Where You Live Can Impact How You Get Sick!

• Set the purpose for the video by telling students that they will need to think about the impact of outbreaks on the community when creating their action plans. Suggested statement: Outbreaks happen differently depending on where you are in the world. In a big dense city, disease may spread differently than it would in a farming community where people live miles away from each other. We are going to watch a video that highlights how the locations of Ebola outbreaks affect the community response to the disease. You will want to consider how the location of an outbreak of your focal disease might impact the things you put in your action plans!
• Pete Muller, a National Geographic photographer and 2017 Fellow, tells the story of how Ebola has impacted a rural community in Sierra Leone. Have students watch the video Ebola: Photos From the Heart of the Struggle.
• After watching the video, have students discuss the following questions in small groups:
• How do you think people in the community perceive the disease?
• What resources are available in this community to respond to the outbreak?
• How might it be different if the Ebola outbreak happened in a big city like New York?

Suggested follow-up questions to scaffold student thinking might include: How far away might the nearest hospital be? How clean is the water? Who is preparing food? How educated are people about disease transmission and prevention? How do people communicate with the government to get help?

• Next, as a whole class, have students brainstorm ideas for how to better educate the community about the Ebola disease and its survivors.
• Record their ideas on chart paper. This chart paper can later be used a resource for students to think about educating the community about their focal diseases.
• Review the concepts of rural and urban and add to the word wall that was started at the beginning of the Menacing Microbes unit.

2. Read about National Geographic Explorer Hayat Sindi and what she is doing to overcome challenges with healthcare in rural India.

• Set the purpose for reading by informing students that monitoring health is an effective and important proactive measure to contain and prevent disease. Suggested statement: Being in a rural place can have big challenges. You are going to read about, Hyat Sindi, a woman who is learning how to overcome some of these challenges. As you read, think about how you might address similar challenges if there was an outbreak of your focal disease in rural India.
• Distribute the explorer profile on Hayat Sindi to students and discuss how she is working to overcome challenges with bringing affordable health care to rural India.        
• While reading, have students think about if and how their action plan would work in different kinds of communities.
• In pairs, have students read the Explorer Profile of Hayat Sindi.
• After reading, have the pairs of students discuss how the context of rural India might impact the effectiveness of their action plan.

3. Jigsaw read to learn about additional cultural complicating factors for vaccination.

• Set the purpose for this part of the activity by telling students that there are many factors that complicate disease containment and prevention. Suggested statement: Location isn’t the only thing that can have an impact on disease containment and prevention. Sometimes, there are cultural factors that can impact disease containment and prevention. You are going to read about some cultural factors that have impacted the effectiveness of vaccine campaigns.
• Conduct a jigsaw read by setting students up in their project groups and assigning each student a different article to read. Students should read their assigned article and then teach the other members of their group about their complicating factor. The four readings are:
• Cultural Perspectives on Vaccination, Section Two: Religious Perspectives and Vaccine Objections
• Taliban Assassins Target Pakistan’s Polio Vaccinators
• Vaccines Do Not Cause Autism
• The Strange History of Vaccines—And Why People Fear Them
• Have students annotate their text as they read by using the following symbols:
• Checkmark next to something important.
• Question mark next to things that you do not understand or have questions about.
• Star next to something your group can use in your action plan.
• After reading, have students with the same article get into a group to share the areas that they still have questions about. Have students try to clear up any misunderstandings as a group.
• Next, have students take a few minutes to write a three-sentence summary of their article. Then, have students reconvene with their project group to share their article summary and discuss how this information should be considered when implementing their disease outbreak action plan.

4. Debrief discussion about how the response to outbreaks might impact people differently in different parts of the world.

To wrap up the activity, have students discuss in their project groups questions that challenge them to think about different community structures in the world and their relationship to disease outbreaks:

• Possible questions include: In what ways might an outbreak of your focal disease in an African tribal community be different from an outbreak in a big city in the United States? From a rural American farming community? In rural India? In a big dense city in Asia, such as Tokyo? In a place where there might be many earthquakes, such as Alaska? In a place where there is war, such as Syria?
• Ask: How might the response to the outbreak be different in these areas?
• Revisit the column of the Action Plan Research worksheet that asks if a policy or practice is realistic. Ask students to consider if there are special geographic or cultural considerations, if there are, have students note them there.