Gillings Around the globe – Page 82 – Local is Global. Global is Local.

Dear, Zambia

Posted on July 19, 2019 by nayavill

This summer, I have been working as a research intern for the NIH-funded Methods for Prevention Packages Program (MP3) study. This multi-component intervention study is at its formative stage and primarily aims to explore if the secondary distribution of HIV self-test kits (SD-HIVST) to pregnant women will increase HIV testing among their male partners. It also plans to explore if the integration of adherence supporters and integrated next step counselling will improve ART and PrEP adherence among pregnant women in Lusaka, Zambia. As a result, I’ve spent most my time here strengthening data collection instruments, assessing questionnaire items, designing semi-structured interview guides, creating training materials for study protocols, and outlining the study’s logic model and timeline plan.

That said, I’ve learned a lot in terms of research design and HIV prevention of mother to child transmission (PMTCT) in Zambia, but have also learned a lot about Zambian culture over the past 6 weeks.

If you read my first blog, The Path You Must Take, it may have seemed as though my bad luck with a missed connection flight turned into an amazing unexpected journey and phenomenal arrival to Zambia, which it did. However, if I tell you that this was not an isolated incident you may begin to think that I just have bad luck with transportation.

Well, this was not an isolated incident (ha ha).

12 p.m., June 21 – Two friends and I began our supposed 8-hour bus journey to Livingstone, Zambia, more famously known as one of the cities bordering Victoria Falls. Victoria Falls is one of the seven natural wonders of the world and being in Zambia, it was a given that I must go to visit.

8 p.m., June 21 – This is the moment where I should be detailing my first impression of the city, but given my adventurous destiny, this is actually the moment where I realize we are in a conundrum.

At around sunset, our #1 recommended bus company breaks down. Now you may think “well these things happen all the time”, apparently not (which is probably a good thing in general but a bad thing for us).

Wall from Café Zambezi – Livingstone, Zambia

Where I have circled in yellow is approximately where I believe the bus broke down and what also appears to be the halfway point between Lusaka and Livingstone.

As I mentioned earlier, it is around sunset when the bus breaks down so what you see here is about all I could see in person as well (I promise this story has a happy ending).

At this point, it’s pitch black outside with nothing nearby, extremely cold given its winter season in Zambia, poor signal and to top it off my friends and I hadn’t eaten for approximately 7 hours. The bus company informs us that they are trying to dispatch the nearest bus but that it would be a couple of hours. That said, the bus drivers attempted to help all of us get on passing buses that were on the way to various destinations.

My friends and I befriended a man by the name of Isaac who helped us drastically when it came to which bus to hop on and where to get off. By the time we arrived to Livingstone it was close to 1 a.m. and Isaac called us a cab to make sure we got to our hostel safely.

In front of the Devil Pools at Victoria Falls

This trip as a whole has not only shown me how to improve my analytical research skills but has also shown me the amazing familial-like ties people in Zambia are so quick to form. From being brought in to a baby shower like family, to being called “mama” out of respect everywhere I go, to then being protected and escorted by new friends on the bus – Zambia has been a phenomenal place with phenomenal people. I will truly miss it but let this not be goodbye forever.

Toki sio [see you later].

– Rebekah

Two Weeks of Fancy Research at Stanford University

Posted on July 18, 2019 by nayavill

It’s getting close to the end of my practicum and I’ve had a well-rounded experience to what global health research is like. My practicum began in Palo Alto, California where I became part of the REAP, Rural Action Education Program, research team at Stanford. This team of talented individuals works on policy change and research to help the poor communities in China. As part of the team for the summer, I focus on building and adding new material to the Healthy Future curriculum, a program to be given by Community Health Workers in rural China to improve maternal and infant nutrition as well as prevent infant injury. China’s rural infants too often suffer from malnutrition but providing such an education program will help improve conditions for them. With this in mind, I’ve enjoyed working on the curriculum knowing that it will make a difference for many individuals once it is implemented.

Outside of the practicum work and research environment, I enjoyed exploring northern California for the first time. I definitely got to feel what it’s like to live locally and stayed two doors down from Mark Zuckerberg! I was also lucky enough to have a bike rental during my time there so that I was able to travel to and from Stanford as well as around town! The flexibility of the work allowed me to work at coffee shops where I ordered my first mint mojito, a sweet and creamy latte with mint, at the very popular Peet’s. Lastly, I was able to rent a car and travel to San Francisco and visit the many well-known places such as China Town, Fisherman’s Warf, and of course the Golden Gate Bridge. I greatly enjoyed my time in Palo Alto and would definitely recommend considering a practicum on the West Coast!

While I was scheduled to travel to China for the rest of my practicum, my trip has been delayed, I continue to work and will hopefully be able to visit the university in the future. While, I’m saddened that my trip has been delayed, I have received a well-rounded experience of global health research and I know that the work that I have been doing this summer will make a difference in foreign communities and I believe that I have gained global experience to prepare me for future endeavors.

– Nicole

Highlights from the Highlands in Guatemala

Posted on July 15, 2019 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.

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