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We have a new blogger, Aninda Sen, a master of public health student working with the UNC Water Institute and World Vision in Malawi and Kenya this summer! He’s checking in from Malawi!

As I have discovered first hand, this country is fully deserved of that title, as you cannot walk down the streets for 5 mins without someone waving to you while shouting “Hello” or as they say it here “Muli bwanji”. The country is beautiful, and its people are warm and welcoming to all, and in recent times, there has been great leadership shown in access to safe water, sanitation and hygiene. And this is where I will be working for the first half of this summer.

I am currently in Malawi working on my summer practicum with 2 other students on a project which is part of the long-standing successful partnership between the UNC Water Institute and World Vision Malawi. As part of the assessment team working on the functionality of solar powered water pumps in rural Malawi, I am collecting data in order to understand the sustainability and effectiveness of solar pumps, as well as testing water samples from various water points in order to determine the safety standards and any health risks involved to those who depend on this water for their daily activities. My work also involves gauging the impact of the improved access to safe water on the economic development of these rural communities. The vast majority of my data is collected through the use of electronic surveys and interviews with the local people and water committee members living in the villages served by solar pumps. This has allowed me work with the team trying to understand the future potential of such large-scale projects in areas where water has traditionally been difficult to come by. It has also given me the opportunity to interact with the people who are directly being affected by these water systems. And to be honest, that is the most rewarding part of my work. Everyone I come across in these small communities has such useful information to provide when it comes to evaluating the effectiveness of the water pumps. Coming from a developing country myself, where electricity is not always available throughout the year, this has allowed me to begin exploring the possibilities provided by clean, sustainable energy sources such as solar power. Also, the villagers cook a mean pot of psima with “mileage” chicken, so that’s a bonus that accompanies all the traveling.

The work often takes me off the beaten path, to some hard to reach communities, and that is my opportunity to get to explore the country a bit more closely. I am a trigger-happy cameraman, which means all the travel has exposed me to some dramatic scenery and breath-taking African sunsets. I am only 4 weeks into my work, and I feel like time is flying by way too fast for me to take all of this in. We have been to the villages of Langa and Sandram, and every community offers the opportunity to learn something new about the WASH system, and how it is being managed for a bright and sustainable future.

Our team of interns recently went to Lake Malawi for the weekend to take a small break from all the field work, and it was one of the best holiday destinations I have ever been to. Beautiful scenery, amazing beaches and crystal-clear water, to go with the amazing food.

The time I have spent so far in Malawi has been very helpful in helping me become a more well informed public health practitioner. I cannot wait to see what the next few weeks have in store for me. I will be sure to keep you all updated. Till then, have a nice day, or as they say here “Mukhale ndi tsiku labwino”.

-Aninda

The second part of my time in Malawi was meant to be spent working on the second objective of my practicum experience, which is to help to create an interim report (“results brief”) for the partners, funders and key policymakers, using the study’s protocol information and the data collected thus far. Since mid-January 2018, the study team has been gathering data from participants who were referred to and/or enrolled in the national Prevention of Mother-to-Child Transmission of HIV (PMTCT) Program between July 2016 and June 2017 at 11 different facilities in Lilongwe district. The plan was for me then to work with the Head of the Analysis and Manuscript Writing Unit of the UNC Project-Malawi, to analyze the data and produce the report. The study’s timeline projected that all data in Lilongwe would be collected by May, and that after a couple weeks the study team would move north to enroll participants from the Mzimba South District. I would then work on the interim report and perhaps spend one of my last weeks with the study team up north.

After a slight delay, the study moved to the Mzuzu Health Center, a five-hour drive from Lilongwe. Unfortunately, two weeks later, half of the team had to come back to Lilongwe because as we crosschecked information and started data cleaning for the statistical analysis, we discovered that there was some missing data. There had been issues related to data collection and recording methods, and we would need to return to some sites. The study design proposed the collection of retrospective data on each woman and her infant from PMTCT enrollment through the child’s second birthday, but several logistical difficulties have delayed the team’s efforts. The challenges include reduced time to access the electronic medical record system and the lack of electrical power in the facility. Furthermore, in Area 25, the biggest site in Lilongwe, 307 Mother-Infant Pairs (MIPs) were sampled for the study’s nested cohort, but about a third of those could not even be contacted or traced because their location information was not enough to enable my colleagues to find them.

While that is being sorted, I have been continuing to support the research team with data entry and management tasks, such as quality control, tabulation of information and the improvement of different control tools used for the study. Towards the completion of my second practicum objective I have been working on analyzing some of the data with STATA and summarizing information from our study protocol to be relevant to our audience. You can see the first two pages of the draft results brief below. The report is formatted according to pre-determined design guidelines.

As my departure approaches, I can say that the last two months have been extremely significant to me. I have been able to combine my previous professional experience and my MPH knowledge and skills, and have a positive impact in very meaningful and interesting work. I now very much look forward to being back home (my heart is in Chapel Hill/Carrboro) to complete the program and to work with an amazing Capstone team for the next academic year!

My deepest thanks to the UNC Project-Malawi SOAR PMTCT study for hosting me, to the amazing Health Behavior faculty and staff who have been so supportive, and of course to the Research, Innovation and Global Solutions team who helped make the trip and stay here easier. I look forward to sharing more details about the study and my work during Practicum Day!

See you! Tiwonana!

-Rigo

Let me start by telling you a bit about the organization I’m partnering with and the work they do. Shifra is an NGO in Melbourne, Australia dedicated to increasing access to sexual and reproductive health services for refugees, migrants, and asylum seekers through the use of an app. Shifra was started by a Gillings alum, Beccah Bartlett, and is the only organization addressing this need in this way in the world. When refugees, migrants, or asylum seekers come to a new country, they often have a hard time accessing the resources that are available to them due to language barriers, an unfamiliarity with the host country’s health system, and unawareness about their rights as a patient- such as the right to ask for a translator. This is even more true when the health needs are sensitive, such as questions about contraception and pregnancy. The app allows women to access the information they need, whenever they need it, in their own language. It launched about a year ago and is currently available for Arabic speaking women in Melbourne.

When considering my options for a practicum this summer, I was drawn to working with a small organization because I would have the chance to practice a number of different public health skills. This has certainly proven true! In the two weeks that I’ve been on the ground, I have been a part of key partner meetings, evaluating existing resources, developing marketing materials, and laying the groundwork for a process evaluation that I’ll be completing during the rest of my time here.

My main project is evaluating Shifra’s use of human centered design to create the app. I love this project since systems and design thinking has been my favorite class at Gillings! While it is exciting to be on the cutting edge, it also requires a lot of cross-disciplinary research to learn how human centered design has been used with refugees, how it has been used with mhealth interventions, and how it has been used to address sexual and reproductive health needs. In the coming weeks, I’m looking forward to speaking with refugee co-designers and learning more about their experiences with the co-design process.

-Jess