Bruce Cairns, who is entering his second year as chair
of the Faculty Council, and Charles Streeter, who
is starting his third year as chair of the Employee
Forum, represent different constituents, but they serve the
same University. They are also bound by a shared goal for the
new academic year: restoring public trust in the institution.
Cairns and Streeter said the completion of the Wainstein
Report, a sweeping, eight-month outside investigation,
proved that University leaders were determined to get to
the bottom of academic fraud and to institute reforms to
ensure it wasn’t repeated.
Building on a foundation
“What has happened over the past year laid the founda-tion
that will allow us to address what are critical issues for
the University,” said Cairns, a successful surgeon and direc-tor
of the North Carolina Jaycee Burn Center.
“Now is the time for us to make sure we do what we said
we would do. It has to be who we are.”
That review process has begun as part of the reforms that
Chancellor Carol L. Folt announced last fall, including the
creation of two working groups – one focused on policies
and procedures, the other on ethics and integrity, Cairns said.
Streeter said the forum has exercised restraint as events
unfolded over the past year to avoid making matters worse.
“If we add our voice to the discussion, we want to do it
in such a way that we are not just adding to the noise,” said
Carolina Faculty and Staff News
Vol. 40, No. 13
gazette.unc.edu
An affordable college education
is part of Carolina’s DNA.
“Carolina began as a great experi-ment
that came out of the Revolution-ary
War,” Chancellor Carol L. Folt
told approximately 100 journalists
and communications professionals at
the National Press Club in Washing-ton,
D.C., on August 4.
“It was an idea that if we were
going to have freedom, we needed
to have education. We were going to
provide education that would change
the lives of North Carolinians at the
lowest price practicable.”
For more than two centuries, Car-olina
has remained dedicated to mak-ing
that opportunity a reality, thanks
to programs like the Carolina Cov-enant,
Carolina Firsts and C-STEP
(Carolina Student Transfer Excel-lence
Program). Folt, who has con-sistently
shared her commitment to
making affordability and accessibil-ity
for students a top priority, talked
about that mission during the discus-sion
in the nation’s capital.
Folt was selected as one of the
75 guest speakers each year to talk at
the National Press Club’s luncheon
series. Past speakers have included key
leaders and numerous heads of state.
She was asked to discuss the Uni-versity’s
success in providing acces-sible
and affordable education to stu-dents
from a wide variety of socioeco-nomic
classes.
“Folt is keenly interested in boost-ing
undergraduate graduation rates,
particularly among low-income, first
generation and underrepresented
students,” said Thomas Burr, vice
president of the National Press
Folt discusses college accessibility
at National Press Club luncheon
Campus leaders
determined
to help restore
public trust
uni v e r s i t y
See FOLT page 4
See restoring public trust page 7
August 12, 2015
Faculty Chair Bruce Cairns, left, and Employee Forum Chair Charles Streeter discuss the upcoming academic year.
For a quarter century, the Carolina Popula-tion
Center’s MEASURE Evaluation program
has helped developing countries around the
world to gather, interpret and use data in
order to strengthen health care systems and
save lives. In the special section inside, the
Gazette takes a closer look at the program’s
global impact and the challenges that await.
Melanie Busbee
The University must be prepared to handle any danger, including the
possibility of responding to separate incidents in different locations.
That’s the scenario that unfolded Monday morning (Aug. 10) during
the emergency preparedness drill that involved fatal shootings at the Pit
on main campus and a hostage situation at the bus garage on Carolina
North, University-owned property along Martin Luther King Boulevard.
“We are committed to constant improvement in our emergency
response procedures and communications,” said Chief Jeff McCracken,
director of public safety.
“Conducting emergency exercises, such as today’s exercise involv-ing
all of our neighboring law enforcement agencies and first respond-ers,
helps us pinpoint what works and what needs to be improved,”
McCracken said.
The full-scale exercise went very well, he added.
“It helped us really focus on how we work in the field, coordinate
among various outside agencies and organizations on campus, and
ensure our Alert Carolina system gets messages out quickly and accu-rately
to keep our community informed.”
2 University Gazette
State budget still in process
A pay raise for state employees is among the
issues that remain unsettled as state lawmakers
continue working on a budget for the 2015–16
fiscal year that began July 1.
North Carolina collected $400 million more
from taxpayers than anticipated when the fiscal
year ended on June 30, giving lawmakers more
money to consider the possibility of pay raises.
The House proposal includes a 2 percent pay
raise for SPA employees and an equivalent pool
for EPA faculty and non-faculty plus an extra five
days of bonus leave.
The Senate did not include a state pay raise in
its plan.
The House and Senate are roughly $70 mil-lion
apart in their proposals to fund higher edu-cation.
The House proposal:
Doubles the amount of funds unspent at the
end of the fiscal year that can be carried over
from 2.5 percent to 5 percent
Supports the Governor’s ”Innovation to
Jobs” recommendations for research and
commercialization.
The Senate proposal:
Makes a smaller management flex cut,
with fewer institutions exempted from the
total reduction.
Restores historic split of repairs and renova-tions
funding between state government and
universities to 50:50
Contains preferred special provision language
to allow universities to manage their own
investments.
Both budget proposals fully fund enrollment
growth and building reserves; however, Caro-lina
is not slated to receive any funds from these
two items.
The House approved its proposed bond pack-age,
providing just under $1 billion for stra-tegic
and targeted capital investments in the
UNC System. The proposal supports the
request to replace the Berryhill Medical Educa-tion
building at the School of Medicine, Caro-lina’s
top capital priority.
The replacement of Berryhill, built in 1970 –
together with the completion of Marsico, BRIC
and planned renovations of Mary Ellen Jones –
will round out a facilities core that will set Caro-lina
apart from other universities in terms of
being able to leverage research dollars from the
National Institutes of Health.
For now, the state is operating under a budget
continuing resolution that expires Aug. 14 but
could be extended.
on the web
go.unc.edu/Cc84B
go.unc.edu/i7LCw
Bucket list
Summer is almost over. Students will be moving in
soon. How many items can you check off the Chapel
Hill summer bucket list?
Reading, writing and reusing
Deloitte surveyed over 1,000 US parents with stu-dents
in grades K–12 to determine back-to-school
shopping trends – like more people reusing last
year’s supplies rather than buying new.
We Tar Hel emojis!
So we know emojis recently added more shades to
their faces – no longer just smiley face yellow – but
Carolina blue still wasn’t an option. Until now.
go.unc.edu/An25Y
Editor
Gary C. Moss (962-7125)
gary_moss@unc.edu
Managing editor
Susan Hudson (962-8415)
susan_hudson@unc.edu
Design and Layout
Linda Graham
lgraham@gmail.com (919-417- 4474)
Contributors
Office of Communications
and Public Affairs
Editorial Ofices
210 Pittsboro St., Chapel Hill, NC 27599
FAX 962-2279 | CB 6205 | gazette@unc.edu
change of addres
Make changes at: directory.unc.edu
Read the gazete online at
gazette.unc.edu
The University Gazette is a University pub-lication.
Its mission is to build a sense of
campus community by communicating
information relevant and vital to faculty
and staff and to advance the University’s
overall goals and messages. The editor
reserves the right to decide what informa-tion
will be published in the Gazette and
to edit submissions for consistency with
Gazette style, tone and content.
uni v e r s i t y
Brandon Bieltz
University conducts successful emergency drill
UNC Pembroke juniors and identical twins Kevin and Kyle
Cheek spend their summers in Chapel Hill working at the Uni-versity
to make their college experience possible.
For the past two summers, the Sanford natives performed
maintenance work throughout residence halls across campus
with the facilities’ team.
The opportunity to work on campus not only provides funds
for their education, but it also gives them the opportunity to spend
summers with their mother Karen Jenkins-Cheek, a 15-year vet-eran
with the Department of Parking and Transportation.
The Cheek brothers work hard to stay in college and main-tain
high grades. In recognition of their outstanding academic
credentials and to ease the financial burden of paying tuition,
they have been awarded $2,000 for each of the past two years
from the Carolina Family Scholarship.
“The Carolina Family Scholarship has been extremely help-ful
because it provided us with money that we did not have,”
Kevin said. “We probably would not have been able to go to
school if we didn’t have this scholarship.”
Saving the scholarship
The scholarship, which was established more than 10 years ago,
provides need-based aid to employees’ dependents that they can
use at any of the 17 campuses in the UNC system or 59 institu-tions
in the North Carolina Community College System.
A year ago, the future of the Carolina Family Scholarship
appeared tenuous. Bruce Egan, one of the original organiz-ers
of the scholarship, who had retired, asked the Employee
Forum to champion and promote the scholarship to ensure
its continued success.
Jenkins-Cheek, a long-time Employee Forum delegate her-self,
said she was excited the forum responded to Egan’s call.
“I am honored that someone paved the way and now the
forum can continue to carry the torch,” Jenkins-Cheek said.
As a mother of four children, including two daughters in high
school, she always taught her children the importance of get-ting
a college education.
“All of my children have excelled in their academics, A/B
honor roll, and have done really well in their scholastic achieve-ments,”
she said. “I am proud of all of them.”
Paying it forward
Kevin and Kyle are both majoring in biology and minoring
in psychology. They are active in Life Group, a student organi-zation
that provides them with the opportunity to discuss life
situations from a biblical and religious perspective.
They have participated in the university’s gospel choir and
have set their sights on graduate school. Both brothers aspire
to attend the UNC Physician Assistant Program through the
Department of Allied Health Sciences. They believe this will be
a chance for them to give back to their community, an impor-tant
value in their family.
She believes the Carolina Family Scholarship shows great
support from the University to employees, but emphasized
faculty and staff can provide support as well.
“If someone is able to provide and help you, then you pay
it forward,” Jenkins-Cheek said. “You give back and donate
money to help someone that is in financial need. Paying it for-ward
is a big thing for me and my family.
“I would strongly encourage all faculty and staff members
that believe in education for our future to financially support
the Carolina Family Scholarship Fund.”
If you’d like to learn more about ways that you can
support other families in the Carolina community through
the Carolina Family Scholarship Fund, please visit
go.unc.edu/a9WNy or contact the Employee Forum at
employeeforum@unc.edu.
– Ronda Manuel, InTouch
August 12, 2015 3
Hard-working twins benefit from Carolina Family Scholarship
Kyle, left, and Kevin Cheek with their mother, Karen Jenkins-Cheek.
Ronda Manuel
The University Board of Trustees wel-comed
five new members at the July 23 meet-ing
and re-emphasized its focus on internal
improvement and external communication.
In his opening remarks, new Chair Dwight
Stone of Greensboro set the tone for the future
with four goals for the board:
Support Chancellor Carol L. Folt and her
evolving strategic plan;
Tell the story of how Carolina improves
lives across the state, nation and world;
Accelerate, measure and communicate the
growth and economic impact of the Uni-versity’s
innovation and entrepreneurship
initiatives; and
Help Carolina become more efficient
and effective in key operational areas, par-ticularly
finance, administration, teaching
and research.
The trustees also agreed they would all
take the University’s Title IX training as soon
as possible.
“In today’s environment, the challenges
facing universities and academic institutions
across the country are huge. We must face
those challenges head on and have the courage
to change,” Stone said.
Paraphrasing evolutionary biologist
Charles Darwin, he added, “It is not the
strongest university that survives and thrives.
It is not the most intelligent university
that survives. It is the university that is the
most adaptable to change that will survive
and thrive.”
Stone replaces previous Chair Lowry Cau-dill,
who keeps his seat on the board and
received kudos and a board resolution thank-ing
him for his calm and steady leadership the
past two years.
Stone is president and chair of D. Stone
Builders Inc. and board chair of the Educa-tional
Foundation. He also served on the
search committees for a new chancellor and a
new athletic director.
The new vice chair is Haywood D.
Cochrane of Elon, chair of the board of direc-tors
of DARA Biosciences Inc.
Five new members were sworn in at
the meeting:
Julia Sprunt Grumbles of Chapel Hill, a
former corporate vice president for Turner
Broadcasting System Inc. who previously
served as Carolina’s interim vice chancellor
for development;
William A. (Bill) Keyes IV of McLean, Vir-ginia,
founder and director of the Institute
for Responsible Citizenship, a summer
enrichment program for African American
male students;
Allie R. McCullen of Keener, owner of The
McCullen Group Inc., a real estate sales and
appraisal firm in Clinton;
William E. (Ed) McMahan of Charlotte,
former chairman and CEO of Little-
McMahan Corp who served six terms
in the North Carolina House and just
finished a term on the UNC Board of
Governors; and
Hari H. Nath of Cary, retired founder
and CEO of the management consulting
New BOT chair calls for ‘courage to change’
See Board of trustees page 4
Club. He noted that the Carolina Covenant – a program
that awards low-income students a combination of grants,
scholarships and work-study opportunities so they can avoid
student loans and have the opportunity to graduate debt-free
– was instituted at UNC-Chapel Hill a decade ago.
At Carolina, nearly half of the University’s 18,000 undergrad-uates
receive aid, and it is one of the few public universities that
offer need-blind admissions and cover full financial need. The
average debt for Carolina students at graduation has remained
largely flat for more than a decade. As a result, The New York
Times recently ranked Carolina the third most economically
diverse top university in the country.
By providing the aid needed for graduating high school
students, Folt said, students who would have been unable to
attend college now have the opportunity – something that
makes her extremely proud.
“This is enormously important if you’re going to help stu-dents
obtain a successful degree,” Folt said. “Keeping the costs
low is a way to really attract capable students.”
On average, Carolina students graduate with $16,150 in
debt; the national average is more than $35,000, Folt said.
“Americans have $1 trillion in student debt,” she said. “They
see tuition rising and we have to be able to counter that. To
keep our tuition low we have to make choices all the time. And
some of those are not fun – they hurt.
“Because affordability and accessibility are at the heart of
everything, they will always be our default.”
More than 20 percent of current undergraduate students at
UNC-Chapel Hill are the first in their families to attend col-lege,
and programs like the Carolina Covenant help provide
support. Without that support, Folt said, college for many still
wouldn’t be a possibility.
“I wouldn’t be standing here if I couldn’t have gone to col-lege
and worked as a waitress to pay my way through college,”
Folt said. “I did that many years ago. I want to make sure that all
those other people like me have that chance.”
Visit go.unc.edu/Fs2w3 to watch a video of Chancellor
Folt’s full speech.
– Brandon Bieltz, Office of Communications and Public Affairs
4 University Gazette
Chancellor Carol L. Folt discusses the importance of preserving accessibility to an affordable college degree at a National Press Club
luncheon on Aug. 4.
Fol t from page 1
Brandon Bieltz
firm Technology Planning and
Management Corp. who recently
completed a term on the UNC
Board of Governors.
Keyes, whose late uncle Louis
Taylor Randolph was a founding
member of the UNC Board of Gov-ernors,
asked his aunt, Betty Ran-dolph,
to hold the Bible while he took
his oath.
The Board of Governors appointed
Grumbles, Keyes and McCullen to
their seats, and Gov. Pat McCrory
selected McMahan and Nath.
Student Body President Houston
Summers was sworn in for his term on
the board at May’s meeting.
For more coverage of the trustees’
meeting, including a video highlight-ing
two big-data success stories told by
John Buse, co-principal investigator
and director of the North Carolina
Translational and Clinical Sciences
(NC TraCS) Institute, and Javed
Mostafa, director of the Carolina
Health Informatics Program (CHIP),
go to go.unc.edu/g4FMr.
– Susan Hudson, Gazette
Board of trustees from page 3
Judge Willis Whichard delivers the oath of office to trustees Bill Keyes, Julia Sprunt Grumbles, Lowry Caudill, Ed McMahan, Allie McCullen, Hari Nath and
Don Curtis at the July 23 meeting of the Board of Trustees.
Melanie Busbee
August 12, 2015
To understand the remarkable global impact of MEA-SURE
Evaluation, part of the Carolina Population
Center, think back to 2003.
Back then, HIV/AIDS in America was no longer a death sen-tence
but a manageable, long-term illness for those with access
to antiretroviral drugs.
Yet in sub-Saharan Africa, where there were no such medi-cations,
more than 20 million people had died of HIV/AIDS,
and the virus infected a third of the surviving population. Thou-sands
were dying every day.
And so President George W. Bush created the U.S. Presi-dent’s
Emergency Plan for AIDS Relief (PEPFAR). The plan
called for $15 billion for AIDS prevention, treatment and care
over five years, concentrating on 15 hard-hit nations in Africa
and the Caribbean. (The plan has been renewed every five
years since then.) A few months after PEPFAR’s launch, the
Clinton Foundation supported the cause by reaching an agree-ment
with four pharmaceutical companies that cut the cost of
HIV/AIDS drugs in these countries nearly in half.
PEPFAR is the largest initiative by any country to fight a dis-ease
globally, although most people have never heard of it. A
half-billion in PEPFAR funding has allowed MEASURE Eval-uation
to play an indispensable role in the international fight
against HIV/AIDS for the past 12 years.
A far-reaching collaboration
MEASURE Evaluation began in 1991 as The EVALUA-TION
project, which received $17.4 million from the U.S.
Agency for International Development (USAID) for family
planning projects.
In 2003, USAID turned to the EVALUATION project to help
with PEPFAR. Since then, USAID has given the organization now
known as MEASURE Evaluation more than $500 million, includ-ing
a five-year grant for $180 million announced a year ago.
The expansion from family planning to AIDS isn’t as odd
as it seems. MEASURE Evaluation is not a team of doctors
and nurses delivering care to the sick; it’s the organization
that makes that treatment possible. Staffed by epidemiolo-gists,
data analysts, computer scientists, public health manag-ers,
policy wonks and others, MEASURE Evaluation gathers
the information that nations need to make the best healthcare
decisions.
MEASURE Evaluation staff members also mentor local
healthcare system employees on how to collect and evaluate
the information themselves, after MEASURE Evaluation has
moved on. The goal is to strengthen health information sys-tems
in developing countries to make them capable of handling
not just AIDS but any disease or healthcare challenge.
“The basic idea that underlies all our work is the belief that,
by improving information, public health practitioners in the
countries we serve will be equipped to make better decisions
about the allocation of resources, which in turn will result in
building better public health systems, which will lead ultimately
to better health outcomes for people,” said Jim Thomas, direc-tor
of MEASURE Evaluation and an associate professor of epi-demiology.
MEASURE Evaluation’s partners in this work are
the Futures Group, ICF International, John Snow Inc., Man-agement
Sciences for Health and Tulane University.
An unfolding story
The importance of building stronger healthcare systems in
developing countries became glaringly apparent with the 2014
outbreak of Ebola in West Africa, the deadliest occurrence of
the disease since its discovery in 1976.
“Ebola came along, and it acted very differently from HIV/
AIDS. It produces death on a scale that is very sudden, very dra-matic.
It caught the world’s attention, and it revealed that the
health systems in the affected countries were not strong enough
and fell apart very quickly,” Thomas said. “The talk after Ebola
is the need to develop health care systems that can detect the
next epidemic and respond to it very quickly.”
That’s the specialty of MEASURE Evaluation. Although
much of its funding is for battling AIDS, MEASURE Evaluation
also uses its special skill set – interviewing, mapping, analyzing
data and connecting the dots – to improve health outcomes
for other diseases and for vulnerable populations. The proj-ect
helps generate evidence and develop systems that allocate
resources to the most effective practices, such as:
Supporting the distribution of insecticide-treated bed nets
so that children in Africa can go to sleep without contract-ing
malaria from a mos-quito
bite.
Helping women in
remote villages survive
their pregnancies by
improving their access to
and use of health facili-ties
and family planning.
Encouraging concurrent
treatment for tuberculo-sis
and HIV to improve
patient survival rates.
Instructing mothers to
breastfeed their babies
instead of giving them
river water so contami-nated
that it could cause
fatal cases of diarrhea
in infants.
And, yes, it’s continuing
the battle against AIDS,
Thomas said.
World-changing science
That battle got a huge boost in 2011 thanks to preliminary
results from a study led by internationally renowned AIDS
researcher Myron Cohen, the University’s associate vice chan-cellor
for global health and director of the Institute for Global
Health and Infectious Diseases.
The Strategic Timing of Anti-Retroviral Treatment
(START) study showed that early treatment reduced the risk
of HIV transmission to an uninfected partner by at least 96
percent. The results of the study were so astounding that an
oversight board decided that the magnitude of benefit made it
unethical not to act on the results before the study was done.
The “treatment as prevention” benefit fundamentally changed
attitudes toward the HIV epidemic. In 2014, the Joint United
Nations Programme on HIV/AIDS (UNAIDS) set the “90-
90-90” target: getting a diagnosis for 90 percent of the people
infected with HIV; putting 90 percent of those on antiretroviral
therapy; and getting 90 percent of those virally suppressed.
In July, at the International AIDS Society conference in
Vancouver, Canada, Cohen presented the final results of his
10-year study, showing that START’s dramatic early findings
continued through the study’s conclusion.
Yet major challenges remain throughout much of the world,
Thousands of people with HIV have never been tested. Thou-sands
more who have tested positive never begin treatment or
discontinue it.
“The significance of the research findings is that AIDS medi-cations,
when used consistently, can break the chain of HIV
transmission, with the potential to eradicate the virus when all
infected people die natural deaths,” Cohen said.
“For the foreseeable future, however, such a medical strategy
will disproportionately benefit industrialized countries whose
residents have wider, though far from universal, access to mod-ern
health care.”
PEPFAR 3.0 includes strategies to overcome these chal-lenges
to reach the 90-90-90 goal. For MEASURE Evaluation,
that means collecting more data to determine what works and
keeping programs on track to achieve these goals. New PEP-FAR
initiatives aim to deliver on the promise of an AIDS-free
generation with such new initiatives as DREAMS (Deter-mined,
Resilient, Empowered, AIDS-free, Mentored and Safe)
directed toward the estimated 380,000 adolescent girls and
young women who are still infected with HIV every year.
Being part of something that has had such a real and endur-ing
impact on the world is more satisfying than, as a scientist, he
can describe, Thomas said.
“One of the frustrations I get as a professor is that I will do a
project and write it up and for a time it will get notoriety, but
then, poof, it’s gone, and I’m on to the next thing,” Thomas
said. “I never get the sense that I am getting enough real trac-tion
on anything to make much of a difference.”
MEASURE Evaluation changed all that for him. “This proj-ect,
because of its size and longevity, is different,” he said. “The
science that we are doing is not getting stuck on shelves. It is
science that is changing the world. We see it happening and
that is tremendously rewarding.”
– Gary Moss, Gazette
Measuring the success of
MEASURE Evaluation
Jim Thomas, director of MEASURE Evaluation.
Universi ty Gazet te / MEASURE Evaluat ion Feature August 12, 2015
The
Evaluation
Project
MEASURE Evaluation improves health worldwide
MEASURE Evaluation’s mission is to contribute to better health for people living in low-income countries by assisting
governments and health institutions to generate and use information to change what doesn’t work and to scale up what
does. Better information leads to better decisions, better programs and better health.
System Building
MEASURE Evaluation helped scale up Ethiopia’s reformed
health management information system (HMIS). In just
under two years, all administrative health units from the
regional health bureau to 157 district health offices were
accessing electronic HMIS data for performance monitoring
and decision-making.
Sharing
MEASURE Evaluation uses the Odum Institute’s Data-verse
Network to share data while protecting the privacy
of research subjects. This sharing and re-purposing of data
gives future researchers around the world opportunities
to make new discoveries without having to duplicate data
collection efforts.
Evaluating
To fulfill the need for reliable information about maternal
mortality in Bangladesh, MEASURE Evaluation collabo-rated
with the Government of Bangladesh, International
Centre for Diarrhoeal Disease Research and USAID/
Bangladesh to construct a sampling frame from which a
nationally representative sample of 175,000 households
was drawn for the Bangladesh Maternal Mortality Survey
2010, the country’s second survey of its kind.
Innovating
To improve availability and timeliness of malaria data in
Mali, MEASURE Evaluation partnered with an IT ser-vices
company to create a mobile- and web-based report-ing
system that provides users with analyzed and validated
malaria data monthly. Under the new system, users can
access malaria data in as little as three weeks after the end
of each month.
Leading
MEASURE Evaluation has helped advance the progress of
geographic information systems in global health by uniting
the public health community with the spatial data infor-mation
(SDI) community. Bringing the two communities
together gives the public health community access to SDI
committees, where national policy regarding spatial data is
made and where spatial data and knowledge-sharing flourish.
PLACE method works to control AIDS epidemic in Uganda
A Priorities for Local AIDS Control Efforts (PLACE) worker interviews a member of the community privately for
information about her sexual practices. A key question for AIDS prevention efforts is whether condoms and AIDS pre-vention
messages are reaching people who have high rates of new sexual partnership acquisition. The PLACE method
used in Uganda provides for descriptions of the rate and pattern of new sexual partnership formation in a community and
identifies where to focus AIDS prevention programs in order to reach key members of the underlying sexual network.
In areas where HIV transmission via injecting
drug use is common, the PLACE method can
be adapted to also provide information about
the rate and pattern of injecting drug use.
The PLACE method was developed based
on epidemiological models of the HIV epi-demic.
These models indicate that the HIV
epidemic in Uganda is determined by a com-plex
set of biological and behavioral factors at
the individual and population levels. Among
the most important factors at the population
level are the rates and pattern of new sexual
partnership formation and injecting drug use.
HIV and TB co-infection in Ukraine
Concurrent treatment for patients infected with tuberculosis
(TB) and HIV has improved patient survival rates and is recom-mended
by the World Health Organization (WHO). In Ukraine, the
health system was slow to adopt this recommendation. To support
the government’s efforts, the USAID Mission is funding a project to
integrate TB and HIV services, including cross-training, improved
lab services, better documentation of referrals and improved medi-cal
supply chains. The intent is to improve treatment and outcomes
for co-infected patients, an improvement that MEASURE Evalu-ation
has been tasked with measuring. Baseline research found
that concurrent treatment for TB and HIV does improve patient
survival rates among the co-infected. Recommendations shared
with the Mission and the government highlighted the need for
improved tracking, referrals and patient record-keeping to improve
patient care.
Mentoring
In Cote d’Ivoire, MEASURE Evaluation partnered with
four national training institutions to build and deliver aca-demic
courses that train local health officials in monitoring
and evaluation and health information; now, each institu-tion
is able to provide these courses independently.
Growth of USAID funding for MEASURE Evaluation over the years
1991 1997 2003 2008 2014
$200
$150
$100
$50
Millions of dollars
Other major awards include:
$21 million Task Order of
MEASURE Evaluation (2007)
$7 million PRH Associate
Award (2008)
$2.9 million Ethiopia
Associate Award (2009)
Countries with active
MEASURE Evaluation programs*
$17.4 mil.
Phase IV
$180 mil.
Phase I
$173 mil.
Phase I
$89 mil. Phase I
$47 mil.
Mali
Ghana
Côte
d’Ivoire
Kenya
Uganda
Democratic
Republic of
the Congo
South
Africa
Swaziland
Botswana
Zambia
Madagascar
Malawi
Tanzania
Rwanda
Burundi
Bangladesh
Dominican
Republic
Ukraine
In Ukraine, MEASURE Evaluation is work-ing
to integrate TB and HIV services
because concurrent treatment saves lives.
Thanks to MEASURE
Evaluation’s Elizabeth
Robinson, Denise
Todloski and Kathy
Doherty for words and
photos and to Becky
Wilkes for the map.
Measure evaluation
* In any given year, MEASURE Evaluation
typically works in an additional 15–30 countries.
Visit gazette.unc.edu for an interactive map showing
information about all of the countries marked here.
University Gazette / MEASURE Evaluation Feature
Chris Bernard Otieno Agala knows what he
wants to do.
For Agala (pictured below), science isn’t
merely a tool to uncover facts. Science is what
might have saved his childhood. His mother
was 38 when she died of breast cancer. When
she died, he was 14. “That’s when my family
collapsed,” he said, as his gaze seemed to focus
on that loss back in Kanyipola, Kenya, a few
kilometers from the shores of Lake Victoria.
Agala, 37, is now a doctoral candidate in
health policy and management at the Gillings
School of Global Public Health and a fellow
with MEASURE Evaluation in the Carolina
Population Center. The little agricultural vil-lage
where he grew up may seem like an unlikely
place for a career in public health to begin, but
Agala’s childhood there inspired his work.
As a boy, Agala wove papyrus mats with his
father and grew vegetables with his mother
in the family plot. Once or twice a week he
walked with his mother to the market village of
Aherro in Kisumu County to sell them.
Their family had 10 children. Two girls died
in infancy. One surviving girl died young of
tuberculosis. He was the second boy among
seven, eventually the eldest after his older
brother died young of HIV/AIDS.
His mother was the glue for the family. “My
mother was the strength, bedrock, motivation
and source of our security and inspiration,” he
said. “She cared a lot about our well-being and
achievement in school. She was there for us
even when she was sick and unable to walk.”
When she died, the family lost the bulk of
its livelihood.
“We didn’t have enough money for my
mother to travel to Nairobi for treatment. Our
ill family members were never on treatment,”
he said.
After his mother’s death, Agala – whose
friends call him “Bernie” – focused on school,
a decision his family supported. He received
a scholarship to the Starehe Boys Center and
School in Nairobi, the start of his transforming
trajectory. He went on to attend Starehe Tech-nical
Training College, studying computer sci-ence,
and then entered Kenyatta University,
where he majored in finance. “I was the first in
my whole village to go to college,” he said.
In addition to school, Agala had a three-month
internship with a local nongovernmen-tal
organization (NGO) working on public
health information technology issues. Three
months as an intern became almost a year as a
paid worker, helping public health researchers
analyze data. He was put in charge of interview-ing
children and their caregivers. “My role kept
expanding. I ended up in the field with these
people and that’s how I met the Duke folks.”
After he graduated from the university, he
was hired to monitor the HIV/AIDS proj-ects
sponsored by The Global Fund. The
Duke researchers he met through his previ-ous
internship invited him to enroll in a train-ing
course in Amsterdam. He got his first
passport in less than a week and soon found
himself on his first airplane ride then in his
first snowball fight. After his training, Duke
assigned him as lead interviewer working
with a Duke research project implemented by
ACE Africa, a Kenyan NGO.
MEASURE Evaluation provided some of
the tools and training used in the project. “We
depended a lot on MEASURE,” he said. “And
I on my mentors at Duke.” Duke asked Agala
to come to Durham for two months of further
training in community resource management,
research ethics, research methods, institutional
review board and management of research staff.
Duke then hired him to oversee three studies in
Tanzania. After four years, his Duke mentors
suggested he apply for the doctoral program at
UNC. And that’s how he came to be in Chapel
Hill and at MEASURE Evaluation.
Agala’s work today focuses on how to pro-vide
improved access to health treatment in an
environment of scarce resources. Science has
identified treatments for HIV that extend life
expectancy and quality of life, he said, but who
receives the treatment is often determined
by resources.
Anti-retroviral therapy is made available to
those whose viral load meets a specific thresh-old.
If their count isn’t high enough, they don’t
get treatment and may continue to infect their
partners. “The existence of that threshold is
based on scarce resources,” he says. “How do
we wisely use our resources? I don’t know how
WHO [the World Health Organization] and
governments will answer that question, but I’m
sure that one day everyone will get treatment.”
His dissertation examines referral networks in
Ethiopia and their ability to get people to start
HIV treatment and stay on it. MEASURE Evalu-ation
provided the data set. Jim Thomas, MEA-SURE
Evaluation project director, is one of five
people on Agala’s dissertation committee.
Agala is looking at patient attitudes and sat-isfaction
with care. He will factor in how dis-tance
affects their retention in care and how
their attitudes toward the network of caregiv-ers
affect their adherence to treatment. As for
the networks themselves, he will be asking
questions about staffing and budgets for opti-mal
performance of provider organizations
and how to improve the quality of care and
avoid delays in treatment. His results will show
what motivates the network and the providers
within it, how good networks for treatment
perform and how they can be sustained.
His work will influence health policy, but it’s
also personal for Agala. If a family can’t secure
treatment for a member who is ill, he said, “it
increases the disease burden for the family. It
leads to loss of livelihood. It leads to not seek-ing
appropriate care because it costs resources
for the family.” Like what happened to his
mother, his family.
“Back home, we have low resources and
much need,” Agala said. His manner is quiet,
his voice soft – even more so when he remem-bers
his mother and wonders if treatment
might have saved her. His research is too late
to help his mother, but Agala sees it as an
investment for the future in her honor.
Agala hopes his dissertation and public
health research will result in more people
receiving potentially life-saving treatment for
as long as they need it. “For any disease, but
cancer is a big problem,” he said. “I am looking
at science in its practical sense – to impact
people’s lives…immediately.”
– Kathy Doherty, MEASURE Evaluation
A doctoral student,
his mother and the
practical uses of
public health science
The fishing community of Nyanza Province on Lake Victoria reports some of the highest HIV prevalence rates in Kenya.
This photo is of a fisherman in Homabay, where Bernie Agala conducts research with UNC’s MEASURE Evaluation
project on HIV referral networks.
Khou Xiong, MEASUR E Evaluation
August 12, 2015 5
Twitter Basics
Staff and faculty are invited to attend one of two Twitter Basics
classes, an hour-long workshop designed to introduce new users to
Twitter and its features. Professor Andy Bechtel (School of Media
and Journalism) will lead each workshop and a 30-minute Q & A
session afterward. The classes are offered Sept. 10 or Oct. 13 from
noon to 1:30 p.m. in Davis Library 247. For more information and
to register, please visit go.unc.edu/i7S9G.
Humanities Welcome
The Institute for the Arts and Humanities will hold its annual
welcome reception Aug. 20 from 5 to 7 p.m. in the University
Room of Hyde Hall. Join Director Mark Katz, IAH Fellows and
friends for refreshments, music and conversation to celebrate the
beginning of the academic year.
Deadlines to watch
Sept. 1 – Nominations of full-time faculty for the National
Endowment for the Humanities Summer Stipend Competition
are being accepted now. NEH Summer Stipends support indi-viduals
working full-time on a humanities project at any stage of
development by providing $6,000 for two consecutive months
of full-time research and writing. UNC full-time faculty must be
nominated by an internal committee appointed by the director
of the Institute for the Arts and Humanities. For more informa-tion
and to apply, please visit go.unc.edu/Fd5b8.
Sept. 23 – Recently tenured humanists (fall 2011 or later)
may apply for the Burkhardt Residential Fellowships for
Recently Tenured Scholars. Burkhardt Fellowships support an
academic year of residence at any one of the national residen-tial
research centers participating in the program and provide
a stipend of $75,000 plus additional research and relocation
funds. Applications from UNC faculty must be submitted in
consultation with the director of the Institute for the Arts and
Humanities, as Burkhardt Fellows also receive a semester’s
on-campus leave at the institute. For more information and to
apply, please visit go.unc.edu/e5LNb.
Sept. 30 – The Institute for the Arts and Humanities is currently
accepting online applications for the 2016–17 IAH Faculty Fel-lows
Program. Faculty Fellows receive on-campus semester-long
leaves to pursue scholarly or creative projects in which the
arts or humanities play a central role. Faculty in the College of
Arts and Sciences in tenure-track positions of all ranks in and
beyond their second year at UNC are eligible to apply. Fixed-term
faculty are also eligible under certain conditions. For more
information and to apply, please visit go.unc.edu/Kk5o7.
Oct. 3 – To recognize an individual or team who has provided
outstanding technical support, nominate them for an Informa-tion
Technology awards. Permanent employees who provide
computing support, write code or administer a network or
teams working together to provide specific technology services
for a department or the University are eligible. Please provide
specific information that will tell this year’s committee how the
nominee or team stands out. Links and information on indi-vidual
and team nominations are available at itawards.unc.edu.
News In B rief
NEWS IN BRIEF Submisions
Next issue includes events from Sept. 10 to Sept. 23.
Deadline for submissions is 5 p.m., Mon., Aug. 31.
Email gazette@unc.edu. The Gazette events page in-cludes
only items of general interest geared toward a
broad audience. For complete listings of events, see
the Carolina Events Calendars at events.unc.edu.
Little Sprouts
Share a morning of “Flower Power” Aug. 15 from 10 a.m.
to 11 a.m. learning about pollinators through nature hikes,
games, crafts and stories at the North Carolina Botani-cal
Garden. For ages 3–5 with accompanying adult; $10
($8 members). www.ncbg.unc.edu/calendar
Impresions in Beswax
Professional artist Martha Petty leads a class Aug. 15 from
10 a.m. to 4:30 p.m. on techniques in encaustic painting,
painting with hot beeswax to create six small works to make
a larger work of images. Dip plant materials in beeswax,
iron onto paper and stain with walnut ink to make a small
stitch book. $70 ($60 members) plus $10 materials fee.
www.ncbg.unc.edu/calendar
Butterflies, Science and You
Christine Goforth, senior manager of Citizen Science
at the North Carolina Museum of Natural Sciences, leads
a lunchtime talk Aug. 20 from noon to 1 p.m. on how to
become a citizen scientist. By making simple observations
of butterflies and reporting what they see online, citizen
scientists contribute to the understanding of butterflies and
their pollination services. Free, pre-registration required.
www.ncbg.unc.edu/calendar
Pollination
Botanist Anne Lindsey leads a class Sat-urdays
(Aug. 29 to Sept. 26) from 9:30 a.m.
to 12:30 p.m. on how to explore the part-nership
of flowering plants and importance
of pollinators to ecosystem and food pro-duction.
Brief lectures, field observations
and some lab work. This course has prereq-uisites.
$130 ($117 members). www.ncbg.
unc.edu/calendar
Native Flowers:
Gifts of Pollinators
A collection of more than 30 photo-graphs
by John Pringle will be on display
Sept. 1 through Nov. 1 at the North Caro-lina
Botanical Garden’s Deberry Gallery.
Pringle took these photographs of native
flowers of the Southeastern United States and some of their
pollinators, including insects and birds in the Chapel Hill
garden of his wife, Betsy, and in the mountain region they fre-quent
in Transylvania County. www.ncbg.unc.edu/calendar
Richard Nonas, American, born 1936. Points
North (for John and Irma Honigmann), 1980;
steel. Gift of the Artist, 90.99.
Testing, Testing
An exhibition of late modern and contempo-rary
art, “Testing, Testing: Painting and Sculp-ture
since 1960 from the Permanent Collection,”
continues through Jan. 3 at the Ackland Art. The
exhibit is the largest presentation of the Ack-land’s
relatively unknown collection of modern
and contemporary painting and sculpture to
date, featuring works by over 50 artists.
Savoring summer at the Botanical Garden
This photograph by John Pringle is of a historically significant plant, Oconee
Bells, first discovered in 1788 by French botanist Andre Michaux. Ignored and
forgotten, the plant was re-discovered in the wild almost 100 years later by a
teenager walking along the banks of the Catawba River near Marion.
contributed
Joh n Pringle
Eight faculty members have been named to
endowed professorships. They are:
Kenan Professors
Nancy Allbritton
Career at Carolina: Professor and chair of
the UNC-NC State Joint Department in Bio-medical
Engineering since 2009 and professor
of chemistry since 2007
Research specialty: World-renowned pio-neer
in the areas of bioanalytical chemistry
and biomedical engineering who holds 11 pat-ents,
with eight patent applications pending;
known especially for her work in the growing
area of single-cell analysis and in cellular signal
transduction underlying the heterogeneity of
human cancer
Accomplishments: Her discoveries as a
scholar and inventor have been the basis of
new technologies for biomedical investiga-tions
that have led to the creation of several
successful companies, including Cell Biosci-ences
and Cell Microsystems.
Joseph Kieber
Career at Carolina: Professor of biology
since 2004
Research specialty: International leader
in the study of cell signaling in plants – how
cells communicate with one another to regu-late
both growth and development. This is a
critical question in understanding such things
as how fertilized eggs develop as well as the
causes of cancer and aging.
Accomplishments: His work has special rel-evance
to the challenge of producing food in sus-tainable
and efficient ways in response to climate
change and the world’s increasing population.
He has produced more than 90 peer-reviewed
publications with more than 10,000 citations.
Gary Pielak
Career at Carolina: Professor of chemistry
since 2000
Research specialty: Scientist known for
cutting edge work on how proteins function in
the complex environment of living cells.
Accomplishments: He is one of only
two Carolina faculty members to receive
the National Institutes of Health Director’s
Pioneer Award, the most prestigious award
given by the NIH. He has published more than
120 peer-reviewed articles in the top journals
in his field, resulting in over 5,000 citations
and has had three manuscripts accepted at the
Proceedings of the National Academy of Sci-ence
(PNAS) in one year. His international
standing is evident from the nearly 50 talks he
presented over the last four years.
Cary C. Boshamer Professors
Jianwen Cai
Career at Carolina: Professor of biostatis-tics
since 2004
Research specialty: One of the top living
experts on the analysis of multivariate, time-to-event
data. Such analyses are fundamental to
health research in a variety of domains.
Accomplishments: Her case-cohort
expertise was used to elucidate how the
relationship between mortality and body
mass index changes with age – a discov-ery
that fundamentally altered how phy-sicians
advise patients about weight as
they age. She has published more than
160 peer-reviewed articles resulting in
nearly 10,000 citations. She is currently
president of the International Biometric
Society- East-ern
North
A t l a n t i c
Region. She
is primary
i n v e s t i g a -
tor for the
H i s p a n i c
Community
Health Study,
the largest
study ever
c o n d u c t e d
of Hispanic
populations.
Blosom Damania
Career at Carolina: Professor of microbiol-ogy
and immunology since 2011
Research specialty: Highly regarded scien-tist
in the study of Kaposi’s Sarcoma-Associated
Herpesvirus and other related herpesviruses.
Accomplishments: Widely acknowl-edged
as one of the most important research-ers
in virology in the world today, she has
published nearly 100 peer-reviewed arti-cles.
The prestigious awards she has won
include the American Association for Cancer
Research Gertrude Elion Research Scholar
(2004), the Leukemia and Lymphoma
Society Scholar (2005–2010), the Ameri-can
Heart Association Established Investi-gator
Award (2006–2011), the Burroughs
Wellcome Investigator in Infectious Disease
Award (2006–2011) and Carolina’s Hettle-man
Prize (2008).
Beth Mayer-Davis
Career at Carolina: Professor of nutrition
since 2008 and professor of medicine since
2009; chair of the Department of Nutrition
in the Gillings School of Global Public Health
since 2008.
Research specialty: An internationally rec-ognized
expert on diabetes, she is best known
for her work on childhood diabetes, especially
among minority populations.
Accomplishments: She has published
240 peer-reviewed articles, producing more
than 10,000 citations. President Obama
appointed her to the Advisory Group on Pre-vention,
Health Promotion and Integrative
and Public Health; she has also served as presi-dent
of the American Diabetes Association
(ADA).
She has
contrib-uted
to
the ADA
S t a n -
dards of
Medical
Care and
Nutrition
Recom-me
n d a -
tions for
m a n y
years.
Dennis Mumby
Career at Carolina: Professor of communi-cation
studies since 2002 and former chair of
the Department of Communication Studies
from 2005 to 2013
Research specialty: A leading global
authority in communication, especially orga-nizational
communication.
Accomplishments: One of the founders of
critical organizational studies, Mumby wrote
the highly influential 1987 essay “The Politi-cal
Function of the Narrative,” which intro-duced
the concept of narrative. His book
“Communication and Power in Organiza-tions”
(1988) helped define the agenda for
the entire
field. He
has writ-ten
seven
books, 30
book chap-ters
and
24 peer-reviewed
a r t i c l e s
that have
produced
n e a r l y
6 , 0 0 0
citations.
Louise McReynolds
Career at Carolina: Professor of history
since 2006
Research specialty: Internationally
recognized as one of the most promi-nent
and interesting historians of late
Imperial Russia.
Accomplishments: Through exhaustive
and highly original research, McReynolds
has done much to discount the idea that late
Imperial Russia was not sufficiently indus-trialized
for a middle class to develop its
own political vision. Instead, by exploring
the history of popular culture, McReynolds
reveals the vibrant nature of the Russian
middle class during this era. Her first book
on this era offered a careful analysis of Rus-sia’s
newspapers; her second examined the
l e i s u r e
activities of
Russians;
her most
r e c e n t
b o o k
e x p l o r e d
the cul-tural
sig-n
i f i c a n c e
of murder
that bears
on Russia’s
p a t h t o
modernity.
6 University Gazette
Eight endowed professorships awarded
Albriton
Kieber
Pielak
Cai
Damania
Mayer-Davis
Mumby
McReynolds
August 12, 2015 7
Streeter, a 1992 Carolina alumnus who has worked as an IT specialist
in Student Affairs since 1995.
“We want to make sure that any suggestions we offer are very well
thought out and adding to the conversation in a constructive manner.”
The Wainstein report also prompted further reviews by the NCAA
and the regional accrediting agency, the Southern Association of Col-leges
and Schools Commission on Colleges (SACSCOC).
In May, the University received a notice of allegations from the
NCAA as the next phase in its investigation of academic irregularities
and possible bylaw infractions. In June, the SACSCOC placed Caro-lina
on probation for one year because of past academic irregularities.
As important as those reviews are, Cairns and Streeter said, it is also
important to restore confidence in Carolina among all of its many
stakeholders, from state taxpayers who pay the bills to parents who
trust the University to educate their children.
Difficult conversations
Both Streeter and Cairns also emphasized the importance of con-tinuing
the conversation about the University’s full history.
The Board of Trustees’ decision to remove the name of William L.
Saunders, a leader in the Ku Klux Klan, from a University building did
not end that discussion, Streeter said. It started it.
But Streeter said he was against the idea of removing statues such as
Silent Sam, a monument erected in 1913 to honor University alumni
who fought for the Confederacy and died in the Civil War.
It is not because he likes what it represents that he wants it to stay,
he said.
“I am not in favor of a monument being removed because we don’t
like it or because it makes us feel uncomfortable,” Streeter said, empha-sizing
he was expressing his personal views and not that of the forum.
“We need to feel uncomfortable. Silent Sam needs to stay there
so that every time you walk by, you are reminded of the lineage of this
institution. We need to be reminded so that we cannot allow ourselves
to forget.”
Cairns agreed.
“A great public university is the place these kind of dialogues are
supposed to happen,” Cairns said. “If you can’t have them here, where
are you going to have them?”
Finally, both leaders said faculty and staff need to work together
on a range of issues that affect faculty and staff, from parking to
campus safety.
Streeter said another issue that is important to him is raising aware-ness
about the role staff members have with students.
“One of the things that everyone is looking at is promoting student
success. We need to do more to encourage staff members to recognize
the vital link between the teaching faculty members do inside the class
and the array of services that staff members provide outside of it to
ensure students are getting what they need while they are here and are
ready for the real world when they leave.”
Cairns credited Folt and her administrative team for creating an
atmosphere that invites faculty, staff and students to raise tough ques-tions
and look for answers together rather than separately.
“I think what is really remarkable is that, even through these difficult
times, we get along quite well,” Cairns said. “That is not a given every-where.
We are very fortunate here that we have wonderful leaders who
are willing to listen to us.”
– Gary Moss, Gazette
Restoring public trust from page 1
The man
behind the
camera
Dan Sears always stood
behind the camera – never
in front of it – yet over the
course of his 23-year career
at Carolina he became one
of the most recognized and
beloved figures on campus.
Everyone knew Dan and
came to depend on him to get
the job done no matter how
big or small the assignment.
As the University’s official
photographer, Dan became
its all-seeing, ever-present
eye who was counted upon
again and again to capture
the magic of a moment with
the press of his finger.
Dan retired last month –
at his insistence – without a
parting salute from us.
His incredible body of work,
including this picture of the
Old Well reflected in drops
of water, says everything that
needs to be said about how
much he will be missed.
Carolina
Club
membership
At the Aug. 6 Employee
Forum meeting, Elizabeth
Cheek of the Carolina Club
invited all faculty and staff
to an open house at the club
Aug. 19 from 4 to 6 p.m.
The event is free, but an
RSVP is required by Friday,
Aug. 14. Now through Oct. 1,
the Carolina Club is offering
half-off memberships for new
staff and faculty, as well as
current club members who
refer new members. The club
also offers Tar Heel Advan-tage,
a dining program for fac-ulty
and staff club members.
Call Cheek at 919-962-0021
for more information.
8 University Gazette
Studies have long shown that the best start for babies is
with breast milk, with the World Health Organization
recommending that babies be exclusively breastfed for
at least the first six months of their lives and for as long as mutu-ally
desirable for mom and baby.
While breastfeeding is an affordable and available option for
many mothers, it is a misconception that it always comes natu-rally,
said Diane Asbill, program coordinator for lactation ser-vices
at N.C. Women’s Hospital at the UNC Medical Center.
Preterm birth, illness, latching problems, pain and a host of
other difficulties can get in the way for a new mother trying to
feed her newborn. Even those who breastfeed fine at the hos-pital
face roadblocks when they return home: extended fami-lies
where breastfeeding or pumping is not the norm, limited
maternity leave, other responsibilities and the stigma of breast-feeding
in public.
“When breastfeeding is hard, it can feel like failure for many
of our moms in the hospital and even after they get home,” said
Asbill. “This is one thing they thought their body was supposed
to do on its own.”
Carolina demonstrates a campus-wide commitment to
healthy mothers and babies through clinical practice, cutting-edge
research and both patient and practitioner education. From
hospital rooms to University classrooms, faculty and staff are
dedicated to helping new mothers provide vital nutrition for their
babies – and supporting them when it doesn’t go as planned.
A ‘BABY-FRIEND LY ’ BIRTH PLACE
In 2012, N.C. Women’s Hospital was the third hospital in
the state to receive international recognition as a Baby-Friendly
birth facility from Baby-Friendly USA, a program of the World
Health Organization and the United Nations Children’s Fund
which recognizes an optimal level of care for breastfeeding
mothers and babies.
Lactation services began with a team of two in 2000, and now
14 International Board Certified Lactation Consultants are on
staff to serve every nursing baby and mother in the hospital
seven days a week and, often, in the middle of the night.
“I don’t know of many hospitals with that much night cov-erage,
and it’s essential for the continuity of care, ” said Asbill.
“The night is not when adults are used to being awake, making
decisions and competently using new skills.”
Nearly 30 years ago, Asbill herself was a neonatal intensive
care unit (NICU) nurse at UNC. She knew that breast milk
was essential to support the NICU babies in her care – babies
who were often born premature or sick. She became a lactation
consultant in 1989.
“Our lactation consultants in the NICU help these moms to
pump and store their milk and
have a plan for when they get
home. We teach them how to
transition the baby to breast if
the baby is medically and devel-opmentally
ready to do that,”
she said. “Food is important, but
it’s also their medicine.”
This hospital also makes
available donor breast milk to
all breastfeeding newborns who
need early supplementation
during their hospital stay.
“The previous thinking was
that full-term babies didn’t need donor milk. But if your goal
was to exclusively breastfeed and something after delivery
changed your ability to do that, you won’t be able to meet your
breastfeeding goals,” she said.
Support doesn’t stop at discharge. Lactation consultants see
all the newborns who come to the UNC pediatric clinic and
staff the Lactation Consultant Warmline, a hotline for moms
with questions about breastfeeding.
“We hear from moms all the time who tell us that our team was
there to give them confidence when they didn’t think they could
keep going. We have mothers with significant barriers to doing
this, and it’s gratifying when we know we’ve helped them.”
‘A PUBLIC HEALT H IMPERATIVE’
Catherine Sullivan, deputy director of the Carolina Global
Breastfeeding Institute (CBGI) at the Gillings School of Global
Public Health, said the benefits of breastfeeding to maternal
and child health make it a public health priority.
“It’s a public health imperative to reduce chronic diseases
in children and adults, and breastfeeding has been shown
to reduce the risk for various conditions,” said Sullivan,
who oversees training of students seeking to become board
certified in lactation in the school’s Mary Rose Tully Training
Initiative (MRTTI).
“We’re not just focused on the baby; we’re focused on the
mom, too. We know that women who have exclusively breast-fed
have reduced risk for breast and ovarian cancer and diabe-tes,
and new research is looking at the role breastfeeding plays
on heart health,” said Sullivan.
This week, MRTTI welcomes their seventh class, their big-gest
and most diverse yet: 14 students from multiple demo-graphics
and backgrounds, combatting misperception about
who belongs in the field. Over the years, the initiative has seen
enrollment from physicians, nurses, and nutritionists to anthro-pologists
and social workers and has a 100 percent pass rate on
the international board exam.
Because the program is housed in an academic center, the
course work is rigorous and includes 300 hours of clinical work
and 90 hours of classroom time, providing an education that
goes well beyond basic breastfeeding.
“North Carolina is fourth in the nation for the total number
of board-certified lactation consultants, and our numbers grow
every year. We’re training leaders in the field of breastfeeding,
people who can go out in their communities and advocate for
and support entire families and empower health.”
BEST LAID PLANS
When a new mother has tried everything, and breastfeeding
still isn’t working out, Alison Stuebe, a physician and researcher
at UNC’s Department of Obstetrics and Gynecology in the
School of Medicine, calls that a “lactastrophe.”
“Sometimes, it doesn’t work out no matter how hard you try,
and that can be a very stressful time,” said Stuebe, Distinguished
Scholar of Infant and Young Child Feeding. She currently focuses
much of her research on the effects of postpartum depression on
breastfeeding, as well as barriers to breastfeeding such as racial
and ethnic disparities, and she manages a clinic of physicians and
lactation consultants who work toward new approaches for the
management of breastfeeding difficulties.
“Trouble with breastfeeding – whether due to mastitis or
milk supply – can lead to a flood of negative experiences for
a new mother: the inability to bond with her baby or the judg-mental
stares and comments of others if she isn’t able to nurse,”
she said. “We see a lot of mothers with postpartum depression.”
It’s a message that’s important to Stuebe, who nursed three
children while building a demanding career: With the right sup-port,
moms who struggle with breastfeeding don’t necessarily
have to give up.
But she had another message for moms, too: If it’s not work-ing
out, it’s OK to move on.
“We should remember that breastfeeding is a part of mother-hood,
but it’s not the only part. If breastfeeding struggles are
preventing you from seeing your baby smile or hearing your
baby coo, then there may come a time when this is not making
sense for you and your baby.
“We’ll take away as many barriers as possible so you can give
it your best shot – and if it doesn’t happen, then we will help
you make peace with that and find other ways to bond and con-nect
with your baby.”
– Courtney Mitchell, UNC Women’s Care
August is National Breastfeeding Month. For more information
on breastfeeding at Carolina, visit breastfeeding.sph.unc.edu
and womenscenter.unc.edu/lactation-resources.
Lactation consultant Diane Asbill (right) discusses breastfeeding and other newborn issues with Kaila Mitchell and her baby, Anna, born Aug. 6.
Stuebe
Max Englund
Meeting the needs
to breastfeed