Gillings Around the globe

Let me start by telling you a bit about the organization I’m partnering with and the work they do. Shifra is an NGO in Melbourne, Australia dedicated to increasing access to sexual and reproductive health services for refugees, migrants, and asylum seekers through the use of an app. Shifra was started by a Gillings alum, Beccah Bartlett, and is the only organization addressing this need in this way in the world. When refugees, migrants, or asylum seekers come to a new country, they often have a hard time accessing the resources that are available to them due to language barriers, an unfamiliarity with the host country’s health system, and unawareness about their rights as a patient- such as the right to ask for a translator. This is even more true when the health needs are sensitive, such as questions about contraception and pregnancy. The app allows women to access the information they need, whenever they need it, in their own language. It launched about a year ago and is currently available for Arabic speaking women in Melbourne.

When considering my options for a practicum this summer, I was drawn to working with a small organization because I would have the chance to practice a number of different public health skills. This has certainly proven true! In the two weeks that I’ve been on the ground, I have been a part of key partner meetings, evaluating existing resources, developing marketing materials, and laying the groundwork for a process evaluation that I’ll be completing during the rest of my time here.

My main project is evaluating Shifra’s use of human centered design to create the app. I love this project since systems and design thinking has been my favorite class at Gillings! While it is exciting to be on the cutting edge, it also requires a lot of cross-disciplinary research to learn how human centered design has been used with refugees, how it has been used with mhealth interventions, and how it has been used to address sexual and reproductive health needs. In the coming weeks, I’m looking forward to speaking with refugee co-designers and learning more about their experiences with the co-design process.

-Jess

I am more than half way through my internship with United Nations Population Fund (UNFPA) in Cape Point, The Gambia. UNFPA does amazing work in the areas of family planning, sexual and reproductive health (SRH), gender-related issues (e.g., early marriage, FGM, GBV) and HIV prevention. They are currently working to accomplish the objectives of their Strategic Plan 2017-21. During my first few weeks, I participated in a sensitization campaign for obstetric fistulas on International Day to End Obstetric Fistula. UNFPA went to the Bundung Maternal and Child Health Hospital, a public hospital under the Ministry of Health and Social Welfare, and Sinchu Baliya Health Post, both facilities that garner a large population of pregnant women attending antenatal care (ANC) visits. During the event, messages regarding symptoms and treatment options for fistulas were delivered in three local languages (Wolof, Mandinka, and Fula) to accommodate for the group present.

Due to the lack of available data on fistulas in Gambia, UNFPA is hoping that the sensitization campaign will produce a fistula count of women who have the condition. By lifting the stigma and encouraging women to sympathize with affected women, hopefully more women will seek treatment and get registered through the fistula count camp. One of the most valuable lessons that I have been lucky enough to learn is how to deliver culturally sensitive messages and cater to the communities you are trying to serve.

This observation was made at a weekly male engagement clinic that Bundung MCH Hospital initiated back in 2012. The session is a discussion style program with men whose wives (or significant other) attended an ANC visit that week. These men are contacted via SMS and/or phone calls and encouraged to attend the clinic. Men who accompany their wives to ANC visits are given priority and allowed to bypass the long visit lines as incentive for their participation. Bundung’s investment in male involvement has inspired UNFPA to pilot similar programs in other organization supported facilities across The Gambia. I am currently co-writing a concept note that implements a pilot project strengthening Bundung’s male clinic and eventually developing a standardized programme to be applied to other health facilities.

Additionally, since UNFPA works through Implementing Partners (IPs), I have been able to observe the operation of these organizations, including the challenges they encounter in fulfilling their goals. There are so many organizations in Gambia that are working to empower women and girls, including Think Young Women, a mentorship programme that is one of UNFPA’s Youth and Adolescent IPs. During the next couple weeks, I will be diligently laying the foundation for the pilot male clinic initiative and going on four-day upcountry visits to the more rural facilities. Since Bundung is a public hospital that began with funding, it will be an opportunity to compare rural vs. urban facilities and ways that male clinic would be incorporated while considering the existent financial situation of the facility. I’m a little sad that the weeks are going by so fast, but I feel a deep sense of gratitude for all the exposure I’ve been getting. Can’t wait to share more experiences!

-Fanny

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