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Every summer U.S. physicians and medical students travel to developing countries performing charitable work and learning firsthand about the delivery of primary health care on a shoestring. My teenage daughter and I joined a Stanford-led team of pediatricians, infectious disease specialists, and medical students last August in the rural Kaqchikel-speaking communities of Guatemala. We captured our unforgettable journey in a series of photographs that show how a handful of determined medical volunteers working alongside indigenous health workers is able to transform humble resources—a pickup truck, a binful of medical supplies, a makeshift clinic—into vital health outcomes.

At the volunteers’ home base in the town of San Lucas Toliman (1) an earlymorning gathering of medical trainees from Stanford, Harvard, and Columbia combs through donated medical supplies, organizing them for deployment in the field. Bronwyn Baz, MD (standing center), a Stanford pediatric resident, is on her fourth visit to the area and serves as a team leader. FSI’s Cross-Campus International Fund is sponsoring her trip to Guatemala this summer.1

Patients crowd into the makeshift clinic, set up that day in the dusty outbuilding of a local elementary school (2) as part of an organized program of health services. Devin Briski (seated), a 16-year-old volunteer from Menlo School, searches the village’s patient records, while Stanford medical student Kimberly Montez stands behind her, ready to see her first patient. Working with the health promoters from the village, the clinic was able to serve 100 or more villagers in a single day.

Stanford infectious disease specialist Manual Amieva (3) examines a child as Harvard medical students Norris Kamo and Shanthini Kasturi gain valuable primary care skills under the close supervision of Amieva and other physicians. The students encounter a variety of medical problems, from severe scabies to epilepsy. Gastrointestinal infection and diarrhea are particularly insidious and widespread health threats.

With tooth decay rampant, volunteers try to schedule regular visits to local schools to administer prophylactic fluoride treatments (4) and dispense basic dental supplies, such as toothbrushes and toothpaste, to children.


1FSI welcomes donor participation in its cross-campus international fund to help sponsor medical trainees' travel to Guatemala and other developing countries as part of the Stanford School of Medicine's commitment to international health.

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Teresa Whitfield (speaker) joined the Social Science Research Council in early March 2005 to direct the Conflict Prevention and Peace Forum (CPPF). Her latest book, Friends Indeed: the United Nations, Groups of Friends and the Resolution of Conflict, was researched and written while a visiting fellow at New York University’s Center on International Cooperation. From 1995-2000 Teresa worked as an official within the UN’s Department of Political Affairs, latterly in the Office of the Under-Secretary-General of Political Affairs. She has also worked as a consultant with the Ford Foundation and the Centre for Humanitarian Dialogue and has a long association with CPPF, serving as regional advisor on Latin America from 2001-2003 and as acting director from 2001-2002. Her research interests include the United Nations, peace operations and the mediation of internal conflict. She has published on peace processes in Central America and Colombia, as well as on the role played by informal groups of states, or “Friends” in the resolution of conflict. A journalist and filmmaker in her early career, Teresa’s publications include Paying the Price: Ignacio Ellacuría and the Murdered Jesuits of El Salvador (Temple University Press, 1994), written while living in El Salvador from 1990-1992, and, most recently, a chapter on Colombia co-authored with Cynthia J. Arnson in Grasping the Nettle: Analyzing Cases of Intractable Conflict (ed. Chester A. Crocker, Fen Osler Hampson and Pamela Aall, United States Institute of Peace Press, 2005). She holds an MA in Latin American studies from the University of London and a BA in English literature from Cambridge University.

Patrick Johnston (discussant) is a PhD candidate in the Department of Political Science at Northwestern University and a CISAC predoctoral fellow. His dissertation, "Humanitarian Intervention and the Strategic Logic of Mass Atrocities in Civil Wars," asks why ethnic cleansing and genocidal violence frequently increase dramatically after international actors threaten to intervene militarily or deploy significant numbers of troops in coercive interventions. Johnston received a BA in history and a BA in political science, both with distinction, from the University of Minnesota, Morris and an MA in political science from Northwestern University.

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Teresa Whitfield Director, Conflict Prevention and Peace Forum Speaker Social Science Research Council
Patrick Johnston Predoctoral Fellow Speaker CISAC


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Elizabeth Levy Paluck (speaker) received her PhD in 2007 from Yale University in Social Psychology. Her research focuses on the political psychology of prejudice and conflict reduction, in particular the role of mass media, community dialogue, and education. She has conducted the bulk of her fieldwork using field experiments and qualitative methods in Central Africa and in the US. She is currently an Academy Scholar at Harvard's Weatherhead Center for International Affairs.

Desha Girod (discussant) is a doctoral candidate at Stanford, where she researches the effects of international organizations on local institution-building. She is devoting her fellowship at CDDRL to completing her dissertation, "Why being poor helps postwar development." For her dissertation, Desha carried out field work in Mozambique and Uganda. In addition, she is conducting a study on democracy promotion after regime change by investigating the impact of US intervention in Panama, where she also did field work. Another study investigates the effects of remittances on access to public goods in Mexico. Desha's advisors at Stanford include Jim Fearon, Steve Krasner, David Laitin, and Jeremy Weinstein.

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Elizabeth Levy Paluck Academy Scholar Speaker Weatherhead Center for International Affairs, Harvard University

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Desha Girod is a postdoctoral fellow at the Center on Democracy, Development and Rule of Law at Stanford University where she manages the program Evaluating International Influences on Democratic Development.  Her research focuses on the influence of external actors on political and economic development.  In 2009, she will join the faculty of the Department of Government at Georgetown University.
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Desha is a doctoral candidate at Stanford, where she researches the effects of international organizations on local institution-building. She is devoting her fellowship at CDDRL to completing her dissertation, "Why being resource poor helps postwar development." For her dissertation, Desha carried out field work in Mozambique and Uganda. In addition, she is conducting a study on democracy promotion after regime change by investigating the impact of US intervention in Panama, where she also did field work. Another study investigates the effects of remittances on access to public goods in Mexico. Desha's advisors at Stanford include Jim Fearon, Steve Krasner, David Laitin, and Jeremy Weinstein.

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CDDRL Postdoctoral Fellow 2008-2009
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Desha Girod is a postdoctoral fellow at the Center on Democracy, Development and Rule of Law at Stanford University where she manages the program Evaluating International Influences on Democratic Development.  Her research focuses on the influence of external actors on political and economic development.  In 2009, she will join the faculty of the Department of Government at Georgetown University.
Desha Girod CDDRL Hewlett Fellow 2007-2008 Speaker
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Robert R. Amsterdam, founding partner of the international law firm Amsterdam & Peroff, is counsel to the former Yukos head and political prisoner Mikhail Khodorkovsky. For more than 25 years, Mr. Amsterdam has represented corporations and investors in a variety of emerging markets lacking in rule of law, such as Russia, Nigeria, Venezuela, and Guatemala, overseeing complex commercial litigation and advising on political risk. He has delivered speeches before the Carnegie Endowment, the Cato Institute, Georgetown University, University College London, and Chatham House. He has published numerous opinion articles on energy politics and law in the Wall Street Journal, International Herald Tribune, the National Law Journal, the Guardian, and the Independent, among other media. Mr. Amsterdam maintains a blog at www.robertamsterdam.com and is working on a forthcoming book.

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Enloe and Painted Crow will discuss the implications of the militarization of women's lives in the context of the increasing escalation of US militarism. They will also dialogue about their views on various approaches to peace, bringing to bear their respective experiences as feminist-scholar and former-woman soldier. There will be an opportunity for audience members to participate in the roundtable discussion.

Cynthia Enloe

Cynthia Enloe, who grew up on Long Island and received a Ph.D. from the University of California/Berkeley, has served as chair of Clark's Government Department and Director of Women's Studies. Professor Enloe is currently a Research Professor in the Department of International Development, Community, and Environment (IDCE) and teaches the intensive seven-week seminar, "Gender, Militarization, and Development." She has been awarded Clarks "Outstanding Teacher of the Year" three times and has been named the University Senior Faculty Fellow for Excellence in Teaching and Scholarship.

Enloe's feminist teaching and research has focused on the interplay of women's politics in the national and international arenas, with special attention to how women's labor is made cheap in globalized factories (especially sneaker factories) and how women's emotional and physical labor has been used to support governments' war-waging policies-- and how many women have tried to resist both of those efforts. Racial, class, ethnic, and national identities and pressures shaping ideas about femininities and masculinities have been common threads throughout her studies.

In recent years, Enloe has been invited to lecture and give special seminars on feminism, militarization, and globalization in Japan, Korea, Turkey, Canada, Britain and numerous colleges across the U.S. She has written for Ms. Magazine and Village Voice and has appeared on National Public Radio and the BBC. She serves on the editorial boards of several scholarly journals, including Signs and the International Feminist Journal of Politics. Among her nine books are: The Morning After: Sexual Politics at the End of the Cold War (1993), Bananas, Beaches and Bases: Making Feminist Sense of International Politics (2000), Maneuvers: The International Politics of Militarizing Women's Lives (2000 ), and The Curious Feminist: Searching for Women in a New Age of Empire , (2004).

Eli Painted Crow

Eli Painted Crow, of the Yaqui Nation in Tucson, Arizona, is a mother of two sons who served in the military and has seven grandchildren. An army veteran of 22 years, she retired at the rank of Sergeant First Class E-7. She served assignments in Honduras in 1988 as an interpreter and communications specialist and in Kuwait and Iraq in 2004 as a Training NCO, Transportation NCO and Support Operations Sergeant.

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Julie Veroff, a senior in the CDDRL Honors Program, has been named a Rhodes Scholar. She is one of 32 American men and women selected each year for this prestigious award, the oldest and best known for international study, which provides for two to three years of graduate study at the University of Oxford in England. Veroff plans to begin a M.Phil. program in development studies at Oxford next fall.

Veroff has done volunteer work on behalf of women's and refugees' rights in Nicaragua, Ghana, and Zambia through a United Nations partner organization focusing on refugee empowerment. At Stanford she is majoring in international relations, and will be working closely for the rest of this academic year with her advisor, CDDRL faculty affiliate James D. Fearon, on her honors thesis project, The Impact of Elections on Peace Durability and Quality of Democracy After Civil Wars. This fall Veroff had the opportunity to interview one of CDDRL's Stanford Summer Fellows in Democracy and Development, Luhiriri Byamungu, a human rights lawyer from the Democratic Republic of Congo.

The CDDRL Honors Program offers students majoring in International Relations the opportunity to conduct an independent research project focused on issues of democracy, development, and the rule of law under CDDRL faculty guidance. Such a project requires a high degree of initiative and dedication, significant amounts of time and energy, and demonstrated skills in research and writing. Honors students present a formal defense of their theses in mid-May of their senior year.

Students interested in the CDDRL Honors Program should consult with prospective honors advisers in their junior year and plan to submit their honors thesis proposal in the spring quarter of that year. Choosing courses that provide academic background in an applicant's area of inquiry and demonstrating an ability to conduct independent research are prerequisites for the program, as are a 3.5 grade-point average and strong overall academic record. Required coursework includes INTNL REL199, an honors research seminar that focuses on democracy, development, and the rule of law in developing countries.

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Pamela Constable is the deputy foreign editor of The Washington Post. Previously she covered South Asia for The Washington Post for several years from April 1999, with extensive coverage of Afghanistan as well as both India and Pakistan.n She continues to visit and report from Afghanistan.

Before arriving in New Delhi in 1999, Constable worked for The Post from 1994 to 1998 covering immigration and Hispanic affairs in the Washington area, and reported from Honduras, El Salvador, Haiti and Cuba.

Prior to joining The Post, Constable worked for The Boston Globe as deputy Washington bureau chief and foreign policy reporter from June to September 1994. From 1983 until 1992, she was The Globe's roving foreign correspondent, Latin America correspondent and diplomatic correspondent. During this time she reported from Haiti, Chile, Peru, Argentina, Cuba, Colombia, El Salvador, Nicaragua, Mexico, South Korea, the Philippines, the Soviet Union and Brazil, as well as in Washington.

Her latest book is Fragments of Grace: My Search For Meaning in the Strife of South Asia. She is the co-author with Arturo Valenzuela of A Nation of Enemies: Chile Under Pinochet and has written articles for Foreign Affairs, Foreign Policy, Current History and other publications. She was awarded an Alicia Patterson Fellowship in 1990 and the Maria Moors Cabot Prize for coverage of Latin America in 1993. Constable is a member of the Council on Foreign Relations. She received a B.A. from Brown University.

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This issue of CHP/PCOR's quarterly newsletter, which covers news from the spring 2006 quarter, includes articles about:

  • a study led by CHP/PCOR trainee Hau Liu which found that teriparatide (Forteo) -- the first in a new class of osteoporosis drugs -- is not cost-effective compared with the most commonly prescribed osteoporosis drug, alendronate (Fosamax), due largely to teriparatide's much higher price;
  • an update on projects and priorities at CADMA (the Center on Advancing Decision Making in Aging) and CDEHA (the Center on the Demography and Economics of Health and Aging), two multidisciplinary research centers based at CHP/PCOR that support promising early-stage projects on health, economics and aging;
  • an April working trip by CHP/PCOR research assistants Meghan Fay and Raina Mahajan, in which they traveled to San Lucas Toliman, Guatemala, with faculty member Paul Wise, assisting him with various medical treatment and health promotion activities in the region; and
  • a meta-analysis led by CHP/PCOR trainee Smita Nayak which evaluated the accuracy of an emerging screening test for osteoporosis -- heel ultrasound -- compared with the standard test, known as DXA. The study found that there is not enough evidence to recommend heel ultrasound over DXA as an osteoporosis screening tool.
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BACKGROUND: Gender differences in health system usage can lead to differences in the incidence of morbidity and mortality. We conducted a pilot screening targeted towards men to evaluate gender differences in cardiovascular disease risk factor detection and time since last clinic visit.

METHODS: Three evening sessions in two communities screened 148 people, mean age 47.7 years. Height, weight, body mass index, blood pressure, blood glucose, and total cholesterol were measured. A questionnaire on past medical history was administered. Participants with elevated measurements were referred to appropriate care.

RESULTS: Men accounted for 60.1% of those screened; 65.5% of the group was overweight, and 22.3% was obese with 42.6% hypertension, 39.2% hypercholesterolemia, and 2.7% high blood glucose. Among men aged 35 to 65, 65.2% were overweight, 20.3% obese, 46.4% hypertensive, 42.0% hypercholesterolemic, and 1.5% with high blood glucose. Within the last 2 years, 53.3% of men and 9.1% of women aged 35 to 65 had not visited a doctor (P = 0.004).

CONCLUSIONS: A significant portion of those screened had elevated cardiovascular disease risk factors. Given that men visited doctors significantly less frequently, efforts to involve men in prevention of cardiovascular disease within these communities are warranted.

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Preventative Medicine
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Jeremy Goldhaber-Fiebert
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