Border Crossing with Dabney Evans, integrating health and human rights

Dabney P. Evans, assistant professor in the Hubert Department of Global Health in the Rollins School of Public Health, director of the Center for Humanitarian Emergencies and the Institute of Human Rights, and interim director of the Institute for Developing Nations, was one of the first faculty to incorporate health and human rights as a theme in the public health curriculum. Trained in public health and international law, Evans researches and teaches at the intersection of international human rights, global public health, and humanitarian emergencies.

On focusing on research that impacts communities

[One project in Brazil] is looking at the relationship between violence against women laws and the way that those laws are perceived at community level. In the case of Brazil, in 2015 they passed an anti-femicide law that was aimed at stiffening penalties for perpetrators of violence against women, and what I do in this particular study is look at the opportunity for the public health sector and public health professionals to prevent and respond to violence.

What we decided to do as a first step was a baseline study to find out about women’s experiences of violence, as well as community perceptions of intimate partner violence. We also did a survey of health care professionals. This project received funding from the University Research Committee, and I also had a Global Health Institute multidisciplinary team that was involved. Those are two very unique Emory University initiatives that directly contributed to the work. I think that’s really important. And I’m very grateful to them, as well as our community partners.

We finished up our preliminary data analysis in March, at which point I went back to Brazil and shared the results with our partners, and now we’re finalizing our data analysis. In the case of the women that we interviewed, there were some pretty extreme cases of violence. We’re interested in examining the characteristics of those extreme cases of violence to look at the missed opportunities for intervention. What are the things that might have been different? Those are the worst-case-scenarios. Then, we’re also looking at – from the public health perspective – the social determinates of health. What are the other social co-occurrences, or I’m calling these, the social co-morbidities, which are the things that are happening at the same time as violence, particularly things like alcohol and drug use, experiences of community violence, or other family violence?

The other thing that I think is the kind of major finding coming out of these data is that [the women we interviewed] definitely do not trust the legal system and the police system. Public health professionals [also] aren’t trusted. If there’s this kind of bleed over [onto health professionals] from government institutions and from the legal and police sectors, particularly around the issue of violence, then we have a problem. Now, what we’ll be looking to do in the next study when we’ve finished up with the analysis is to actually think about how do we intervene? How do we address that?

On the opportunities and challenges of global work

The biggest opportunity is that the world is your oyster, right? You can choose to collaborate, and again, it’s so much about collaboration, it’s so much about relationships, you can choose to collaborate anywhere. You just have to find your people – the people that resonate with you. And this is the advantage of globalization is that we don’t only have to work in certain places or certain communities. We’re not limited anymore. So, the opportunities are kind of limitless for global work. I think that the challenges that people face – particularly in the U.S. is that we don’t do a good job of teaching people foreign language skills. So, I think that it’s really important for people working in other cultures and contexts to actually have language skills, but also, and it’s a little bit cliché to say, but cultural competency. Really what that means is some humility and awareness about our own biases, our own cultural biases, our own cultural expectations, our own privilege.

I think that the critical piece to that is having community partners and having long-term relationships with communities. So, this particular community in Brazil is a community that I’d already been working in for several years. I have an established relationship with my primary partner there. I have a faculty appointment at the university there. We engaged the Ministry of Health in our research – they were a partner in our research. So, this isn’t about parachute global research. I’m not parachuting in, doing a data grab, and getting out. There’s an ongoing relationship. There’s an ongoing collaboration. I’m invested in them. They know that I’m invested in them. And more importantly, the research is not for research’s sake. Now we have these baseline data, what I want to do is be able to turn around and be able to make an impact in this community. And the way that I do that is not by stopping with this data analysis. The way that I do that now is to say we’ve problematized this issue, how are we going to address it in the community? A really critical piece, I think, of doing global work is about the partnership and the collaborations that have to be maintained.