Gillings Around the globe – Page 85 – Local is Global. Global is Local.

At home in Mauritius

Posted on June 25, 2019 by nayavill

It has now been three weeks since I landed in Mauritius, together with my husband and our two children. Many of you may know Mauritius as a tourist destination; Mark Twain is often quoted to have said: “You gather the idea that Mauritius was made first, and then heaven, and that heaven was copied after Mauritius.” Surrounded by stunning coral reefs, Mauritius spans less than 800 square miles and is home to over 1.3 million people. Beyond its flourishing tourism industry, Mauritius is often cited as a model of democracy amongst African nations and an example of social cohesion where people from African, Indian, Chinese and French heritage have created a peaceful co-existence.

Although I have been back several times to visit my family and on holidays, it has been 15 years since I first left to go study abroad. I have lived in different countries during that time, and when the possibility of completing my practicum in Mauritius arose, I knew that this was something that I should do. I was curious about how I could apply what I have learnt during my time at UNC to the reality here, and learn about the ways that I could give back to my home country.

Being a dual degree student with the School of Social Work and Public Health, I am working with two different organizations in order to complete all my required field hours: Gender Links (GL) and the Global Rainbow Foundation (GRF). Gender Links is a South African Women’s Right Organization with offices in ten Southern African Development Community (SADC) countries including Mauritius.

On the second day of my internship with GL, I was asked to be on a jury at the Voice and Choice Summit, which regrouped NGOS, local government councils, media organizations and individuals who are creating change in their communities across the island. The goal of the summit was to create a learning platform where each one came and presented their best practices for promoting gender equality through their current work. The presentations were made under various categories such as gender and climate change, gender and governance, sexual and reproductive health and rights, and others. A winner would then be chosen within each category to represent Mauritius at the African Regional Voice and Choice Summit in South Africa. For me this was an incredible opportunity for networking and for learning about the work of over 20 organizations in one sitting. I appreciated learning about how gender is intersecting with various issues such as poverty and education in Mauritius.

GRF is dedicated to the service of those who live with a disability in their life, be it mental or physical. Their approach is to provide a one stop shop, where someone interacting with their foundation can receive all the services necessary to be a fully functional member of society. To this end, GRF makes and provides prosthesis to its clients, provides employability training, provides medical services by a team of doctors which includes an occupational therapist, psychologists, and a physical therapist. It also engages in advocacy work in order to promote the rights of individuals living with disabilities.

The bulk of my work with both organizations consists of strengthening their internal capacity for monitoring and evaluation. While there is a strong emphasis on regular monitoring of activities, the evaluation component is often minimal, in part because organizations are strapped for staff and resources.

I am looking forward to the coming months as my family settles into the rhythm of the island (which is sometimes not so slow) and as I gain more field experience through both of my practicums. Beyond that, I am also excited to be meeting various individuals and talking about future ideas for collaboration such as strengthening and standardizing the practice of Social Workers in Mauritius and encouraging more research around gender issues, so that NGOs can more frequently engage in evidence based practices. There is so much happening and I am loving it!

– Yovania

Life in Lusaka

Posted on June 17, 2019 by nayavill

I arrived in Lusaka, Zambia about three weeks ago, after a grueling 26 hours of travel, and jumped right into my internship with the UNC Improving Pregnancy with Progesterone (IPOP) Study. I spent my first week in the UNC Global Projects office familiarizing myself with the study and the issue of preterm birth in Zambia and getting settled into my new accommodation and neighborhood. I am now working mostly in the University Teaching Hospital (UTH) to finish collecting and cleaning the data that will be used to evaluate the cost-effectiveness of using progesterone during pregnancy as a way to prevent preterm birth among high-risk women.

It took me about a week to feel confident navigating the halls of UTH in Lusaka. A large hospital that also receives many transfer patients from other clinics, especially in the maternity ward where I am working. I recovered from my first day where I found myself locked in a bathroom for overthirty minutes before the door had to be broken in.This brought alot of laughter to the crowd of staff and patients that had gathered around the door to see if I would get outand is now one of my top embarrassing moments.Most of my time is spent in the NICU right now, observing preterm babies and recording allthe actions themedical staffperformto care for the infants,and the length of time spenton the care. There is a long list of activities we are following, including performing physical exams and setting up IVs to resuscitating babies and delivering oxygen. There are anumber of preterm babies in Zambia that never leave the hospital, these days are by far the most difficult.

The infants are regularly moved around and are difficult to keep track of and doctors and nurses are constantly in motion asI trail them with my notebook and timer. They work quickly and efficiently,movingvery much in sync. I am usually in awe with how effortlessly they move around each other, and me, in the often-crowded rooms. All of the staff are incredibly nice and accommodating andnever forget to start each day by saying “good morning” to everyoneandtheyare always willing to answer my many questions about the activities they are performing.It has been a great opportunity to not only learn more about the issue of preterm birth in Zambia but also about the local healthcare system more broadly.

Outside of work there is plenty to do in Lusaka and around Zambia; so much that it would be impossible to see everything in the short ten weeks I am here. The winter weather here is very ideal and is a welcomed break from the North Carolina summer heat. Multiple national parks and animal nurseries are home to much of Zambia’s diverse wildlife, which the country is making a great effort to preserve. These are great day trips from Lusaka. I will soon be traveling to Livingston for a weekend to see Victoria Falls, one of the natural wonders of the world and a sight I hear is nothing short of amazing. In Lusaka, there are many restaurants and cafes serving food from all over the world. Local cuisine is heavily centered around nshima, a pounded white maize which is scooped up and rolled into a ball with your hands and eaten with different meats, beans and vegetables.

I have learned so much in the few short weeks I have been in Lusaka. Everyone has been incredibly welcoming and have quickly made me feel at home. I look forward to continuing to learn and collaborate throughout my internship and to see what life in Lusaka has in store for the next couple of months.

-Taylor

Saludos desde Guatemala!

Posted on June 10, 2019 by nayavill

Saludos desde Calhuitz, Guatemala! It’s nearing the end of a second week in the rural highlands of Huehuetenango. For my practicum I am working with Curamericas Global and Curamericas Guatemala, who partner with the Guatemalan Ministry of Health to provide community-based maternal and child healthcare services, as well as basic health education, to remote areas which historically experienced high maternal mortality. Over the years the project has constructed Casas Maternas, or birthing homes, which serve as clean, safe settings where women can elect to deliver according to cultural traditions, but with nursing supervision and referral to higher level care if needed. The project also includes post-partum home visits for mother and child health, and community-run Care Groups focusing on women’s and adolescent health topics.

The first week here turned out to be a more collaborative learning environment than anticipated, with the staff from the project’s three territories all coming together in Calhuitz for meetings and trainings. A Haitian doctor from a potential partner organization presented on refining ultrasound interpretation skills for assessing potential pregnancy complications such as hydrocephalus, placenta previa, and placental abruption. It was exciting to learn so much from his expertise in a health area unfamiliar to me, and then to immediately see these skills demonstrated during prenatal visits at the Casa’s clinic. Another day focused on the project’s data management systems and future changes in reporting required indicators. This presentation turned into an important opportunity for staff to share their perspectives on current challenges in their monitoring and evaluation systems, and to discuss their preferred strategies to improve the organization’s data and M&E capacities.

The following weekend, when most staff leave the Casa for their own homes, turned out to be a busy one for the Calhuitz Casa Materna with three births occurring. It was remarkable to be in a setting where multiple new lives were beginning while simultaneously feeling so far removed from the rest of the world, and to witness a tiny newborn’s first cries while helping to dry and swaddle them. As a nurse myself, it was humbling to recognize the variety of responsibilities and breadth of knowledge the staff here have in order to successfully run the Casas and programs. The nurses are the primary providers and decision-makers during deliveries, with a doctor available via phone if necessary. Role-shifting is clearly also an important strength, as the data manager and community educators have been quick to assist nurses with births or consults for pregnancy complications in the Casa.

As I focus on practicum-specific tasks centered around analyzing neonatal outcome data and staff focus groups on managing neonatal complications, I’ve been reminded of key lessons applicable to public health work in general and perhaps particularly to global work. Challenges in locating and accessing data needed—not to mention understanding the organization of a new data system as a whole—have made me check my own assumptions about how much time certain work “should” take and the ease with which information “should” be available. Being so used to having information at my fingertips via the internet and digitalized charting systems, I forget that that is a luxury.

Got internet? For internet, the prime office space is the roof.

The importance of understanding the perspectives of local health workers and their work-loads has also been re-emphasized. Gaining more background knowledge of prior project changes, expansions, and funding has allowed me to better comprehend the work and program goals through staff’s eyes. These conversations lead to a greater understanding of the challenges and power dynamics in global health work and the importance of maintaining a decision-making process based upon beneficiary impact.

I look forward to further learning and collaboration as my practicum continues, and am grateful that the staff here have been patient, open, and welcoming. In the next couple weeks we will be traveling to other Casas in the region for data collection, focus groups, and home visits. I am sure to continue enjoying the simple pleasures of life here—such as the staff’s sense of humor, fire-fueled hot showers, and the best homemade salsa I’ve ever had—and will be curious to see how the terms “communication” and “planning” continue to take on new meanings in new contexts.

– Emily