Author: Adriana Gaona

PrEParing with Song Hanh Phuc Clinic

Posted on by Adriana Gaona

Hello everyone! My name is Lauren, and I am a Master of Public Health candidate in the Global Health concentration. This summer, I am completing my practicum with the Center for Training and Research on Substance Abuse – HIV (CREATA-H) at Hanoi Medical University. CREATA-H runs the SHP Clinic which provides counseling, examinations, screenings, and treatment for sexually transmitted infections (STIs). While the SHP Clinic is named after “Sexual Health Promotion” in English, their name in Vietnamese is “Song Hanh Phuc” which means “happy life.” The SHP Clinic offers free pre-exposure prophylaxis (PrEP), an oral drug taken to prevent HIV infection, alongside free STI screenings and health monitoring to over 5,500 clients in their PrEP program.

It is mid-July, and I am 1.5 weeks into my time here in Hanoi. I was delayed in my arrival by the visa application process; however, I am grateful for the extra time I had to learn more about the context of HIV and PrEP in Vietnam. The values of quality preparation and adaptation have been a theme as I’ve begun my practicum. My first objective was to conduct a descriptive analysis of the PrEP program, which included talking with clinic staff, wading through clinic data, and reviewing PrEP materials in the SHP Clinic. This experience will inform my evaluation of STI screening activities within the PrEP program over the next few weeks. As I refine my evaluation plan, I incorporate the team’s feedback and adapt my plan accordingly. The CREATA-H team has been incredibly supportive, and I am grateful for their insights and recommendations.

Preparation and adaptation have been a major part of my life as I adjust to the busy streets of Hanoi. During my first week, while suffering from jet lag, I woke up with the sunrise. I started taking walks in the morning to take care of my own health and avoid the summer heat. On my walks, I join hundreds of the city’s residents, from children to older adults, in exercising around a nearby park and lake before they begin their day. As with my projects, taking time to prepare before our workday is important and is something I have enjoyed participating in here.

I am looking forward to engaging with the team and delving into the STI screening data in the coming weeks!

Street murals in the Old Quarter depicting historical events. Hanoi includes a mixture of old and new buildings and art. There is a sense of pride in Hanoian history throughout the city.

 

A view of the Dong Da neighborhood at sunrise.

 

A poster in the SHP Clinic detailing an ongoing study by CREATA-H.

 

Lauren 

Joy and Complexity in the Congo

Posted on by Adriana Gaona

I imagine a variety of impressions come to mind when people hear about the Democratic Republic of the Congo (DRC).

With increasing awareness of the violence and humanitarian crisis in eastern DRC, likely attributed to an uptake of social media coverage and hashtags such as #freecongo, images of conflict are impressed upon many.

For others, the rhythmic strum of an acoustic guitar alongside the swift tempo of percussion, or resonant sound of the Likembe, tempt the sway of hips, impressing the lure of Congolese rumba and other popular genres.

An impression that pleases the tongue is the variety of dishes featuring cassava leaves, smoked fish, palm oil, peppers, plantains, and fluffy beignets.

There is also the thought of the largest expanse of rainforests in Africa containing ripe mangoes, intelligent Bonobo apes, and the ever flow of great waterfalls.

All these images and more come to mind when I think about the place of my heritage. My parents emigrated from the capital city of Kinshasa in the 80s and 90s. They envisioned a future with plentiful opportunities and great education for their children. I’ve seen their sacrifices reap many blessings for my siblings and me, as we each enjoy the quality of life they dreamed for us.

I grew up as what some would call a “third culture kid,” meaning my upbringing was influenced by my parent’s Congolese origin in addition to the American communities I inhabited. The cultures and traditions I uphold are an amalgamation of these influences, and I find myself somewhere in the middle, not always quite sure where I fit. So, when I had the chance to visit the DRC for the first time in 2022, I was ecstatic. It was my first time meeting my Koko (grandma and grandpa) and larger family, who I had only seen through mailed photos and spoken to through phone calls and eventually WhatsApp video calls. My first trip was a short 10 days and I felt that I was in both a familiar and foreign place.

During this second visit, I am spending five weeks in Kinshasa completing my practicum with the Infectious Disease Epidemiology and Ecology Lab, within the UNC School of Medicine’s Institute for Global Health and Infectious Diseases. As an MPH candidate in Applied Epidemiology, I am supporting hepatitis B virus (HBV) prevention work in the DRC. I support a project that targets pregnant mothers and infants for care, a subgroup highly impacted by HBV and facing many barriers to accessing healthcare and medication. My role is to ensure data quality and completeness, develop reports on the significance of community health workers in this effort, and document effective strategies for patient retention and follow-up.

Working in-person has been invaluable as I get to strengthen my French-language skills, witness how pregnant mothers are educated on HBV at the clinic and celebrate with the local team when babies are reported as not having contracted HBV. The joys are balanced with difficulty as I recall the cries of an inconsolable mother who lost her child soon after birth, and the frustration of not being able to retrieve a mother for follow-up visits.

Joys balanced with challenges has been the theme of these past few weeks. Being here is complex, as I revel in the stories of how my mom sold fish at the market and helped care for her siblings, while disheartened by the apparent poverty and trash-filled canals. I’m encouraged by the efforts of Congolese artists and influencers highlighting the beauty of this grand country on social media platforms, while discouraged by the lack of Congolese-owned industries and exploitation of resources. I enjoy laughter with my colleagues, adding light to gray skies permeated by pollution during the dry season.

Being of Congolese origin but American nationality, I continue to wrestle with where I fit in while I am here. Just as I consider the many facets of what the DRC represents, I am learning to accept that I also represent many things. While I am here for just a few weeks, I choose the posture of serving a people and a place near to my heart through public health.

Hepatitis B educational poster designed by the project team.
My preceptor and me in front of the poster.
Laughter, dancing, and Congolese rumba with colleagues.
Maternity center in the Binza health zone.
At the Bonobo ape sanctuary, the animal most genetically like humans.

 

 

Nefer

Ethical Content Development in Tanzania with Nguzo Women and Youth Foundation

Posted on by Adriana Gaona

As I began the second half of my practicum in Tanzania, my focus shifted from finalizing the website as my first deliverable for Nguzo Women and Youth Foundation to content development.

The Director of Nguzo invited me to several events with a variety of Non-Governmental Organizations during the week leading up to International Day of the African Child. First, we went to Gabriela Rehabilitation Centre, where teams from local schools in the Hai District competed in the championship brackets in football, otherwise known as soccer in the United States. Although the occasion appeared to be sports-oriented, there was a strong component of celebrating community partnerships that support the process of establishing well-being and health education efforts across communities. The nonprofit leaders and local mothers (Mamas) invited me to play net ball with them, so I joined in despite not being able to understand any of the rules given in Swahili.

One of the most special moments was when I realized that my concern and care to be an ethical global health professional was received well by the community. On day one of my practicum, the Nguzo Women and Youth Foundation team gave me a nickname of “Manka,” which is a name from the Chagga tribes given to second-born children. After participating in events with local nonprofits, children, and their Mamas, they would all greet me with enthusiasm, saying “Manka!” and sometimes approaching for a hug. In these moments, I realized that a great measure of a community’s receptivity to the global health work you are doing is how they respond to your presence.

This day was a turning point in learning that global health work does not equate to being serious 100% of the time, as long as ethical choices are being made. People are smiling, so you might as well too. People are dancing, so you might as well too. Standing in a corner watching people at events is even more voyeuristic than joining in. If the community wants you there and you are doing intentionally ethical work, it is logical, permissible, and welcomed to join the fun and let memories be made, when invited.

Another event involved participating in a parade with children and a multitude of nonprofits and gathering for an assembly to celebrate International Day of the African Child. The Nguzo team asked me to capture content for marketing materials, which are essential for fundraising, partnership development, and recruitment of volunteers. On this occasion, I struggled to find a balance with ethical photography since so many people were involved and I was clearly one of very few people in the room who was visiting from another country. When cultural dances were performed by the children, I communicated with my preceptor to determine whether it was appropriate to record.

I returned to the office for the remainder of my practicum and developed videos for Nguzo’s social media based on the material gathered from the events. If you are interested in viewing them, the YouTube channel and Instagram accounts share the username of @Nguzo_WY_Foundation. I also worked with the Director to develop a set of interview questions for the team to answer for a clear description of Nguzo’s programming and communicate their desire for funding support to expand their movement. Piecing together this interview-based video was my second deliverable.

Lastly, and perhaps most importantly, I focused on sustainability. I developed a maintenance guide for the website, reviewed key points with my preceptor, and recorded an explanation of several editing procedures for the website. I compiled the ideas and future tasks that we brainstormed together as a team for the organization and ensured that the community partners and Non-Governmental Organizations from the events received the photos.

I am grateful for the brief time I shared with Nguzo Women and Youth Foundation and the team has expressed they are certain that my work will have a lasting impact on the future outlook of the organization.

If you are interested in learning more about Nguzo Women and Youth Foundation, please visit nguzofoundation.org.

Thank you for reading!

Kelsey Cohn