Archive for July 5th, 2020
Re-inventing Public Health: Covid-19 inequity
COVID-19 and inequity — public health needs a third revolution
For many Americans, George Floyd’s murder ignited a new level of momentum to confront police violence against people of color.
The COVID-19 pandemic — which is killing black Americans at nearly two and a half times the rate of whites — has put a spotlight on our nation’s shameful racial divide in public health.
While the first and second public health revolutions vastly extended life expectancy by making strides against communicable disease (cholera, typhoid and dysentery) and chronic illness (heart disease and diabetes), racial gaps (and minority ethnic groups) remain a persistent contributor to negative health outcomes.
In a nation with growing economic disparities, scarred by centuries of systemic racism, the third revolution in public health must address the root causes of our remaining pervasive health inequities — poverty, pollution, housing, food security and other basic needs.
Since our systems have resulted in these issues disproportionately impacting communities of color, we need to conceive, develop and implement solutions that prioritize the wellbeing of people and communities that have been overlooked for far too long.
It’s a daunting task, to be sure. But, with an approach I call precision community health, we can target our limited resources to be effective at addressing the most urgent public health inequities, while also supporting the eradication of racism throughout our society.
Investment is needed in public health systems, including state-of-the-art data collection and communications tools.
With these we can collect granular data on everything from asthma rates to housing conditions and police violence, broken down by race and income.
That data can then be transformed into knowledge to guide decision-making.
We can leverage social media and other communications strategies to deliver precisely targeted messages to ensure people have information they need, when and where they need it, to make informed decisions for themselves and their loved ones.
We can also invest in people by creating a national Public Health Corps, similar to AmeriCorps.
Recruitment could start with our country’s community health workers, our invaluable set of frontline public health workers who are already trusted members of the communities we serve today.
But importantly, these workers’ expertise and training can also build equity in communities today, by linking people to resources on housing, food security, employment and more.
Community health workers are also uniquely positioned to have an immediate impact on the spread of COVID-19 by performing the critical task of contact tracing — reaching out to those who test positive for COVID-19, helping them identify others they may have been exposed, then supporting them through quarantine and testing.
For any of our efforts to succeed, we must account for and honestly confront the distrust many people feel in our public institutions.
In this time of massive societal upheaval, we have a tremendous opportunity to shift our focus and resources to fully embrace public health solutions. But our field will need to reckon with our own painful history of systemic racism to realize our full potential.
If we are to continue making the breakthroughs that improve and extend lives as public health has done for decades, we must embrace the moment we are in.
It’s time to rethink public health by understanding the inequities that are making people sick and targeting resources where they are needed most.
Bechara Choucair, a family physician by training, was commissioner of the Chicago Department of Public Health from 2009 to 2014.
He is currently senior vice president and chief health officer at Kaiser Permanente and author of “Precision Community Health: Four Innovations for Well-being.”
Note: My Daydreaming health re-structuring project https://adonis49.wordpress.com/2011/12/17/daydream-project-restructuring-medical-and-health-care-providers/
Here we go again: Five Majestic Outdoor Destinations in Lebanon. Every country has Majestic sceneries.
Posted on: July 5, 2020
Here we go again: Five Majestic Outdoor Destinations in Lebanon. Every country has Majestic sceneries.
The Wilderness Project. June 30, 2020
Nature is a gift to us and we should preserve it well! If you go on an amazing hike do tell us about it and share any pictures, too. We always love to hear from you!
Lebanon is a country truly blessed for its unique topography rich with gorgeous green landscapes throughout, and unlike the rest of the Middle East, it has no desert. (Though desertification and polluted water sources are catching up)
Its temperate, weather and abundance of lush rolling hills, natural waterways and diverse flora makes it an ideal country to explore by foot, pretty much anytime of the year. (This lush rolling hills and natural waterways are exaggerated description with the failure of this pseudo-State to shoulder its responsibilities)
While hiking and camping outdoors have always been popular activities in Lebanon, since the pandemic, more Lebanese than ever before have turned to nature looking for safe ways to unwind and to get some exercise.
As a hiking enthusiast myself, I always suggest to others that the best remedy for stress is a long walk amid beautiful surroundings. It certainly works for me.
In Lebanon you also get to see ancient ruins along the way thanks to the country’s rich and storied past. This could be anything from centuries old water mills, Ottoman arched stone bridges, Roman era terra cotta pottery pieces embedded in the soil to rock structures engraved in Latin letters
(During the second century A.D. the Roman Emperor Hadrian carved more than 200 rocks as boundary markers to control the logging of Lebanese Cedar trees, which were the most highly sought after building materials at the time).
Many hiking trails are also adjacent to historic Lebanese villages, which means if you finish your walk early you can benefit from additional sightseeing for the day (visit the local landmarks), stop by for a beverage or a meal or buy some local Mouneh (homemade preserved delicacies) before heading back home.
Now let me share with you five wonderful places in Lebanon that are definitely worth walk touring “à pied”.
Cedar Tree in Tannourine
Mill Trail
1- Tannourine
Tannourine is perhaps most famous for its cedars forest covering 12 square kilometers which is also one of the country’s most picturesque and pristine areas for walking, some even growing on extreme vertical slopes),
You can spot grottos and plenty of vibrant wild flowers. If you prefer a more rugged terrain with some sightseeing, try the Mill Trail of Tannourine.
You can start this hike at the centrally located historic Medieval Church of Mar Challita (famous for having two alters). Then head towards the nearby Mill Trail, which is alongside the picturesque Walnut River (Nahr el Jawz).
Like the trail’s name suggests, you will come across several old mills (Al Aabara, Al Nsoub and Emm Zahra). You can also visit the impressive Baatara Sinkhole, a natural phenomenon, and sit and marvel at the 255-meter-deep Jurassic limestone cavern.
While it is mainly dry during summer, in winter and spring a dramatic waterfall flowing into the sinkhole can be enjoyed. After a long morning hike this place is great to rest and have your picnic lunch (it also has a few snack areas serving sandwiches and mezza).
2- Qadisha Valley (Holy Valley)
Also referred to as Wadi Qannoubine (Valley of the Saints), this place has an incredible vibe, landscape and legacy (all three).
This place is an UNESCO World Heritage Site (Lebanon has five in total) so it is a protected zone, with the few people living on the premises comprised of those in the monasteries and churches.
Qadisha valley is a breathtaking gorge marked by rocky hillsides covered with natural caves, which have been used as shelters and burials going back to the Paleolithic period. Later on it became a refuge for those in search of solitude or escaping religious persecution, from Sufis to Christians (It has hosted monastic communities since the earliest years of Christianity, and again in the 12th, 17th and 18th century, for those fleeing persecution at the hands of the Mamluks and later the Ottomans).
Often penned the Lebanese mini Grand Canyon, this utterly peaceful sanctuary is 1,400 meters above sea level with sweeping views all around and has a river that carves out the floor of the valley with water flowing through it in the springtime.
There are various entrances to begin a hike in this valley, but the most commonly used is Mafraq Qannoubine (the main road in Bcharre).
Once you enter Qadisha you can follow the signposts and walk towards Mar Elisha monastery or Qannoubine monastery. Otherwise you can plan ahead and seek the advice of Lebanon Mountrail Trail (LMT) which has mapped out most hiking trails in the country www.lebanontrail.org.
(I did this hiking expedition with the steepest and awkward of stairs for many miles)
Rocky cliffs dotted with ancient natural caves
St. Marina the Monk Church
3- Jabal Moussa Biosphere Reserve (JMBR)
Our next hiking gem is a biosphere reserve. JMBR has an exceptionally rich biodiversity hosting 750 species of flowers and trees.
In addition, 137 migratory and soaring bird species and 25 mammal species make this mountainous area their home (among them are foxes, squirrels, hedgehogs, wild boars and the very rare striped hyenas).
You can also find historic sites, such as Roman era stone stairs, a Byzantine church, a centuries old watermill and olive press, several ruins of old houses, an abandoned Ottoman settlement and rocks with the famous Emperor Hadrian’s inscriptions.
The reserve covers an area of 6500 hectares and offers 10 different trails, which can be accessed from three main entrances: Qehmez. Mchati and Chouwen.
I highly recommend the hike to its highest summit Qornet el Mzar (1600m) that shelters the ruins of a Roman temple; it offers sweeping panoramic views of the entire country, and on a clear day you can see as far as Cyprus and Syria.
There is a small entrance fee of 8,000 Lira (4,000 Lira for the under 16) to enter Jabal Moussa. On your way out check out their kiosk selling Mouneh and handicraft products made by local women. You can support them with your purchase!
Floral diversity of Jabal Moussa
Remains of an old house
Forest boundary marker of Emperor Hadrian Picture Credit: https://followinghadrian.com/tag/jabal-moussa/
4- Jannet Chouwen
If there is a place to be crowned heaven on Earth, Jannet Chouwen on a sunny day might come pretty darn close. This stunning area is ideal for hiking, camping out, going for a swim and just basking in nature for as long as possible.
The hiking hotspot is most famous for its stream that runs down the mountain and flows into the Nahr Ibrahim River, also known as the river of the God Adonis (a.k.the river of immortal love!)
A year ago I swam in this pristine stream and I can assure you, being in this fresh invigorating natural bath outdoes any spa! This river is accessible through JMBR’s Chouwen entrance. From there you need to walk downhill for about 45 min until you reach the area.
(You may read my humoristic trekking adventure on this supposed Promised Paradise)
https://adonis49.wordpress.com/2020/03/30/trekking-to-the-promised-paradise/
Aerial view of Nahr Ibrahim
5- Darb El Mselha (Mselha Walkway)
This hiking destination takes its name from the Mseilha Fort in Batroun, which was built by Emir Fakhreddine II in the 17th century to protect the city from enemy attacks.
The actual walk begins from the Mseilha Fort and is parallel with the picturesque Nahr El Joz so you can also enjoy the beautiful water canals as you stroll along. The trail can take you all the way to Kaftoun village, which is approximately 12 kilometers away.
This is actually a new hiking spot in Lebanon and has been immensely popular with hikers and families alike looking for areas to have a nice walk and even stop for a picnic along the way.
Parts of the trail have cement blocks with small gaps in between which can be unsafe for younger children, so just make sure they are well attended to if you bring them along with you. Dogs are also forbidden on this trail.
Darb Mseilha is easily accessible from the Batroun highway before Chekka. You can conveniently park your car at the entrance of this well maintained public trail and see where it takes you!
Glad you enjoyed reading about five of my favourite hiking areas in Lebanon. While I only mentioned a few, the country has countless excellent nature destinations so you are spoilt for choice.
You can read more about the various trails via LMT, which I previously mentioned. So, wishing you all happy trails if you go for an outdoor adventure! Remember wherever you go, keep the area clean and respect the rules in any reserve or outdoor area.
References:
First Picture: Arz Hadath El Jebbeh in Bcharre taken by Alia Fawaz. All pictures (with the exception of Hadrian’s Rock in Jabal Moussa) have been also provided by the author taken during her hikes.
Adonis Diaries 