Students Tackle Complex Global Health Problem in Inaugural Yale Competition

Simmering tensions this summer at the Marikana mine erupted as striking workers and police clashed in a confrontation that was aired on television. When the gunfire stopped, 34 miners were dead and many others severely injured.

Everyone agreed the violence in South Africa was horrific and a tragedy. But is also drew attention to deep economic, social and health disparities among mineworkers, many of whom struggle to make a living in conditions that are dangerous and unhealthy.

The question now is can policy and health responses improve conditions to the point that miners will not feel compelled to strike or to confront police in the first place?

Half a world away, more than 100 Yale undergraduate and graduate students from eight professional schools participated in the inaugural Global Health Case Competition Saturday where they presented recommendations to improve a deeply rooted and seemingly intractable problem.

Each of the 20 student teams had less than a week to do research and formulate their responses in preparation for Saturday’s presentation to a panel of 20 judges drawn from University faculty as well as public health practitioners and consultants, including  Fatima Hassan, a prominent South African human rights lawyer and activist.

“The difficulty of the assignment lay in that before we could even begin to make recommendations, we had to spend a tremendous amount of time and effort in understanding the history, context and tensions that exist in the mining industry, a topic that was foreign to all of us,” said Javier Cepeda, a doctoral student at the School of Public Health and a member of the winning team. “Coming up with a framework from which to guide our recommendations also proved especially challenging.”

Cepeda said his team approached the challenge by identifying the topics they found to be most pertinent to the problem and then split them up evenly among the team’s six members. Their preparation included a marathon session before the presentation to synthesize their proposal and integrate all of the recommendations into a coherent action plan. Among their recommendations were a more responsible business plan for mine owners, adequate housing for miners, reduction of the tuberculosis rate and wage equity.

The plan was innovative and linked a human rights framework to political, social, and economic development initiatives, taking the interests of all key stake holders into account, said Rafael Perez-Escamilla, a professor at the School of Public Health and one of the event’s judges.

“It demonstrated the application of high-level critical thinking skills to come up with a constructive approach to prevent the recent tragedy involving the unnecessary deaths of miners at the Marikana mine from ever happening again,” Perez-Escamilla said. “At the end of the day the winning team also distinguished itself by its collective assertiveness and thoughtful responses given to the many questions and concerns raised by the highly diverse audience.”

The winning Yale team, which in addition to Cepeda also included Ryan Boyko (YSPH), Hilary Rogers (Yale College/YSPH), Bingnan Zhang (YSM/SOM), Jordan Sloshower (YSM) and Yi Zhou (SOM), will travel to Emory University in Atlanta early next year where they will compete in an international competition.

Rogers, who traveled to Emory last year for the competition, enjoyed it so much that she wanted to compete again.

“I lucked out and wound up working with a group of incredibly committed and intelligent students who came from different disciplines and made their own individual contribution. I think this is what helped us win—not only did we work exceptionally well for not really having known each other before, but we also took an interdisciplinary approach to the case.”

It was a challenge this year to get a strong grasp in under a week of the long history of political, social and cultural issues of South Africa, a country none of the team had ever visited and knew little about. “It wasn't possible to fully understand all of the factors that led to the tragic shooting of South African miners on August 16, but we tried our best,” she said.

As a first-year B.A./M.P.H. student, Rogers has just started focusing on public health and global health in her academics. The case competition, she said, gave her an opportunity to use what she has learned in class and showed her the many potential routes of a global health career.

Saturday’s event was organized by three students, Jared Augenstein (YSPH), Sejal Hathi (Yale College) and Sunny Kumar (Yale College) in conjunction with several faculty advisors.

“In organizing this competition, we hoped to incubate cross-campus collaboration between students of all schools to devise realistic yet innovative solutions to tackle a pressing global health issue. Based on the positive response we have received from South African experts, we believe the competition to have been a resounding success,” said Augenstein.

Student interest in global health has grown sharply at Yale in the past several years and the University has responded with a variety of programs and initiatives to meet the demand. The School of Public Health offers a Global Health Concentration and the University has created the Yale Global Health Initiative (GHI) and the Yale Global Health Leadership Institute (GHLI), among many other programs.

Gregg Gonsalves, who has done research in South Africa and served as a judge, said the competition showed what Yale students have to offer. 

"I was overjoyed to see so many bright young minds apply themselves to the plight of miners in Southern Africa. The epidemics of HIV, TB and silicosis among this population are a public health and human rights catastrophe. Although the teams only had a week to prepare for the competition, their presentations bubbled up with new ideas and approaches for governments, the industry, the unions, international agencies," he said. "The competition was Yale at its best: thinking from a variety of disciplines--public health, business, medicine, law---focused on solving a problem of tremendous importance in global health."

Elizabeth Bradley, a professor at the School of Public Health and director of both the GHI and GHLI at Yale, started the daylong event in the School of Public Health with a welcome to the students and the judges.

“The event far exceeded my dreams about what might be possible in global health at Yale,” Bradley said. “To have such interdisciplinary work across 9 schools and departments all working on a critical issue of human health in the world was inspiring and just awesome.”

The first-place team won a $3,000 prize. The second-place team won $2,000 and the third-place team won $1,000. There was also an innovation prize with a $500 award.

Student perspectives on the inaugural Global Health Case Competition at Yale:

“I really enjoyed this experience as I was able to work with people from many different schools and was able to learn a lot from their perspectives. The competition topic was quite interesting, particularly given the current issues and the impact that our strategy can have in the entire mining industry in South Africa.”

~ Shreya Agrawal, School of Management 

“It's not until you work on a case with people from very different backgrounds that you realize just how interdisciplinary global health can be. The opportunity to meet and work with new people was invaluable, and the team spirit, even in a competitive context, was something that had previously been missing from global health at Yale.”

~Dennis Wang, Yale College

“I enjoyed diving deeply into a subject that merged epidemiology and public health with human rights. In my Ph.D. training, I learn how to design and implement studies on diseases in developing countries, but do not learn much about translating that into action that directly helps the people I study. This helps bridge that gap and has put me in touch with people who can help me translate research into social benefit.”

~Ryan Boyko, Yale School of Public Health

“With no background in public health but with an interest in natural resource industry, I enjoyed tremendously working with such a diverse group. The case gave me a wonderful opportunity to understand the complex nature of public health issues in modern global economy, a very important topic that business school students should appreciate.”  

~Yi Zhou, School of Management

“I'm a sophomore in Yale College, majoring in anthropology. The invaluable lessons that I learned from my teammates, in conjunction with the opportunity to present and receive feedback from a panel of judges who are so prominent and accomplished in their fields, was invigorating, engaging, and exciting. I feel lucky to have engaged with a community who is so passionate and willing to put into practice their studies in global health.”

~Lauren Tronick, Yale College

“I am always excited about challenges that involve putting theory into practice. I viewed the case competition as a chance to do exactly that. The added advantage of the case competition was being able to work with students from other schools who bring different perspectives and skill sets. That was a large part of out team's success - whether it was conceptual framing or budget creation, we each made a unique contribution toward solving the complex challenge.”

~Jordan Sloshower, Yale School of Medicine

“The Yale Global Health Case Competition was an unprecedented opportunity for me to think deeply and critically about a real-world public health issue that's in dire need of solutions. Above being able to directly apply public health tenets and strategies learned in the School of Public Health's classrooms, the process of devising a proposal to address South Africa's mining sector issues was a eye-widening reminder that no one school of thought has all of the answers and multidisciplinary approaches coupled with creativity and cultural competence are key to improving health outcomes.”

~Ffyona Patel, Yale School of Public Health

This article was submitted by Denise L Meyer on November 12, 2012.