Locally Located but Globally Connected

While in danger of sounding repetitive, my summer practicum experience was not exactly what I had originally imagined. To be honest, I felt a sense of disappointment not being able to spend the summer in Johannesburg, South Africa working directly with the amazing team at the Anova Health Institute and their peers at Wits University. However, as soon as I began my practicum my attitude completely changed, and I couldn’t help but feel such appreciation to still be included in the incredible work that Anova is doing for their community. The fact the Anova was still willing to invest time and energy into my professional and personal development in such unprecedented circumstances was humbling.

The project I am currently working on is part of the UNC-Wits University Implementation Science partnership. As part of this program, I am working with the Anova Health Institute, a leading organization in the implementation of HIV care in South Africa. Currently, I am analyzing data from patient file audits in order to identify gaps in care, especially in regard to a new HIV treatment protocol that was rolled out across South Africa in December 2019. The goal of this project is for Anova to develop recommendations for quality improvement within their partnering facilities in order to be able to best support the health of the patients they serve.

Finishing up a Zoom meeting with some of the amazing staff at the Anova Health Institute.
Finishing up a Zoom meeting with some of the amazing staff at the Anova Health Institute.

Although I’m completing this practicum remotely, the team at Anova has made me feel included even thousands of miles away. For example, last week I was sitting in on a staff meeting where each person took the time to welcome me and explain the projects they were working on so that I could follow along with their conversations. This small gesture highlighted how global connectedness can transcend great physical distances. I am overwhelmingly grateful to still be able to engage in this important work in the face of such difficult circumstances for many across the world. Quality HIV care is especially vital during this pandemic. I am honored to be growing and learning from incredible professionals in the field who are committed to improving the health and well-being of those living with HIV.

Hannah

The Balancing Act of a Global Public Health Practicum Amid a Global Public Health Crisis

The COVID-19 pandemic has challenged us to change our attitudes and behaviors radically, as both students of public health and members of society.  Together, we are bound by our collective anxieties and feelings of uncertainty.  As students of the field, many of us have been frustrated with the shortcomings of our country’s infrastructure and feel overwhelmed as we take note of areas which call for improvement.  Some of us have felt a personal sense of responsibility to contribute to the response at home, whether that be to volunteer at our local health department or learn how to make DIY face masks from Pinterest.  Regardless of which emotion is most predominant on any given day, each of us feels a great sense of confidence as we see how necessary our skills are during these trying times.

The shared workspace of my husband and I.
The shared workspace of my husband and I.

Like other students planning a global practicum, I was disappointed when I learned that my position in Zambia would be shifted to remote work.  However, I am grateful that through the UNC Gillings Zambia Hub under the mentorship of Dr. Stephanie Martin, I am able to work with an issue which I am so passionate about.  I will be working with the Scaling Up Nutrition Learning and Evaluation project (SUN-LE) which provides survey, research, evaluation, and dissemination services to Zambia’s Scaling Up Nutrition (SUN) program.  SUN aims to reduce childhood stunting in Zambia through nutrition-specific and nutrition-sensitive interventions.  I will be working to provide quantitative and qualitative analyses of the cross-sectional baseline survey as well as key informant interviews to identify key indicators of childhood stunting.

My four-month-old puppy, Tanooki, enjoying our post-lunch routine of frolicking through Merritt’s Pasture.
My four-month-old puppy, Tanooki, enjoying our post-lunch routine of frolicking through Merritt’s Pasture.

By establishing routines, setting internal deadlines, and scheduling virtual check-ins with my preceptor, I hope to make my practicum experience feel as “normal” as possible – but that’s not to say that it won’t come with challenges.  My wily four-month old German Shepherd/Lab (mutt) puppy named Tanooki forces me to break up my day with periodic sprints to the mailbox and back – but I’ve been relishing in all outdoor activities.  From running and biking on the American Tobacco Trail, to fishing (so far, without success) at Jordan Lake and swinging in my backyard hammock, I have come to appreciate now more than ever how essential fresh air and movement is for my productivity and overall sense of wellbeing.

Grace

Global from Local: Compiling Best Practices from Afar

By Ellery Walker

I know I echo the sentiments of many others when I say that 2020 sure has been a year full of the unexpected. When I traveled back to Michigan to visit my family over Spring Break, I had no idea just how much would change in the coming months. Though I had not yet secured a practicum, I had been pursuing opportunities across the nation and globe. I wasn’t sure where I would end up, but I was quite sure it wasn’t going to be anywhere near Chapel Hill. However, as the COVID-related travel restrictions grew, I shifted my search to anything that I could do from North Carolina. I stumbled upon Family Health Ministries (FHM), and, lo and behold, here I sit in my Chapel Hill condo. That’s the first piece of unexpected irony in my summer.

FHM’s Carmelle Voltaire Women’s Health Center in Tom Gato, Haiti.
FHM’s Carmelle Voltaire Women’s Health Center in Tom Gato, Haiti.

The second bit of irony comes in the work that I’m doing. FHM is a small, faith-based, community-directed, outcome-focused, partnership-oriented, and relationship-driven global health nonprofit based in Chapel Hill that has been working to “support Haitian communities in their efforts to build and sustain healthy families” for more than 20 years. What began as a commitment to reducing cervical cancer and maternal mortality among Haitian women has expanded to include several clinics, an orphanage and school, educational opportunities, and substantial community development. Earlier this year FHM opened a new birthing clinic at the Carmelle Voltaire Women’s Health Center (CVWC) in Tom Gato, a rural area in the mountains of Haiti. The clinic is managed by two Haitian midwives, with oversight from a local OB/GYN physician, and they have delivered about 20 babies thus far. Since the clinic is still a fairly new operation, this summer I am conducting a literature review on birthing centers and intrapartum care in low resource settings, and compiling recommendations for best practices for the CVWC.

Now, I mentioned that my work is somewhat ironic… so where’s the irony in a lit review? Well, I am the daughter of two OB/GYNs, and I have spent the last 24 years trying desperately to NOT engage in conversations surrounding maternal and infant health. And yet, here I am, dedicating my summer to learning as much as possible about childbirth. It all comes full circle, and yes, my parents are thrilled. This summer is ironic and unexpected, but I think it’s unexpectedly just what I needed.

Working remotely does have some nice perks… like this view!
Working remotely does have some nice perks… like this view!

Before I ever knew exactly what I would be working on this summer, I was drawn to FHM by the way that they empower and equip Haitian communities and leaders through intentional and respectful long-term relationships. As I think and learn more about global health and my role as a practitioner, I want to be committed to developing true relationships characterized by listening and learning, and working with the FHM team is a great opportunity to practice just that. As much as I wish I could be on the ground in Haiti, I am grateful that working remotely has forced me to rely so much more heavily on collaboration and trust with the FHM team and the Haitian staff. I have to rely on the input of the physician, midwives, country director, and my preceptors because I’m simply not there. I like to think that I would be engaging them in the conversation and prioritizing their thoughts even if I was physically there, but the truth is that it’s so much easier to become the expert as soon as we’ve experienced something. So, for now, I’m glad to be working from afar. I’m compiling best practices on something I’ve never experienced in a place I’ve never been. I cannot fall back on my own understanding, which means I must trust that of those who live, work, and have spent substantial time in that setting. And that’s how it should be anyway, right? Sure, global from local is a challenge, but it’s good practice, because whether I’m walking through a clinic on my own two feet, or just seeing it on a computer screen, my role should never be to dictate, but to amplify the voices of those I serve.