Challenging Myself in a Spanish Speaking Environment

I am completing my practicum with Ipas LAC. Ipas LAC addresses reproductive health and justice needs throughout Latin America and the Caribbean. The team I am working with is specifically addressing access needs along the US-Mexico border. Before pursuing a Global Health MPH at Gillings, I was a medical assistant and trainer in reproductive health clinics in San Diego. This practicum has allowed me to build on my previous experience addressing the reproductive health needs of border populations by utilizing the skills I gained in the first year of my MPH. My Ipas LAC teammates are primarily Spanish speaking, and this has been my greatest personal challenge through the practicum. Though I have worked with Spanish-speaking patients in the past, working and collaborating in Spanish almost exclusively has been a new challenge. The team I work with is international, hailing from Central and South America and Mexico. Working with such a diverse team has been a unique learning opportunity. I have applied many skills I learned throughout the previous school year, particularly communication skills and decentering my cultural perspective.

Some of the resulting artwork from a tie-dye party we had.

So far in my practicum, I have had the privilege of meeting with multiple teams of community leaders. Together we have strategized about feasible and appropriate resource allocation in the region to maximize patient safety and access.

My dog, Goose, cooling off mid-trail.

Outside these meetings, I have primarily been improving existing English language resource materials for clarity and accuracy. This has been a more sensitive project than I first anticipated because of the challenge of maintaining the voice of the original Spanish language materials through translation. I am also cognizant of the variety in educational attainment and English proficiency of potential utilizers of the resources. As the border is a culturally diverse region, I know that non-native English or Spanish speakers may still seek English language materials. I am careful to ensure that materials are accessible to non-native English speakers through clear visualizations and simple language. Ipas LAC places a particular emphasis on de-stigmatization and encouraging self-sufficiency in their materials. As someone who has previously worked in highly regulated clinical settings, the less institutionalized perspective that professionals outside of the United States bring to access efforts has expanded my understanding of possible avenues of intervention.

Goose and I recovering at the top of Occoneechee Mountain.

When not working on my practicum or my other research work, I am trying to get to know North Carolina better. Most evenings, I take my dog for a run or a bike ride, which he loves. Unfortunately for my car’s interior, his favorite thing to do in the heat is roll in whatever mud puddle he can find. I’ve also thrown a couple of bonfires and done some tie-dying with friends this summer.

– Maddy

Nurturing Health through Nutrition: Building Bridges between Clinical Expertise, Field Trips, and Community Engagement

As my fulfilling journey in the field of Public Health and Nutrition practicum comes to a close, I reflect on the remarkable experiences that have shaped my path. Throughout my practicum, I witnessed the seamless integration of clinical expertise, field trips, and community engagement, forging strong bridges between them. This holistic approach has revealed the transformative power of nutrition and public health in promoting well-being.

And let’s not forget the luck I have in enjoying fresh avocados every day from my friend’s garden, reminding me of the abundance of healthy food options available to us.

Avocados from the garden.

Clinical Expertise: Nurturing Health from the Inside Out

Within clinical settings, under the guidance of Dr. Caro Roman, we had the privilege of assessing and addressing the nutritional needs of diverse patient populations. Together, we developed algorithms for managing conditions such as dysphagia, gastrostomy/jejunostomy, and created personalized artisanal diets for patients at Clinica de la Merced. These innovative approaches ensured that patients with specific nutritional requirements received optimal care.

A Desire to Help, Beyond Material Constraints: Assessing nutrition status and delivering education in Lloa, Pichincha, Ecuador.

These experiences reinforced the importance of evidence-based practices in delivering optimal nutritional care and highlighted the vital role nutrition plays in patients’ recovery and overall well-being. Our collaboration and innovative approaches have contributed to improved patient outcomes and enhanced the quality of care provided.

Medical Brigades: Empowering Communities through Nutrition

Participating in medical brigades provided a platform to directly engage with communities in need and make a tangible impact on their well-being. From assessing the nutritional status of individuals of all ages to delivering personalized nutritional counseling, I witnessed the transformative power of education and support. These brigades, conducted in vulnerable areas, such as Lloa and Pifo, Pichincha, offered communities their first exposure to formal nutrition education and invaluable access to professional guidance.

One of the most rewarding aspects of my work has been the appreciation I have received from individuals who have never had the opportunity to connect with a nutritionist or a professional in this field. Being able to offer them guidance and support and witnessing the positive impact it has on their health fills my heart with gratitude. It serves as a poignant reminder of the importance of bridging the gap between clinical expertise and the community, ensuring that nutrition is accessible to all.

Contrasting Water Quality: The polluted Rio Machangara in Pichincha, Ecuador.

Water Quality and Public Health: Safeguarding Communities’ Well-being

Immersive field trips to breathtaking locations like Lago San Pablo and the Río Machángara unveiled a profound correlation between water quality and public health. Through hands-on water quality testing and assessments, I witnessed the impact of contaminated water sources on the prevalence of malnutrition and its associated risks. Studies conducted in Ecuador’s Lake and River areas have specifically highlighted the heightened vulnerability of indigenous communities and their children living near these bodies of water. Addressing water contamination becomes an imperative step in preventing malnutrition and improving the overall health of the community.

Contrasting Water Quality: The Lake San Pablo in Imbabura, a popular tourist destination in Ecuador.

These eye-opening experiences deepened my understanding of the environmental factors that shape nutritional outcomes and underscored the need for comprehensive interventions that consider both nutrition and water quality. We observed a profound correlation between contaminated water sources and the prevalence of malnutrition, particularly among vulnerable populations living near the Lago San Pablo and the Río Machángara. Notably, the Río Machángara exhibited higher levels of pollution compared to other water sources. These findings emphasize the critical importance of addressing water quality issues and their detrimental impact on community health, particularly in areas like the Río Machángara.

I am immensely grateful for the invaluable opportunity to work with La Universidad San Francisco de Quito and learn from the expertise of Ma. Belén Ocampo and Daniela Chiquito. Their guidance has been instrumental in shaping my learning journey and has contributed significantly to my growth in the field.

– Mili

Remembering Why I Chose Public Health

Hola from the Caribbean! Almost 3 weeks ago I arrived in Santo Domingo,  Dominican Republic, to start my practicum with my fellow classmate, Tiffiany. This beautiful country has greeted us with open arms,  and even though our time here has been short, I already feel that I will miss this place.

Parque Colon, Zona Colonial, Dominican Republic

I am Sophia, a first-year MPH student, and an international student from Guatemala. I truly miss my family, friends, and the way things work in my country. Being here has been a breath of fresh air. The colmadones (corner stores) remind me of the tienditas in my country, which you can literally find in every corner stocked with goods and fresh fruits. The food, oh my God! The food is probably the best part! The fruits and vegetables are fresh, and the variety is amazing. Avocados almost twice the size of my hand, natural juices that taste delicious without any added sugar, tostones, mofongo, mangu, and all sorts of prepared dishes that are extremely tasteful and available at almost all times of the day. A place that remains awake into the late night when the air is cool, while people play dominoes, sit outside their houses to chat, or dance to melodic bachata. The hot air from early morning to dawn makes this place incredibly unique. People here treat you like family; they make you feel welcome.  In a way, to me, that feels like home.  I can note the effects of colonization similar to my country, starting with inequality. I hear it on the streets as people sell whatever goods they can, offering all kinds of services. I can feel it when I ride the Guagua (bus) and the sweat runs down my back in the blazing heat. I can see it in the expensive and luxurious hotels and restaurants frequented by foreigners and only a few locals.

The DR team after our first training session before starting to collect data.

I consider myself very fortunate to have found this opportunity with  Dr. Clare Barrington, PI, whom I have been working with since the start of my first semester. Dr. Clare´s works focuses on HIV, particularly HIV stigma and the use of PrEP and other interventions to improve HIV outcomes. She has previously worked with populations who have been disproportionately affected by the epidemic, such as men who have sex with men, transgender women, and female sex workers.  During my time here, Tiffiany and I will be working with cisgender female sex workers and transgender women living with HIV. For the latter, we will be implementing an intervention called “Gender Affirming Abriendo puertas (GAP)”. The intervention consists of individual counseling, social cohesion, and peer navigators to improve program retention, treatment adherence and other HIV outcomes. For the former, we aim to understand the burden of nontransmissible chronic diseases (NCDs) among female sex workers. We also want to understand how they access care for NCDs through HIV clinics by conducting in-depth interviews with providers.

I am very passionate about research in all its phases. At the moment, I am working on setting up the baseline survey for GAP in REDcap, which has been nothing but fun. We have also piloted the instrument with some of our colleagues here in the DR and will soon be ready to start collecting data. Working with the team here in the DR has been nothing but enjoyable. They are people who truly care and are passionate for what they do, and I am grateful to get to be a part of this team. I am eager to start working with our participants. I have heard of their hardships and struggles, and that has been a constant reminder of why I chose this field.

I leave you with this beautiful sunset on the beach. Until next time.

Sunset at Bayahibe, Dominican Republic.

 

– Sophia