Students and global health experts share their global field experiences and thoughts on global health.

Author: Global Health (Page 2 of 9)

SPH - Research, Innovation and Global Solutions Operations

Evolving and moving forward, together

It is hard to believe that the summer is coming to a close. What started out as a summer full of unknowns seems to be leading into a fall full of unknowns. Despite this uncertain time, my practicum experience has been humbling and fulfilling. I have been amazed and inspired in working with my preceptor and the exceptional teams at UNC Project-Malawi and the Tingathe Program over the past three months.

In the face of unprecedented and evolving challenges caused by the pandemic, they continue to do vital work for HIV programming while remaining both flexible and resilient. In working with them, I not only learned more about adaptation at both the interpersonal and organization level, but also gained new skills and experiences along the way – from connections with amazing researchers and staff, to irreplaceable mentorship with quantitative analysis, to a newfound appreciation for the processes behind intervention design and testing.

At the center of this work was the teams’ focus on the community, as well as their trust in and reliance on one another, which created an environment that was collaborative and supportive. This spirit of solidarity is something that I leaned into on days when I felt particularly overwhelmed by the state of the world. Our systems were inadequate and unequal before the pandemic—plagued by asymmetries in power and privilege—and these inequalities are being grossly magnified amid the current crisis. Addressing such stark challenges will require ongoing accountability and open collaboration between individuals, communities, and nations.

One of several heart-shaped ornaments spotted in the trees on a walk through my neighborhood!

One of several heart-shaped ornaments spotted in the trees on a walk through my neighborhood!

What continues to sustain me is knowing that I am not alone in this, and that brilliant people are working towards shared goals of improving health and wellbeing. I leave this summer feeling tired, but more passionate that ever in fighting for a future for global health that refuses to compromise in the face of unprecedented threats, recognizes our shared vulnerability and humanity, remains committed to advancing health justice, and pushes forward for a better, brighter future.


Wrap Up

I finished my practicum this past week with the Water Institute at UNC, and it is hard to believe that this work and the summer have passed so quickly! I am grateful to my preceptor Nikki Behnke for her guidance and support, and the Water Institute for having me on as a research assistant.

Over the past couple months, I have made an annotated inventory of WASH guidelines for humanitarian settings, identified and summarized publications about environmental health in healthcare facilities, and mapped out current research in humanitarian settings. I learned a great deal about water and sanitation, challenges and interventions in refugee camps, and the intersectional needs of women, children and people with disabilities living in these settings. Forced migration due to conflict, famine and climate change will continue to get worse in the coming years, and providing adequate water and sanitation for displaced persons and refugees is paramount. I am glad I could support the Water Institute this summer while they continue to work towards tackling these issues. 

Blue Ridge Parkway

Blue Ridge Parkway

Working from home has been a challenge, but has taught me about myself and what I need to thrive as a student and as a human being. Being in nature, engaging in self-reflection and seeing my friends (6 feet away or on FaceTime) have sustained me these past few months. I was even able to take a trip to the mountains with my family, which allowed me to recharge. I was looking forward to being in a new setting this summer, but it has been grounding to be in my hometown with my family and enjoy what I love about North Carolina.



Summer of COVID-19 – Perspectives from a Barcalounger

The lounge lizard in all its glory.

The lounge lizard in all its glory.

I ended up having quite the busy summer from my parents’ basement barcalounger in Madison, WI. For about six weeks from mid-May until late June, I made a valiant effort to balance my time between keeping up with studying for my MCAT, and collecting news, social media, video blog, and other disseminated stories of North Carolina frontline health workers regarding their COVID-19 experience…along with the occasional Zoom trivia or game night with friends, Global Health Concentration social committee meeting, or meeting with the COVID Behind the Numbers project team. I only escaped my lounge lizard life for a few workouts a week, walking the dog, or a much needed socially distanced Sunday afternoon round of golf. While the effort was valiant, by early June, the MCAT had consumed my life, my mind, and my soul, as it does to so many pre-medical students.

Despite the preoccupation with the MCAT, I continued to follow video blogs, podcasts, and other social media posts from frontline healthcare workers through the up-and-downticks of the summer of COVID-19 in North Carolina. Obvious themes began to present themselves as I worked with my initial data: PPE shortage or surplus, preparedness, rural homecare facilities versus urban hospitals, and support and appreciation for frontline healthcare workers existed among others. However, underlying these themes were a few more compelling, yet unsettling themes. As I reviewed stories, no matter the position in healthcare from Emergency provider or administrator, to public health analyst, nurse, or homecare facility worker, I found a concern for mental health to be interwoven in the stories I read. Many healthcare workers described the stress of not knowing what is to come, if they were prepared, or if their PPE was effective in protecting them and consequently their families. Many used spending time outside during breaks, or keeping up with yoga, meditation, or other practices to alleviate the stress of the time.

While not always applicable to the specific healthcare workers telling stories, inequity flowed through aspects of almost every set of stories I analyzed. Throughout the data collection process, Latinx and African American communities in North Carolina bore the brunt of this outbreak in terms of disproportionate cases and deaths relative to the percentage of the population each group occupies in the state. The most promising aspect was that, from early on, public health and other healthcare workers acknowledged, or highlighted the importance of recognizing and addressing these inequities in their stories. However, the numbers have yet to even out, or even come close. Seeing the themes streaming from this project to this most recent Black Lives Matter movement and protests of police brutality, looking at two major historical events occurring at the same time, and analyzing how issues of ethics, equity, and empowerment overlapped was simultaneously heart wrenching and fascinating. One physician likened dealing with the pandemic to “building the airplane while flying it” and “knowing how to build the plane…[but] being thrown different parts at a time.” Once we recognize an equity issue exists – mid-pandemic or not – this part of the plane needs to take priority in design, build, and reinforcement before any other area.

Considering my interest in infectious disease and mixed methods research, it has been extremely rewarding to apply the skills I have acquired to this point in my public health career to such a pertinent project. It provided a fun twist in that we had the freedom to search and gather qualitative data from a variety of open sources, rather than more standard qualitative interviews, which hopefully will be done in the future. I feel this project has been extremely informative: from finding expected and unexpected themes, to the roller coaster of ups and downs seen in the pandemic, to looking at the pandemic in conjunction with a critical social movement, and more. During hard times, many people turn inward, and harbor their feelings, emotions, and opinions. With the social response and activism this summer, and throughout the pandemic, it’s incredibly encouraging to see so many facing outward, using their voices, and expressing their triumphs and hardships. Now, we need to turn to those whose voices remain stifled, amplify them, listen, and work to make real change.


Unexpected Lessons in Global Health

It seems like just last week I was getting ready to start my practicum, and now suddenly I’m here wrapping everything up. As I begin to reflect on another summer work experience, I always enjoy realizing how out of all the things I’ve learned, very few are actually the things I was expecting to learn. Sure, I’ve learned plenty about intrapartum care in low-resource settings… I’ve read dozens of articles about patient experience, provider care, facility administration, and community involvement. I’ve had Zoom calls with a Haitian physician and program director and other midwives and researchers. I’ve written a literature review and a communications plan. And these are all good things—things I expected out of this summer.

But, this summer has been about so much more than those things. This summer I have also sat in on non-profit board meetings and consortium updates. I’ve been a part of engaging with donors and updating records. I’ve been active in supporting local health, even while working for a global organization. From my little desk in my Chapel Hill condo, I’ve been able to engage in far more than a research project, and I’ve learned some things I didn’t expect.

Some of the St. Antoinne school children enjoying the playground.

Some of the St. Antoinne school children enjoying the playground.

As part of their work in Haiti, Family Health Ministries supports children in an orphanage and school in Fondwa. This support would not be possible without the generosity of hundreds of donors from all across the United States. I’ve been sending each donor updates—a letter and some photos—on how the students are doing, and it struck me that global health work, especially in the NGO world, relies on contributions and support from all sorts of different people and places. Thus, the work is not just global in its destination, but also in its source. We all have the chance to be a part of global health work in some way, degree or not, which means wherever we are, we can be part of building a healthier world.

I’m about one third of the way through my cross-state trek… and I’m excited to “arrive” in Winston-Salem soon!

I’m about one third of the way through my cross-state trek… and I’m excited to “arrive” in Winston-Salem soon!

Back in May my preceptors shared that they wanted to be intentional about supporting local health alongside their global mission, especially during the pandemic. We all signed up for the Blue Ridge to the Beach virtual race—a 6-month, 475-mile challenge that takes you across the state of North Carolina from Asheville to Wrightsville. So far, I’ve gone about 150 miles, I passed through Charlotte, and I’m on my way to Winston-Salem. I enjoy walking and running, and I’m grateful for the motivation and reminder that taking breaks and getting outside is really good for me. But I didn’t only commit to getting in 2.6 miles per day til December for my own benefit. We chose to participate in the race because all proceeds go to fighting food insecurity in North Carolina. In a time when it seems like life is dictated by all the things we cannot do, this is something that we can do. We choose to move our bodies each day because that choice gives someone else better access to food. We choose to put in the work of improving our own health, so that we will be able, prepared, and healthy enough to help others with theirs. I’ve been reminded that global health work isn’t always glamorous or extreme. Sometimes, it’s as simple as choosing to go for a walk.

Sunset is one of my favorite times to get a walk or run in because it’s not as hot and the views are great!

Sunset is one of my favorite times to get a walk or run in because it’s not as hot and the views are great!

All those extra things, those lessons found between the expected moments and between the lines of my practicum agreement—those are the things I’ve enjoyed most about my summer. Those are the things you cannot learn in a classroom, and those are the things I will take with me into my career. The skills are important, but the life experience is even more so.


PS—The Blue Ridge to the Beach challenge starts a new wave each month, and the next one kicks off August 1st. Check out their website to register and join us!

The End of a Practicum?

My dog, Shumaq, enjoying the summer days.

My dog, Shumaq, enjoying the summer days.

I am writing this while I sit on my bed with my dogs at my side, reflecting on my life over the past few months. I have spent a good deal of my time working on different projects, primarily through the SER (Salud, Estrés, y Resiliencia/Health, Stress, and Resilience) Hispano Project, which looks at the effects of acculturation stress on Latinx immigrant communities. I have spent my time translating survey items and IRB consent forms (so much translating!), writing, reading research articles, and occasionally meeting with other members of the research team. Some weeks I have had very little tasks and been able to perfect my Kombucha brewing skills while other weeks I feel the impacts of numerous Zoom calls and looming deadlines. Through it all, I have realized the importance of staying resilient and adapting to change. My original practicum plan was to finish my practicum and turn in my deliverables by the end of July, but some delays in research and data collection due to COVID-19 and other unrelated events have forced a change in my plans and I will continue to work through the fall semester.

Spending time in nature is great way to release stress.

Spending time in nature is great way to release stress.

Despite these setbacks, I find that I am more open-minded and flexible. Before, I may have felt discouraged, but now I recognize the fact that there are many things outside of my control and being able to continue working with the amazing people who are part of the SER Hispano team is a true blessing. Throughout my time in school, from elementary all the way to graduate school, there are few places that I could truly call home and feel welcome. Being a part of a team of majority Latinx folks has refreshed me and made me realize the importance of being part of an environment of people who are supportive and uniquely understanding of my life experiences. During my free time I enjoy taking walks with my family, meditating, and trying out new experiments in the kitchen. I hope to be able to continue some of these hobbies and stay grounded even as the stresses of the new semester take hold.



A Different Kind of Summer

I was looking forward to my practicum even before I was accepted into the MPH program. As a marine biologist transitioning to public health, I knew the practicum would be essential for me to establish myself in the global health field. I dreamed of doing my practicum at an international humanitarian agency in Amman, Jordan and spending the summer with my family there. Just as soon as I had secured a position there in March, all international travel was restricted. As an aspiring global health professional, I was so disappointed to be confined to my home state for the summer.

It certainly felt like a loss at the time, but I quickly realized the loss was not just mine. With the world in a chronic state of emergency, you quickly learn to let go of your plans and expectations. You eventually stop mourning all the events, activities, trips and travels you were supposed to take. Instead, you yearn to merely be able to safely see your friends and family. You stop touching your face and start second guessing every cough.

Looking on the bright side, work from home has its perks!

Looking on the bright side, work from home has its perks!

Fast forward five months, I am in the last week of my practicum with only a week left before the fall semester begins. While my original practicum dreams dissolved, I was granted an amazing opportunity to do work I am extremely passionate. I am working with my faculty mentor (something which would not have been possible pre-COVID19) on a research project which examines the breastfeeding experiences of internally displaced Yazidi mothers in Iraq. The Yazidi are a Kurdish ethnic minority who were brutally and systematically targeted by the Islamic State (ISIS) in August 2014. Over a matter of days, 2.5% of the Yazidi population was either killed or kidnapped. Now globally recognized as a genocide, the events of 2014 have forever changed the lives and futures of this community. Through this project, we hope to better understand the unique challenges and needs of Yazidi women to ultimately improve the humanitarian response for displaced pregnant and breastfeeding women and their infants. Not only I am getting to work with a Middle Eastern population, I am also developing qualitative data analysis and manuscript drafting skills, all the while learning about a new topic area with which I was previously unfamiliar. A resounding theme that has stood out from this research is resilience. With so many tragedies constantly confronting the world today, my spirit is continually renewed by the resilience and strength of human beings. It’s a powerful reminder that nothing is ever guaranteed and that we must be grateful for every new opportunity and every new day.


BE KIND (to yourself).

This past week, I completed my practicum under the North Carolina Institute of Public Health where I received the chance to create three products as part of my practicum requirements. I hope my contributions prove to serve as meaningful additions to the Behind the Numbers project. It was a pleasure working with my preceptors, who created a fun and welcoming environment for me during these difficult times.

Although, I managed to complete quality work in a timely manner, admittedly a portion of my experience was bogged down by external happenings. With the consistent and open oppression of Black people due to racism, I honestly suffered from poor mental health this summer. During the early stages of my practicum, I possessed little to no energy, I hardly ate, living in a predominantly white area I constantly experienced paranoia throughout the day and night (despite public notices of Black Lives Matter signs), and I barely slept due to insomnia. Therefore, everyday posed an internal conflict. Should I give myself the space and time to process these intense emotions or put those emotions aside for the sake of productivity? At first, I always chose the latter given the pressure to perform well in a new organization. However, I noticed these attempts at work and emotion suppression produced the opposite effect, and caused me to procrastinate.

My energy and productivity remained in this problematic cycle for several weeks until I reached my limit in terms of dealing with my poor mental health. As a way to alleviate this, I tried embodying a “treat yourself’ mentality. I allowed myself to experience any and all emotions associated with Black oppression: anger, anxiety, fear, sadness,etc… In addition, I constantly reminded myself that it is absolutely OKAY to be in this state, and that it is okay to function with little to no energy. At first, I thought this would lead to overindulging and excuses to not do work, however as the days progressed, I found that my spirits began to ease and my interest in my work began to increase. By July, I felt like myself again and began to function at my normal and familiar levels. In the end everything turned out well, however it was certainly a journey.

Normally, I do not share my inner feelings to this extent nevertheless I aim to normalize the concept of balancing work and mental health. In my opinion, it is foolish to push yourself for the sake of productivity if you lack energy and the will to do so. The ultimate strategy is practicing and showing yourself kindness and grace. Hopefully, this post inspires others to do the same, because you certainly deserve it.


All Eyes on Health Security

As I finish up my practicum with the Office of Pandemic and Emerging Threats with the US Department of Health and Human Services, I have been reflecting on how my areas of focus – epidemiology, health security, pandemic preparedness – have suddenly become topics of interest for almost every individual around the world. These issues that used to be reserved for a small but growing group of public health experts have now become the domain of dinner table conversations and social media posts. This made my practicum working with countries around the world on the Global Health Security Agenda and antimicrobial resistance feel increasingly important as we not only combat the COVID-19 pandemic but also consider how to better prepare the world for future pandemics and public health threats.

Exciting to see my work make its way onto the GHSA website as a resource for countries.

Exciting to see my work make its way onto the GHSA website as a resource for countries.

Much of my practicum focused on collecting best practices of sustainable financing for emergency preparedness and response, providing countries with practical steps and examples to mobilize domestic resources for building preparedness capacity and having funds available for rapid response. I spoke with countries such as Argentina, Republic of Korea, Italy, Nigeria, and Thailand on how they have been able to use national plans, legislation, and innovative financing mechanisms to fight COVID-19 and invest in broader preparedness. What I learned was that there is not one “right” way to invest in health security, but there are certain mechanisms that are extremely important to have in place. These conversations also brought me optimism, as one of the biggest challenges noted in the past was that Ministries of Finance and other leaders outside of health often failed to see the value or return on investment of preparedness. Now, with the economic impact of COVID-19 reaching unseen proportions, the return on investment of preparedness and prevention versus response is clear. While my time supporting these global initiatives has come to an end, I look forward to seeing how countries use the COVID-19 pandemic to make the case for investment in preparedness, not just response and economic recovery.

The benefits of a remote practicum include making the most of North Carolina's beautiful hikes.

The benefits of a remote practicum include making the most of North Carolina’s beautiful hikes.

My practicum was also a great reminder that while the world is currently focused on COVID-19, it is by no means the only public health threat we are facing. I also spent much of my practicum researching global progress on antimicrobial resistance, and providing recommendations for future multilateral commitments to ensure that we can continue to make progress towards addressing it. More broadly, we are also seeing how COVID-19 is affecting the delivery of childhood immunizations and life-saving medicines for diseases such as HIV, TB, and malaria, and it will be important to not lose sight of these other global health challenges as we combat COVID-19. I believe there has never been a more important time to be pursuing careers in public health, and I look forward to returning to campus shortly to continue to build my knowledge and technical skills to further health security.


Wrapping Up

I am back in Chapel Hill, where I am self-quarantining for fourteen days as I wrap up my practicum. To complete my products, I am writing a report to summarize my work over the past two months, including a logic model describing the peer support program in the Dominican Republic, a literature review of the evidence base for such programs, and a compilation of instruments that are commonly used in evaluations of such programs.

View from my window while quarantining in Chapel Hill.

View from my window while quarantining in Chapel Hill.

I am grateful to my preceptor, the community health workers, doctors, and researchers from Chronic Care International who have been extremely resourceful, flexible, and patient in guiding me throughout my practicum. I have learned a lot about how to listen to and prioritize the needs of the community and organization while being mindful of the financial and time barriers they face. In some ways, working remotely has provided me with a unique opportunity to practice reflecting on my biases for my future work. Since I am not in the Dominican Republic because of the coronavirus-related travel constraints, I wonder if some opportunities for biases, such as those introduced from my perceptions of being in and experiencing a foreign country, are reduced. Instead of falling into a false sense of security about my knowledge of the context for having spent time there physically, it was easy to recognize that I know very little – for I have never even been to the Dominican Republic – and therefore needed to rely heavily on the word of local experts to describe the context, program, and patients, which is probably how it should always be anyway.


Through Unity

As I write this, it’s nearly unbelievable that over three months have passed since COVID-19 was on the news and rapidly spreading across the globe. A weekly Zoom call, hours in front of my screen, and my newfound amusement for staring out the window surely do not help tally or structure my days. Like for many others I expect, the reality of our situation seeped in fast. What some swiftly shrugged off soon came to be something that shook the entire nation and beyond. Now we face our days asking if things will ever be the same, and it’s getting harder to recall what life was like before COVID-19. Nevertheless, while this new normal has taken some time getting used to and more and more things seem to be uncertain, some genuinely special joys have emerged amidst this pandemic. This threat has asked us to reflect on what connection looks like and has given us the pause to envision what a strong community can truly look like—and in this field, my preceptor and practicum organization surely deserve the stage.

Zoom meeting with the Director and Coordinator of CAS' research unit.

Zoom meeting with the Director and Coordinator of CAS’ research unit.

Not only have I been grateful to practice qualitative research skills in the context of HIV self-testing through my practicum, but I have learned what the strength of a community can do for the health and wellbeing of one another. Colectivo Amigos contra el SIDA (CAS) has been ahead of the curve and thriving thanks to their cohesion and connectedness to their community. CAS works tirelessly to improve gay men’s health in Guatemala City and during this pandemic, they have gone above and beyond to remain available and supportive of their communities. Undoubtedly, CAS is one of the leading community-based sexual health organizations in Latin America, but they truly stand out because of how they engage with and equip their communities, and how they adapt and respond to their community’s most pressing challenges.

It has been outstanding to recognize and appreciate that the success of CAS’ programs and initiatives are all because of the genuine care, love and attention they place on their community. CAS has the reach and impact they do because their leadership, staff, and volunteers are devoted to combatting HIV and other infectious diseases and advocating for their people. This spirit of community is something that will stay with me even beyond the confines of my career and I am sincerely honored to be working with the incredible team at CAS now and during this pandemic. They have shared not only tools with me but have taught me that the driver of change comes from the passion and cooperation of groups of people who have respect for one another and a vision for a better, healthier future.


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