Global Health Travel Blog

UNC Gillings students share their global field experiences around the world.

Month: July 2019

¡Adios, Guatemala!

“You just missed it, she gave birth while you were in the bathroom.” This is what one of the Casa Materna managers, Michelle, shared with me during one of my barrier analysis survey trainings in Tuzlaj, Guatemala. She assured me that I hadn’t actually been in the bathroom that long (which was a relief) and that the birth had happened a lot faster than anyone had expected. I was extremely lucky to share half of my experience in Guatemala this summer with fellow Gillings Student Emily Berns, who joined me moments later. Before we entered the room to visit the mother and newborn, Michelle told us that the girl who had given birth was thirteen years old. Having never seen a birth before, I began to feel fortunate for my poorly-timed bathroom break. This was one of many surprises that this summer held, including playing multiple games of dreidel with the staff and finding Philadelphia cream cheese in the rural highlands!

It rained most days in Calhuitz, but one day we were rewarded with a rainbow!

After completing a barrier analysis training at three different Casa Materna locations, I had some down time. I was able to observe the nurses at the Casa Materna as they did some routine prenatal consultations. Despite a slight miscommunication at first (the word for ultrasound in Spanish “ultrasonido” sounds a lot like the word for United States “estados uniods” when said quickly and made for some strange context clues), I was able to observe my first ultrasound. The nurse, Anne, told me to feel the woman’s stomach to see if I could tell what position the baby was in. I’m not a nurse, so touching this woman’s stomach felt strange and like I might offend her in some way, but she smiled at me and told me it was alright. I felt around blindly until I found a hard area, which Anne told me was the baby’s head. She then drew a small picture of the position of the baby on a form which she used for the rest of the consultation. Anne took out a small tablet-like laptop to begin the ultrasound and determined that the woman was 8 months pregnant.

In the United States, medicine is a very private matter. But in Guatemala, it’s a family affair. The exam room was only separated from the entrance to the Casa Materna by a curtain. In the sectioned off area for the exam room was the woman, the nurse, me, the woman’s three children, and her mother. “Look, that’s the baby’s leg” Anne said to the woman’s daughter who was watching the ultrasound intently, trying to decipher what was darkness and what was her future sibling. I was impressed how Anne had effortless made this a teachable moment and included this child in the experience. It was extremely powerful to see and I felt very lucky to have been there to experience this moment with this family.

Flore a “mujer de apoya” (helper woman, who is similar to a doula) at the Casa Materna getting a woman’s signature before beginning the barrier analysis questionnaire.

In addition to observing nurses in the clinic, I was able to go into the field with some of the community health educators to watch them survey women in the communities. Using records kept at the Casa Materna, the educators were able to identify women who reported using a method of family planning, so that’s where we started. This was an effective way to identify potential participants, but meant that women who may be using a modern method of family planning but did not already have children would probably be excluded from our sample size. As frustrating as this was, I understood that due to staff capacity, this was just a limitation that I would have to accept. Sometimes we would get to a house and a woman wouldn’t be home or it would turn out her child was too young to participate. Since exclusive breastfeeding for the first six months of life is a form a contraception, we decided to only include women who had children older than 6 months to ensure that she was she was using a modern method of family planning. Due to the size and close-knit nature of the community, we were also able to ask women if they knew of any other women who might be able to participate and use snowball sampling to find other participants. This allowed me to get a glimpse into the lives of the women who we were surveying and better understand what everyday life in Calhuitz was like. I also got to see a lot of kids chasing around chickens, pigs, and pigeons, which is always fun.

A goodbye photo with a few comadronas (midwives) from the surrounding communities and some of the Curamericas Guatemala staff who lent me a gorgeous huipil and corte for the picture. Can you spot me?

I am still in awe of the efforts by the staff to complete these surveys. It was a close call, but on my second to last day in Calhuitz, I received the last of the 96 surveys that we needed for the barrier analysis. Although the analysis and recommendations were supposed to be finished in Guatemala, as with most field work, we had a few setbacks that changed our timeline. Instead, I will be completing my analysis back in the US and will make a presentation to staff on the findings in order for us collaborate on recommendations in mid-August. I am deeply appreciative to the Curamericas Guatemala staff for their patience with this new type of study, their willingness to include me into their daily activities, and their politeness when eating my first attempt and making tortillas by hand.

¡Gracias y hasta pronto!

– Kay

Once in a lifetime learning experience

Guest blog post by Caroline Nelson, MPH-RD student, Kenan Foundation Asia Joan Gillings Public Health Intern

This summer I’ve had the opportunity to live in Bangkok, Thailand for ten weeks to participate in the Kenan Foundation Asia Joan Gillings Public Health Internship in Asia NextGen Healthy Aging Program. Though challenging at times, this internship has been a once in a lifetime learning experience that I am very thankful to have accomplished.

When I arrived in Bangkok, I was rather nervous to spend ten weeks in a completely new environment, surrounded by a different language, culture, and way of life . This soon changed once I was introduced to the incredibly warm and kind people that make up this beautiful country. As soon as the other interns and I entered the Kenan Foundation Asia office on our first day, we were immediately welcomed with open arms. My preceptor, nicknamed K. Pop, has been very supportive of this educational experience, and has included me on several important projects and events.

My favorite event was a community health event that took place in the Khlong Toei community of Bangkok. This district contains some of the largest wealth gaps in Bangkok and a goal of the Kenan Foundation Asia is to improve health disparities for refugees and lower socioeconomic citizens. This event was led by community leaders and change agents who are working to provide better public health resources to their elderly neighbors. Thailand will be a super-aged society by 2030 and the geriatric population already is struggling with obesity, type two diabetes, and hypertension, so Kenan is aiding communities in preventative healthcare education. The community leaders led aerobics classes, meditation sessions, provided blood glucose and blood pressure checks, and massages. It was very informative to observe this health event and see how engaged the community is on their collective health. Participating in this event helped me realize that listening to the community and understanding their personal needs is more impactful than instilling one’s own desires or goals as an outsider.

Khlong Toei Community Health Event sponsored by the Kenan Foundation Asia. Pictured are community leaders and their families, Kenan employees, and the Khlong Toei district representative.

My main project as an intern is to create a Health Literacy Training Event for key change agents in Khlong Toei. This falls under the Pfizer Healthy Aging Project in which Kenan has focused on providing preventative interventions to the super-aging population in Thailand.

When we are not in the office, the other interns and I travel around Southeast Asia. So far, I have visited Laos, Cambodia, and various cities in Thailand such as Phuket, Chiang Rai, Chiang Mai, and Ayutthaya. The other interns and I get along very well, and we have enjoyed traveling throughout the area together.

(L-R) Jack Deering, Andrea Prego, Jessie La Masse, Alexa Young, Caroline Nelson, Catherine Sugg. All are UNC students interning with the Kenan Foundation Asia. Alexa and Caroline are master’s Students at Gillings and the others are undergraduate business students at Kenan-Flagler. Here we are visiting the temple ruins of Ayutthaya in Thailand.

Here we are attending the ASEAN SMEs Regional Conference on Health Tourism in Bangkok. These are various employees of the Kenan Foundation Asia, including the President, K. Piyabutr Cholvijarn. We are making the Korean hand sign known as the ‘mini chi’, aka small heart, that is very popular in Bangkok.

(L-R) Catherine Sugg (Undergraduate Business Intern), Caroline Nelson (MPH Nutrition Intern), Alexa Young (MPH Health Behavior Intern).
Here we are attending the WATS conference in Bangkok.

– Caroline

From Thailand to India to Home

It’s been a whirlwind of a summer so far! About a week after my last exam, I flew to Thailand and then spent two weeks exploring in Thailand and southern India. I ate so much delicious food, met a ton of people from all over the world, and got to explore beautiful temples and palaces! I may have gotten the worst sunburn of my life but I think it was worth it to be surrounded by this much natural beauty.

The beach at Phi Phi Don.

After the two weeks were up, I went to Kalpetta in India to start my first practicum, which was with SEEDS, an organization working in disaster relief and recovery. I supported their Community Health Empowerment program, which serves tribal youth in the Wayanad district through community improvement programs. While I was there, I had a chance to visit several of the tribal communities and assist with documentation of their project activities. However, I spent the majority of my time researching Kudumbashree, as SEEDS was hoping to get more of the tribal communities involved in this program.  Kudumbashree is a program that serves low-income women in Kerala (the Indian state which Wayanad sits in) through financial opportunity—job training, business creation, and microloans—as well as health, environment, and community programming. It was really interesting to have a chance to both read about it and to interview local government officials within the Kudumbashree offices about their work.

A pre-school in one of the tribal communities which the adolescents of the community rebuilt.

I was lucky enough to be working with a UNC alum, and it was great to have a piece of home when I was so far away. I was also very lucky to be surrounded by kind co-workers who set up fun things for us to do, taught me more about their culture, and welcomed me to India. In my first week there, my co-workers band had a concert on the hotel rooftop, and afterwards they all sang traditional songs together. We were also invited to the home of another co-worker, Harris, for Eid, to break the fast after Ramadan. His mom cooked us a ton of delicious chicken biryani and spicy lamb and would not take no for an answer when she offered seconds. On my last day in Kalpetta, I almost missed my bus to start my trip home, and wouldn’t have made it if one of my co-workers, Abu, hadn’t chased down the bus on his scooter and made it wait for me, while another, Tonia, grabbed us an auto to speed over to the bus. Getting to know them was absolutely one of the best parts of my practicum, and I am so grateful for everything they did for me.

My coworkers breaking fast after Ramadan.

Now, I’m back at home in the Washington, D.C. area, working as the Adolescent Sexual and Reproductive Health (ASRH) Intern for Save the Children US. My primary job is supporting the Interagency Working Group on Reproductive Health in Crises (IAWG) on a revamp of the ASRH Toolkit for Humanitarian Settings. I’m also helping to update some resources, and I’ll be supporting a team in Cox’s Bazar, Bangladesh as they lead their first Training of Trainers around ASRH in Emergencies. As someone who is interested in working on sexual and reproductive health (SRH) in humanitarian crises, Save the Children is a really great place to be. I have access to information and updates on crises happening around the world and can follow the humanitarian response as it develops. I’ve also had a chance to complete a lot of e-learning courses focused around SRH in crises from various perspectives, which have helped me to get a better understanding of what this work looks like on the ground. It’s also been wonderful to meet people from all over the world who are doing the work I want to do, and to learn about their work. I’m excited to continue to learn and to be able to play even a small role in this very important sector of Public Health!

– Erin

Go raibh maith agat, HPRC! See you soon

Greetings from Corcaigh (Cork)! It’s hard to believe that I’m officially done with my internship in Galway and back with my partner in Cork. The 6 weeks with NUIG HPRC absolutely blew by and left me with so many meaningful, lasting connections. Things changed a bit since my last blog post—I was originally hoping to explore health outcomes among Traveller school-children and immigrant school-children, but due to a bit of a delay with the data cleaning around the immigrant variable, I ended up focusing solely on health outcomes among Traveller school-children. Although I’m disappointed I didn’t have time to explore the data on 1st and 2nd generation immigrant school-children in Ireland, the delay allowed me to dedicate all of my efforts to the Traveller data—and I got so much more out of it because of that. I was able to finish analyzing the mental health outcomes and had time to run bullying perpetration and victimization statistics, as well. I wrote up a report on Traveller school-children mental health outcomes compared to non-Traveller school-children, and am excited to hopefully get it published! We’ll be sharing it on the NUIG HPRC website and submitting it to the NIHS bulletin—unfortunately, I can’t tell y’all what we found until the National Report is published this fall. Check back into their website in October and read my report on Traveller School-Children Mental Health & Wellbeing to see what we found (  😊

Shout-out to the amazing team at HPRC!

With the newfound time I had without the immigrant data, I ended up reaching out to a few Traveller advocacy organizations around Ireland in an effort to find outlets for disseminating our findings. Their response was incredible—they’re hoping to get access to the infographics as soon as they can and use the data to spread awareness about health inequities in Ireland. I created about 20 infographics with a variety of data around bullying, social support, sexual health, and mental health. I can’t wait to share them with the community organizations once I’m allowed!

One of the (blinded) infographics about Traveller well-being.

Although I’m no longer in the HPRC office at NUIG, I know that it is not the end of my work with them. I am so incredibly grateful to the team’s dedication to improving the health and well-being of all of Ireland’s population. Their dedication to conducting research which ultimately informs policies and programs across Ireland is truly inspiring. Before my time with HPRC, I had conducted research in the private sector for pharmaceutical companies, and in the public sector at UNC. However, this was my first time working at the intersection of research and policy with an international organization, and I absolutely loved it. I’ll miss the friendly faces of the research team at HPRC, and the cows and horses I passed by each day on my walk to work. I’ll be back, HPRC! Until then, I’ve got one more Irish adventure camping on the coast of the Gaelic-speaking island of Cape Clear.

Camping in Clifden at Ireland’s only carbon-neutral accommodation.

Wish me luck!

– Casey

Dear, Zambia

Victoria Falls

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.

The bus.

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

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.

City view from Twin Peaks.

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!

The Golden Gate Bridge.

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

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

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

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

Home is where the chapatis are

Kisii, Kenya is a city that is full of life. Less than one mile from the city’s center, I wake up to the sound of a rooster crowing at the small farm across the street and fall asleep to local music playing in the city. The streets are populated by locals walking, driving, or riding “boda bodas” (small motorcycles) around town. Vendors line the streets to sell their delicious, locally-grown produce, grains, meats, and clothes. I quickly learned that the staple food in Kisii is “chapatis,” which are basically glorified flour tortillas to accompany meat, vegetables, or beans. You will not find a single restaurant without them! Thank goodness, because I was hooked on day one.

Part of the urban center of Kisii, Kenya.

Walk just a few miles from the city center in any direction and you will find yourself surrounded by trees and small farms. Here, cars and boda bodas are replaced by cows, goats, chickens, and local farmers transporting their goods to the city.

The view from my room overlooking small farms and the urban center.

For my practicum, I am working with Curamericas Global to conduct operational research on an intervention in Kisii aimed at encouraging healthy behaviors for prenatal, postnatal, and newborn care. Curamericas has partnered with the Kenyan Ministry of Health to form what is called the Kisii Kenya Oroiboro Project (KIKOP), which has implemented health education programs in two catchments (called Iranda and Matongo) thus far. KIKOP initiated a Care Group training cascade in each of the two catchments and expanded the hours of each catchments’ health center so that they are now open 24/7.

Through my qualitative research on the project, I will meet with various stakeholders to determine what is going well so far for the project and what can be improved going forward. I am also conducting qualitative research on what constitutes a culturally appropriate birthing space for women in Kisii. Many mothers chose to give birth at home with a traditional birthing attendant rather than at the local health centers with nurses who are trained to handle birthing emergencies. My research will be used to create a birthing space at the Matongo Health Center that mothers in Kisii are more comfortable using.

One of the buildings at the Iranda Health Center in rural Kisii.

I have only spent one week in Kisii, but I am enjoying the city, culture, and my projects here already. My first day began with an orientation of the project and meetings with individuals at the Ministry of Health. I also visited the Iranda Health Center and observed a training that KIKOP staff were conducting for community health volunteers, clan elders, and traditional birthing attendants who are involved with the project. I was greeted with many warm smiles and a local song and even given my very own Kisii name (Betuku)! The rest of my first week has been spent on preparing for focus groups, qualitative interviews, and training sessions for KIKOP staff so that they can assist with data collection. I am excited for next week when I will begin field work to collect data and meet with local community members to hear about their experiences with the KIKOP project.

– Dana