oxford? Did you ever imagine going to Oxford? These are the common questions people ask me every time.  Of course, I imagined being at Oxford, but I can’t point out a single factor which I can single-handedly attribute to my acceptance to Oxford. My life was a product of hard work, but also of luck, like meeting the right people who believed in me at the right time, giving me opportunity at the right time, all of whom were important in the trajectory I had over the years. My fundamental being hasn’t shifted after my acceptance to Oxford. I am still the same person.
Below are ten key lessons which I picked up along the way and through them you can understand the principles that sustained me during my journey to Oxford.
Master your English
Very early on, I understood that if I want to be successful in my studies, I have to master the English language. But having a good command of the English language wasn’t easy. English is my third language. Arabic was the medium of instruction in my primary school. Somali was the only language spoken at home, in the local media and in the wider society. As I progressed to high school, an afternoon English tuition class greatly helped me. I started to read English grammar books to improve my English. But it was my avid listening to the BBC World Service radio which proved most crucial in improving my English. The BBC radio programs also significantly improved my understanding of the world, my thinking horizon and my perspective on many global issues. The level of one’s English affects the quality of writing and the effectiveness of communication with people, all of which are critical in achieving success. Having good English has a bigger significance than a simple communication in today’s world. Most academic books are written in English, many of the best universities in the world are in English-speaking countries of the Western world, the world’s two biggest financial capitals are in English speaking countries and most international organisations have English as their medium of communication. I am also aware that I come from a British colony and I resent the English colonisation of my homeland, but I am also aware that English is key in navigating the current world order which, I believe, is not going to change anytime soon at least in my lifetime. I think there is nothing wrong with learning your former colonial master’s language and use it to your own advantage. As I passed by the Oxford English Centre one afternoon, it reminded me the Oxford English Dictionary, the world’s most trusted English dictionary. I held the Oxford dictionary in high esteem as it helped me greatly when I was an English language student.
Focus, aim for the best and believe that you are meant and destined for greatness
Focus as you plan to the end. But aim for the best and for the highest.  According to most studies, great people and historic figures led normal lives before they took a dramatic decision at various times in their lifetime which made them great. Many of them did after the age of forty while others did it considerably later in their lifetime. This means that anybody can achieve greatness anytime in their lifetime. I want to be great for a great cause. But greatness can come in many forms. From a meaningful community service and empowering the girl child to freeing your people from the shackles of poverty and destitution and fighting environmental degradation, the opportunities to be great are endless. A genuine belief that you can be great and that you should do great things must underpin one’s own view in life. This is important because it affects your day-to-day decisions and priorities in life. Believing you are destined for greatness affects the way you conduct yourself and prevents you from bad behaviour such as political corruption.
Build your confidence to the level of believing you are the best in the world
Many people often ask me where I got that confidence. Again, it is a difficult answer. I wasn’t a confident person all my life. I have got my own insecurities and uncertainties. In my early years in school, I was shy and unable to speak before class. But I strove not to let them undermine my confidence to the level that I would believe that someone else can do better than I could. Today, I am invited to speak before many people. Confidence can be grown. But how does someone build his/her confidence? This is the million-dollar question. My answer is simple though controversial- first believe you are the best in the world in your respective field or area of interest. I won’t be apologetic on this point however absurd it may sound to many people. But one cannot be good on everything. Instead you’ve to identify a particular area of interest. You’ve to believe that you have the potential to be the best in that area. You also need to voraciously read about that field, contact the leading scholars in the field, chat with them, keep up with the latest literature, critique the direction of the current debate and come up with an original hypothesis or scientific discovery if you are in scientific research field. Overconfidence shouldn’t lead you to arrogance and close-mindedness, but be dynamic and open to change when facts against your position pile up. Be open to learn, but deep inside, believe you are the best while not uttering it publicly.
Genuinely acknowledge your biggest fear
My biggest fear in life wasn’t a financial or a political career failure; it was simply leading an unremarkable life and dying in obscurity. To be honest, I haven’t publicly shared it before, but I know it is my biggest fear. I always wanted to leave behind a meaningful legacy for my people and the world. I have always had a deep disdain for mediocrity. While I am not sure what that legacy would turn out in the end or whether I would even live long enough to see it or make it, but it is my hope that it would be profound. It is this very fear that drives me every day to move ahead so that I can stay ahead.
Develop a fierce competitive spirit
My competitive nature started largely with working hard to perform well in school, but it stayed with me right through to adulthood. Later in life, it became instrumental in motivating me to compete for more important matters in life than finishing top in class. A competition for a job, a scholarship or a cash grant would motivate me and I would put all my effort to win it. If I won it, it felt exhilarating, when I failed to get it, I would attribute it to my approach to the competition but not to my ability. I hardly took it personally or lost momentum. And I would most likely run again for the same thing or run for a bigger job, a better scholarship or larger grant, and most likely I would land on one. For example, when I first applied to Oxford University, my application was rejected. I had two options then: to give up my pursuit for a place at Oxford and believe that maybe I am not an Oxford university material because I am not white and rich, or to refine my application and apply for a slightly different course in a different department, which I did. When I submitted my second application, in less than a week, I was invited to an interview by the university which was successful. So, my lesson is if you lose a competition, don’t take it personally, but blame your approach to the competition, revisit it and run again, chances are that you will nail it this time and harder. You will finally reach a stage where you will enjoy any competition regardless of winning a trophy. Some competitions and applications cost money. Don’t be too mean and withhold a small entry or application fee. I often see people who can’t take a small financial risk to go for a big prize. My advice is don’t be mean. You’ve to financially stretch yourself to go places.  Also you’ve to push the boundaries and prove your critics wrong. Don’t just settle for a good job and a place at university, go for the best job, create the best business, aim to join the best university, meet the best people. In other words, push the boundaries and more importantly prove your critics wrong. There is nothing that gives me more pleasure and satisfaction than not only proving my critics wrong but also very wrong. When I had the car accident and during the lengthy hospitalisation that ensued, many people wrote me off. I did my best to prove them wrong. When I left the hospital, I was a changed man. Since then, I went back to work, travelled to New York, London and Moscow without carrying a North American or European passport. I had the opportunity to shake hands with President Obama in Washington D.C in 2015. I won a postgraduate British scholarship, I got accepted to Oxford, and more importantly I got married to the love of my life whom I am happily living with in the UK. I am not listing my progress to boast about it, but I am sure they utterly surprised my critics.
Believe that you can rise above the circumstance of your birth
Coming from Somaliland isn’t only coming from a place ranked bottom of the international socio-economic index. It simply does not exist on the world map. If you complain of coming from a poor country, I complain of coming from a country that doesn’t officially exist where you feel an outsider to the world order. If you complain of living in a city council house and live on state benefits, I never saw a welfare state in my life. If you complain of going to poor schools in poor neighbourhoods, I went to a roofless school and I suppose yours had some roof at least. If you complain about belonging to a patriarchal society, I too had my first female teacher in college. But when you rise above such circumstances, don’t just appear in the media and criticize your community wholesale as many people do. Instead, go to the grass root level, talk to the people and change your society from within and help them be more forward thinking so that they embrace positive change.
Be open-minded
I grew up in a homogenous society where everybody looked like me, spoke the same language and belonged to the same faith. I struggled to be an open-minded person. Getting rid of certain prejudices wasn’t easy. But finally, I like to believe that I did away with them or at least most of them. I like to engage with people, have simple conversations, ask them about their countries’ culture and history. After every discussion, I realise how we, as humans, are astonishingly similar in our emotions, psychology and aspirations.
Use your background to your own advantage and work twice harder
If you are the only black person in a predominantly white institution or the only woman in an all-male workforce or the only disabled person in all-able-bodied environment, use that to your own advantage. When I was interviewed for my UK postgraduate course by a British diplomat in Hargeisa in 2016, she asked me why I chose to do MSc in Public Policy at Bristol University. I told her that I trained to be a clinician in my undergraduate degree but shortly after leaving medical college and a few months into my medical practice, I was involved in a car accident and I spent many months in hospital, and that the accident made me experience both sides of care. I also told her that I came to understand to importance of having efficient public service such as health care and education and that is why I wanted to do MSc in Public Policy. ‘I want to make our government efficient’ I told her. ‘Ok, got it’ nodded the apparently convinced diplomat, and in a couple of months, she sent me the acceptance letter to come to the UK and do my course at Bristol University. In this example, I used the accident, a tragic moment in my life, to my own advantage and it worked.
Believe there are better days ahead and seize the opportunity very early
My life has seen its fair share of adversity from poverty and displacement to physical pain and lengthy hospitalisation and most of them in childhood and at the prime of my youth. I have always had a deep sense of belief that it is not yet over and that there is a better day ahead. I don’t mean that I am a tough man and that I can overcome any a serious challenge that life throws at me, but I strive to be optimistic about life. There are many times that I feel blue. I often get rejections to my applications which also disappoint me. As humans, we are emotional beings. There is nothing wrong with feeling sad, angry and depressed in certain situations, but continue to believe there is a great day ahead of you. Such belief must be grounded on unwavering hope that there is not only a better day ahead, but also a much better day. Seizing opportunities is also crucial. Some opportunities come and go like a flock of birds and sometimes never to return. For example, when I came back from America after finishing my summer fellowship at the University of Delaware, I understood it was the right moment for applying for an overseas postgraduate scholarship. Also, when I finished my masters at Bristol University, I knew this was the right moment to apply for my dream university – Oxford. It is crucial that someone recognises these opportunities as they pass, and never let them slip away, for we live in a very competitive world as one needs to outsmart his counterpart.
10 Don’t be intimidated by the disempowering statistics and big names
As joining Oxford was always a childhood dream, I used to read the news and reports about Oxford University. But most of the reports demotivated me. For example, I read that 42 out of the 56 UK prime ministers went to Oxbridge universities- Oxford and Cambridge with Oxford’s Christ Church College producing 13 UK prime ministers, more than any other Oxbridge college. The two universities have also produced many world leaders such as Bill Clinton and Australia’s Tony Abbott.  Most UK members of parliament, most high-profile BBC journalists, most UK cabinet members, most CEOs of companies went to Oxbridge. Even the Governor of the Bank of England went to Oxford. These staggering statistics demonstrated the class culture entrenched in the English society of which I do not belong. But I kept believing that I can defy this culture and still go to Oxford. So, when you are told to lower your expectation because of your background, don’t bow to that. Never believe in a disempowering statistic or data.