Kilns, Dust, and Hope: A Fight for Health and Learning with Dr Jim Johnston

 Summary: In this episode, Dr. Jim Johnston shares his powerful experiences researching occupational health in Nepal’s brick kilns, where workers face constant exposure to hazardous dust and air pollution. Beyond the health risks, his research uncovered an unexpected but urgent need—access to education for workers and their children. Dr. Johnston discusses how interdisciplinary collaboration is shaping solutions, from improving air quality to creating educational opportunities. This conversation highlights the intersection of workplace safety, community-driven change, and the hope that education brings for a healthier future. 

Recorded, Edited & Produced by Christy Gonzalez, Harper Xinyu Zhang, Kailey Hopkins, and Tanya Gale

Transcript

 Cougar: [00:00:00] Welcome to Y Health, a podcast brought to you by the BYU Public Health Department. I'm Dr. Cougar Hall, a professor here at Brigham Young University. Whether you are a student, parent, or BYU fan, this podcast We'll help you navigate the world of public health. Our podcast strives to help individuals receive accurate information regarding public health. 

So whether it's global or local, we will discuss how it pertains to you. Just kick back and relax. As we talk about Y Health, Dr. Jim Johnston, welcome to the Y Health podcast. So nice to see you. Thanks Cougar. It's so good to be here. [00:01:00] Thank you. I feel like we've been efforting to sit down together and do this for a bit now and your schedule's been busy and my schedule's busy. 

It's just, what a blessing to be able to be here this morning. 

Jim: Well, I'm mostly shy and I've been avoiding it as long as I can. But they finally caught up to me. Not true. Yeah. 

Cougar: You're, you're a great guy and a great friend on a personal level too. So likewise. It's great when we have colleagues that are also friends. 

I think that's, I think we expect that, but it's not always the norm in it, in every academic setting. And we're so blessed here. I really appreciate all the colleagues and friends I have here. Yeah. Likewise, Cougar. It's, it's a pleasure. Well, would you introduce yourself just a little bit for the audience, maybe a little bit of your personal life and then certainly your professional journey, which has landed you here in the department of public health. 

Jim: Sure. I'm Jim Johnston. I'm a professor in the Department of Public Health at BYU and I'm in the Environmental and Occupational Health Emphasis. In my personal life, Cougar, I have a pretty, pretty boring life. I have a wonderful family. [00:02:00] And I like to mountain bike and fly fish and hike and just be outdoors. 

So I don't know, nothing too exciting there, I don't think. I'm just a regular guy, just doing regular things. You sure you are? Yeah, I love it. Tell me a little bit, how did you, so you're a professor here in the Department of Public Health, Environmental Occupational Health, which is really cool. What, what's been your journey when you were 22 years old, did you think, I just want to be an academic, I want to work at BYU, how did you get here? 

No, so I so I went to Weber State University for my undergrad, I studied microbiology and chemistry. And at the time, you know, I was trying to figure out what I wanted to do. And I had a friend who was actually a student at Utah State University up the road in Logan. And he was telling me about this. 

Crazy career path called industrial hygiene that I had never heard about. And so I just started talking with him about it and he well, I just was intrigued by it. [00:03:00] And so he told me, oh, there's a program at the university of Utah for that, a master's degree program. So. I went down to the University of Utah and met with the director of the program. 

And this was probably my late junior year at Weber State. And I met with a guy named Jeff Lee. Dr. Jeff Lee, who I realize now was just an icon in the field of industrial hygiene. But I didn't realize it at the time. I was just this undergrad that didn't know anything. I went down and met with him and he, I remember sitting across the desk from him and he said, well, what do you think industrial hygiene is? 

And I said, well, I think it's like some environmental stuff and some, like you do some air testing stuff. And he said, you've got a year before you apply. I want you to go back and figure out what it really is. And I, I was very humbled by that Cougar, but I could tell just this man's passion for. the field. 

And he, I mean, he was, he was very kind when I met with him. Well, during that year, Jeff Lee [00:04:00] passed away. Oh, actually from a lung disease. Which is a lot of what industrial hygienists do to prevent. And I don't know if his lung condition was, had anything to do with some early life work exposure. I don't know, but he he passed away during that year and. 

And I went back and I took his advice and learned a little bit more about the career field and I applied and was accepted into the program at the U. And from there I I earned my bachelor master's degree and then I went to work for several years in the field. And so I worked for the Idaho National Lab as an industrial hygienist and then I moved back to Utah and worked for the Utah Labor Commission where I was a big part of my job there was investigating workplace accidents and fatalities. 

Okay. And I think just during that time, the the importance of workplace safety. and the impact that it has on people's lives really just kind of settled in [00:05:00] on me that like, this is super important that, you know, I saw I had to investigate some fatalities of mostly men. It's mostly men who die at work. 

And I investigated some fatalities of men who were still quite young, who, who died or were killed at work from various exposures. And I think it just kind of just settled in that this is a really big deal. It's, it's it affects a lot of lives. It affects the, I mean, the worker obviously, but also their families and their children. 

And I, I think just fell in love with the, the discipline and along the way realized, I think I want to teach this and it. It just kept coming back to me that way. And so I ended up applying you know, for a graduate school again, a second time at the University of Utah. And I went back and got my PhD from the University of Utah. 

And yeah, the, that's [00:06:00] sort of my path of how I ended up where I'm at now. But it's been a wonderful career path. I feel like it's just been very meaningful work. It's kind of a niche part of public health, but, but it's very much public health. And, and it's just, I don't know, it's been an exciting career. 

Cougar: Yeah, I love it. I often. We'll explain to my friends that public health is really about making the healthy choice, the easy choice, making it really easy to remain safe, making it really hard to get injured. And so, so much of that in occupational health is really, you're going to spend a third of your life working. 

Can we do that when someone goes to work in the morning? they should fully expect to come home safe in the evening, right? But you're right, that's not the case. The data between men and women in this particular area is stark as far as those who lose their lives you know, in the pursuit of their occupation. 

Jim: Well, those who lose their lives, and also [00:07:00] those who are disabled, who sort of carry that disability throughout their life. And that's far more common in men than it is in women in this particular area of public health. Yeah. Just anecdotally, I have a family member my brother in law who was a welder early in his career. 

He was injured in an accident at work where a large steel plate landed on his ankle and his foot and crushed the bones. Mm hmm. He was an avid water skier. Just a very active lifestyle. And it has, this happened in his early twenties and he's in his fifties now, but it has affected the course of his life for that probably 30 plus years. 

And, and the rest of his life from here on out that he cannot do after multiple surgeries. A lot of pain, a lot of suffering that he's gone through. His, his whole life has been changed from that industrial accident that happened. So even though it didn't kill him, it, it's taken a, a heavy toll on his quality of life. 

And, [00:08:00] and the, just, I think sort of taken away from him those things that he loved doing. 

Cougar: Yes, no, I really appreciate that. And I, I've taught just a little bit of, I mean, just a sliver. I've never taught industrial hygiene or environmental occupational health class, but just a little sliver in just a general introduction of public health class, looking at the industrial revolution, looking at the number of deaths. 

But you're right, not just fatalities, but injuries. And where we, how far we've come. From the mid 1800s to now. And I remember in college, as a physical laborer, working on a very large construction site, some of the frustrations I had with all of the policies and all of the regulations, I'm like, man, I could do this job so much faster. 

I didn't have to wear all this safety equipment and harness it every 10 seconds. Right. Yet, those policies didn't just fall from the sky, like there's a reason why we have implemented those, [00:09:00] those protocols to protect the labor and and you're right to protect their family, to protect the generations of people that will rely upon and benefit from that individual's contributions and, and, and their livelihood. 

So it is a really cool field for sure. 

Jim: It is a really cool profession, Cougar. One of the, well, in my opinion, it's one of the great success stories in public health. In 1970 when the Occupational Safety and Health Act was passed. There were around 17, 000 fatalworkplace fatalities in the U. S. that year in 1970. 

And since then the numbers have gone down. It's under 5, 000 a year now. So it's just been a huge public health success. And you think about that, 17, 000 people per year, that's the size of a that's a good sized town every year that, you know, of people who are dying at work. And that's not counting injuries and, you know or chronic diseases that come from work. 

That's just looking at deaths alone. And so it's it's been a huge public health [00:10:00] success. 

Cougar: Absolutely. And, you know, living in the United States, we've made such tremendous progress. I've had a little bit of experience traveling and had some exposure to the still developing world. And this is one of the glaring differences is seeing laborers wherever you're at in Southeast Asia, Africa, Latin America. 

I've seen you know scaffolding that is just very, very life threatening sketch. I've seen you know, I, In Guatemala a couple years ago, I saw approximately 25 laborers in the back of a small Toyota pickup. Just, there's just, and I'm not faulting those individuals. I have found around the world people work. 

They are breathing hard. They're making hay. They are, they are just doing everything they can to provide for themselves and for their families. And, but there's, there is An opportunity to help [00:11:00] individuals, workers in those areas. They can continue to be productive and provide for themselves, but also provide some protection for them. 

And I bring this up, Jim, because you've just returned from Nepal and I'm anxious to hear your thoughts and your, as you, as you've now traveled in that part of the world, which I've never been, so I'm, I'm jealous. What your observations have been, what the experiences have been. I don't think you can travel and not have it impact you. 

So I'm anxious just to turn this over to a little bit to tell us about your project. Tell us about how it's changed you, the professional and the personal observations you've made. Is that okay? Sure. 

Jim: Yeah. So maybe to start with Cougar, I'm going to start here at home first and maybe kind of transition to the work that we're doing in Nepal. 

When. When I worked for the Utah Labor Commission, I was sent out to investigate fatality at a, a brick manufacturing facility in Utah. And what had [00:12:00] happened in this case is there was a, a man who shortly after he graduated from high school, he took a job making bricks at, for this company. And he, he worked there for, I don't know, probably maybe 16, 17 years. 

And at that point in his career, he developed, which was really weird, he developed lupus, which is rare among men. He was diagnosed with lupus and then a couple years after that was diagnosed with silicosis which is a, a very debilitating lung disease. That comes from breathing in small particles of silica crystals. 

And brickmaking that dust has a lot of silica in it, and so the workers breathe it in. So, after he developed silicosis, a couple years after that, he, he passed away. And it was reported to the Labor Commission, and I was sent out to investigate this fatality in this brick manufacturing company in the state here. 

 It was very eyeopening to me [00:13:00] to, you know, as a young man kind of this freshly minted industrial hygienist to be, out in industry here in the U S and to see you know, one of the eye opening things to me is in that position, you would see the best of the best. You'd see companies that had really good safety policies, and then you would see other companies that did not. 

And it gave us really kind of broad perspective of what industry in the U. S. looks like. And Taking from that, you know, I when, when the opportunity came up for me to go to Nepal to look at brick making there, I jumped on it because I. I thought, wow, this is really, you know, I've seen this, I've seen what it can, can lead to. 

Going internationally then, you know, when I had this opportunity come up to go to Nepal I was very intrigued by that partly because of the, the brick manufacturing side of it because I had some history with that and, and just a professional interest in it. But also for the chance to see sort of international occupational safety and health. 

So I've been, this was my fourth [00:14:00] trip to Nepal working, and on each of those trips I've worked in the, the brick industry there with the workers and with our team. The observations that I've had are, that there are very limited workplace safety standards in Nepal. And you know, and as I've mentioned, I mean, we do have some of that here in the U.S.. too. I would say it's, it's far more rare. So I have seen it, but it's it is, it is more rare and we can see that in the numbers, you know, from 1970 until now that, you know, our, the culture of safety in the workplace has, is much improved from what it was. In Nepal, the, there are very, very limited safety standards in the, at least in the brick making industry, from what I've seen, the there, there's really no respiratory protection at all so this case that I told you about here in Utah, the workers did have respiratory protection, it's just that the program wasn't managed well, and they were still being exposed, but the employer had at least tried to manage it. 

to prevent, you know, in a, in a [00:15:00] way, you know, tried to prevent the exposures from happening. But in Nepal, there's none of that. There's no no respiratory protection to speak of. I mean, some of the workers will tie a bandana around their face, but that's not sufficient. So the the working conditions are there. 

Relatively harsh, I would say they're you know, the workers, they work long days under you know, it's very labor intensive, very dusty so there's a lot of respiratory exposures. And then to compound that and this is one of the things that we've, we've actually tried to pay a lot of attention to is that the workers are exposed to brick dust. 

most of the job categories that they have. They have high levels of dust exposure, but in the Kathmandu Valley, there there's, they have very high outdoor air pollution problems there. So the, the workers, not only are they breathing in this brick dust, but they're also outdoors breathing in just ambient air pollution pretty much [00:16:00] all day long at levels that are, 10 times or more what we see here in Utah. 

Cougar: So the program, because. We, when we, when we have a public health program, we, we need to do an assessment and find out, you know, what, what's the level of risk or the level of harm exposure, if you will. And then, and from there we can identify, do we need a policy or is there a policy in place we need to strengthen the policy? 

And then maybe we need some regulation. Sometimes when we do this, we find, oh, well, here's. Here's our blind spot. Yeah. We, we have a policy, but actually the employees don't have access to, you know, the personal protective equipment, to a mask, to a respirator, what, where, where are you at in your program? Are you still assessing the level of risk to the silica dust or to ambient air pollution? 

Or are we trying to, are we trying to persuade? Policymakers that this is [00:17:00] a wonderful investment. It's going to cost you a little bit on the front end, but it is going to save lives and increase productivity on the back end. Like where are we at there? 

Jim: Yeah. So career, let me add one more piece to this before I answer that question. 

You bet. So because fixing a problem like this is not easy. It's there, there are a lot of, a lot of factors that lead to the conditions being what they are, but I want, I feel like this is an important piece to add to the puzzle here. So the workers are breathing in brick dust in most of the job categories at very high levels. 

And that brick dust, it has silica in it. They're exposed to outdoor air pollution at very high levels and the third main factor from inhalation exposure, cause that's the primary thing that we started out looking at was there sort of this burden of inhalation of dust and pollution. Right? So the third, the third thing that, that we've spent a lot of time looking at is their household air pollution. 

So the brick workers typically live at the brick factory in very rudimentary housing. So it's usually like a, it's [00:18:00] a. A small hut basically made with, with bricks. So let's stack the bricks up, make four walls, put a tin roof on it. The homes are usually probably, you know, like maybe five feet tall at the highest point the size of a small bedroom and the family will live in this hut. 

It's usually a dirt floor hut and they live there during the brick season. And many of the brick workers. Cook with biomass fuel. So wood or well, I'd say primarily wood. So it's similar to having like a campfire in your house. That's what you're cooking with. Other workers, and I would say in Nepal, they're making great strides with moving the, at least among the brick workers, moving them to cook stoves that use LPG fuel, which burn much cleaner than. 

than a wood fire in the home. But really what we found, Cougar, is that even at night when they're not working the, the pollution levels in their homes are way, way [00:19:00] above what would be considered to be acceptable here in the U. S. And, or, you know, based on like World Health Organization guidelines for air pollution. 

And so really what we're seeing is the brick workers never They're never not exposed to a respiratory hazard. It's pretty much 24 hours a day, seven days a week for the, the entire brick season is what it looks like to us. And so, so it's really a complicated problem because there, there are multiple exposures and really no break from it. 

Okay. So your question to answer your question about, the, you know, where are we at with policy development and that sort of thing. So here's an interesting finding that we, we just. It sort of arrived at on this latest trip that we had to Nepal. So our team right now is made, it's an interdisciplinary team made up of faculty and students from multiple departments on campus. 

So we have public health food and nutrition sciences because we're looking [00:20:00] at, at their diets and, and that sort of thing. Cell biology. And then who am I missing here? Nursing and then the engineering department is working with us on solutions to how do we, sort of, how do we fix this problem, or, well, not how do we fix it. 

How do we work with our collaborators in Nepal and the brick kilns and you know, build this, how do we build this intervention to help these brick workers? One of the, the data points we've, we've looked at and, and our, our efforts to intervene in the problem are really based on the the United Nations sustainability goals and recognizing that any intervention that we do has to be based on kind of what the community wants with their input. 

their guidance and direction, all of that. And so here we're going in thinking, Oh, we've got all these respiratory problems and we need to deal with that. And so the engineering team, what they did is they've done. Hundreds of interviews with brick workers, brick, brick kiln management, community [00:21:00] leaders, NGOs, and they've tried to gather all of this data. 

And they've been asking these questions all along about, well, what do you think is important? What would you like to see change? And here we're thinking air pollution, brick dust, guess what they're thinking, Cougar? You got to tell me, I don't know. Their education for their children. Oh, that's where they're at. 

So the brick workers, they recognize air pollution as a problem and that'll show up as maybe like number three or four on the list of important things, but the number one thing that they're reporting that they want and that they need is education for their children. So a lot of these, these workers, they'll, they come as a group from their village to the brick factory and they'll work there during the brick season and they'll bring their children with them quite often. 

And so At this particular kiln that we worked at this time, what we, what we noticed is that the children were not going to school and mom and dad are both working doing their jobs during the day. And so the children were just basically kind of hanging out in [00:22:00] this industrial environment all day long. 

And which meant while we were there, they were hanging out with us all day long, which was really fun. And I mean, they're just just beautiful children just full of light, you know, just happy kids and, and that, but but they're not going to school and they're you know, so there are some problems that way. 

And so a lot of what we were hearing from people is, hey, we want, we want education for our children. And so I think right now you know, as far as, you know, we look at, at intervention strategies I think we, we recognize that we need to meet the population where they're at and it may be Cougar, honestly, that our first intervention has nothing to do with air pollution. 

And, and it might be more based on, on education, and we've got some ideas on how we might go about that but we're, we're working very closely with some NGOs and some faculty colleagues and students in Nepal to kind of see what our, our next steps are. And we don't have that nailed down yet, [00:23:00] but but that's the direction that we're going in. 

So anyway, so kind of one of the ideas that we've kicked around right now is for some of these kilns that maybe don't have access to schools, we don't know if it's an access issue or money issue or something like that, but we've, we've wondered about you know, what if, what if we could, you know design, you know, with, with our team in Nepal and that design a small, affordable community center that could be at the kiln. 

And so we have Andrew South. He's the main engineering guy that we're working with here. Professor he specializes in dome buildings, which is great for Nepal because they're much safer in earthquakes, things like that. But but they're also fairly cheap to build. And so that, that community center could potentially be used like a multi purpose facility where there could be a school there. 

And we're working with NGOs that they might be able to provide. Educational resources and that pulls the kids out of this industrial environment during working hours And I mean so there could be so many benefits from that you know, so we're looking at just different ideas like that about how would [00:24:00] you go about solving that problem? 

But my guess is we'll probably actually start with something like that, but that community center could also be used to teach classes about nutrition, about, you know, maybe financial well being, you know, other things like that. So we're looking at ideas like that right now. But it's exciting because I feel like we're, you know, we go in with these preconceptions about, oh, this is what they need and this is what we specialize in. 

So that's what we see through our filter. And it's been so eyeopening to me to see. No, in a lot of ways there I mean, there are cultural differences, but the parents. They're have the same worries that the parents here have just about their children and and that's been That's been really cool to see that's where their priority is on their kids And that's that's where my priority is as a dad is like my kids, you know And I want to make sure that they they have the best opportunities available to them For their futures and, and that, and I, anyway, so [00:25:00] that's been very eyeopening to me that, you know, just that perspective change that although they are worried about air pollution, that's not their number one concern. 

So I think right now our, our hope is to meet them where they're at and say, okay, if that's what we need, and I'm not an education expert, and it may mean that some of our future work, I'm not, I'm not over there collecting air pollution samples. We're doing something else. But you know, maybe in the, in the short term and then we'll see how that evolves and what we can do with it. 

My daughter, she went with me on this trip. And when we think about like the education piece, she, she had the opportunity. She was out with. Some of the Nepali students from Kathmandu University and they were out doing surveys, like surveying some of the brick workers and one of the, my daughter came home, she actually talked about this in sacrament meeting. 

And I didn't even know this had happened to her until her sacrament meeting talk, she said they were interviewing this one female brick worker who said that she was very concerned about education as well.[00:26:00] 

She said, I want education myself. So she was an adult. So this education piece just keeps coming back. And. She said, I, I don't know how to read. I'm a recent convert to Christianity and I want to be able to read the Bible. And I can't, and that just struck my daughter that wow, this is like, I don't know, it just was kind of this eyeopening moment and just how, how important education is to us, you know, that just that ability to read that can open you up to I don't know, being closer to God. 

And I, I've thought, what if I couldn't read my scriptures? You know , and just have that communion with God in a sense through the scriptures. And anyway, but this, this woman was feeling that and wanting that. So, you know, as we move forward, I actually feel really excited about this, even though it's, it may not be an air pollution, brick dust. 

Intervention in the beginning but it still feels like we were doing some really valuable important work there and we'll see where it goes. 

Cougar: Oh, that's [00:27:00] exciting. It really is, it's community health. And we've not always done it. Well, as you're saying, there's been times in the past, many times for decades, in fact, where we've come in and said, here's what you need to do. 

Here's how we solve this problem in Salt Lake city. Here's how we solve this problem in Boston. And we want to go drop that on a village on the other side of the world or the globe without listening to. What are the resources they have? What are the limitations they have are most important? What are the desires that they have, right? 

It's fascinating, right, that education comes up every time, right? It is a main driver This is our, I mean, this is social determinants of health, if you will. Right. And as a parent myself, and you might say my, I didn't have the bar high enough, but I remember being pressed once, like, what's most important for you as a parent? 

And there were two things I wanted my children to be able to read. And that may sound silly, but I didn't learn how to read till the fourth grade. And I had a special tutor who was [00:28:00] very privileged. My parents were able to hire a tutor at my elementary teacher's request. And the teacher was very honest and said, you don't understand. 

He's in the fourth grade and he doesn't know how to read. And when he gets to junior high, you're going to lose him. So we have to figure this out. And that's what I wanted for my kids. If they know how to read, they can access knowledge. And then the second thing I wanted them to know how to pray. There's a lot of other, you know, religious or spiritual objectives you might have for your children. 

I just wanted my kids to know how to pray because if they can pray, they can access divine power. So I'm really touched by your experience because I'm just like that Nepalese mother. That's what I want. That's what I want for my kids. That's what I want for myself. And for some of us in the United States Learning how to read is still a challenge. 

We have work to do here and I'm an educator, so this, this is really close to my heart. Right. But I have, like you, I have seen around the globe, young children [00:29:00] dressed in beautiful school uniforms, walking a dirt road together, hand in hand. At seven o'clock in the morning. Right. And knowing that this comes at tremendous sacrifice to their parents. 

Right. Because A, those, those kids could be working alongside mom and dad, whether that's in a brick kiln or in, in a field. And that's, that's a tremendous challenge for parents to sacrifice and send their kids to school. But that's exactly what they want. They're doing everything they can so they can do that. 

In some ways, this is really drilling down into a fundamental concept in public health. Which is how do we strengthen capacity? How do we increase self resilience? So that we don't need academics or non profits you name it. We don't need USAID programs going into Nepal. We, we can strengthen local capacity, so that at the end of a [00:30:00] program, whether that's three, five, ten years, They don't need us anymore. 

That is public health done well. Like if we do our job, we've worked ourselves out of a job. Is there, is there an aspect of this? I know this is early in the program now that I, I understand where you're at as far as assessments and identifying needs. Is there a component to this where you're working with local partners and strengthening their capacity? 

And I should say they're, they're remarkable already, but you have an opportunity to. Add to their strengths so that they're self-sufficient. Can rock and roll. 

 How are these projects strengthening your colleagues who are Nepalese, who live in Nepal so that in 10 years from now. 

You don't need to parachute in so, so that they can say, okay, here's how we do our needs assessment. Here's how we come up with an intervention. Here's how we have the, you know, the policy component. Here are the levers that we can pull. And maybe the lever is, hey, if you'll [00:31:00] invest as As the owner of, of a brick kiln in a community center where there's education for the kids, there's activities, there's engagement for the kids during the workday, then the parents will wear a respirator or like, I'm just, I'm just saying, how are we building the capacity, whether that's infrastructure or whether that's technical skills and knowledge so they can do their own assessments? 

Are we, are we building the I love the, just working with our engineering group here on campus building is not the right word because they have this, are we strengthening their capacity so that this can move forward without you? 

Jim: Oh, definitely. Definitely. And that's the goal here. And that's been the goal all along. 

I love the, just working with our engineering group here on campus. It's been so fun to just see that part of it. So I'm an air pollution nerd and, you know, so I've been focused on, you know, exposure assessment and, you know, we've got the food and nutrition sciences people, you know, they're looking at like vitamin levels and, you know, looking at dietary intake and all this stuff and the [00:32:00] nursing group, they're looking at, you know, lung health and anyway, so we have all these moving parts, but the engineering team that we're working with, and this is one of the things we realized early on Cougar is that. 

In order to, to go in and, and make change like you as a public health person, you, these problems are too big. Like you, you have to work with an interdisciplinary team because it's, there's just stuff that you don't know. And so I know air pollution, but but how to go into a community and make long lasting change that when, when we're done. 

 That they don't need us. That we're, in a sense, our goal is to become obsolete there. And it's been so fun to work with. team because they get that. They understand it. And so what we're doing is working with the United Nations sustainability goals to that end, exactly what you're talking about, that by the time we're done that we basically worked ourselves out of a job and that's our hope. 

And so right now we're very much in the we're kind of in that transition [00:33:00] period from doing kind of our initial assessments to working into early intervention work, that's right where we're at right now. And so Andrew South's team, they've been working with just multiple collaborators and partners. 

And I was able to meet some of them while we were in Nepal this time. But some of the, just to give you a flavor, I guess, of what some of the things are that we're doing, we have so we have several students from Kathmandu University who have been going around with our engineering team learning together you know, how to implement these sustainability goals from the United Nations. 

So we're working very closely with faculty and students at Kathmandu University. We have along as they've been sort of working toward needs assessment of what, you know, what interventions, where would we even start with that? They've been involving community leaders brick kiln management the faculty at the universities the brick workers themselves. 

And with the, the idea that in the end, that whatever, whatever intervent intervention direction that we [00:34:00] go in, that there will be buy in from the community, that it's, it's really what they want. And so we had, we have had some struggles with it. I mean, you know, working I know like on the air quality side we've tried to work with one of our collaborators to bring, into learn with our students you know, with how to operate the equipment, how to collect the samples, all of that. 

So far that piece has not worked out. We've, we keep trying though, but part of it is a funding issue and, you know, so we're still kind of working out how to either take our students to another part of Nepal to work with what the students think. another university basically, or, or to fund them to come to, to meet us in the Kathmandu Valley to learn from our students, but we're still trying to work on that piece. 

So it is complicated. It's you know, the travel's expensive and, and trying to work work all those pieces. But but I would say so far, I mean, it hasn't gone off perfectly, but I think that we are building some really strong collaborations and it just takes time. It [00:35:00] takes I don't know. It just takes whatever time it takes to sort of get all the pieces in place and, and, and that, but yeah, that's definitely the direction that we're going in. 

And it seems like there's there's just so much support from all of the people that we've been working with to say, yeah, let's. Let's see what we can do here and to make a difference and so that's been exciting to Just be a part of that that whole process. 

Cougar: Yeah, what I think you're you're communicating and revealing if you know you've said this or not is Public health is really messy It's very messy. 

And public health will never be successful when we work in our own little silo. And so this is Y Health systems and systems thinking has become the buzzword for public health in the last, you know, 15 plus years is we can't do this alone. We do need, you know, we need water and sanitation and hygiene and we need we need engineering. 

We need, we need. Program development, like we need all of this to come [00:36:00] together. Education is a huge component of that. So working on a complex and large problem and not knowing like, where do we take the first bite? We really have to get a lot of people at the table. Right. And it's not just what what I think we should do, it's what, what can we do? 

Is there, is there will, is there a collective will to be able to make some of these changes? Because every change comes at a cost. Right. So. I think it's fascinating, James, tell me, because I got to get you out the door here shortly, maybe two things on the way out. Is that okay? Sure. Yeah. One actionable item, not for the Nepalese, but for, for me and for my family. 

Is there one thing that we're not doing related to air quality and exposure? Is there, is there one actionable item that we should all be doing? 

Jim: Yes. So, so I'm going to take a little bit of a different direction with this Cougar. Yeah. Okay. So I imagine you're not too far away from being a grandparent, [00:37:00] right? 

I don't know. Maybe. I can't give my kids any pressure there, but yeah. Okay. 

Cougar: Okay. Nothing's in the works. Well, 

Jim: so we, we have our, our first two grandchildren and we're just kind of at this transition, you know, our, our kids are. Our last kid has graduated from high school next week. And you know, but we have our adult children are, you know, very slowly starting to, you know, give us grandchildren. 

So we've got two now and, and I keep preaching this Cougar, but the, let your kids play in the dirt, get a dog when they're young, you want your children to have the technical term for it is infectious pressure on your immune system, but those developmental years from You know, probably up to age three are incredibly important for your immune system development and it gets into, so it's not really an air pollution issue, but it's an indoor environmental quality issue is what it is, which is related to air quality, but bio aerosol exposures. 

So things like endotoxin, for instance bacteria, viruses. Your children need that your [00:38:00] grandchildren need that exposure at a very early age to for their immune system to develop properly. So we are born into this life with our immune system is primed, ready to take on the world. And there's some. 

Thought out there that we're living too clean, that children are not being exposed to enough. And that's, what's leading to allergies and asthma down the road is they're not getting enough infectious pressure at an early age to train their immune system to go down sort of the healthy immune system pathway. 

And, and if you don't have that, then it can lead to allergies and asthma. 

Be, be tidy, but it's okay if they're, if they're exposed to germs and have, I tell them to have lots of kids because children who have more siblings tend to grow up with a healthier immune system. So there's some evidence for that too. So I could go on forever about this, but, Germs, germs are good for kids when they're, when they're young. 

So love it. Get outside, get outside, 

Cougar: play in the [00:39:00] dirt, rewilding. Like let's, let's get back to nature and yeah. And the five second rule applies. So if you're cooking a weenie over a campfire and it falls in the fire, brush it off and, and go for it. 

Jim: And you know, I, I don't recommend this for me. Like, you know, sharing my ice cream with the dog, but for a kid, it's probably okay. 

 I think that that microbial exposure appears to be really, really important for children, but it's interesting. The literature shows it's good with dogs, not so much with cats. So like dogs are more important. So I'm more of a dog person than a cat person. I'm glad that the science supports that. 

So. 

Cougar: You have a whole bunch of people who don't like you anymore now. 

Jim: Oh, I know. 

Cougar: All right. Okay. Last one. Last one. Thank you for that one. Yep. What are you reading? What are you listening to? What's getting you excited? This could be personal life, professional life, but we, we're trying to communicate to our students here at BYU, but also to our children, as you've mentioned lifelong learning. 

Yeah. And to approach certainty with great caution. Yes. So to [00:40:00] temper some of our opinions and to listen, because we are in a moment now where information is tailored to you based on an algorithm. Right. And we can get in these echo chambers, but there's, we, we want to. have broad exposure to ideas, to knowledge. 

And there are ideas that are millennia old that our kids need exposure to. But the great books, the great movies, the great podcasts that are out there, what are, what are you dialed in on right now and how is it impacting you? 

Jim: Yeah. So I'm reading a couple of books right now. I kind of go back and forth between them. 

I'm reading the, the two parent privilege. I've just started that. And then I'm also reading Sapiens. So just to try and understand a little bit, you know, from an evolutionary perspective where we came from and, and that, just to kind of get that that side of it which has been an interesting read you know, when I, when I find myself driving and, and you know, I have time to listen to things I, I actually listened [00:41:00] to I listened to a lot of Jordan Peterson you know, he's a, Yeah. 

just a world renowned psychologist. And I think has some really, really good advice for young people as far as just finding meaning and purpose in your life. Which I think right now, there's a lot of, there's kind of a purpose void, I think for a lot of, a lot of people. And I, I, I think I don't know. 

I've just found a lot of Jordan Peterson's work really interesting, you know, where he talks about you know, that Your meaning, your, your purpose and your meaning in life is found through accepting responsibility in your life. And anyway, so a lot of, I think just really solid life advice like that, that it's good for me. 

I think good for society in general. So anyway, so I listened to a lot of Jordan Peterson as well. So now that, 

Cougar: that meaning and purpose. Point that you just made. I teach a class where we talk a lot about that because truthfully, you can get through anything. We are so resilient. Right. We are. 

But if there's not meaning and not purpose, what's [00:42:00] fascinating when we've, when my class and my students have looked into some of this, we always talk about burnout. Oh, I'm burned out at work. I'm burned out on parenting. I'm burned out in my, in my church service. Burnout is not too much. It's too little. 

Stress is too much. Stress is I have too much to do and too little time, typically. But when we're feeling burnt out, it's that we've lost the purpose and lost the meaning. So then we need to go back and say, why am I doing this? Am I, am I just going to work to get a paycheck? 

Jim: Right. 

Cougar: Or am I going to find the meaning and the purpose of what I'm doing? 

Am I just fulfilling my church calling? Cause some guy called me into an office and I said, yes. Or like identify, drill down. What? purposeful and how is it meaningful for you and for those you're serving? When we do that, it's remarkable how I'm not burnt out anymore. I've actually tapped into this whole nother source of energy and enthusiasm and zeal. 

So I really liked that component and I would agree that whether it's social media, whether it's phones, [00:43:00] whatever the moment is you know, in a post post COVID 19 shutdown world to move forward, to feel hopeful And to find meaning and purpose and to get, I mean, get doing something. If I don't do anything and I have that luxury from time to time in education where I have a few months off, it's remarkable. 

My mental health suffers unless I have something to engage with and something where I can find meaning and purpose. I think we're. We're designed, as I said earlier, I've been using this phrase, it, it comes from one of my favorite songs, but we are designed to breathe hard, to make hay, to get after it. 

Right. And, and that doesn't need to be just earning money and acquiring things, but like, are you really engaging with life and finding that meaning and purpose? 

Jim: So Cougar just taking us back to the work in Nepal. Yeah. And maybe I'll just, I'll finish with this. So I've seen the. You know, four trips over there working at four different brick kilns, basically, well, I've had, I feel [00:44:00] like enough exposure to the, the brick workers to realize that they seem like a pretty happy bunch and there, there's a lot of poverty, they have really hard working conditions. 

But the people seem happy. And I look at them and I'm like, man, they are struggling through life. Like they're, they don't make a lot of money. They, they live in extreme conditions compared to you know, Western society for sure. And you know, they work long hours under heavy loads. It's, it's not a, what we would consider to be a desirable lifestyle, but I think there's something Cougar in the struggle that. 

Sometimes I wonder if life has gotten too easy for us, maybe, that there's something in that struggle that I, I feel like they, maybe their meaning, their purpose is just the struggle to provide and, and take care of their family. And, and I think people, you know, will do just about anything to, to do that, you know, to provide for their children. 

And I see this Like maybe it's in the struggle that you find the meaning and the purpose. And I think that gives [00:45:00] you joy in life that your, your life, your effort, your will is spent on something meaningful, something bigger than you. And and I think that we, as people just find deep purpose in that deep meaning and, you know, I, I think right now, I don't know if I've been trying to figure this out is, is life too, is it too easy that there's not enough struggle, maybe that, you know, that we're missing out on that. 

You know, maybe we've progressed in Western society to a point where, where we don't have to struggle as much. And then maybe it leaves a little bit of a purpose void in our lives. I don't know, but it's just made me wonder, but the, the people in Nepal seem. Maybe a little happier to me. And I, I'm really curious about that. 

And so I don't know. It's, it's been it's been really, really neat to see it just to, to be around them and to experience that. And, and They just, they smile a lot, so, I don't know, it's, it's a cool thing. 

Cougar: Yeah, it's wonderful. [00:46:00] Now, Dr. Johnston, thank you. This has been, this has been wonderful. I appreciate it. 

Jim: Thanks, Cougar. 

Cougar: If you had more time, we would just keep rockin and rollin and chattin it up, but I really appreciate your time today. I know you have other things to do, so let me just thank you. Finally, it took a minute, but let me say thank you for joining the Y Health Podcast. Really appreciate it. 

Jim: Thanks, Cougar. It's been a pleasure. Awesome. 

Cougar: Thank you for joining us today. Catch us on our next episode, and don't forget to subscribe to future Y Health episodes.