Highlights from the Highlands in Guatemala

Posted on by nayavill

It’s hard to believe another month has gone by and that I am wrapping up my practicum very soon!  During the second half of my time with Curamericas in Calhuitz, Guatemala, I continued collecting and analyzing data on neonatal outcomes, modifying my interview guide, and then conducting and analyzing these group interviews with the nursing staff to collect their perspectives on managing and improving neonatal outcomes.

I am lucky to have shared most of my time in Calhuitz with another Gillings practicum student, Kay, and for both of our projects we needed to visit the neighboring Casas Maternas of Santo Domingo and Tuzlaj.  This was a great opportunity to learn first-hand about the different catchment areas covered by the organizations’ projects, meet more staff, and switch up the scenery.

We were told the Casa Materna in Tuzlaj had a different feel, that the area was more remote and unaccustomed to seeing foreign volunteers, and that it would be close quarters due to the Casa’s small size.  After a jostling two hours up and down rocky mountain roads, it’s true we found a cozy atmosphere, but with welcoming vibes.  We walked into what felt like a data-organizing party serenaded by Romeo Santos and reggaeton.  There was hot chocolate for breakfast and Philly cream cheese.  Dogs sprawled lazily on the grass rather than lurking fearfully for scraps.  A 13-year old was admitted to the Casa, and rather than experiencing a prolonged and difficult labor, delivered a healthy baby within a couple of hours.  Tuzlaj was full of surprises.

Entrance to the Calhuitz Casa Materna.

One of the main objectives for visiting Tuzlaj, and one of the most engaging parts of my practicum, was to conduct these group interviews with staff about their perspectives on neonatal complications and deaths.  I continue to admire these nurses and mujeres de apoyo for their hard work with limited resources.  These conversations convey a strong initiative and sense of responsibility to prepare and educate oneself due to their isolation and limited access to cell signal.  They share a holistic view of health and social determinants that’s at the heart of nursing, but which we hospital-based nurses can lose during hectic days.  As with many public health issues, it was clear these neonatal and maternal health challenges we were discussing had deep roots in longstanding gender and socioeconomic inequities, discrimination, and language barriers.  The staff knew the solutions still lie in preventive measures such as continuing to strengthen their health education outreach, community engagement, and garnering more support from civic and government partners.

View of Calhuitz and the Casa (tall green building) at dusk.

At the end of my time in Calhuitz, we were pleased to step fully back into tourists’ shoes for a couple days and visit Lake Atitlán on my way back to fly out of Guatemala City.  It’s one of those places that pictures don’t do justice and distance perception must be altered due to the enormity of the volcanoes and the beauty of the water.  We walked to a popular lookout and cliff-jumping site and after Kay confidently took a birthday jump, I of course had to follow. Only afterwards we learned that it was almost 40 feet—twice what it had looked to me.

Numbers that balance at Lake Atitlán, unlike in spreadsheets.

Back in NC I am continuing to work with both the quantitative and qualitative data in order to report back findings to staff and discuss next steps.  It is interesting to see how the data complement each other and also the amount of information available from a data set that was a bit confusing to piece together.  It’s been very meaningful having a practicum that places a foot both in global health and nursing, and hopefully this research work will offer the organization some insight into their outcomes and assist in determining next steps for reducing neonatal mortality.

– Emily

A seat at the table

Posted on by nayavill

Since starting my practicum at the Migration Health Division (MHD) at the International Organization for Migration (IOM) in May, I have worked on and/or am currently working on the following major deliverables:

  • Partnered with the MHD Logistics Team to plan and implement a three-day global health training where current migration health needs and strategic priorities for MHD were discussed amongst IOM leaders across the globe
  • Data entry and cleaning of IOM’s Health in Emergencies training program evaluations
  • Drafted content for the following reports:
    • UN Report of the Secretary-General on what IOM can offer through the development cooperation with middle income countries
      MHD Annual Report 2018
    • United Nations (UN) Interagency Task Force on Noncommunicable Diseases (NCDs) Report on IOM’s response to the challenge’s migrants and mobile populations experience when dealing with NCDs
    • Policy brief on international health workforce mobility
  • Assisted in the preparation of presentations on emergency response for new IOM employees serving in country offices
  • Community-based participatory research (CBPR) toolkit for IOM country offices to use when engaging with communities to tackle health challenges
(L-R) UN agency interns, Farhaa, Mikayla, and I taking a selfie right before catching a bus to meetings with colleagues from the World Health Organization.

In all, being an intern at a UN agency this summer in Geneva, Switzerland, has been such a rewarding experience. I have had a seat at tables I would have never imagined myself to be offered an invitation; for example, I got a seat at the 72nd World Health Assembly – the world’s highest health policy sitting body – where I got to meet Ministers of Health from around the world discuss and come together on new global health policies they want to set. In addition, this month I am preparing myself for a meeting I will have with diplomats from the US Mission to International Organizations in Geneva to learn more about their daily role of advancing U.S policy and job opportunities. Thankfully, my internship is still not over. This means I still have about 4 more weeks in Geneva to continue to take advantage of every opportunity that I can grab as I strive to enhance my global health portfolio.

– Fatima

Dia dhuit from Galway

Posted on by nayavill

Dia dhuit! It’s hard to believe that I’m already halfway done with my practicum with the National University of Ireland at Galway Health Promotion Research Centre (NUIG HPRC). Although I still haven’t quite mastered Gaelic, I have been fortunate enough to have already been exposed to so many of NUIG HPRC’s critically important health promotion activities. As a WHO Collaborating Centre for Health Promotion, their work spans the small, rural communities of Ireland’s coast, to the management of global research projects that span over 45 countries.

HPRC itself is tiny—a small, two-story building on the north end of NUIG’s campus with only 5-10 people in the office on a given day. But what those 5-10 people have been able to accomplish is truly incredible. My practicum consists of two primary tasks: the first is the development of content for the new Mental Health Promotion online postgraduate degree, and the second is data analysis and dissemination of the 2018 Health Behavior in School Aged Children (HBSC) survey data (details on that to come below!).

‘What do children need to be healthy?’ youth engagement workshop hosted by NUIG HPRC at a school in Galway.

For the first two weeks, the majority of my time was spent working on the mental health promotion content. The program is unique in its focus on positive mental health versus the more traditional understanding of mental health as the mere absence of mental illness. Even so, I consistently found myself instinctively leaning towards language of traditional models of prevention of mental illness rather than promotion of universal mental health, and I’ve been really pushed to challenge my own assumptions and understanding of wellbeing.

Now, with the majority of the mental health promotion content behind me, I’ve switched full gear into data analysis and dissemination for the HBSC study. For context, the HBSC study is a global survey-based research study of school-aged children across the world. Surveys are administered to students in schools every four years, and the questions includes items around mental, physical and social health, as well as key demographic factors such as ethnicity, religion, and socioeconomic status. (Interestingly, some countries have specific rules on what you can and cannot ask children about—particularly when it comes to sexual orientation and sexual health! But that’s a discussion for another time).

Although I had a high-level understanding of the HBSC study before my first day, I wasn’t expecting to have so much freedom in the direction of my analyses. My first day at NUIG HPRC was intimidating—while sitting at a table of some of the top health promotion researchers in Europe, I was asked ‘what populations specifically are you interested in?’ If we were in America, I would know how to answer: indigenous and immigrant populations. But sitting at the table in Ireland thinking of evaluating mental health among Irish school children, I found myself lacking the necessary cultural context to answer that question. So I started reading. After a few days of background reading and close inspection of prior HBSC, I found myself increasingly interested in two key populations. The first is the Irish Travellers—a historically nomadic ethnic minority indigenous to Ireland with a long history of social isolation and discrimination. Irish Travellers are often mistakenly grouped together with the Roma community but they are in fact two completely distinct populations, though they both share a history of discrimination. The second population I am deeply passionate about is the study of UK immigrants vs. non-UK immigrants. Prior studies in Ireland have found disproportionately poor health outcomes among non-UK immigrants in Ireland, and I am interested in digging deeper into how health among first generation and second generation immigrant children in Ireland varies by their country of origin.

Although I’ve just begun digging into the data, I am already finding myself with so many more questions I wish I had the time to answer. My ultimate goal is to complete two short reports: one on mental health among Irish Traveller school children, and another on mental health among immigrant school children in Ireland. I’ll be writing a few ‘academic’ reports to post on NUIG HPRC’s website, but will also have the opportunity to use more creative means of communicating our findings to local non-profits such as infographics and brochures. I’m so excited to be able to pull together the findings and start disseminating them—NUIG HPRC’s work is critical to informing national policies and programs around childhood health and well-being. Drawing awareness of inequities is so critical for policy development, and I’m psyched to be part of the team!

Commuting buddies from my rural Irish home to the NUIG HPRC office.

Stay tuned for more updates on the data!

– Casey