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Category: Policy Page 1 of 7

Rethinking the Mutual Relationship Between Science and Justice

When you think of environmental science, what comes to mind? Studies? Analyses? Hypotheses?

What about environmental justice? Clean air? Restoring forests?

Ryan Emanuel, an associate professor of Hydrology in the Nicholas School of the Environment, redefines these two concepts of environmental science — or shall I say, combines these two concepts. He appeared in person and on Zoom in the Trent Center for Bioethics series recently, presenting his new-ish book: “On the Swamp: Fighting for Indigenous Environmental Justice.”

Through three compelling anecdotes, Emanuel showed us how environmental science and environmental justice can be viewed as a bidirectional relationship.

Ryan Emanuel (photo by Duke University)

Story one:
After earning his degree in hydrology from Duke in the 90s, Emanuel pursued advanced studies in evaporation and carbon cycling. With an education, Emanuel began fieldwork — conducting studies and climbing tall towers (all the fun sciencey stuff). However, as a person from North Carolina’s Lumbee Tribe, he noticed the disconnect between his work and his community. He was acutely aware of a cultural emphasis on education –the expectation that you will use your education to give back to your community. He didn’t feel his work in hydrology was serving the Lumbee tribe’s interest, so he decided to change that. 

Sean Jones from the Lumbee Tribe (photo by News & Record Final)

During his talk, Emanuel emphasized the significance of “accountability” and “motivation.”

“Examining our motivation can allow us to better understand who we are accountable to in our work… We are all accountable somehow, and we can be accountable in different ways to different groups.”

Understanding that his work had to be accountable for the Lumbee tribe, Emanuel became an ambassador for STEM in higher education. This new path enabled him to mentor youth with tribal backgrounds, prepare them for higher education, and even form strong relationships with them.

Story two:

The EPA says environmental justice is “fair treatment and meaningful involvement of all people in environmental decision-making.”

Emanuel recognized that governments should be accountable for including the voices and opinions of marginalized groups — ‘all people’ — within their environmental decision-making. But Emanuel said there was a dissonance between these promises and reality. One example is the placement of Concentrated Animal Feeding Operations (CAFOs) where livestock are raised in confinement for agricultural purposes.

CAFOs in North Carolina are disproportionately located in communities of minority groups. Many issues arise from this, such as the pollution produced from CAFOs (air and water).

I was shocked to see the many ways that smaller, marginalized communities are affected. These issues are often relatively hidden — not surprising given that mainstream media usually focuses on large (easily observable) community-based discrimination. 

Map of locations of CAFOs in North Carolina (photo by Jiyoung Son)

Emanuel began to look at the interplay between environmental science (observation, analysis, testing) and environmental justice (lived experience, regulations, fairness). He let go of the previous idea that environmental science only seeks to provide data and support to drive change in environmental justice. He began to ask, “How can environmental justice improve environmental science?”

Story 3:
Combining his accountability for the Lumbee tribe with his hypothesis about the bidirectional relationship of environmental science and environmental justice, Ryan Emanuel began looking into the observably negative impacts of the Atlantic Coast Pipeline (ACP). Spanning over 600 miles, this gas pipeline will provide many benefits for North Carolina communities, such as lower costs, new jobs, and less pollution, according to Duke Energy.

Emanuel saw that the pipeline route went right through Lumbee territory, which could mean devastating effects for the community, such as health impacts and declining property values. 

Proposed Atlantic Coast Pipeline route (photo by SAS Blogs)

The crux of the issue lay in the negligence of project developers who failed to connect with the marginalized communities the pipeline would run through (such as the Lumbee). Tribal voices and input were completely ignored.

Emanuel helped prepare tribal leaders for meetings with corporate representatives and wrote a commentary on the need for the federal government to collaborate with the tribes they would be affecting.

Eventually, after years of lawsuits, the companies in charge of the project abandoned the ACP project. When I searched “Why was the Atlantic Coast Pipeline project canceled?” Duke Energy claimed the cancellation was because of “ongoing delays and increasing cost uncertainty, which threaten(ed) the economic viability of the project.” Other sources provide details on the legal challenges and criticism the project faced.

After the companies dropped the plan, they were quick to purchase forest land near the Lumbee tribe and begin the development of natural gas infrastructures that would allow for the storage of gas when the demand was low and the ability to release the gas when prices went up.

I found it quite impressive that Ryan was able to attend many meetings between the Lumbee Tribe and the company, without saying a word. The tribal council had asked him to only observe and not speak. During one meeting, a representative from the company that purchased the forest land said that they wanted to clarify that “pipelines are not disproportionately located in marginalized communities — they are everywhere.”

Emanuel began testing this hypothesis, eventually gathering enough evidence to statistically prove that there is a “spatial correlation between social vulnerability and pipeline density.” His findings gathered significant media attention and have even been expanded on to show the need for change and increased safety within pipeline communities. 

Emanuel concluded by explaining that the principles of environmental justice can show us what questions we should be asking, who we should be asking them of, and who we should be keeping in mind when conducting research.

The statement Emanuel made that stuck with me the most was, “If we value examining problems from all angles, we have to pay attention to which perspectives are missing.”

Ryan Emanuel’s book (photo by The Magazine of the Sierra Club)

After Emanuel’s talk, I was surprised that I had never been introduced to this way of thinking before. It seems like common knowledge that focusing on justice and equity can improve how we investigate problems scientifically. However, it is not completely surprising that this information is not common sense, given the systematic issues within our country.

Emanuel’s book, “On the Swamp: Fighting for Indigenous Environmental Justice,” dives deeper into these concepts about the relationship between environmental justice and environmental science. I believe this book would bring nuance to our world today, where there is a clear need for change and the uplifting of voices that have been quieted for so long.

By Sarah Pusser Class of 2028

Understanding the Shifting and Complex Views of Muslim American Voters

“We are techies in Silicon Valley, but we are also laborers in rural areas.”

That’s how the head of one of the nation’s largest Muslim voter-mobilization groups described the diverse socio-economic backgrounds of Muslim voters during a Sept. 30 talk held as part of the Provost’s Initiative on the Middle East.

Wa’el Alzayat is a first-generation Arab and Muslim American who serves as the CEO of Emgage, an organization that educates and mobilizes Muslim American voters in support of policies that enable our communities to thrive and democracy to flourish.

At his talk at the Sanford School of Public Policy, he showed the predominantly South Asian and Arab audience the political trajectory Muslims are undertaking this election; highlighting important turning points for the community – specifically, the events of October 7, 2023, and September 11, 2001. 

Who Are Muslim American Voters?

“They are the most diverse religious group in America, consisting of Black Muslims, South Asians, Arabs, Hispanics, and others,” said Alzayat. This diversity meant that when we talk about Muslim voters, we’re not looking at a homogenous group but rather one with a wide range of perspectives, backgrounds, and priorities.

This is a community not confined to one particular industry or region but spread across the economic and social spectrum, contributing to the U.S. in a wide variety of ways.

But, just because Muslims make up 1-2% of the electorate doesn’t mean their vote doesn’t matter. 

After all, in the 2000 presidential election, the deciding factor was the state of Florida, where Bush won by just 537 votes after a contentious recount process. This is 0.0034% of the population, so it’s fair to assume that the Muslim American voting bloc — more than three and a half million people — matters.

Post 9/11 and the War on Terror

Before 9/11, many Muslims supported the Republican Party. George W. Bush and Dick Cheney earned significant support from the Muslim community due to their positions on Palestine and their alignment with conservative values, including opposition to same-sex marriage.

However, the post-9/11 landscape changed everything. Alzayat shared data showing how Muslim Americans, once allied with the GOP, shifted toward the Democratic Party in response to policies like the Patriot Act, increased Islamophobia, and the Iraq War. These events alienated many Muslims, who felt targeted by the government. Since then, the Democratic Party has made strides in embracing Muslim Americans, especially during Obama’s presidency, when over 92% of Muslims supported him.

Post-October 7: The War in Gaza

Alzayat also addressed the current moment, particularly in light of the events in Gaza that began on October 7. He noted that foreign policy has always been central to Muslim voting behavior, especially regarding Palestine, Syria, Kashmir, and other Muslim-majority regions. The Gaza conflict has reignited these foreign policy concerns, driving more political engagement but also creating new divisions within the community.

Post 9/11, Muslims shifted to the Democrats. In the wake of October 7, Muslims are once again, conflicted. Since, according to Alzayat, most of the people in the community are issue voters – the Gaza war serves as one of the most colossal issues. 

But neither party, Republican or Democrats, seem to side with defunding the Israeli military. 

To no one’s surprise, Alzayat’s data shows a growing number of Muslims leaning toward third-party candidates, a significant shift from the 75% who voted for Biden in 2020. 

Other Issues and Where Muslims Stand 

As the research from Emgage illustrates, the Muslim community is not monolithic in its political beliefs. While some support progressive causes, such as gay marriage, others align more closely with traditional conservative values. This generational divide is becoming more pronounced, with younger Muslims more open to progressive social policies while older generations hold onto more conservative positions.

Issues like abortion are far from settled within the community, with different sects interpreting Islamic law differently. Alzayat pointed out that this diversity of opinion adds another layer of complexity to understanding Muslim American political behavior.

The Road to 2024: Green Party, Trump or Harris?

Alzayat went on to explain how there is no third party alternative, it’s just Trump or Harris, and Emgage has decided to endorse Harris. While he didn’t delve into this deeply, it’s reasonable to assume his stance is rooted in the historical impact of third-party votes. In key battleground states like Michigan, Wisconsin, and Pennsylvania, Jill Stein’s votes in the 2016 election arguably swung the result. Clinton lost these states by less than a percentage point and merely half of Stein’s votes could have reversed her losses. 

Alzayat explained why he endorsed Harris, and not Trump. 

According to him, there is no black-or-white answer and his organization could be wrong. It could be business as usual when Harris is elected, but with Trump the “could” will be a “will.”

With Trump’s presidency comes a threat of white supremacy, “We believe there is a dual threat of white supremacy and anti-Palestinians should Trump win based on what he said he will do. Jared Kushner wants to build condos in Gaza and he has been given 100 millions by funders who want to annex the West Bank,” he said. 

“That fight has an option to continue if Trump isn’t an option,” he said.

Post by Noor Nazir, class of 2027

What Comes Next for the Law of the Sea Treaty?

More than 40 years since its signing, the United States still has not ratified an international agreement known as the “constitution of the oceans.” In a webinar held April 2, two of the world’s leading ocean diplomacy scholars met to discuss its history, challenges, and the U.S.’s potential role in the future.

The 1982 United Nations Convention on the Law of the Sea was truly revolutionary for its time. Unraveling against the backdrop of decades of conflict pertaining to maritime affairs, the significance of this conference and its attempts at negotiating a comprehensive legal framework cannot be understated. Key figures in this development include the members of the United Nations, coastal and landlocked states, the scientific community, environmental community, and developing nations. Yet, with the conclusion of this unifying conference, a singular question remained: What comes next? 

This question is what David Balton, the executive director of the U.S. Artic Steering Committee, and David Freestone, a Professor at George Washington University and the Executive Secretary of the Sargasso Sea Commission, aimed to address in a webinar titled, “The UN Convention on the Law of the Sea at 40.” In this discussion a range of topics were discussed but the primary focus was providing viewers with a comprehensive understanding of the events of this convention and the way this history plays out in modern times. 

Picture of Ambassador David Balton (Obtained from the Wilson Center)

The 1982 convention was one of multiple attempts at setting parameters and guidelines for maritime control. In 1958, the council met for the first time to discuss growing concerns regarding the need for a comprehensive legal framework regarding ocean governance. In this they brought multiple representatives worldwide to discuss the breadth of territorial waters, the rights of coastal states, freedom of navigation, and the exploitation of marine resources. This conversation laid the groundwork for future discussions. However, it was largely ineffective at generating a treaty as they were unable to reach a consensus on the breadth of territorial waters. This first conference is referred to as UNCLOS I. 

Following 1958, in 1960 the members of the council and associated parties convened once again to discuss the issues brought forth by UNCLOS I. The purpose of this conference was to further discuss issues pertaining to the Law of the Sea and build a framework to begin ratification of a binding treaty to ensure that conflict regarding the sea diminishes greatly. This discussion was set in the context of the Cold War. This new setting complicated discussions as talks regarding the implementation of nuclear weapons under the deep seabed further elicited great debate and tensions. While the aim of this meeting was of course to reach a general agreement on these subjects, major differences between states and other parties prohibited UNCLOS II from producing said treaty. 

UNCLOS III served as the breadwinner of this development, yet this is not to say that results were immediate. Negotiations for UNCLOS III were the longest of the three as they spanned from 1973 to 1982. UNCLOS II was particularly special due to its ability to produce revolutionary concepts such as archipelagic status and the establishment of the exclusive economic zone (EEZ), granting coastal states exclusive rights over fishing and economic resources within 200 miles of their shores. In addition, this led to the development of the International Seabed Authority and the International Tribunal for the Law of the Sea. Despite the limitations and unfinished agenda that preceded this, the treaty was officially ratified in 1994 at Montego Bay. The convention initially received 157 signatories and currently holds participation from 169 parties. Absent from this group are the United States, Turkey, and Venezuela. The convention was designed to work as a package deal and required nations to fully commit to the agreement or abstain entirely. For this reason, the United States retains a nonparty, observer status despite to their adherence to the rules and guidelines of the treaty. 

After this explanation, Balton and Freestone addressed the big question: What comes next? As of right now, the United States is still not a signatory of this treaty. However, this is not to say that they are in violation of this treaty either. The United States participates in discussions and negotiations related to UNCLOS issues, both within the United Nations and through bilateral and multilateral engagements. In addition, the Navy still upholds international law in dealings concerning navigational rights. The one factor many claims prohibits the United States from signing is the possibility of their sovereignty being challenged by certain provisions within the treaty. In spite of this, many continue to push to change this reality, advocating for the United States to ratify this agreement. 

Picture of Professor David Freestone (Obtained from Flavia at World Maritime University)

The 1982 United Nations Convention on the Law of the Sea remains a pivotal moment in the history of international maritime governance. This Convention led to many insightful and necessary developments which will continue to set precedent for generations to come. While imperfect, the efforts put forth by many nations and third parties to ensure that it remains consistent with modern day times is very telling of the hopeful development of this treaty. Furthermore, while the future of U.S. involvement in the treaty is uncertain, the frameworks established by the three UNCLOS’ provide a solid foundation for addressing contemporary challenges and furthering international cooperation. 

Post by Gabrielle Douglas, Class of 2027
Post by Gabrielle Douglas, Class of 2027

Echoes of Liberty: Revisiting the Swatantra Party’s Vision for India’s Economy

If you’re looking to revisit the nuanced history of the Swatantra Party in post-colonial India, you’ve come to the right place! During Aditya Balasubramanian’s talk on his book, ‘Toward a Free Economy: Swatantra and Opposition Politics in Democratic India’, I embarked on a journey that not only took me back to South Asia’s economy but also helped me reflect on the broader implications of Balasubramanian’s vision for a free economy. 

I grew up to have an interest in India’s economic history. Living in Pakistan, we (my household) always looked toward our neighboring country, India, to reflect on our own economic situation. The echoes of discussion on free economy versus socialist planning reverberated in the hallways of everywhere I turned to. The narrative of the Swatantra Party, as captured in the book and the talk, presents a fascinating counterpoint to the dominant economic narratives in post-colonial India, challenging us to ponder the possibilities of a different economic path.

Balasubramanian talked about the heart of Swatantra’s ideology: a profound belief in a nonsectarian, right-wing political stance, advocating for an unfettered private economy and a decentralized economic system. The party’s anti-communism stance wasn’t merely ideological but a practical caution against nationalization. This reminds me of discussions with my grandmother, who, amidst the economic challenges of her time, often lamented the lost opportunities for economic liberalization that Swatantra championed.

Balasubramanian went on to explain the narrative of the Indian libertarian, Ranchhoddas Bhuvan Lotwala, and his transformation of a flower shop into a machine-operated flour mill encapsulates the spirit of economic innovation and entrepreneurship that Swatantra celebrated. This story, emblematic of the broader push for modernization and the embrace of new technologies, serves as a reminder of the countless small businesses across India that continue to innovate and adapt in the face of changing economic landscapes. These small businesses play a bigger role than we think, and the economy of the government can aid in transforming their potential. Swatantra and its stories serve as proof for that. 

He concluded the talk by pointing out three things that need our attention::

1)    Exploring how a free-market economy can work alongside federal government policies.

2)    Addressing how special interests have influenced policies in a way that ignores regional concerns, particularly noting the removal of corporate taxes. 

3)    Emphasizing the importance of limiting authoritarian tendencies to ensure a balanced and democratic governance system.

The Swatantra Party’s story is a reminder of the enduring power of ideas and the impact they can have on the economic and political fabric of a nation: it is a story that must never be forgotten. Afterall, there’s too much to learn from it.

Post by Noor Nazir, class of 2027

“Biodiversity Is Essential, and It’s Not a Nice-to-Have”

Filmmaker Ashley Hillard and cinematographer Alan Dunkin in Yellowstone. Photo by Hillard.

“I have been interested in storytelling and the environment since my earliest memories,” says Ashley Hillard, a documentary filmmaker with an interest in wildlife management and conservation practices in the United States.

Hillard has a background in film, largely with production companies, talent agencies, and independent projects on the side, but she later shifted into climate tech recruitment. Now she is pursuing an environmental leadership Masters in Environmental Management degree at Duke while working on documentary projects. She is also a  Communications Assistant Intern in the Duke Environmental Law and Policy Clinic.

She has been working on a film called “Coexistence,” a documentary that spotlights North American species and wildlife management practices. Hillard got the idea for the project when she noticed that U.S.-based researchers often choose to study species in other countries, perhaps “because it’s easier to go over and say ‘Why don’t you try this?’ rather than having to deal with issues in your backyard.”

“We need to pay attention to our own backyards,” Hillard emphasizes. “The hope,” she says, is “more laws and policies and values change along with behaviors as we become more informed and more aware.” She also believes that “local efforts can usually go further.” Part of her goal in creating films about conservation is to help viewers realize that “individuals can be part of change.” Films and other forms of storytelling can inform people about specific species and conservation efforts, but Hillard hopes her work can help shift perspectives more broadly as well. Effective conservation is often “a social attitudes and values issue,” Hillard says. “There needs to be a shift in how we view the environment.”

An American bison that Hillard saw while filming in Yellowstone.
Photo by Hillard.

Shifting baseline syndrome is the idea that people’s expectations of how nature should look reflect their own experiences rather than an accurate picture of the natural state of landscapes, flora, fauna, and wildlife abundance. Our understanding of what nature “normally” looks like changes over generations and is skewed by the societies and time periods we inhabit. The more we damage our environments, the less we collectively remember what they looked like before—and the less motivated we may be to restore them to a condition most of us can’t remember.

When humans and wildlife come into conflict, our perceptions of how nature “should” be can matter tremendously. Gray wolves were recently delisted from the Endangered Species list, then re-listed in most places—both were controversial decisions—but their numbers are far lower than they were historically. Still, some think there are too many wolves. In the Western U.S., gray wolf conservation efforts often clash with the desires of ranchers and and hunters, who may view higher wolf populations as a threat to livestock or game animals like deer and elk. But some of these hunters and ranchers, Hillard says, “are real conservationists doing amazing work,” and she thinks they should get more attention.

While creating the film, Hillard has tried to capture the complexities of wildlife conservation. It’s not as simple as “They’re bad, they’re good, and this is how we solve it,” Hillard says.

There are different ideas about how conservation efforts should be conducted and which animals should be protected in the first place. The dominant approach to wildlife management in the U.S., Hillard says, is rooted in the idea that there are “good” species that people can use and “bad” species that people don’t like to live with, such as wolves and other predators. “This perspective,” she says, “came over with colonists.” She mentions Little Red Riding Hood and the Big Bad Wolf; the stories we tell about animals can reflect societal attitudes toward them. Many indigenous peoples, meanwhile, have traditionally viewed all species as kin. This “cultural aspect” affects people’s willingness to coexist with species like wolves, which in turn affects our conservation practices.

A gray wolf at the Grizzly and Wolf Discovery Center in Yellowstone.
Photo by Alan Dunkin, provided by Hillard.

In this country, very few people are killed by wildlife—about 700 annually, according to one review that counted deaths from bites, wildlife-vehicle collisions, and zoonotic diseases. Car accidents, on the other hand, are more than 60 times more deadly, killing about 43,000 people in the U.S. per year. “We have a certain acceptance of how we die,” Hillard says. “There are a number of things that kill people with much higher percentages [than deaths from wildlife] that we… accept as day-to-day,” but we don’t tend to hear calls to eliminate cars from society, while an animal that harms a human is often given a death sentence. Hillard thinks media in general should be more careful about how they share stories about wildlife, especially negative encounters. If stories focus only on rare but tragic incidents, it can distort perceptions of species and “feed into that doom loop.”

Films, Hillard says, can inspire people “to look at things differently and see things from different perspectives.” Storytelling is also a way of communicating scientific information and encouraging action. Hillard feels that some stories about environmental issues are told in a one-sided, black-and-white way, but the nuances of these problems are important. “Finding those complexities and working through them… and then trying to craft stories around that to share with the public so they can make more informed decisions” is part of the goal of Hillard’s films.

“Coexistence” focuses on well-known, often controversial species like red wolves and mountain lions. “Familiarity and awareness of a species can contribute to interest in protecting them,” Hillard says. Such species are sometimes referred to as charismatic megafauna and can be viewed as ambassadors for conservation or umbrella species whose protection helps other wildlife as well. But Hillard has concerns about the term charismatic megafauna. “It diminishes a species’s value and reduces them to ‘cute’ so you no longer see them as an intrinsic part of an ecosystem,” she says. She believes it’s important to emphasize protection of entire ecosystems, not just specific species within them.

A Mexican gray wolf pup at the California Wolf Center. The Mexican gray wolf is a gray wolf subspecies.
Photo by Hillard.

Hillard hopes that her films inspire more awareness of and interest in environmental issues. “There’s a lot of pressure to get it right,” she says. And storytelling can have its own issues when it comes to presenting accurate information. “Information can be left out or shaped in a way to make it more compelling,” Hillard acknowledges. She feels that many wildlife films focus first on scenery and animals, then discuss conservation issues at the end. But “Coexistence” is “very much focused on the issues.” It is expected to be released by early 2025.

“I strive to tell impactful stories in creative ways that are more upbeat in tone,” Hillard says. She believes it’s important for people to be aware of the challenges facing wildlife, but she also wants to inspire hope and the belief that individual actions can matter. “To feel powerless can make you feel hopeless, and there is a lot to be hopeful for,” she says. “But there needs to be a shift in how we view the environment.”

One major problem she sees is our consumerist, materialistic society. “We’re kind of consuming ourselves off the planet,” Hillard says. “How do you change behaviors within a society that’s so hyper-consumptive?”

Films and other forms of storytelling can make scientific information more accessible. “Communicating is that bridge to getting people to care, to understand it, to learn about it,” Hillard says. “Without communication, science studies and research may be siloed in academia.” When we lack accurate and accessible information, we may rely on “‘I heard someone say something about that thing’” rather than science to inform our understanding of issues.

Along with providing accurate information, Hillard wants to encourage “a view of mutualism with other species” and raise questions like “How can we be better neighbors to nonhuman species?”

Ultimately, she wants viewers to recognize that “biodiversity is essential, and it’s not a nice-to-have.”

Hillard at Lands End Lookout in San Francisco.
Photo credit Alan Dunkin, provided by Hillard.

Post by Sophie Cox, Class of 2025

Casting roles, casting votes: Lessons from Sesame Street on media representation and voting

Elmo greets the audience during a Sesame Street Live children’s show at Naval Support Activity Naples. Credit: U.S. Navy

La la la la, la la la la, Elmo’s world. La la la la, la la la la, Elmo’s world! 

After listening to Dr. Claire Duquennois, it’s come to my attention that we might actually be living in Elmo’s world. On February 29, Duquennois, an assistant professor in the Department of Economics at the University of Pittsburgh, spoke at the Sanford School of Public Policy about her research on the impact of “Sesame Street” on voter turnout and behavior. As the first of a series of papers on child media representation, Duquennois and her co-author Jiangnan Zeng examined the impact of the highly popular television show on voters born in the 1960s.

For those who didn’t have “Sesame Street” as a cornerstone of their childhood, the show first aired in November 1969, and quickly attracted a large audience of young children from 2-5 years old. The show was unique in its academic and socio-emotional curriculum, as well as in its diverse and integrated cast. Duquennois described the show as having two intents: the first was to create academic curriculum for preschool age children. But the second, more implicit goal was to improve children’s self image, increase their racial tolerance, and highlight the importance of different perspectives, cooperation, and fairness. This is exhibited by the amount of documentation from the creation of the show, as well as the consultation of psychiatrists like Dr. Chester Pierce, who was an expert in the consequences of racism and television’s impact on the portrayal of minorities.

Whereas other shows like “Mister Rogers’ Neighborhood” featured a more white and suburban cast and setting, “Sesame Street” aimed to relate to kids in more urban or low income areas. For example, both the adult and adolescent cast featured numerous people of color, and the show’s set was reminiscent of Harlem brownstones. The show also brought on numerous diverse guest stars, many of which were important figures in the Civil Rights movement. For many children living in white-dominated suburbs at the time, “Sesame Street” was their first introduction to people of different cultural backgrounds. This “hidden agenda” did not go unnoticed by more conservative governments. For example, the Mississippi commission for education TV vetoed the airing of “Sesame Street” due to the messaging of integration and diversity, although this decision was later overturned due to popular support for the show. Duquennois and Zeng wanted to know: Can child media reduce prejudice in the long-run, impacting voter preferences and behaviors in adulthood?

There had already been a lot of research on mass media in terms of short-term voting outcomes, Duquennois said. In particular, she spoke about research on the news and mass media creating a negative impact on racial and ethnic tensions. However, there was a lack of research on both child media and its impact on later life voting, as well as media’s ability to reduce biases in the majority group. In particular, Duquennois frequently referenced a paper by Melissa S. Kearney and Phillip B. Levine titled “Early Childhood Education by Television: Lessons from Sesame Street.” Duquennois also spoke on the previous research done on contact theory, which has proven that interactions with other groups can help to reduce biases. For example, research done on random college roommates has found that introducing college-age students to people from differing cultural backgrounds has a positive impact on reducing prejudice. 

To any readers still waiting to hear the connection, here it is. Duquennois used a difference in difference model with four different segments (really, a scale of low to high coverage, but she simplified for our sake). The treatment group is identified as children younger than six (“Sesame Street’s” target audience, as well as kids who would be home the majority of the day instead of at school) and with high coverage. This methodology is primarily based on Kearney and Levine’s 2019 study mentioned earlier. Since it’s impossible to tell which children were actually watching “Sesame Street,” Kearney and Levine relied on the statistic that nearly 50% of children were watching the show if it was available to them. They also controlled for general patterns in a particular cohort in that particular state like migration and attenuation bias. 

Kearney and Levine’s difference in difference chart referenced by Dr. Duquennois.
Kearney and Levine’s Sesame Street Coverage Map

In terms of getting voting reports, the study used election year responses from 2006-2020 on the Cooperative Congressional Election Study (CCES) as well as Implicit Association Test (IAT) scores. Specifically, the report used data in major party ballots for US House elections. 

In terms of results, Duquennois broke elections into various different demographic compositions. This included elections between two white men, a Republican white man and Democrat woman of color, vice versa and et cetera. 

The results were quite interesting. In the case of electoral participation, an increase in coverage by one standard deviation (20 ppts) increased the treated cohort’s voter turnout by 2.8 ppts (4.4%). Voter registration increased by 1.8 ppts (2.4%), and treated cohorts were more likely to know whether they were registered or not.

Additionally, those with more television coverage in their childhood later on expressed increased political knowledge, including more interest in public affairs, better recognition of elected officials’ names, and increased engagement for marginal voters. There was also increased identification with a party and political ideology. However, there were null effects on more costly forms of political engagement like protesting or primary turnout rates.

The most interesting part to me, however, is the impact on voter preferences. Duquennois found that former watchers of “Sesame Street” are more likely to vote for minority and female candidates, regardless of political party.

Dr. Duqennois’s data on voter patterns for minority candidates
Dr. Duqennois’s data on voting patterns for women candidates

Even more interesting, the decreased race and gender bias in voting patterns does not translate to policy views. There’s evidence that “Sesame Street” viewers both support gay marriage and restrictive immigration policies, which are often seen as opposing political views. That said, what is consistent is that those in the treated cohort were more likely to have an opinion, regardless of what the opinion actually is. 

Moreover, it appears that the hidden messaging of “Sesame Street” was effective in decreasing bias. According to the IAT score results, one standard deviation increase in television coverage reduced the race IAT scores of white subjects by 0.013 standard deviations. However, it had null effects on non-white respondents. There was no evidence of selection bias of taking the race IAT in treatment versus non-treatment groups. As for the gender-career IAT test scores, there was no clear change on bias results, but there was evidence of a selection bias with the treated cohort more likely to take the gender-career IAT.

Duquennois concluded her presentation with a few final takeaways: “Preschool age exposure to child media portraying an inclusive, egalitarian and diverse America reduced prejudice in the long run, with consequential implications for voter preferences.”

Written by Emily Zou, Class of 2027

Acknowledging America’s Unspoken Caste System

Pulitzer Prize-winning author Isabel Wilkerson took the Page Auditorium stage on February 22 to discuss her most recent book, “Caste,” and its implications for modern-day America. Co-hosted by the Sanford School of Public Policy and the Mary Lou Williams Center for Black Culture, the event featured a lecture and Q&A section.

A caste system is an artificial construction, a fixed and embedded ranking of human value that sets the presumed supremacy of one group against the presumed inferiority of other groups.”

Isabel Wilkerson

When Wilkerson first published “Caste: The Origin of Our Discontents,” it spent 55 weeks on the U.S. best sellers list. Barack Obama put it in his 2020 reading list, and Oprah Winfrey sent the book to Fortune 500 CEOs around the world. Since then, it has sold over 1.56 million copies and has become a #1 New York Times best seller.

In other words: “Caste” is the Beyoncé of books.

Pictured: Author Isabel Wilkerson and her book, “Caste.”

Wilkerson began by reminding the audience of the recentness of our country’s progress. “In recent times it’s not been unusual to hear people say something along the lines of ‘I don’t recognize my country,’ Wilkerson began. “And whenever I hear that I’m reminded that tragically not enough of us have had the chance to know our country’s true and full history.” She described the U.S. as a patient with a preexisting health condition, asserting that America has been plagued by racism since its inception. Like a chronic disease, these roots continuously persist and flare up.

Pictured: A visual timeline of Black oppression in the United States

For context, the United States is 247 years old. A full 89 of those years were spent in slavery and 99 were spent in the Jim Crow era. For 227 years, race was considered an innate, factual construct (until the completion of the Human Genome Project in 2003). Racial injustice isn’t a period of history in this country, it is this country’s history.

Wilkerson furthered her point by detailing the dehumanizing customs of the Jim Crow caste system in the South. “You could go to jail if you were caught playing checkers with a person of a different race,” Wilkerson said. “That means that someone had to have seen a Black person and a white person in some town square… And they felt that the entire foundation of southern civilization was in peril and took the time to write that down as a law.” Before the late 20th century, there was even a separate Black and White Bible to take an oath in court. “That means that the very word of God was segregated in the Jim Crow South,” Wilkerson said.

She described this system of racial oppression as an “arbitrary, artificial, graded ranking of human value” – in other words, a caste system. She highlighted how race was weaponized by early colonists to determine “who would be slave or free, who would have rights and no rights.”

This caste system wasn’t just a “sad, dark chapter,” Wilkerson said. It’s “the foundation of the country’s political, social, and economic order.”

For 6 million Black southerners, the caste system became so suffocating that migrating across the country (a movement called The Great Migration), seemed like the only path to freedom. “No other group of Americans has had to act like immigrants in order to be recognized as citizens,” Wilkerson said. “So this great migration was not a move. It was not about moving. It was a defection. A seeking of political asylum within the borders of one’s own country.”

But the U.S. caste system extends far past slavery and Jim Crow. Take the vastly different police response to the January 6 Capitol riot compared to BLM protests during the summer of 2020. “We alive today are tasked with explaining to succeeding generations how…a rioter could deliver the Confederate flag farther than Robert E. Lee himself.” The United States has never adequately dealt with its racist history, which is why it keeps repeating itself.

Photo Credit: NBC

In a powerful call to action, Wilkerson urged the audience to honor these histories and “teach the children so that we can end these divisions now with the next generation.” She shared the aspiration of novelist Richard Wright: “To transplant in alien soil…and perhaps just perhaps to bloom” in a more equitable world.

Want to learn more about Isabel Wilkerson’s work? Click here.

Written by: Skylar Hughes, Class of 2025

On the — Very Cold — Ground for the Iowa Caucus

As a kid who grew up on the west coast, the midwest has always befuddled me. This land of blizzards, corn fields, cheese, and a severe lack of ocean was a complete mystery. And to be quite frank, this was a mystery I had zero desire in solving. 

Evan Brown, Olivia Schramkoswki, Anne Dillon, Amaia Clayton, and Emily Zou at the Fox News Town Hall with Nikki Haley.

However, from January 4 to 9, I found myself in Des Moines, Iowa with a group of around 20 other Duke students. I put on my best ski gear and braved the snow to observe a truly Iowan experience — the presidential caucuses. Although we missed the caucus itself because we had to be back in Durham for the first day of classes, we had amazing opportunities to meet presidential candidates, get behind-the-scenes tours of debate stages, meet with journalists and campaign teams, and speak with Iowans to understand their voting priorities. 

“My favorite part of the trip was getting to meet all of the presidential candidates and ask them questions of my own,” said first-year political science major Evan Brown. 

Duke professor Mark Dalhouse has been taking students to the Iowa caucus for multiple election cycles starting in 2008, first at Vanderbilt, then at Elon, and now at Duke. Students who are interested in politics visit Iowa to observe rallies, volunteer for presidential campaigns, and to learn more about the Iowa caucus. He says the trip is intended to help students learn lessons in bipartisanship and make our campus less politically polarized. 

When asked about polarization on Duke’s campus, Professor Dalhouse said “I think the very first step is doing what we did in Iowa; talking to individuals and learning their story, seeing people who might have different belief systems than we do as people, not as “them.” I think this demystifies stereotypes and enables us to see that we have a lot more in common with those on the other side of the political fence than we might think.”

Vivek Ramaswamy at his rally in Toledo, IA on January 4.

The Iowa caucus is a way of nominating a party’s presidential candidate. As a party-run process, Democrats and Republicans both have their own particular methods for caucusing. For 50 years, Iowa has been the first state that each party has held their caucus in. However, after Biden took office in 2021, he changed the processes for Democrats. You can read more about that decision here. That means that this year, only Republican Iowans participated in this coveted first-primary-of-the-election-season tradition. Registered Republicans across Iowa come together in school gymnasiums, church basements, and community centers to advocate for their primary candidate of choice and submit a secret vote. 

Nikki Haley at her rally in Indianola, IA on January 6.

On the first day, we attended a Vivek Ramaswamy rally and back-to-back CNN town halls with Nikki Haley and Ron DeSantis. The Ramaswamy event took place in a small room in a motel; he brought out his wife and kids.

“I thought that Vivek was a very intelligent man and very well-spoken,” Brown said. “But, at that event, the solutions to our country’s problems that he proposed solidified, to me, the fact that he is not my candidate.”

Ramswamy suspended his campaign on caucus night after an underwhelming performance that he felt left no real shot at a presidential nomination. 

At the CNN town halls, we got to see the media-trained versions of Haley and DeSantis as Iowan voters asked their questions to the two candidates. 

Nikki Haley at her CNN Town Hall, with me.

The second day, we went to a DeSantis rally at a wine bar. He was accompanied by Representative Chip Roy of Texas. Freshman public policy major Amaia Clayton said, “The DeSantis rally was packed, and people seemed especially eager to engage and ask him lots of questions.” DeSantis finished second in the caucuses but suspended his campaign on January 21.

We attended a Ron DeSantis rally and got to meet him.

On the third day, we saw Haley at her own event at a vineyard. She was introduced by New Hampshire Governor Chris Sununu. Clayton said, “She had a unique method of talking about her policy goals… [she] was very intentional in explaining the ‘why’ behind many of her policies.”

We also attended an event for former Arkansas Gov. Asa Hutchinson at a restaurant. As an underdog in the Iowa caucus, he dropped out of the presidential race shortly after the results came out. “It was interesting to see that when he had a much smaller audience than the other candidates, of which many were students, he altered the issues that he spent the most time talking about,” Brown said.

This year, the Republican primary candidates were heavily overshadowed by former President Donald Trump. With 51% of the votes, he was crowned the winner of the Iowa caucus only minutes into the vote counting process, proving his decisive lead in the polls. Following behind him was Ron DeSantis with 21.2% and Nikki Haley with 19.1%. Vivek Ramaswamy received 7.7% of the votes and candidates Ryan Binkley, Asa Hutchinson, and Chris Christie (who called off his campaign days before the caucus) all received less than one point. 

When speaking to voters, the candidates very clearly fell into two camps: pro-Trump and anti-Trump. Voters at Ramaswamy, Haley, and DeSantis rallies all echoed their disapproval of the chaos that tended to follow Trump. Although all three candidates had praises for Trump’s policy priorities, they emphasized his tendency to get caught up with media frenzy and make enemies. That said, Trump won every single district in Iowa except Johnson County, where he was losing to Haley by a single vote as of January 17.

Asa Hutchinson at his event in Waukee, IA on January 7.

On the topic of Trump, Professor Dalhouse said, “Trump changed this Caucus just by the steady accumulation of his continued command of the front pages in the news. He is the story and everything else is tangential. His four trials, his successful planting of the idea that our voting system is “rigged,” and his successful articulation of the anger I referred to earlier made him the prohibitive favorite in Iowa. Also, he has a much better on the ground organization than in 2016 when Ted Cruz beat him.”

“If you crunch the numbers from this Iowa Caucus, it’s quite interesting,” Dalhouse said. “In Iowa, there are 719,000 registered Republicans. Only about 56,000 came out on Caucus Night; of those, nearly half voted AGAINST Trump. This suggests to me that he has some structural weaknesses even among Republicans. I think this also suggests the strong potential that he will bleed votes all year long into November and that number will go up if he is convicted of even one felony between now and November. I think that will give a lot more Republicans pause before voting for him. As the old baseball saying goes, ‘it ain’t over ‘til it’s over.’” 

As someone who was raised in a very Democratic area and family, I had never truly been immersed in Republican politics like I had on this trip. Although I went into the trip with caution, I can confidently say that it was an extremely eye-opening experience.

Talking with Iowan Republicans, it was obvious to see that they were Americans who had much in common with me. At the rallies, it was clear that Democrats and Republicans both saw similar problems with our country: increasing rates of mental health disorders, a broken immigration system, a lack of access to affordable housing, and much more. Obviously, the pathways to solving those problems are where the political parties tend to diverge.

This did leave me with a lot more perspective on political polarization. On one hand, common viewpoints can spark bipartisan and productive conversation. On the other, the two parties so clearly see the same things from completely different angles.

The next step for the candidates still in the running is the New Hampshire primary, which will take place on January 23. You can read more about the NH primaries and what to expect here.

Post by Emily Zou, Class of 2027

Putting Stronger Guardrails Around AI

AI regulation is ramping up worldwide. Duke AI law and policy expert Lee Tiedrich discusses where we’ve been and where we’re going.
AI regulation is ramping up worldwide. Duke AI law and policy expert Lee Tiedrich discusses where we’ve been and where we’re going.

DURHAM, N.C. — It’s been a busy season for AI policy.

The rise of ChatGPT unleashed a frenzy of headlines around the promise and perils of artificial intelligence, and raised concerns about how AI could impact society without more rules in place.

Consequently, government intervention entered a new phase in recent weeks as well. On Oct. 30, the White House issued a sweeping executive order regulating artificial intelligence.

The order aims to establish new standards for AI safety and security, protect privacy and equity, stand up for workers and consumers, and promote innovation and competition. It’s the U.S. government’s strongest move yet to contain the risks of AI while maximizing the benefits.

“It’s a very bold, ambitious executive order,” said Duke executive-in-residence Lee Tiedrich, J.D., who is an expert in AI law and policy.

Tiedrich has been meeting with students to unpack these and other developments.

“The technology has advanced so much faster than the law,” Tiedrich told a packed room in Gross Hall at a Nov. 15 event hosted by Duke Science & Society.

“I don’t think it’s quite caught up, but in the last few weeks we’ve taken some major leaps and bounds forward.”

Countries around the world have been racing to establish their own guidelines, she explained.

The same day as the US-led AI pledge, leaders from the Group of Seven (G7) — which includes Canada, France, Germany, Italy, Japan, the United Kingdom and the United States — announced that they had reached agreement on a set of guiding principles on AI and a voluntary code of conduct for companies.

Both actions came just days before the first ever global summit on the risks associated with AI, held at Bletchley Park in the U.K., during which 28 countries including the U.S. and China pledged to cooperate on AI safety.

“It wasn’t a coincidence that all this happened at the same time,” Tiedrich said. “I’ve been practicing law in this area for over 30 years, and I have never seen things come out so fast and furiously.”

The stakes for people’s lives are high. AI algorithms do more than just determine what ads and movie recommendations we see. They help diagnose cancer, approve home loans, and recommend jail sentences. They filter job candidates and help determine who gets organ transplants.

Which is partly why we’re now seeing a shift in the U.S. from what has been a more hands-off approach to “Big Tech,” Tiedrich said.

Tiedrich presented Nov. 15 at an event hosted by Duke Science & Society.

In the 1990s when the internet went public, and again when social media started in the early 2000s, “many governments — the U.S. included — took a light touch to regulation,” Tiedrich said.

But this moment is different, she added.

“Now, governments around the world are looking at the potential risks with AI and saying, ‘We don’t want to do that again. We are going to have a seat at the table in developing the standards.’”

Power of the Purse

Biden’s AI executive order differs from laws enacted by Congress, Tiedrich acknowledged in a Nov. 3 meeting with students in Pratt’s Master of Engineering in AI program.

Congress continues to consider various AI legislative proposals, such as the recently introduced bipartisan Artificial Intelligence Research, Innovation and Accountability Act, “which creates a little more hope for Congress,” Tiedrich said.

What gives the administration’s executive order more force is that “the government is one of the big purchasers of technology,” Tiedrich said.

“They exercise the power of the purse, because any company that is contracting with the government is going to have to comply with those standards.”

“It will have a trickle-down effect throughout the supply chain,” Tiedrich said.

The other thing to keep in mind is “technology doesn’t stop at borders,” she added.

“Most tech companies aren’t limiting their market to one or two particular jurisdictions.”

“So even if the U.S. were to have a complete change of heart in 2024” and the next administration were to reverse the order, “a lot of this is getting traction internationally,” she said.

“If you’re a U.S. company, but you are providing services to people who live in Europe, you’re still subject to those laws and regulations.”

From Principles to Practice

Tiedrich said a lot of what’s happening today in terms of AI regulation can be traced back to a set of guidelines issued in 2019 by the Organization for Economic Cooperation and Development, where she serves as an AI expert.

These include commitments to transparency, inclusive growth, fairness, explainability and accountability.

For example, “we don’t want AI discriminating against people,” Tiedrich said. “And if somebody’s dealing with a bot, they ought to know that. Or if AI is involved in making a decision that adversely affects somebody, say if I’m denied a loan, I need to understand why and have an opportunity to appeal.”

“The OECD AI principles really are the North Star for many countries in terms of how they develop law,” Tiedrich said.

“The next step is figuring out how to get from principles to practice.”

“The executive order was a big step forward in terms of U.S. policy,” Tiedrich said. “But it’s really just the beginning. There’s a lot of work to be done.”

Robin Smith
By Robin Smith

Doctors Share a Vision for Ending Preventable Blindness

Cataract surgery is often perceived as a garden-variety medical intervention akin to the colonoscopy, mammogram, or flu shot. But outside of higher-income countries, the following is not an understatement: eye care can be revolutionary. 

A cataract is described as “the clouding of the lens of the eye.”

It is estimated that, globally, 36 million people are blind; that around 90% of preventable blindness cases are demarcated within low and middle income countries; and that nearly 75% of blind individuals could regain their vision with medical intervention. 

Today, cataract surgery can be performed for $100 or less and, with a practiced hand, in as little as three minutes. 

In that context: a blind individual can completely regain their sight in the time it takes to brush their teeth. For the price of a discounted pair of running shoes. 

Dr. Geoffrey Tabin is an ophthalmologist and co-founder and chairman of the Himalayan Cataract Project. He is also the fourth person in the world to reach the tallest peak on each of the seven continents.

In late September, the Duke Global Ophthalmology Program hosted the A Vision for Ending Preventable Blindness panel to address the global scope of vision impairment, eye care interventions, and subsequent socioeconomic implications. Panelist Dr. Geoffrey Tabin, Professor of Ophthalmology and Global Medicine at Stanford University, characterized the nature of these eye conditions: “Glaucoma’s preventable, trachoma’s preventable, river blindness is preventable, vitamin A deficiency is preventable, even… diabetic changes [in vision] are preventable.” In fact, cataract surgery, in most cases, is a 100% and lasting cure.

What other health interventions boast similar statistics? 

Dr. Llyod Williams holds an ice cooler which will soon contain corneas for transplantation. Photo credit: Chris Hildreth/Rooster Media

Panelist Dr. Jalikatu Mustapha, new Deputy Minister of Health of Sierra Leone, and moderator Dr. Lloyd Williams, director of Duke Global Ophthalmology Program, established a corneal transplantation program in Sierra Leone. Pictured above with a box of corneas, Williams performed the country’s first corneal transplant in 2021. Mustapha and Williams recounted a clinical experience that well-represents their objectives:

Dr. Jalikatu Mustapha is an ophthalmologist, has overseen Sierra Leone’s Eye Care programme, and lectured at the University of Sierra Lione. She is currently the Deputy Minister of Health of Sierra Leone.

While operating in Sierra Leone, Mustapha and Williams worked with a patient completely blind since her teenaged years. After 29 years and a successful corneal transplant, she regained sight in one of her eyes. Walking out of the clinic, she saw a crying young woman and asked what was wrong. When the young woman responded, the patient recognized the woman’s voice, realizing that she was, in fact, her daughter. This would mark the first time she had physically seen one of her children. Her daughter was 19. 

Over the course of his career, Williams has performed thousands of eye surgeries in Africa including, of course, a number of corneal transplants. 

Despite the obvious efficacy of eye health interventions, blindness has little priority on the global health agenda nor in low income countries where preventable cases are disproportionately located. Tabin emphasized the “travesty” of this disconnect, describing blindness as “the lowest hanging fruit in global public health.”

Why is this the case? 

NGOs and governments point to the high mortality rates of infectious diseases like HIV, malaria, cholera, COVID. Blindness is not fatal, they argue, it is an apples and oranges comparison, cataracts to Ebola.

A glance at notable foundations and charities with health-related mission statements cements this sentiment. For example, among its laundry list of initiatives, the Gates Foundation funds the fight against enteric and diarrheal diseases, HIV, malaria, neglected tropical diseases, pneumonia, and tuberculosis; the Rockefeller Foundation “established the global campaign against hookworm… seeded the development of the yellow fever vaccine… supported translational research for tools ranging from penicillin to polio… spurred AIDS vaccine development;” and the Wellcome Trust financially supports infectious disease, drug-resistant infection, and Covid-19 research. 

Of course, this is not an effort to undermine the impact of these institutions but merely to point out a lack of urgency to redress blindness.  

The panelists challenged this “if not fatal then not urgent” thinking. Tabin cited two poignant WHO estimates: 1) vision impairment contributes to an annual $411 billion global productivity loss, and 2) the cost of providing eye care to every in-need individual would be around $25 billion.

The US Department of Defense’s proposed 2024 fiscal year budget is $842 billion. If this funding was allocated towards eye care, every case of preventable blindness could be mitigated 33 times over in one year.  

The downstream effects of blindness are substantial not only for the effected individual but for their family. In the absence of sufficient eye care, children with congenital cataracts, for example, will struggle/will not attend school; they will require care, potentially removing family members from the workforce; they will struggle to find employment; and, on average, they will have a life expectancy about a third of their age- and health-matched peers. Because 90% of preventable blindness is localized in low and middle income countries, community productivity and GDP may be significantly impacted by curable conditions. 

Tabin explained that “blindness really perpetuates poverty” and, on the flip side of the same coin, “poverty really accentuates the suffering of blindness.” Through his work at Stanford, Tabin identified pockets of agricultural Northern California with mass migrant workforces and high rates of preventable blindness. Documentation concerns, language barriers, and/or lack of healthcare often prevents seasonal workers and immigrants from accessing and benefiting from care, comparable to that in low and middle income countries. 

Dr. Bidya Pant is an ophthalmologist and director of  Geta Eye Hospital in Nepal. He has worked with HelpMeSee to lead a team of cataract specialists.

Dr. Bidya Pant, a leading ophthalmic surgeon, challenged this so-called eye care vacuum in a number of countries, including Myanmar, Uganda, and Nepal. His work speaks for itself. In 2016, Pant built six new hospitals, worked with a number of local monks to facilitate care, trained countless ophthalmology specialists, and completed 200,000 cataract surgeries. His high volume cataract surgery model dramatically decreased cost such that even individuals from the poorest communities in Nepal are still able to afford life-changing care. 

In 1984 the population prevalence of blindness in Nepal was 0.84%. In 2015, it was just 0.35%. 

Similar to Pant’s collaboration with the Myanmar monks, Mustapha, in her role as Sierra Leone’s Deputy Health Minister, has worked to increase access to eye care by training community healthcare workers who already provide maternal care, chronic disease management, vaccinations, etc. to rural communities lacking access to public health initiatives. Mustapha also advocates for a national prioritization and an integration of eye health “… into a strong health system that focuses on delivering quality healthcare that’s affordable to every Sierra Leonean across all life stages, whether they be pregnant women, babies, teenagers, adults, or elderly people, without financial consequences.”

Mustapha then posed the question: If you provide a child with a vaccine for measles or pneumonia and they later go blind from cataracts, have you really helped that child? 

Of course not!

Photo from the Himalayan Cataract Project

At face value, ending preventable blindness seems overly idealistic. But, let’s return to Tabin’s “low hanging fruit” analogy. As exemplified by the work of Tabin, Mustapha, Williams, and Pant, eye care is public health’s blueberry bush. Given proper investment and government initiative, this aim is arguably realistic. It’s just a matter of enough hands reaching for and plucking berries from the bush.

I will defer to Williams who best situated the scope of their mission. He said: “You could make a serious case that there [is] no intervention… for the dollar… that would send more girls in Africa to school than cataract surgery.”

If interested, you can watch the A Vision for Ending Preventable Blindness Panel here: https://www.youtube.com/watch?v=3fSw5w2nk6k

Post by Alex Clifford, Class of 2024

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