Global Mental Health: Five Areas for Value-Driven Training Innovation.

OBJECTIVE: In the field of global mental health, there is a need for identifying core values and competencies to guide training programs in professional practice as well as in academia. This paper presents the results of interdisciplinary discussions fostered during an annual meeting of the Society for the Study of Psychiatry and Culture to develop recommendations for value-driven innovation in global mental health training. METHODS: Participants (n = 48), who registered for a dedicated workshop on global mental health training advertised in conference proceedings, included both established faculty and current students engaged in learning, practice, and research. They proffered recommendations in five areas of training curriculum: values, competencies, training experiences, resources, and evaluation. RESULTS: Priority values included humility, ethical awareness of power differentials, collaborative action, and "deep accountability" when working in low-resource settings in low- and middle-income countries and high-income countries. Competencies included flexibility and tolerating ambiguity when working across diverse settings, the ability to systematically evaluate personal biases, historical and linguistic proficiency, and evaluation skills across a range of stakeholders. Training experiences included didactics, language training, self-awareness, and supervision in immersive activities related to professional or academic work. Resources included connections with diverse faculty such as social scientists and mentors in addition to medical practitioners, institutional commitment through protected time and funding, and sustainable collaborations with partners in low resource settings. Finally, evaluation skills built upon community-based participatory methods, 360-degree feedback from partners in low-resource settings, and observed structured clinical evaluations (OSCEs) with people of different cultural backgrounds. CONCLUSIONS: Global mental health training, as envisioned in this workshop, exemplifies an ethos of working through power differentials across clinical, professional, and social contexts in order to form longstanding collaborations. If incorporated into the ACGME/ABPN Psychiatry Milestone Project, such recommendations will improve training gained through international experiences as well as the everyday training of mental health professionals, global health practitioners, and social scientists.

Virgin Territory: Theology, Purity, and the Rise of the Global Sex Trade

Sex sells. A lot. But who exactly is on the market?

What kinds of bodies are calibrated for traffic and consumption, and how exactly do they get there? When it comes to “sex” trafficking—which comprises a minority percentage of human trafficking, yet dominates the moral imagination as an “especially heinous” crime—the rise in predominantly white, evangelical Christian American interest in the trafficked subject galvanizes an ethical outrage that rarely observes critiques of race, ethnicity, sexuality or class as conditions of possibility. Though a nuanced mandate to fight trafficking is all but cemented in the contemporary American political and moral conscience, Virgin Territory accounts for the ways Christian ideas of purity annex both gender and sexuality inside the legacies of racialized colonial encounter, and foreground the market expansion of the global sex trade as it exists today.

In Part I, I argue that the narratives of virginity tied to Mary’s body simultaneously foregrounded the gendered, sexed Other as sparked disdain for the religious Other, for the Jewish body and for Mary’s Jewish identity. Through this analysis I explore the connections of racial identity to the Christian theological elision of Jewish election. I demonstrate how the questions of sexual ethics materialized at the site of the Virgin Mary, and align the moral attachments of sex and purity in the production of whiteness. These machinations, tied to the emerging European identity of empire, irrupt horrifically into the narrative ontology of dark flesh in Africa, Asia, and the Americas.

In Part II, I highlight the function of these narratives inside of the moments of colonial encounter, demonstrating how the logics of purity and virginity were directly applied to manage dark female flesh. I map the visual iconography of the Black Madonna first through a Dutch painting entitled The Rape of the Negress. I read this image through the social theological imagination instantiating the idea of the reprobate body and white imperial gaze. This analysis foregrounds a theological reading of Sarah Baartman, the “Hottentot Venus,” as the center of a complex sex trafficking investigation, outlining the genealogy of race, as well as the ideologies of the racial, ethnic and national Other, as mitigating factors in the conditions of possibility of a global sex trade. By restoring these narratives and their theological undertones, I reiterate the ways Christian thought is imbricated in the global sex trade, and propose theological strategies for rethinking humanitarian responses to sex trafficking.

The Philippines in the Aerospace Global Value Chain

This report uses the Duke CGGC Global Value Chain (GVC) framework to examine the role of the Philippines in the global aerospace industry and identify opportunities for the country to upgrade. The Philippines is a newcomer to the growing global aerospace manufacturing industry. Although the country has been host to a major flight controls manufacturer since 1985, the industry really only began to expand within the past five to ten years. During this recent period (2007-2014), the country has rapidly ramped up its aerospace manufacturing exports, reaching US$604 million in 2014 and more than tripling employment. The industry now employs 3,000 full time and 3,000 part time workers. Although still a very small player, accounting for less than 0.15% of the global industry, this incipient growth is promising. Both foreign firms and local suppliers that have established operations in the industry have already achieved some degree of upgrading within a short timeframe. These include expanding the product lines served, obtaining essential process certifications and upgrading beyond basic assembly operations to undertake additional manufacturing processes such as machining as well as initiating procurement and engineering functions in country.

The Philippines in the Paper Global Value Chain

This report uses the Duke CGGC Global Value Chain (GVC) framework to examine the role of the Philippines in the global paper industry and identify opportunities for upgrading. The Philippines’ paper sector is a domestically oriented industry that provides significant indirect employment opportunities for wide swaths of workers as well as indirect exports for sectors such as electronics, food and beverage, and cosmetics. However, the country’s overall participation in the paper GVC is limited, with raw material constraints hindering export development. Abaca pulp production, a niche product category that uses the Manila hemp plant to generate specialized outputs such as tea bags and bank notes, is the country’s most dependable export, but even with the export value of abaca pulp approaching an all-time high in 2014, the overall paper industry only generated US$127 million in export revenue, 54th among 193 countries in the world.