Impoverished Village Research Articles

SOC and TN fluctuations determine the variations in microbial enzymatic activities under diverse land use types in the Central Himalaya, India

Soil microbial enzymatic activities, often used as indicators of soil health and fertility, are vulnerable to changes in climate and anthropogenic activities. This study analyses the responses of specific soil enzymatic activities– dehydrogenase (DHA), acid phosphatase (APH), β-glucosidase (BG) and urease (URE)– in Nitosols/Luvisols of the subtropical zone of the Central Himalaya, India. We investigated how these enzymatic activities vary with different land uses: arable land (AL), kitchen garden (KG) and peach orchard (PO), across four villages– Niglat, Kainchidham, Majhera and Syalikhet. Considering associated management practices, we quantified cumulative average soil enzymatic activities for the rabi season (2017–2018). In general, catalytic activity of the selected enzymes was highest in Syalikhet and lowest in Majhera. However, for land use types, enzymatic activities were lower in AL and KG (75.56–90.17% and 39.41–61.72%, respectively) compared to PO values. MANOVA analysis evaluated significant spatial differences (P < 0.001) in enzymatic activities. Soil enzymatic mean values were highest in the surface layer (0–10 cm) and decreased gradually with increasing depth. Parameters such as soil moisture content (SMC) and pH, along with vegetation, management practices, and nutrients such as SOC, TN, K, AP, and N forms (NH4+–N and NO3––N) showed significant and strong correlations with all the soil enzyme activities (r = 0.40–0.97; P < 0.05). TN, SOC, K, SMC, pH, AP, NH4+- N, and clay content were key determining factors of soil enzymatic activities, explaining approximately 59% of the variation. These results suggest that using soil microbial enzymatic activities as soil quality indicators is a feasible approach to assess the impacts of vegetation, management practices, and soil profile depths in soils under different land use types/systems in selected impoverished villages of the fragile Central Himalaya, India.

Cost and thermodynamic analysis of wind-hydrogen production via multi-energy systems

With rising temperatures, extreme weather events, and environmental challenges, there is a strong push towards decarbonization and an emphasis on renewable energy, with wind energy emerging as a key player. The concept of multi-energy systems offers an innovative approach to decarbonization, with the potential to produce hydrogen as one of the output streams, creating another avenue for clean energy production. Hydrogen has significant potential for decarbonizing multiple sectors across buildings, transport, and industries. This paper explores the integration of wind energy and hydrogen production, particularly in areas where clean energy solutions are crucial, such as impoverished villages in Africa. It models three systems: distinct configurations of micro-multi-energy systems that generate electricity, space cooling, hot water, and hydrogen using the thermodynamics and cost approach. System 1 combines a wind turbine, a hydrogen-producing electrolyzer, and a heat pump for cooling and hot water. System 2 integrates this with a biomass-fired reheat-regenerative power cycle to balance out the intermittency of wind power. System 3 incorporates hydrogen production, a solid oxide fuel cell for continuous electricity production, an absorption cooling system for refrigeration, and a heat exchanger for hot water production. These systems are modeled with Engineering Equation Solver, and analyzed based on energy and exergy efficiencies, and on economic metrics like levelized cost of electricity (LCOE), cooling (LCOC), refrigeration (LCOR), and hydrogen (LCOH) under steady-state conditions. A sensitivity analysis of various parameters is presented to assess the change in performance. Systems were optimized using a multi-objective method, with maximizing exergy efficiency and minimizing total product unit cost used as objective functions. The results show that System 1 achieves 79.78 % energy efficiency and 53.94 % exergy efficiency. System 2 achieves efficiencies of 55.26 % and 27.05 % respectively, while System 3 attains 78.73 % and 58.51 % respectively. The levelized costs for micro-multi-energy System 1 are LCOE = 0.04993 $/kWh, LCOC = 0.004722 $/kWh, and LCOH = 0.03328 $/kWh. For System 2, these values are 0.03653 $/kWh, 0.003743 $/kWh, and 0.03328 $/kWh. In the case of System 3, they are 0.03736 $/kWh, 0.004726 $/kWh, and 0.03335 $/kWh, and LCOR = 0.03309 $/kWh. The results show that the systems modeled here have competitive performance with existing multi-energy systems, powered by other renewables. Integrating these systems will further the sustainable and net zero energy system transition, especially in rural communities.

ROLE OF ENTREPRENEURIAL SCHEMES IN THE DEVELOPMENT OF ENTREPRENEURSHIP IN NAGALAND

Entrepreneurship development has contributed to economic growth, rural development, job creation, and business expansion, as well as providing a source of income for impoverished villagers. India has demonstrated that entrepreneurial activities contribute to their countries progress. Similarly, the growth of entrepreneurship in India has been on the rise. Many researchers have studied the progress of entrepreneurial growth across India states. Since the implementation of government policies encouraging many local business people to venture into business, entrepreneurship development has been on the rise. The purpose of this paper is to investigate entrepreneurial schemes and the development of entrepreneurship in Nagaland. KEYWORDS: Entrepreneurs, Entrepreneurship and Entrepreneurship Development, Economic Growth, Rural Development

Impact of HIV-1 Infection on the Natural Progress of an Anti-HCV Positive Population in an Impoverished Village in China from 2009 to 2017.

Our study aimed to determine the impact of HIV coinfection on the natural progression of liver disease in treatment-naive HCV-infected patients. From 2009 to 2017, we tracked non-invasive markers of liver fibrosis and end-stage liver disease (ESLD)-associated mortality among HCV mono-infected and HIV/HCV coinfected patients in an impoverished village in China. The study cohort consisted of 355 HBsAg-negative and anti-HCV (+) or anti-HIV (+) patients recruited in July 2009, 164 of whom were diagnosed with HIV-1 infection. The surviving patients were re-evaluated in August 2017. During the follow-up, the disease status, liver biochemical, and non-invasive indicators of liver fibrosis (APRI and FIB-4) were measured. The transaminases ALT and AST were significantly higher in HIV-positive HCV resolvers (HIV+ HCVr) than in HIV-negative HCV resolvers (HCVr) (p = 0.019 and p < 0.0001, respectively). APRI and FIB-4 scores of HIV-positive chronic HCV carriers (HIV+ HCVc) were significantly higher than in HIV-negative chronic HCV carriers (HCVc) (p < 0.001). Similarly, APRI and FIB-4 scores were higher in the HIV+ HCVr group than in the HCVr group (ps < 0.001). From 2009 to 2017, the levels of ALT (p = 0.006), AST (p = 0.003), APRI (p = 0.015), and FIB-4 (p = 0.025) were significantly elevated in the HIV/HCV coinfected patients with CD4+ T counts below 500 cells/l. ESLD-related mortality was significantly greater in HIV/HCV-infected cases than in HCV mono-infected patients (73.3% vs. 31.3%, p = 0.009) among patients (n = 45) who died between 2009 and 2017 during follow-up. These findings suggest a higher risk of ESLD-related death and rapid progression of liver fibrosis in HIV/HCV coinfected individuals compared with HCV mono-infected patients. During HIV/HCV coinfection, HIV infection may aggravate HCV-associated liver injury.

The intersectionality of religion, race and gender at the time of COVID-19 pandemic: A South African reflection

This paper presents the intersectionality of religion, race, and gender during the COVID-19 pandemic from a South African perspective. Though COVID-19 has affected every area in South Africa, the intersectionality of religion, race, gender class has begun to be interrogated by scholars, NGOs, and faith-based organizations. The interpretative phenomenological analysis study was conducted at a South African rural-based hospital, which is comprised of black personnel who serve only black people from impoverished villages. The data were collected from 11 nurses who had suffered from COVID-19. Following Pietkiewicz and Smith's (2014:7) steps of thematic data analysis, results indicated that nurses who suffered from COVID-19 had faced the dilemma of administering Western medicine or traditional African medicine. In other words, the universality of western medicine as effective and scientific created an epistemological dilemma for those that viewed traditional African medicine as an alternative to western medicine. As such, this was also necessitated by the view that Western medicinal treatments were not as effective in comparison to traditional African medicine. This view indicates the effectiveness of perception. Succinctly put, the social and epistemic locationof the participants functioned as an epistemological discourse in engaging the notion of the ‘supremacy’ of Western medicine and the choice of administering both Western and traditional medicinal treatments. The choice of opting to administer both medicinal treatments was also necessitated by the scarce resources and access to hospital facilities. At the same time, the notion that traditional administration of medicines to treat COVID-19 was also viewed as an act of heathenism, based on religious belief. The intersectionality of religion and class became evident as illustrated in the findings that surrendering one's life to God through prayer was important and central for those infected and affected by COVID-19 instead of administering traditional African medicines. While there appears to be no objection to administering Western medicines, suggesting the convergence of both epistemologies as superior to the traditional epistemologies. Applying a decolonial analysis, the paper seeks to argue that there is a need to decolonise religion (western Christianity) in order to deconstruct the notion of traditional epistemologies as heathenism. This is in order to the delink so as to advance the notion of pluriversality and broader-thinking.

Literature as a Matter of Policy

Literature as a Matter of Policy

The intersection between the dwelling environment and health and wellbeing in impoverished rural Puebla, Mexico

This paper forms part of a major health needs assessment research project of small-scale subsistence farming households in three relatively impoverished villages located close to an active volcano (Popocatépetl) in the rural hinterland of the town of Atlixco, Puebla, Mexico. Our overarching research question is: how do housing conditions, the micro-environment of the lot and dwelling, air and water quality, patterns of food preparation and household behaviors impact health and wellbeing in each community? We use a mixed-methods strategy starting with a survey of almost 250 households to generate baseline data on the health status, treatment, and perceptions of health in each of the four communities. Our housing and health assessment also focusses upon the dwelling structure and perceived problems such as damp and pests; the use of rooms and yard space; and on-site environmental sampling of the water and air quality. In addition, we apply an intensive case-study methodology to five purposively selected farming households in order to highlight how different dwelling structures and conditions, room use, lot maintenance and organization, practices of animal husbandry, fertilizer and agrochemical storage, open fire cooking with wood, and other behaviors shape and impact health and wellbeing. Our findings and conclusions emphasize the need for further research to better understand the epidemiology of these and similar communities. We conclude by offering a series of policy actions to mitigate the risks and hazards that we identify, and argue that in these rural communities the intersections between housing, home, and yard management presents hazards and challenges to health outcomes that are more dynamic and more volatile, than those of most urban housing environments.

Identifying communities’ perspectives on their health needs in impoverished villages to guide non-government organizations’ health promotion efforts in Guatemala

Objective: The aim of this mixed-methods study is to capture and understand impoverished Guatemalan community members’ perspectives of their own health needs on a community level in order to guide Hope of Life (HOL) Non-Profit organization’s health promotion interventions in the villages they serve. Methods: This exploratory research deployed a modified health needs assessment survey with 96 participants from four impoverished villages in the department of Zacapa, Guatemala. Survey responses were analyzed for significant differences in 4-item individual, family, and community health scores across demographic variables and significant correlations with reported personal health conditions and children’s health conditions. Five semi-structured interviews were also conducted with community leaders from three of the villages surveyed. Interviews were audio recorded and responses were transcribed verbatim and translated from Spanish to English. Thematic analysis using HyperRESEARCH qualitative analysis software version 4.5.0. was conducted to identify major themes. Results: The mean age of the 96 participants surveyed was 40.4 years and the majority were women, married or in consensual union, and have children. Women reported a significantly lower individual and family health score than men. The most rural village included in the study had significantly lower family health scores than the three sub-urban villages in the study. Among the personal health problems reported by participants, alcohol consumption, dental problems, and malnutrition were significant predictors of lower individual health scores. Themes that emerged from the interview analysis included the greatest community health needs, perceived negative community health behaviors, barriers to health care access, HOL’s impact, and suggestions for community health promotion. Conclusion: The results of this study reveal many unmet health needs and barriers to healthcare that Guatemalan village communities face. Community-based participatory research using a mixed approach voices communities’ perspective on their perceived needs and is an important tool to guide non-profit aid and intervention serving impoverished communities.

More than the pandemic

More than the pandemic

Re-Designing, Humanizing and Globalizing Higher ducation: Disruptive Strategies for Business School Leadership from the Bottom Up

This paper highlights disruptive strategies to move students from the classroom and traditional business education to using their skills in impoverished villages in the Third World. Beginning in the late 1990s, innovations were designed by faculty and students to roll out a pro-poor agenda that includes the following: Student-led microfinance NGO spinoffs, accounting school faculty and students offering financial training and services, MPA student initiatives that assist African village leaders, annual social entrepreneurship conferences, the establishing of a campus center for economic self-reliance, and more. We will describe the leadership processes that evolved as these and other campus programs were established and rolled out to effect real social change across the globe. As described below, many of these efforts began at the lower level of the university, among students and professors, not at the top. However, this kind of higher education leadership from below promises exciting and path-breaking new strategies for higher education scholars and practitioners everywhere, especially within the context of schools of management.

Discussion of Critical Success Factors in Colleges and Universities Participating in Poverty Alleviation Tourism Based on Analytical Hierarchy Process

Domestic socio-economic development has acquired great achievement, while poverty is still a major problem in restraining the development of domestic rural areas. The past developmental poverty alleviation could not satisfy the requirement for poverty reduction to comprehensively build the well-off society. Although distinct models of poverty alleviation through tourism for impoverished villages were proposed from the aspects of the government, enterprises, and communities, most of them, from macro perspectives, stressed on the development of tourism in impoverished villages, while specific research on who to help the development of poverty alleviation through tourism in pilot villages and how to integrate resources to implement the effective support of impoverished villages was little. For this reason, critical success factors in colleges and universities participating in poverty alleviation tourism are analyzed in this study. Aiming at visitors to Nianshan Village, Fujian Province, 300 copies of questionnaire are distributed for this study. Total 214 valid copies are retrieved, with the retrieval rate 71%. The research result reveals that “government department” is the most emphasized dimension in hierarchy, followed by “social enterprise”, “college and university organization”, and “villages with poverty alleviation through tourism” and top five most emphasized indicators, among 17 evaluation indicators, are policy support, funding support, system design, practice base, and top management support. Finally, suggestions are proposed according to the results, expecting to help the overall development of domestic poverty alleviation tourism and promote the development of both students and impoverished villages.

Report on the Targeted Poverty Alleviation in Southwest China: The Study of Longtou Village, Dazhou, Sichuan Province

Purpose: The year 2020 marks the last year of Chinese poverty alleviation project. 70.17 Million extreme impoverished populations in China will be lifted out of poverty. The purpose of this report is to examine the effectiveness and sustainability of targeted poverty alleviation in Southwestern China, using Longtou village as an example. It will also focus on villagers’ needs and possible future policies. Methodology: The sampling survey covering 30 out of 106 impoverished households in Longtou village, Dazhou, Sichuan province, China was carried out on Auguest 3, 2020, providing sufficient examples for the report. Literature review of China’s poverty alleviation history is mentioned to lay a research basis for the study. Findings: Needs of impoverished villagers from different age groups, different poverty causes, different identities, are almost fulfilled. The potential problems of Longtou village, such as aging population, as well as their possible solutions are presented in the report. Policy implications: The report illustrates China’s targeted poverty alleviation in detail. The mechanism’s implications are well reflected by the conversation with interviewed villagers and their opinions. Basically, after 6 years of targeted poverty alleviation, villagers’ living standards as well as living conditions are well improved. Majority of villagers were satisfied with current poverty alleviation policies.

English

China has made considerable progress in economic, social, cultural and political fields since reform and opening-up started in 1978. In the last forty years the country lifted over 700 million people out of poverty by implementing large-scale, long-lasting, government-led, and very effective rural poverty alleviation and development plan. In health care financing, the country also achieved universal health insurance coverage for 1.3 billion people in a short time, and that is astonishing. This study tried to draw a lesson for developing countries by analyzing China&rsquo;s rural poverty alleviation programs through health care financing. To this end, a study was conducted in Taijiang County in Guizhou province of the People&rsquo;s Republic of China, in six impoverished villages. Data were collected for this study in a three month period (December 2018 to February 2019) through a questionnaire, focus group discussions and interviews. This study seek to answer the following two questions: What lessons do the Chinese experiments of poverty alleviation through health care financing offer to other developing countries? Are the Chinese experiences replicable elsewhere in the third world? To answer these questions, a deductive approach was adopted in this study methodology. First, China&rsquo;s rural poverty alleviation programs was explored in general and based on this the rural development efforts in Taijiang County, in particular was examined. This study showed that clear government vision and determination, and popular participation have great contribution in China&rsquo;s rural poverty alleviation through health care financing. The government used very effective poverty alleviation approaches that include &ldquo;comprehensive control and development area by area,&rdquo; &ldquo;poverty alleviation village by village,&rdquo; &ldquo;participatory poverty alleviation,&rdquo; and &ldquo;one plan, implementation year by year&rdquo;. Such approaches have not only made significant contributions to China&rsquo;s rural poverty alleviation, but also become recognized as best practices for poverty alleviation in developing countries. It is believe that the basic strategies, models, and experiences of poverty alleviation of China are significant references for developing countries. &nbsp; Key words: China, poverty, developing countries, health care financing.

A Dynamic View on Tourism and Rural Development: A Tale of Two Villages in Yunnan Province, China

ABSTRACTThis study traces tourism and agriculture development in two typical villages of contemporary China, where one is tourism-oriented and the other is agriculture-oriented. Through in-depth interviews with 57 villagers, the study presents the complexity of the socio-cultural relationships underpinning agriculture and rural tourism and confirms that these relationships are not static. The comparison sheds light on the villagers’ varying attitudes toward rural tourism, their collective management approaches, and the experiences of rural culture they share with visitors. To capture the changing nature of these findings over time, a dynamic model of rural development is generated as a framework for future studies. This study suggests that large-scale villager participation in rural tourism may not be a desirable outcome, as it may contribute to the decline of rurality. It offers a warning against the use of tourism as the sole tool for rural development, even though that has been advocated by the Chinese Central Government as a primary economic strategy for numerous impoverished rural villages.

The Evaluation and Improvement of Performance for Precise Poverty Alleviation in Hainan Province

Precise poverty alleviation is the strategic deployment of the new stage of the party and national anti-poverty development in the new period, and the poverty alleviation performance in poverty-stricken areas of Hainan province is related to the impoverished city counties and the whole province. Firstly, this study classified and commented on the current situation of research from the aspects of anti-poverty, performance appraisal index and method, index and method of poverty alleviation performance appraisal. And on this basis, the relevant concepts of this study are defined. The data of the first stage of survey is to describe the corresponding conclusions. SPSS 21.0 statistical software establishes the factor analysis model to extract the main factor of the original data and then calculate the weights by factor load and variance contribution rate and measures the precision poverty alleviation performance score of each typical impoverished village. In order to compensate for the single factor analysis model angle and explore whether there is a club effect between the typical impoverished villages, this study also introduces clustering algorithm for the precision poverty alleviation performance of 10 typical poor villages and obtains empirical results. Based on the field survey and empirical results, this study proposes the improvement of poverty alleviation performance, from the improvement of rural poverty management ability, the formulation of targeted pro-poor policies and the formation of diversified poverty network management system three aspects to improve the precision of poverty alleviation.

Village-level multidimensional poverty measurement in China: Where and how

Village is an important implementation unit of national poverty alleviation and development strategies of rural China, and identifying the poverty degree, poverty type and poverty contributing factors of each poverty-stricken village is the precondition and guarantee of taking targeted measures in poverty alleviation strategies of China. To respond it, we construct a village-level multidimensional poverty measuring model, and use indicator contribution degree indices and linear regression method to explore poverty factors, while adopting Least Square Error (LSE) model and spatial econometric analysis model to identify the villages’ poverty types and poverty difference. The case study shows that: (1) Spatially, there is obvious territoriality in the distribution of poverty-stricken villages, and the poverty-stricken villages are concentrated in contiguous poverty-stricken areas. The areas with the highest VPI, in a descending order, are Gansu, Yunnan, Guizhou, Guangxi, Hunan, Qinghai, Sichuan, and Xinjiang. (2) The main factors contributing to the poverty of poverty-stricken villages in rural China include road construction, terrain type, frequency of natural disasters, per capita net income, labor force ratio, and cultural quality of labor force. The main causes of poverty include underdeveloped road construction conditions, frequent natural disasters, low level of income, and labor conditions. (3) Chinese poverty-stricken villages include six main subtypes, and most poverty-stricken villages are affected by multiple poverty-forming factors, reflected by a relatively high proportion of the three-factor dominant type, four-factor coordinative type, and five-factor combinative type. (4) There exist significant poverty differences in terms of geographical location and policy support, and the governments still need to carry out targeted poverty alleviation measures according to local conditions. The research can not only draw a macro overall poverty-reduction outline of impoverished villages in China, but also depict the specific poverty characteristics of each village, helping the government departments of poverty alleviation at all levels to mobilize all kinds of anti-poverty resources.

Innovating Rural Tourism Targeting Poverty Alleviation through a Multi-Industries Integration Network: the Case of Zhuanshui Village, Anhui Province, China

For an impoverished area to employ rural tourism (RT) as an avenue of poverty alleviation, there are two main challenges: building competitiveness with a very limited endowed resource base, and targeting the poor who generally lack financial capital or key capabilities as the main beneficiaries. With a case of Zhuanshui in China, an impoverished village without prominent tourism resource endowment, this paper has shown that the two challenges can be met through an innovation to construct a multi-industries integration network. This paper explores the development of the network, examines its characteristics, and analyzes its operation mechanisms. Results indicate that (1) the common objective of poverty alleviation and the same fundamental resource, combine RT and its extension industries tightly into an integration network; (2) sufficient evidence has been found for the embeddedness, endogeneity and empowerment of the network, but for empowerment, the poor’s participation is just the first stage to make appropriate decisions about the development due to their inadequate capabilities; and (3) vision developing, demonstration driving and centralized decentralization governance are three vital operational mechanisms to encourage the participation and collaboration of stakeholders. We also discussed the possible challenges for sustainability, being replicability of established competitive advantages, temporality of the major leader, and potential environmental degradation.

Maltreatment and Mental Health Outcomes among Ultra-Poor Children in Burkina Faso: A Latent Class Analysis.

ObjectivesResearch about the mental health of children in Francophone West Africa is scarce. This paper examines the relationships between adverse childhood experiences, including exposure to violence and exploitation, and mental health outcomes among children living in ultra-poverty in rural Burkina Faso.MethodsThis paper utilizes baseline data collected from 360 children ages 10–15 and 360 of their mothers recruited from twelve impoverished villages in the Nord Region of Burkina, located near the Sahel Desert and affected by extreme food insecurity. We used a Latent Class Analysis to identify underlying patterns of maltreatment. Further, the relationships between latent classes and mental health outcomes were tested using mixed effected regression models adjusted for clustering within villages.ResultsAbout 15% of the children in the study scored above the clinical cut-off for depression, 17.8% for posttraumatic stress disorder (PTSD), and 6.4% for low self-esteem. The study identified five distinct sub-groups (or classes) of children based on their exposure to adverse childhood experiences. Children with the highest exposure to violence at home, at work and in the community (Abused and Exploited class) and children not attending school and working for other households, often away from their families (External Laborer class), demonstrated highest symptoms of depression and trauma. Despite living in adverse conditions and working to assist families, the study also identified a class of children who were not exposed to any violence at home or at work (Healthy and Non-abused class). Children in this class demonstrated significantly higher self-esteem (b = 0.92, SE = 0.45, p<0.05) and lower symptoms of trauma (b = -3.90, SE = 1.52, p<0.05).ConclusionsThis study offers insight into the psychological well-being of children in the context of ultra-poverty in Burkina Faso and associated context-specific adverse childhood experiences. Identifying specific sub-groups of children with increased exposure to life stressors has implications for program developers. Study findings indicate a further need to explore the mental health consequences of traumatic experiences within the context of ultra-poverty and to develop integrated economic and psychosocial interventions that prevent or mitigate childhood adversities linked with the family-level poverty and violence in the family.

«... I believe in the future of Russian enlightenment...»

The article is devoted to life and activity of Ivan Dmitrievich Sytin, a famous Russian book-seller and enlightener of late ХIХ - early ХХ centuries. Along with primers, books and textbooks, which were available for impoverished village people, Sytin spread his countless calendars have becoming really popular encyclopedias.

Exploring Health Systems Within the Context of Social Determinants of Health: A Global Health Case Study.

Global health case studies can highlight, often in dramatic fashion, topics such as health disparities, health systems, and the social determinants of health. This resource presents a case study of an adolescent Haitian boy requiring lifesaving heart surgery in the US due to an acquired mitral valve disease from untreated streptococcal pharyngitis. While the case begins in a US clinic setting, it then goes on to explore the patient's home context-an impoverished village in rural Haiti-in order to demonstrate the effect of social determinants on both an individual's health and the capacity of health care systems to provide appropriate care. The case study concludes by asking the students to explore which health interventions, from a list of options, they would recommend to improve health in rural Haiti. Students discuss the advantages and disadvantages of developing health initiatives that vary by level of impact and approach. This case study has been presented to two classes of first-year medical students during their Health Systems course and was well received. By providing linkages between the local and international contexts, this case provides greater relevance for global health material to all participating students.