Author: nayavill

A new enterprise

Posted on by nayavill

Like so many adaptations made over the past year and a half, the prospect of a remote practicum left me feeling some sense of trepidation. How could I build relationships with work counterparts over Zoom? Would I be able to meaningfully contribute to my practicum organization from an apartment in Chapel Hill? Still, coming to Gillings after several years working in rural Panamá, I was eager to continue honing my global health experience in Latin America – and I’m fortunate to have the opportunity to do so this summer, as I begin supporting a research collaboration with Colectivo Amigos Contra el SIDA (Friends Against AIDS Collective, or CAS), a Guatemala City-based NGO that provides sexual health services for gay and bisexual men, who bear a disproportionately high burden of HIV infection in Guatemala. While the broader global health field, amidst the pandemic, has rightfully reflected on the necessity of boarding airplanes simply to foster productive international partnerships, I am excited to navigate these new challenges during a remote practicum with CAS. After all, every learning experience carries its unknowns and uncertainties.

In Guatemala, a country of nearly 17 million people, CAS is the only entity that provides HIV pre-exposure prophylaxis (PrEP) – and does so free of charge. In my practicum, I join a long-term collaboration between CAS and UNC researchers. Regular PrEP use is highly effective in preventing HIV transmission, but currently formulated as a daily medication, the logistics of taking PrEP can be onerous. This is only exacerbated by the social stigmas attached to PrEP use and sexual orientation. To address some of these concerns, CAS is partnering with UNC researchers to design a mobile app to serve as a kind of “one-stop shop” for PrEP information: anonymous peer-to-peer communication between PrEP users, information provided by medical providers, and clinical appointment reminders. I will be contributing to data collection about the preferences of CAS’s clinical clients and providers for the app.

Here is probably the point at which I should note that this is my first foray into public health research. I have an undergraduate degree in philosophy, but it was only after gaining practical exposure to HIV education, sustainable agriculture, and water and sanitation issues in the course of my time in Panamá that I felt the pull of global health. Yet the research enterprise is new to me, even as research holds immense value for community-based organization like CAS as they evolve to provide new services, like PrEP. Fortunately, I’ll have some latitude, taking part in – and really, learning about as I go – a range of research methods. On the qualitative side, I’ll conduct in-depth interviews with CAS staff about PrEP and their perspectives on using a mobile app. On the quantitative side, I’m helping to create the survey for PrEP users at CAS and analyze earlier survey data. Besides deepening my professional focus in Latin America, I look forward to gaining this broad experience with the full breadth of qualitative and quantitative skills while forming part of a multinational team.

At the moment, we’re waiting on Institutional Review Board (IRB) approvals at UNC and in Guatemala to begin engaging directly with participants. As much as my instinct is to jump in without looking, such approval processes are of course intended to protect people and their health – the ultimate aim of public health. Just as the pandemic has led me to reconsider the value of hopping on an airplane to “do” global health work, I’m coming to value pace and patience in global health research. Even here at a distance, I can still strive to learn something new every day.

Ian

Hitting the ground running

Posted on by nayavill
My loyal coworker, Elouise the cat, who clearly needs caffeine as much as I do.
My loyal coworker, Elouise, who clearly needs caffeine as much as I do.

If the last year has taught me anything, it is that in-person work and education can be exhausting. I didn’t notice how mentally, physically, and socially drained I was until I was allowed to take a metaphorical breath and work from home for a year. Historically, neurodiverse people have been forced to conform to a neurotypical world that was not designed with them in mind. COVID has certainly brought its own challenges and discomfort, but it has also given us a glimpse of how the world can be made more accessible.

I consider myself to be one of the many people that has benefited from this work paradigm shift. Some of the issues that arise for me in an in-person work environment have been avoided entirely this past year, saving me a significant amount of mental and emotional energy that could then be channeled into something more productive. I am lucky to be completing my practicum with NARAL Pro-Choice North Carolina, a leader in reproductive rights that I have long admired. I was able to hit the ground running on my first day, and my productivity and dedication are both well ahead of where they may be if the work had been in-person.

Despite only being a few weeks into my practicum, I have already been able to utilize many of my different skills, such as GIS, design, systems thinking, and systematic searches. My preceptor is an incredible supervisor and has been so supportive with helping me prioritize my academic and professional interests. I believe that the combination of a great preceptor, a multi-faceted organization, and the remote work setting has allowed me the flexibility to create my own path and utilize my strengths for the best possible practicum experience.

You may be saying to yourself, “but, Abby, don’t you think you would’ve had all those things if you’d been working in-person?” My answer would be yes; I do not think that the quality of the organization or the leadership skills of my preceptor would magically take a hit from returning to the office. What would take a hit, however, would be my own personal comfort and mental capacity for change. By avoiding work in a shared office setting, I also avoid the issue of adjusting to new sensory stimuli and the challenge of adapting to a new workplace social scene.

I am aware that my experience may not be typical (even amongst neurodiverse folks), and I recognize the fact that many of my classmates prefer the in-person setting. However, that is exactly why I believe it is important to avoid putting a monolithic description on remote work. People with disabilities have been deterred from traditional work settings for decades, with companies citing communication issues and fairness concerns as reasons for rebuffing work-from-home requests and office accommodations. COVID forced many companies to make adjustments for their entire staff quite quickly, often proving what their employees with disabilities have been saying for years: alternative workspaces and communication tools can be effective if we give them the chance. As the world begins to return to normal, I hope we can remember that Zoom fatigue is a very real thing, but the many types of fatigue afflicting people with disabilities are just as valid.

Cheers to diverse work settings for diverse people.

Abby

Remote work on remote regions

Posted on by nayavill

If you had asked me a year ago what I planned to do for my practicum experience after the first year of my master’s program, I probably would have laughed and said that I was just happy to have finished my undergrad degree and to have survived the final few weeks of online classes. I wasn’t expecting to spend the past year fully remote, and I definitely wasn’t expecting to be working on a globally focused practicum from the comfort of my Chapel Hill apartment. What I did know a year ago, however, is that my passion for environmental health, clean water and sanitation, would drive me toward a career that allows me to work with communities on global projects for the purpose of improving public health overall.

Even as a child I felt a deep sense of belonging to the natural world around me – growing up in rural North Carolina, I always felt safest surrounded by trees and bugs and the smell of wet leaves. I felt it was my duty to protect this place that also protected me. I now know that our relationship with the environment is symbiotic: by protecting the environment and improving environmental health, we also improve human health. Perhaps the most important resource to sustain this human-environment relationship is water; without it, we would simply not exist. Global access to clean water and sanitation is of utmost importance; for this reason, I decided to take on this practicum opportunity researching interventions targeting sanitation-related behavior change in the developing world – particularly the safe disposal of child feces in the Asia-Pacific region. Poor child feces management is a public health problem of particular importance in this region, especially due to the high risk of enteric infections among children, whose immune systems are not fully developed. Some of the health outcomes associated with these unsafe disposal practices may include diarrheal disease, soil-transmitted helminth infections, and stunting. This project will involve collaboration between Gillings and the humanitarian organization World Vison, which works closely with communities most impacted by the health outcomes associated with inadequate water and sanitation. Thus, I will be exposed to real-world interventions that incorporate the type of community engagement that I want in a career.

My three cats – Grandpa (top left), Franklin (right), and Rosemary (bottom left)
My three cats – Grandpa (top left), Franklin (right), and Rosemary (bottom left)

I always feel proud to tell people that I’m working on my MPH at Gillings, the top public school of public health in the nation, though I never really know what to say with regard to what I actually do on a daily basis. I typically tell people that I work in environmental public health, which is usually met with an “Oh! That’s a really important field nowadays!” Which is especially evident in the era of COVID-19, but I would argue that public health is always important, or was perhaps even more important just before the pandemic as we failed to protect our most vulnerable from this deadly disease. Plus, “I work with child feces” doesn’t really make for good dinner table conversation.

Although I used to dread all this remote work, I’ve actually found it more rewarding to set my own schedule and goals. I also get to spend a lot of time with my cat and foster kittens! With three cats I’ve definitely gotten a lot of real world experience with feces management.

Feeling hopeful for a productive and rewarding summer!

-Lauren