Lessons learned from the World Health Organization’s late initial response to the 2014-2016 Ebola outbreak in West Africa

The purpose of this article is to 1) examine the role of the World Health Organization (WHO) in controlling infectious disease outbreaks, 2) evaluate if the WHO’s initial response to the 2014-2016 Ebola crisis was appropriate, 3) evaluate current WHO’s efforts to prevent future disease outbreaks after the Ebola elimination, and 4) suggest how WHO should be further reformed to provide prompt and accurate guidance to multi-sectoral health stakeholders at local, national, regional and global level for effective surveillance preparedness and response. This is a non-systematic narrative literature review. The articles from PubMed, Scopus, Medline, books, WHO documents and websites, and mass media were collected to be analyzed. WHO is the only specialized agency in the United Nations (UN) that promotes people’s health with legitimacy around the globe. Due to the lack of funding and health workforce, weak global health governance, and political and economic concerns about afflicted countries, WHO failed to respond promptly to the 2014-2016 Ebola outbreak in West Africa. WHO has a central role in the architecture of global health governance. Although WHO was not the only one to be responsible for devastating 2014-2016 Ebola Virus Disease (EVD) outbreak in West Africa, it is undeniable that WHO was unprepared to respond to the EVD and failed to govern the global health response system. Furthermore, WHO should always remember its unique responsibility of taking the initiative to respond to the infectious disease outbreak by alarming a distress call

MERS-CoV infection in South Korea and strategies for possible future outbreak: narrative review

Although there were some positive viewpoints from international press and academia that the Republic of Korea (hereafter South Korea) successfully controlled the Middle East Respiratory Syndrome (MERS) outbreak in 2015, the domestic point of view towards the MERS response in South Korea was critical. As people in the world’s 11th largest economy, South Koreans criticized the failure of hospitals’ initial response to the MERS index case and the lack of a proper control strategy for secondary and tertiary cases. To contain the MERS outbreak, South Korea implemented mainly three MERS control and intervention strategies: quarantine and isolation system, temporary closure of schools and cancelation of public events, and share of correct knowledge of MERS from trustworthy authorities, such as central and local governments and non-governmental organizations (NGOs). The traveler tracking system, the health care delivery system, and the Infectious Disease Prevention Act should be strengthened or amended. The establishment of bioethics and adherence to the World Health Organization (WHO)\u27s guidelines are also recommended to prevent possible future outbreak

Traditional funeral and burial rituals and Ebola outbreaks in West Africa: A narrative review of causes and strategy interventions

Introduction: In West Africa, traditional funerals and burials have proven main contributors to the spread of infectious diseases, such as Ebola, plague, the Marburg virus, and others. Although the World Health Organization has provided guidelines for the safe burial process after learning of the culture of the afterlife in Ebola-affected areas, little effort has been made to integrate theoretical interventions and models for changing West Africans’ funeral behavior. This research was conducted to study 1) the background of traditional burial rituals, 2) interventions to contain Ebola outbreaks in West Africa, and 3) a strategic approach to future disease outbreak in the region.Methods: A narrative review was conducted by using four electronic databases—PubMed, Medline, Web of Science, and Scopus—using search key terms and a manual search of Google Scholar and gray literature. A date range was open to all years, up to 2017 to include a historical aspect of Africans’ funerary rituals and 2014–2016 Ebola outbreak in West Africa.Results: West Africans believe that performing funeral rituals enables them to cement unity between the living and ancestral spirits and to receive spiritual gifts from deaths. Funeral rituals include several actions, such as washing and cleaning the body, washing one’s hands in a common bowl after touching the face of the deceased, and lying over the corpse of a prominent person. Although Ebola-affected countries created national Ebola response and communication strategies in 2014, the efforts at the government level were not sufficiently effective to contain the disease’s outbreak.Conclusion: Traditional funeral and burial practices are a part of the culture in West Africa and should be evaluated and respected. Policymakers should design a theory- and practice-based socioecological model based on social and behavioral strategies for villagers in remote areas to prevent the spread of infectious diseases via traditional burial practices

Analysis of the Doctor of Public Health (DrPH) training and identity needs in the United States: a qualitative study

Background The Doctor of Public Health (DrPH) is the highest attainable degree in the field of public health, specifically designed to prepare professionals to address complex public health challenges in practical settings. This study was designed to explore the importance of achieving a shared and uniform understanding of DrPH education, assess the optimal direction for DrPH training, and investigate the specific curriculum requirements by gathering insights from current DrPH students and alumni in the United States. Methods A total of 13 focus group discussions and two in-depth interviews (total participants: 50) were conducted through Zoom to see how DrPH students and alumni assessed their DrPH educational programs. Results Three overarching findings emerged from the analysis of focus group discussions and in-depth interviews. First, participants expressed a preference against a national DrPH board examination, but advocated for a standardized common core curriculum that extends across the entire nation. Second, the ideal direction for DrPH training was perceived to involve a practice-based approach, emphasizing the importance of multi-, inter-, and trans-disciplinary instruction delivered by faculty with practical experience. Last, there was a demand for a DrPH-specific unique curriculum encompassing areas such as mixed method analysis, leadership and management, applied communication, crisis and change management, proficiency in addressing contemporary topics, and tailored applied and integrative learning requirements specific to the DrPH program. Conclusions We explored a range of DrPH training and identity needs among 50 participants, comprised of students and alumni who directly benefit from DrPH education. By considering these inputs, individuals from institutions that offer the DrPH degree can further enhance the quality of public health practice training and make significant contributions to the overall advancement of the field of public health

The effects of spiritual experience and church commitment on mental health and work performance among a sample of South Korean immigrants in the United States: a mixed methods study

This sequential mixed methods study measured the effects of spiritual experience and church commitment on mental health and work performance among a sample of South Korean immigrants in the United States. It included the screening survey for assessing level of religious belief and involvement in church activities (quantitative) followed by in-depth qualitative interviews about the relationship between church attachment and mental health as well as work/school performance (qualitative), in order to obtain preliminary findings and generate insights regarding future research. High-active believers who engage in church activities were assigned as Group 1, and inactive/low-active members who still have high-level belief were assigned as Group 2. Both Group 1 and Group 2 contained strong believers, and the screening survey proved that the level of belief were not much different between two groups. There was no guarantee that time dedication for church would improve Group 1\u27s work/school performance because they were suffering from a time conflict between work and church activities and could not focus their energy on one thing. However, there was no doubt that their strong belief was a prime motivation to work or study harder as well as the main factor of developing their mental health and common well-being -- though in fact many reported a negative association between intense church involvement and at least some aspects of mental health. This study can serve as a guide to further research on specific factors potentially associated with mental health and social adjustment for Koreans, as well as other immigrants. Specifically, insights from this study shed light on potential elements of religious belief and practice that are related to mental health and work/school outcomes, and on the range of reasons that individuals participate in church. There may be some linkages between the demographics of Group 1 and Group 2 participants that influence level of participation in church activities, but there are not enough data from this study to support any conclusions on that issue

The effects of spiritual experience and church commitment among South Korean young adult immigrants in the United States: a mixed-methods study

Background Korean American immigrants have become one of the largest Asian American ethnic group in the United States, and Christianity have been preserving their ethnic identities. However, little is known if church commitment is associated with developing emotional well-being and work capacity. The study aims to understand the attachment to church and its effect on level of emotional well-being and work (or school) performance among South Korean young adult immigrants who have a strong faith in Christianity. Methods A sequential, mixed-methods study examined two dimensions of church attachment, level of religious belief and involvement in church activities. A total of 23 participants was initially recruited through purposive and snowball sampling, and then 22 of them were divided into two high-belief groups—high-active church members and low-active church members – for further analysis. A screening questionnaire, a quantitative component, was used to exclude a low-level believer. Consecutively, an in-depth interview, a qualitative component, was conducted to further investigate the emotional well-being and work (or school) performance. Results Although a small sample was collected, it generated initial insights into the effects of time commitment for church among immigrants. Regardless of leadership roles and level of activity at church, strong beliefs appeared to improve emotional well-being and support motivation to improve the performance of major activity of daily living. Conclusions The major significance was to support further research on religious belief and practice and its potential association with emotional well-being and social adjustment for Koreans, as well as other immigrants. The study applied a culturally specific lens to focus on a particular minority immigrant population

The Impact of Student Debt on Career Choices among Doctor of Public Health Graduates in the United States: A Descriptive Analysis

(1) Background: As gaps in the public health workforce grow in the wake of the COVID-19 pandemic, graduates of the schools of public health, especially Doctors of Public Health (DrPH), are poised to offer relief. While there are some known recruitment issues, student debt and debt impact on career choices are understudied. (2) Methods: In the present study, we perform a descriptive analysis of the potential impact of student debt on career choices among DrPH students and alumni in the United States using a cross-sectional national online survey. A total of 203 participants (66: alumni and 137: current students) completed the survey. Descriptive statistics, a chi-squared test of independence, and content analysis were used to analyze the funding situation and its impact on career choices. (3) Results: We found that (1) 72% of current DrPH students have zero funding support for their degree, (2) scholarship opportunities for a DrPH degree are limited, especially when compared to PhD programs, and (3) student debt impacts 59% of DrPH students’ and 29% of DrPH graduates’ career choices (about 49% of all respondents). (4) Conclusions: Student debt and a misunderstanding of DrPH are likely impediments to DrPH graduates participating in the public health workforce

The impact of changing nonimmigrant visa policies on international students’ psychological adjustment and well-being in the United States during the COVID-19 pandemic: a qualitative study

Background Since the Immigration and Nationality Act of 1952, the number of international students in the United States had been gradually increasing. However, the total numbers have begun to decrease since 2019–2020 school year due to the Trump administration\u27s policy and COVID-19. Still, little is known about how international students’ psychological adjustment and well-being have been affected by changing nonimmigrant visa policy and the COVID-19 pandemic. Methods We conducted a total of 34 online semi-structured in-depth interviews with international students from 18 countries of origin studying in the San Francisco Bay Area, California. More than 60% of the participants (21 out of 34) were aged 21 to 25. Among our 34 participants, gender and 18 were male and 16 were female, and 19 were undergraduate students and 15 were master’s students. The majority of the participants were first-generation college students (22/34, 64.71%). Verbatim transcription was done for all interviews. NVivo was used for both deductive and inductive approaches to the qualitative analysis. Results Overall, the recent political climate negatively impacted participants’ psychology of adjustment and well-being. July 6, 2020 Policy Directive for international students caused severe uncertainty about whether they can continue studying in the United States. There were many resources or services needed to overcome this period, such as extended mental and emotional support from the counseling services as well as financial and informational support from the international student office and university. Although international students had the benefit of the university\u27s food assistance program, they were not eligible to receive any external support outside of the university and financial aid at the local and federal levels. Whether maintaining F-1 visa status was one of their major concerns. Due to COVID-19, job opportunities were limited, which made international students difficult to obtain Curricular Practical Training (CPT) and secure a job in the United States within the 90-day unemployment limit of Optical Practical Training (OPT). H-1B visa and permanent residency were other challenges to go through, but participants saw positive perspectives from the Biden administration. Conclusions Uncertain policy changes due to COVID-19 and presidential transitions impacted international students’ psychological well-being and adjustment. International students are important populations in the United States who have supported jobs that are high in demand and economically contributed to the United States. It is expected that future policies at various levels support international students’ life and improve their health equity and mental health

The impact of COVID-19 and anti-immigration policy on an undocumented student in the United States: a qualitative case study

Background The change of Deferred Action for Childhood Arrivals (DACA) program has significantly impacted DACA students’ mental health in the United States. The study aimed to conduct a qualitative case study for understanding the effects of DACA program on one undocumented college student’s life during the COVID-19 pandemic. Methods We conducted a two-component qualitative case study, the online survey and the subsequent in-depth interview, with a DACA college student, Leah (pseudonym), in California who was in an ongoing fear of deportation before and during the COVID-19 pandemic. We used Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) in the online survey to measure her level of depression and anxiety. QSR NVivo was used to analyze the verbatim transcription. Results Leah’s anxiety and depression level just before the Supreme Court’s decision to the DACA termination in June 2020 was higher than during the COVID-19 pandemic in 2021. Leah’s concern still remained due to the uncertain legal status in the United States even after the presidential election. Conclusions During 2020-2022, the anti-immigration policy, the COVID-19 pandemic, and the presidential election has impacted a DACA student’s mental health status. However, because of the unstable legal status and fear of deportation in the United States, our participant’s anxiety and depression level maintained high. From our participant’s standpoint, more policy support is needed to sustain her legal status, financial stability, and mental health during the pandemic