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A “Magnificent Occasion”
Jaharis Family Center for Biomedical and Nutrition Sciences dedicated

Dr. Nicolaos Madias, executive academic dean of Tufts School of Medicine, and a colleague were walking along Harrison Avenue recently when the colleague suddenly drew to a halt and glanced up at the new nine-story building that rose majestically beside them. “Why are you stopping?” asked Madias. “I’ve been waiting for this so long, I just want to take it all in,” his friend replied. “I don’t want to miss anything.”

That same spirit of gratification long delayed—a feeling compounded by surprise, appreciation and relief—ran all through the dedication ceremony for the Jaharis Family Center for Biomedical and Nutrition Sciences held in the Sackler Center on November 1. The center houses the Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy as well as biomedical researchers from the School of Medicine and the Sackler School of Graduate Biomedical Sciences.

Three generations of the Jaharis family, whose generous support made the building possible, were in attendance, including Michael Jaharis, a Tufts trustee and chair of the Board of Overseers to the Medical and Sackler schools, and his wife, Mary; son Dr. Steven Jaharis, M87, a medical overseer, and his wife, Elaine; daughter Kathryn Jaharis Ledes; and the Jaharis grandchildren.

Also present were Tufts President Lawrence S. Bacow; Nathan Gantcher, A62, chairman of the Board of Trustees; U.S. Sen. Edward M. Kennedy; Dr. Robert Guen, D77, K78, board member of the Wang Chinatown YMCA; Adrienne Boire, president of the Graduate Student Council at the Sackler School; and His Eminence Archbishop Demetrios, primate of the Greek Orthodox Church in America.

Bacow set the tone by referring to the building’s dedication as a “magnificent occasion” and “a day we’ve all been anticipating for many, many years.” He thanked the Jaharis family for so generously supporting the idea that “research is important to this university and this world,” citing in particular the highly collaborative sort of research to be conducted in the new building. Bacow then struck a light note when he remarked that he had been across the street in Jaharis two hours earlier and found the workers hard at it. “I sometimes say if it weren’t for the last minute, nothing would ever get done,” he joked to laughter from the capacity audience.

For his part, Gantcher took the long view. “This new center is one of the highlights in our 150-year history,” he said, before conjecturing that the facility would likely exert a transformative effect on the Boston campus comparable to what the opening of the Tisch Library did for the Medford/Somerville campus. “The Jaharis Center was a dream nine years ago. Now it’s an actuality,” Gantcher observed. “Scientists here will be working on diseases that probably affect, in one way or another, every person in this room.”

Kennedy extended the theme of Tufts as a healing force, commenting that the University had “touched” him many years ago, in the mid-1960s, when Drs. Count Gibson and Jack Geiger, both then medical school faculty members, took him to see the nation’s first community health center at Boston’s Columbia Point. “Eleven million people are now being served by neighborhood health centers,” he said, “and these were ideas that came out of this magnificent university and medical school.” Kennedy predicted that the scientists gathered in the Jaharis Center would make a similar contribution and become what he called “a cutting edge for change around the world.”

Next the program took a more personal turn. Guen, speaking as one who had been born in Chinatown and gone on to earn degrees from Tufts’ dental school, cited the steadily improving relationship that he had witnessed between Tufts and his native community. “The Jaharis Center brings much promise to two communities that are special to me,” he said. Graduate student Boire praised the center’s emphasis on peer mingling and interaction. “Science is a social endeavor,” she insisted. “We need to be able to communicate our ideas to each other, and Jaharis provides for that.” She ended by thanking members of the Jaharis family personally. “They have given us space to work, reflect and grow,” she said.

Archbishop Demetrios’s talk was inspiring. But first he related how his connection with Tufts extended back to 1965, when he came to Boston for graduate school and suffered from neck pain. A doctor at New England Medical Center examined him. “Then he said to me, ‘You know, it’s a simple thing. Change your pillow,’ ” reported the archbishop, pausing to let laughter fill the hall, and glancing up bemusedly. “For the past 37 years, I have had no pain.”

Without missing a beat, Demetrios turned serious, calling the Jaharis Center’s goal of improving world health “a very noble and a very sacred mission.” He proceeded to track the meaning of what he termed “this beautiful species, the benefactor” down through the ages, citing its classical, Hellenistic roots, its central role in the Judeo-Christian tradition and its place in American life. The Jaharis family, he suggested, had benefaction in its genes.

Dr. Steven Jaharis’ remarks on behalf of his family proved brief and affecting. As at the groundbreaking three years ago, Jaharis fondly invoked the memory of his grandfather, “Papou,” a Greek immigrant who landed penniless in Boston in 1908. “He knew a Greece of poverty, but he rolled up his sleeves and worked,” providing for his children and pointing the way to a better life, Jaharis said. “I can’t help but think of Papou, who might have walked past this very spot in 1908. And it is my hope that someday, perhaps many years from now, my children’s children and your children’s children will walk past this site and recognize that extraordinary medical breakthroughs occurred here.”

Then the program concluded and the assemblage poured into the dark street outside, where, floodlit and still bearing the scent of new construction, the magnificent building and all its promise awaited.

Redefining a Sacred Space

On the Tufts’ Medford/Somerville campus, an appreciation for preserving the past was recently brought to bear on one of Tufts’ most treasured historic buildings. Goddard Chapel, built in 1882, reopened in January following its first extensive restoration. There’s a new dash of color and definition in the chapel’s massive grey-blue stones, repointed and cleaned for the first time in more than a century. In tribute to Charles Tufts’ legendary vision for the fledgling college, a beacon light also was installed at the top of the bell tower. “From a distance there will always be a ‘Light on a Hill,’ ” said University Chaplain Reverend David O’Leary.

Perhaps the most dramatic improvements can be seen inside, where architects, working from a late nineteenth-century photograph, have brought back the building’s natural beauty. The stained glass memorial windows have been cleaned and two amber Tiffany windows, discovered in the basement, were returned to their original place in the front of the chapel. Screening was removed from the front of the organ to expose handsome copper pipes and the ceiling of the worship space was stripped of blue paint to show off the radiant warmth of oak.
Built in a modified Romanesque style, Goddard Chapel was widely admired in its early days for its unusual design paired with its commanding setting on the Hill. Today, the chapel, which once could contain a gathering of the entire Tufts College faculty, remains popular among students for religious services and concerts. It’s also a long-standing favorite among alumni for weddings. In recognition of the chapel’s historic importance and to ensure its future, a Friends of Goddard Chapel Society has been established. And starting in July, every first Saturday of the month will be reserved for Tufts alumni to renew their wedding vows.

“Everyone who worked on the restoration of the chapel fell in love with Goddard,” said O’Leary. “I hope many people will stop in to see its beauty once again. We are so pleased that this beautiful building has been restored with such care to its remarkable details.”

A Marathon Challenge

When President Lawrence S. Bacow laces up his running shoes for the Boston Marathon on April 21, he’ll be racing not only for his own health, but to support an innovative new fitness program at Tufts.

Bacow, leader of the 25-person Tufts contingent at the 107th Boston Marathon, will be raising money for the new Personalized Performance Program, a health and fitness program for Tufts students, faculty and staff. The program, believed to be the first of its kind, draws on Tufts’ expertise and resources in nutrition, physical education and health services.

“It’s so important that our students maintain an active and healthy lifestyle,” said Bacow, well-known for his 6 a.m. running regime. “The Personalized Performance Program is an interdisciplinary approach to guiding Tufts students and supporting their individual fitness needs. With the support of Tufts alumni and friends, this program could help every Tufts student meet his or her own fitness goals.”
The program grew out of a desire to improve fitness services, as well as to work collaboratively with Tufts’ health experts. Athletics Director Bill Gehling, Assistant Athletics Director Branwen Smith-King, and Mike Pimentel, director of the Lunder Fitness Center, had long noted strong student interest in staying fit; some 600 students work out in the fitness center each day.

At the same time, Tufts researchers were contributing groundbreaking information about student health. The Longitudinal Health Study, directed by Christina Economos of the Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, for instance, is finding that students have “not-so-healthy” lifestyles. The study measures a range of student health indicators, from dietary intake and physical activity to bone mass and heart disease. Its preliminary findings argue for comprehensive intervention strategies.

“We began by thinking about improving our delivery of service, and then, it seemed there was a greater opportunity to take advantage of research at Tufts in terms of total wellness,” said Pimentel, particularly given advancements from the Medical School, and the Friedman School of Nutrition Science and Policy, and the Jean Mayer USDA Human Nutrition Research Center on Aging. “A lot of schools have a fitness component, but Tufts has a potential to do something more remarkable if we integrate it with research being done here at Tufts.”

Building support has not been difficult. This fall, the program got under way with the endorsement of the Board of Athletic Overseers and President Bacow. Across Tufts, other departments threw in their sponsorship as well.

The customized fitness program also found ready supporters among the community; with just word-of-mouth advertising, more than 60 participants signed up this fall. The program begins with a consultation with a personal trainer and setting goals; participants are also introduced to Tufts fitness programs, including weight-lifting, spinning and yoga.

Judging from the initial response, the Tufts Personalized Performance Program could easily grow, but it will need an infusion of funds. Right now it is able to accommodate at most 100 clients and charges a $25 fee per session (the first five sessions are free to students).

The Boston Marathon provided an opportunity to heighten awareness about the program, according to Bacow, who is running in his second marathon. John Hancock Financial Services has contributed to the cause by donating marathon running numbers for 25 Tufts runners who are hoping to raise money to support the program’s growth.

Bacow and his wife, Adele Fleet Bacow, will host a dinner at Gifford House the night before the marathon for students, alumni and other members of the Tufts community who will be running in the race. Anyone interested in sponsoring Bacow or the other runners who are raising money for the program should e-mail Athletics Director Bill Gehling at bill.gehling@tufts.edu or call the Athletics Department at 617-627-3232. Anyone interested in joining Bacow and his team to run the marathon should contact Gehling for more information.
  Samson Wamani in the doorway of his home in Pallisa. (photo by Richard Sobol)
An Exhibition of Song, Images and Surprise

The Tisch Gallery this winter will showcase photographs of a remote African community and its musical traditions. Abayudaya: The Jews of Uganda, features more than 80 color photographs by Richard Sobol, combined with recordings of traditional music made by Rabbi Jeffrey Summit, director of the Hillel Foundation.

Longtime friends, Summit and Sobol, a 1976 graduate of the joint Tufts/
School of the Museum of Fine Arts program, traveled to Uganda to document the community and develop not only an exhibition but a book as well. Abayudaya: The Jews of Uganda, includes a CD of field recordings and liner notes by Summit that capture the rich cross-cultural mix of African and Jewish sound. The book was published in the fall of 2002 by Abbeville Press.

“I love the way that the Abayudaya Jewish community challenges so many stereotypes about what it means to be Jewish,” said Summit, an ethnomusicologist. “Here we have a deeply committed group of Bantu people leading deeply committed Jewish lives, observing Shabbat, keeping kosher, observing all the holidays. They are drawn to Jewish practice through their love of Torah and their commitment to the unity of the Jewish people. While the Abayudaya survived persecution and repression during the brutal rule of Idi Amin, they now have strong, productive relationships with their Muslim and Christian neighbors. This is a story of hope, of faith and commitment.”

For photojournalist Richard Sobol, whose assignments have included photographing the mountain gorillas of Uganda and the great gray whales off the east coast of Mexico, the exhibition grew out of a singular experience three years ago. A friend happened to play a recording of the Hebrew prayer “Lecha Dodi” (“Welcoming the Sabbath”) sung by the East African singers.

“I couldn’t believe it was for real,” he recalled. “There was no African context to imagine a group of orthodox practicing Jews that were virtually unknown. From there, my interest grew deeper and deeper.”

To recapture that experience in the gallery, Abayudaya music of worship and celebration will be integrated into the exhibit. Listening stations at strategic locations will provide visitors an unusual opportunity to simultaneously experience cultural context for the music and the photographs.

“The instrumental music and the community’s singing in Hebrew and Luganda join with the photographs to add depth and vibrancy to the portrayal of this unique community,” said Summit.

The project, funded by philanthropist Dr. Bob Shillman and Tufts, is expected to travel to other institutions, including Plymouth State College and Choate Rosemary Hall.
It Takes a Village
By using a model that focuses on what’s going right, not wrong, health programs around the world are gaining new ground

"Positive” and “deviance” are two words that seemingly don’t belong together. But when melded, positive deviance transforms into a development concept that is being applied to nutrition problems across the globe—and changing people’s lives.

Positive deviance (PD) became a recognized concept in the nutrition community as a result of the work of Tufts nutrition professor Marian Zeitlin in the late 1980s. For those in the field who now use PD, Zeitlin is considered the “pioneer,” says F. James Levinson, director of the International Food and Nutrition Center at the Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy. Levinson also notes a resurgence of interest in PD at Tufts in the last couple of years, which reflects the soundness and integrity of the concept and the growing number of students and faculty who relate to its intuitive approach.

Zeitlin believes a quote from nutrition colleague Mark Hegsted in 1967 is the earliest reference to the idea that ultimately would be called positive deviance: “We should pay more attention to the reasons for nutritional success than for nutritional failure.” Zeitlin was doing just that in her research—examining why some children in poor communities were better nourished than others.

This focus on success versus failure is the driving force behind positive deviance, an approach to solving social or behavioral problems by identifying who in a community is able to manage problems by using existing resources. These individuals are termed “positive deviants” because they have found solutions through specific behaviors or practices, even though the majority of their neighbors have not. After these individuals and practices are ascertained, an intervention is designed so that the rest of the community can begin to learn this new model.

“Once folks are told about the concept and the vocabulary, it’s, ‘I’ve done that in my work—I never had a name for it,’ ” says Jerry Sternin, a visiting scholar who has devoted the last 12 years to PD and recently created the Positive Deviance Initiative at the nutrition school with support from the Ford Foundation. While Zeitlin has done numerous research studies focused on PD, Sternin, and his wife, Monique, in association with the children’s advocacy organization Save the Children, have been using the community as their central point.
Vietnam was where the watershed moment occurred. It was there in 1991 that PD was used on a large scale and proved to be extremely successful. More than 65 percent of all children living in the poorer villages were malnourished at the time. The Vietnamese government realized that the results achieved by traditional supplemental feeding programs were rarely maintained after the programs ended. This acknowledgment prompted officials to contact Save the Children for a more permanent solution. Jerry Sternin, then director of Save the Children, recalls, “We needed to come up with a model to have the community take control of their nutritional status.”

Enter positive deviance. It was known that some of the poorest families in this area of Vietnam actually had children who were adequately nourished. By using what is called a “positive deviance inquiry,” villagers were able to observe how these poor families were making this happen. It turned out that mothers and caretakers of the well-nourished children were finding tiny shrimp and crabs in the rice paddies and adding these, plus greens from sweet potato tops, to the children’s meals. Despite these foods being accessible to everyone, most of the community viewed them as inappropriate and harmful for young children.

From this discovery came the intervention. The mothers and caretakers went to a neighbor’s house daily for two weeks every month, where they learned to cook new recipes that their own children then ate right there. The mothers/caretakers were also given information about health and child care practices. When the two weeks were over, the mothers/caretakers continued on their own using the new practices and knowledge. Those children who did not reach normal nutritional status after two weeks were placed in the following month’s session. After the pilot study, which lasted two years, malnutrition had decreased by an amazing 85 percent.

Ten years after this first application, the intervention has become a national model that has extended to 250 Vietnamese communities and helped rehabilitate an estimated 50,000 malnourished children under age 5.

PD works because “through this process, the community owns it and sees how it happens,” notes Stephanie Ortolano, a doctoral student in the Food, Policy and Applied Nutrition (FPAN) program and one of the Sternins’ research and teaching assistants. In other words, it is not a development approach whereby so-called experts come into a community and decide what the best solution is to the problem. The solution resides within that particular community and is based on appropriate practices and behaviors.

The success of PD is due to its being “an assets-based approach…on what’s going right versus going wrong,” says Karin Lapping, a doctoral student in the FPAN program and the worldwide PD coordinator for Save the Children. Lapping adds that PD “fails if programmatically, there are problems, or if the issue wasn’t appropriate for PD.”

Sternin echoes Lapping’s assessment by detailing specific parameters for using PD, such as identifying people in a community who are solving the problem without any special resources. Additionally, the magnitude of the problem must warrant a PD application because it is time-consuming and requires extensive human resources. “If we’re trying to rehabilitate 20 malnourished kids, we wouldn’t use it,” explains Sternin. Instead, “we would provide supplemental feeding or whatever is necessary. But if the objective was to enable their parents to sustain their kids’ enhanced nutritional status and prevent malnutrition in a community, then yes.”
Positive deviance has been so effective that it is now being used to address diverse issues such as childhood anemia, female genital mutilation eradication and condom use among commercial sex workers. In association with Save the Children in Egypt, Levinson and nutrition graduate student Mahshid Ahrari are testing the use of PD for improving pregnancy outcomes in Egypt—an idea developed by Deepa Bhat, N01, and the subject of her lecture before the UN Subcommittee on Nutrition in 1999.

Through a PD inquiry, Levinson and team found three characteristics that distinguish women who have successful pregnancies: They tend to get more rest, receive more prenatal care and manage to keep free of intrauterine infection. Once these characteristics were identified, it was time to find out in detail just how these mothers (i.e., the positive deviants) did it. They found, for example, that women who were able to pay for prenatal care appointments often did so by selling some of their wheat or even their own jewelry. Levinson and team are now doing a pilot study to test the effectiveness of an intervention designed from the PD inquiry.
One goal of the Positive Deviance Initiative is to train a cadre of PD practitioners and trainers. The ball is already rolling with the “Positive Deviance for Practitioners” course taught at the Friedman School of Nutrition Science and Policy, which requires students to do local projects using the PD model. Teaching assistant Ortolano notes that “half the course members are now out in the world doing PD”—a signal that more solutions to the world’s problems are on the way.