Gillings Around the globe

As a 25-year-old, I naturally have not thought much about my retirement, much less where I would live if I ever were to retire. My practicum experience has forced me to think deeply about what it means to be retired and to be a contributing member of society, but it’s become complicated with the concept of immigration. I’m currently working on a study funded by the National Geographic Society to explore the impact American and Canadian immigrant retirees might have in Latin America. We are specifically studying how waves of retiree migration in two colonial cities are simultaneously changing healthcare systems, land uses and real estate practices, and social dynamics. It has only been a week and half in the field and the work is even more complex than I anticipated.

Our first city is Cuenca, Ecuador—a UNESCO world heritage site located in the Andes in Southern Ecuador. There are estimates that anywhere between 8,000-10,000 retired expats are living in Cuenca, potentially making up about 1% of the population. Before arriving to Cuenca, I had the assumption that this small retired expat population had high financial and social capital that contributed to major changes in housing (and displacement) through price inflation in the past decade. To an extent, there is some truth there. However, our preliminary data are portraying a complicated story affected by a growing population of returning (or deported) Ecuadorians from the U.S.A. and Europe, and Venezuelan refugees. These three types of migrants (Ecuadorians, Venezuelans, retired expats) have provoked conjoined public sentiments about immigration and how they are all affecting life in Cuenca. No stakeholder really seems to agree on much except that at least one of these immigrant groups is partially responsible for the sustained economic struggle.

My feelings about this topic are muddled by my background as a Venezuelan American, who is frequently hearing xenophobic remarks about Venezuelans immigrating to Ecuador to steal jobs, commit crimes against natives, and overuse social services. It is always disorienting to think that these comments are heard all over the world against neighboring groups of people. Not surprisingly, this project has become fairly political the deeper we dive into it and how the results compare to our second stop: San Miguel de Allende, Mexico. We will find out soon.

-Karla

One of my biggest motivations in pursuing a public health career and degree is the opportunity to contribute to the existing efforts across the country to improve maternal, infant, and child health in the nation. MAZA has afforded me this opportunity with this summer practicum. MAZA is a social enterprise that provides safe, accessible, affordable and reliable transportation for urgent and emergency health care needs in remote rural areas of Ghana, with a focus on pregnant women and sick infant. They lease motorized tricycles to local drivers at a discounted price in exchange for their being on call for urgent/emergency health care transportation twice a week. For the other five days of the week, the drivers use the tricycles as taxis to earn a living and pay a weekly fee to MAZA. After two years, they own the tricycles outright. MAZA’s service is available 24 hours a day, seven days a week through a toll-free number or by direct contact with the local drivers.

MAZA has been in the Bunkpurugu-Yunyoo District for a year now and has provided transportation during emergency/urgent health care needs for over 200 passengers since. My practicum is a field assessment focused on exploring the geographical limits of MAZA’s intervention in the Bunkpurugu-Yunyoo District. My first week in the Northern Region was spent in the field in Bunkpurugu-Yunyoo collecting location data of MAZA drivers and passengers to investigate the distance between drivers commute to pick up passengers and take them to a health care center during emergencies. Working in this part of Ghana – rural, open, bright, unlike what I’m used to in the capital city of Accra – has been nothing short of exciting.

Little did I know there are communities in this part of the country, that have existed for decades, are now divided by superficial international border lines delineating Ghana from Togo. There are literally families living in the same community with one family’s house in Togo and the other in Ghana. Wild right? That’s one of the most fascinating things I’ve encountered here. As such, there are families technically living in Togo that have benefited from MAZA’s services because they are a part of a community that is also Ghanaian and visit the health facilities in Ghana.

This week, I go back to the rural areas for the second part of the project – community assessment. Looking forward to sharing those experiences with you all.

 

-Edith

Muli bwanji? In Malawi you hardly ever have an exchange without asking the other person how they are, and you can be sure you’ll always be asked back. The country is known as “The Warm Heart of Africa,” and all who visit have the opportunity to confirm this statement. Since 1990, it has hosted the UNC Project-Malawi (UNCPM), a collaboration between UNC Chapel Hill and the Malawi Ministry of Health. It is located on the campus of Kamuzu Central Hospital in the capital city of Lilongwe. The project’s mission is to identify innovative, culturally acceptable, and affordable methods to improve the health of the people of Malawi, through research, capacity building, and care. The scope of activities has diversified since then.

Before I moved to North Carolina and started the MPH program in the department of Health Behavior, I lived in Lilongwe from 2013 to 2016, working for the Brazilian Ministry of Foreign Affairs. In 2015, I met my wife when she was working at UNC Project-Malawi and because of her research in pediatric oncology we have kept in contact with the project since we moved. This summer I was fortunate enough to join the project to work on a research study called, “Mother Infant Retention-Promoting Mother Infant Retention along the HIV Care Continuum: A Comparative Effectiveness Evaluation of Three Models for Community Facility Linkage.” The study’s goal is to characterize widely adopted community-facility linkage models and assess the impact on mother-infant pair care retention and the Prevention of Maternal-to-Child Transmission (PMTCT) of HIV under “real world” conditions in Malawi.

My participation in the study involves a literature review describing issues of HIV linkage to care during the Universal Test and Treat area in Sub-Sharan Africa and other high-burden settings. The review should be published in a special supplement about linkage to care in the AIDS and Behaviour journal, and I will be included as one of the co-authors of the article. For the past week, I have been accompanying the study team during their last data collection activities in two sites near Lilongwe, before they move to other sites in the north of the country. For the rest of my practicum I will be working with an epidemiologist to conduct an interim data analysis and the study’s coordinator to prepare an interim report for the study funder, USAID/PEPFAR, and for key Malawian policymakers.

 

 

 

 

 

 

 

-Rigo