Celebrating World Refugee Day

This summer, we are revisiting some of our previous publications as they relate to various celebrations. World Refugee Day was honored on June 20 this year. As such, we are resharing our 2019 piece “Initiative empowers refugee and migrant women”.

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Before Florence Ackey, MSW knew what public health was, she was inquisitive about prevention. Having lost her 12 year old cousin during her young childhood, she found herself perpetually asking “How can I make things better?”

A lifelong investigator and learner, Ackey completed two years of law school in her home country Niger followed by completion of the University of South Florida Master’s of social work. She is currently pursuing a second master’s degree and will begin her doctorate in public health in fall 2019. She recently completed the Lactation Counselor Training Course (LCTC).

Ackey serves as the State Refugee Health Coordinator for the Florida Department of Health Immunization, and Refugee Services. In this position, she connected with a woman who would inspire her to found Refugee and Migrant Women’s Initiative (RAMWI), a not for profit 501(c)(3) which serves and empowers refugee and migrant women during their resettlement.

This particular woman would come to Ackey’s office almost every day and sometimes simply sit with her. Despite a language barrier, Ackey eventually learned that the woman was lonely and depressed; she couldn’t have children, and her husband was out of work.

These circumstances caused great strife, but connecting with Ackey uplifted her spirit.

Mindful of her mental health, Ackey helped cultivate a social circle around this woman. At the same time, Ackey was driven to incorporate a practical component to the gatherings,  so she taught the women to crochet.

“We made a lot of scarves,” she remembers. “We sold them and [the woman] was able to raise enough money to pay for two months rent. It changed her confidence.”

Ultimately, their informal, weekend meetings grew too large for home meetings, so RAMWI was created. Today RAMWI, run entirely by volunteers, has served over 400 families over roughly six years.

“It’s just beautiful to see how far we’ve come,” Ackey says.

Refugee and migrant women suffer from things like trauma, discrimination and anxiety.

Ackey explains: Often the story goes that the woman arrives with her husband and children from their home country; the husband finds work and grows a social life and the children go to school and make friends. In the meantime, the woman is left alone at home, sometimes too uneasy about the unfamiliarity of their new settlement to leave the confines of her home. Even when her family returns from their daily routines, she’s further isolated because their experiences become less and less common and relatable.

In light of this phenomenon, RAMWI offers corresponding, age-appropriate workshops for mothers and children in order to bridge conversation topics.

“The mom is no longer left alone; she has something she can contribute,” Ackey explains.

RAMWI offers its social, support network and classes and workshopsin a way that allows women to integrate into their new communities while still preserving their cultural identity. For instance, RAMWI’s Annual International Fashion Show during Welcoming Week offers refugees and migrant women the opportunity to share pride in their culture through clothing.

Participants pose during the Annual International Fashion Show during Welcoming Week
Photo courtesy of RAMWI

The show usually represents about 48 countries with over 80 participants.

Monthly support groups cover topics like women’s health, grief and coping mechanism, U.S. healthcare system and resources, nutrition, safety, domestic violence, disaster preparedness, life balance and personal finances among other topics.

Ackey emphasizes that female empowerment doesn’t need to be granted externally.

“Women have the power within in them to freely give,” she begins.

She goes on to describe a visual installation she’ll present at an upcoming RAMWI session to illustrate this idea.

Ackey asks participants questions like ‘Have you helped someone without anything in return?’ or ‘Have you paid a genuine compliment to someone?’ Each time a participant answers ‘yes’, she pokes a hole with a thumbtack into a blank board. The holes initially appear to be randomly placed, but when a light shines through the back of the board, the silhouette of a decorated city appears. The installation represents the seemingly small acts of women impacting entire communities.

This month, RAMWI members will assemble 240 care packages for the homeless.

RAMWI participants at a monthly meeting
Photo courtesy of RAMWI

When it comes to infant feeding, migrant women often look to formula as a status symbol. It’s a mindset Ackey encounters often, but she says the lactation counselor training course has equipped her to become a better healthy infant feeding advocate.

Ackey has also found that hospital staff generally do not take the time to discuss and educate migrant women about breastfeeding. She predicts this is sometimes due to language barriers.

“It’s easier to give them formula and go,” she explains.

Mothers are often happy with the “gift” of formula and all of the “swag” that can come along with formula feeding.

Surely birth and infant feeding culture varies greatly among the women in RAMWI, but Ackey has found that immigrant women tend to share the common value of a strong mother -child bond which stems from their collective upbringing, she explains.

Mother and child, one of Ackey’s favorite photos
Photo courtesy of RAMWI

She shares that this “it takes a village” mentality is reflected in the way they feed their babies.

“Women take care of all the children,” says Ackey.

In some cases, women breastfeed children that are not biologically their own in the spirit of shared duties, but for survival in other circumstances.

“Women breastfeed other children especially from some African countries,” Ackey begins.

She recalls one woman who adopted a child she picked up on the road next to the dead body of his mother. Ackey makes clear this imagery isn’t representative of the entire refugee population, but it is a story that embodies how the women she works with will raise any child.

Amidst the tragedy and hardship that many of the families have faced, there’s so much beauty and hope within RAMWI.

“Hope can, and will heal the world,” its mantra.

One volunteer said:  “The thing I love the most is the environment of support and empowerment that RAMWI creates for women from all over the world…the women learn from each other…form a bond that as women is something that connects you no matter where you are from.”

For Ackey, success is achieved when a woman makes a choice because she has been fully informed and she’s aware of all of her options.

Visit https://www.ramwi.org/ for more information. Connect with RAMWI on Facebook here.

Other relevant pieces

Prioritizing infant and young child feeding in emergencies during National Preparedness Month and beyond

To know is to do: retired nurse dedicates time to humanitarian aid in East Africa bringing awareness to the paradox of direness and vibrancy

A collection of stories by and about those in the AANHPI community

Caesarean Doulas: Implications for Breastfeeding at 24th Annual International Breastfeeding Conference & Nutrition and Nurture in Infancy and Childhood: Bio-Cultural Perspectives

Breastfeeding, peace and justice

Babywearing as a public health initiative

Glints of hope and control in a burning world

As I gathered my thoughts for an Earth Month and infant feeding installment, I got an email notification that Valerie McClain had published something new on her Substack. Of course I hurried over, because her pieces are always illuminating. She writes in Standing on the Precipice:  “We are self-destructing on our Mother Earth, and she may be the last woman standing amidst the rubble and miles of corpses.”

Photo by Tatiana Syrikova: https://www.pexels.com/photo/anonymous-little-kid-touching-tree-with-hand-3932861/

In all of the pieces and years past that we have covered the connections between infant feeding and planetary health, it never actually occurred to me that there might be a scenario where Mother Earth outlives us. This will surely strike some of you as naive, absurd, delusional, or something else considering what has happened and continues to happen on our planet. Even so, I envisioned humans dying alongside our planet, our self-destruction agonizing and inevitable, as we claw, infect, and deplete Mother Earth with our beastly antics, taking down the innocent in our path to complete decimation. 

On a recent trip to The Museum of Modern Art, I was shaken out of this sense of Doom and flurry of eco-emotions. Victor Grippo’s lead containers with beans first spoke to me, metaphors “for the force and persistence of life”. This display coupled with Niki de Saint Phalle’s phrase “What is now known was once only imagined” infused me with a little glint of hope that I’ve been craving. 

Then on a Throughline episode about consumer protections and trust in and accountability from companies and elected leaders, I heard the voice of Ralph Nader. He offered: Cynicism is “a cop-out. That’s an indulgence. That’s an indulgence of quitters that makes them feel good. Because when you’re cynical, you’re obviously smart, aren’t you? You think you’re smart. No, you’re not smart. You’re playing into the hands of the corporate supremacists. You’re playing into the hands of the few who want to control the many who could easily outvote the few and make the corporations our servants, not our masters.” This offered me a shift in perspective too.

Source: https://www.gifa.org/en/international-2/green-feeding/

Among the hopeful is coverage of the Green Feeding Tool by Kristi Eaton. Eaton quotes Julie Smith, co-creator of the tool: “…with the Green Feeding Tool—designed to provide policymakers, climate scientists, advocates and others with clear data about how increasing support for breastfeeding can help save the planet—we have the evidence to support action.”

Now, consider this headline: Breast milk can expose babies to toxic ‘forever chemicals’

“For decades, physicians and scientists have touted breast milk as liquid gold for its immunological benefits.

But nursing parents with considerable exposure to cancer-linked ‘forever chemicals,’ or PFAS, may unwittingly be exposing their babies to these compounds as well…” the author begins. 

The article acknowledges contaminated water could be a potential source of PFAS which infant formula is often mixed with. The author also includes that “the benefits of nursing likely outweigh the potential risk of PFAS exposure through breast milk.” [Note the language used here. There are generally no benefits to breastfeeding. Instead, there are risks associated with not breastfeeding.] 

Nikki Lee asks some important questions: “Why doesn’t formula get tested for these chemicals?  Do folks believe that somehow cows are protected against pollution?”

As with anything, there will be risks associated with any variation of infant feeding. 

Healthy Children Project’s Karin Cadwell points out that if toxins are being detected in human milk, it means we need to reconsider the products being used in industry.

Photo by willsantt: https://www.pexels.com/photo/woman-breastfeeding-her-toddler-under-the-tree-2714618/

The author of Study Finds High Levels of Toxic Chemicals in Mothers’ Breast Milk quotes Erika Schreder, science director at Toxic-Free Future who shares a similar sentiment: “’If we want to make pregnancy and breastfeeding safe and free from PFAS, we really need to eliminate the use of these chemicals and products, so that we can have clean food, clean air, and clean water… We really don’t believe that responsibility should be placed on individuals when we need regulations to end the use of these chemicals.’”

In the predicament(s) we find ourselves in, I’d like to leave you with a few more of McClain’s words: “A mother cannot control events such as: wars, sieges, shortages of infant formula and pitocin, fires, floods, hurricanes, tornadoes; but she has a semblance of control in her and her baby’s world through breastfeeding. Dependency on always having access to infant formula, health care, freedom from human or environmental violence, should be tempered with the reality that there may be times, when all the civility of life vanishes.” 

More for Earth Month 

Industry lies and the Code

Infant feeding and planetary health go hand in hand 

Breastfeeding is eco-friendly 

Goats and Soda’s How do you keep calm and carry on in a world full of crises?



Recent happenings linking maternal child health and planetary health

Late this autumn, I went for a hike with my family that moved me to tears. As I looked over the rolling foothills cascading in green, its beauty, while simultaneously reflecting on the horrors in this world, provoked a surge of emotion like the swell of ocean waves just over the mountain range we perched upon. 

I shared this experience with one of my dearest mentors and she replied: “I also find nature a powerful midwife and teacher about life. I remember being moved to tears by redwoods standing firm bearing deep gouges and gaping wounds from lightning strikes and subsequent fires… yet continuing to grow and foster another generation.” 

Photo by Tatiana Syrikova: https://www.pexels.com/photo/anonymous-little-kid-touching-tree-with-hand-3932861/

When I returned to my neglected inbox after this respite hiking and exploring new-to-me land, I came across the juxtaposed images of a human fingerprint and the dissection of a tree trunk suggesting that ‘we are nature’. 

With my mentor’s poetry in mind and the concept of “human nature,” I’d like to invite you to explore the following happenings, documents and projects as they all pertain to the inextricable connection between planetary and human health and the influence of infant and young child feeding practices on greater population health, a concept coined One Health

First up, the 46th Session of the Codex Alimentarius Commission (CAC46) came to a close this month. The CAC is a UN body established by the World Health Organization (WHO) and the Food and Agriculture Organization (FAO) in 1963 with a mission to protect consumer health and promote fair practices in food trade.

The International Baby Food Action Network (IBFAN) participated in the session, and as the organization reports:  “After more than a decade of challenging negotiations within the industry-dominant Nutrition Committee, the Revision of the 1987 Follow-up Formula Standard has been officially adopted this week – now renamed the Standard for Follow-up Formula for Older Infants and Product for Young Children.

Thanks to the relentless advocacy efforts of IBFAN, WHO, UNICEF, public interest NGOs, Brazil, Ecuador, Nigeria, and numerous [other] countries, the new standard now makes specific references to the International Code of Marketing of Breastmilk Substitutes and relevant WHA Resolutions in a Preamble. Despite sustained opposition from the USA, these safeguards were retained during CAC, although some of IBFAN’s warnings were removed from the CAC46 report.” 

You can find more detailed coverage at the Baby Milk Action blog here

Also this month, WHO hosted a webinar covering the release of the new WHO guideline for complementary feeding of infants and young children 6-23 months of age

Dr. Francesco Branca began by pointing out some hopeful news.

“The past decade we have seen important gains in improving maternal and child nutrition, including a one-third decline in the proportion of children suffering from stunting, and a tend point increase in exclusive breastfeeding on the way to reaching the 2025 World Health Assembly nutrition target of 50 percent of infants below six months exclusively breastfed. Yet multiple forms of malnutrition, poor growth, micronutrient deficiencies and overweight continue to jeopardize children’s ability to survive and thrive…” 

Dr. Larry Grummer-Strawn summarized that while some of what is in the report is repetitive, there are several key updates. 

For instance:

  • “Milks 6–11 months: for infants 6–11 months of age who are fed milks other than breast milk, either milk formula or animal milk can be fed… Milks 12–23 months: for young children 12–23 months of age who are fed milks other than breast milk, animal milk should be fed. Follow-up formulas are not recommended… (p. 15)
  • “Starchy staple foods should be minimized. They commonly comprise a large component of complementary feeding diets, particularly in low resource settings, and do not provide proteins of the same quality as those found in animal source foods and are not good sources of critical nutrients such as iron, zinc and Vitamin B12. Many also include anti-nutrients that reduce nutrient absorption. (p. 24) 
  • “Foods high in sugar, salt and trans fats should not be consumed… Sugar-sweetened beverages should not be consumed… Non-sugar sweeteners should not be consumed…Consumption of 100% fruit juice should be limited…” (p.32) 

There is also an emphasis on responsive feeding (pages 43 to 47). 

Around 38 minutes into the recording of the webinar, Grummer-Strawn recognizes the reality of consumption of unhealthy food and beverages, the convenience of UPFs and calls on the need for broad policy actions to protect child health. 

Finally, Conference of Parties (COP) 28 wrapped up this month. At COP27, Healthy Children Project’s (HCP) Karin Cadwell presented research on the environmental impact of powdered baby formula milks in North America and HCP’s Kajsa Brimdyr on skin-to-skin contact (SSC) in the first hour after birth as a simple and easy, inexpensive, appropriate for all dyads with countless benefits intervention. (Read more coverage here.) 

Notable from this year’s session, among other important endeavors, includes work by the London School of Hygiene and Tropical Medicine (LSHTM) like the Children, Cities and Climate Action Lab and a partnership to understand how floods and heat driven by climate change affect the delivery of maternal and child health care in Brazil and Zambia

For further reading on climate action, check out Hidden Brain’s newsletter blurb:

“Psychologists have studied how to raise awareness about climate change and get people to take action on the issue. The answer can vary depending on a range of factors, like culture, age, gender, political ideology — the list goes on. An international team of scientists behind a recent paper has created a tool that shows which messages and interventions are most effective with different demographics. ‘To maximize their impact, policymakers and advocates can assess which messaging is most promising for their publics,’ said study co-author Kimberly Doell, who also helped lead the project. Check out the tool for yourself here.