Global Health Travel Blog

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

Category: Uncategorized (page 1 of 5)

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.

Zamantha

Thinking outside the box from a box

You can also replace the box with a ‘bubble.’ Very apt for all the online packages and delivery boxes we may be receiving during this global pandemic or the expansion of a personal bubble due to social distancing. A year ago, as a prospective global health student, I imagined my summer practicum would be in Nepal, my home. Instead, I am here in Chapel Hill as I have been working from a box in a box for the past three months, i.e. my laptop [end of metaphor, *fingers crossed*]. Ironically, I also realize that if it weren’t for COVID-19, my amazing practicum would have never transpired.

As multiple full-proof plans for the summer fell through during the Spring semester, the North Carolina Institute for Public Health (NCIPH) reached out to integrate with a project in our Photovoice class about COVID-19. It allowed us to create our narrative during the eve of the pandemic and conduct qualitative analysis. I was eager to continue learning more about the process and applied for their summer practicum posting. I was allowed to carve my path and position within the project. This summer, I am working with three other brilliant UNC Gillings MPH students to collect and archive stories from around the state, the nation, and the world. The objective is to curate healthcare workers’ stories during the COVID-19 pandemic and supplement the numerical data. It is almost equivalent to a scoping review practice for a bigger project of creating an interactive map of stories throughout the pandemic, Behind the numbers. I collaborate to sift through hundreds of potential online stories and am individually responsible for tagging and analyzing them from an equity perspective.

We come up with various themes and analyze trends that may be revealed. We confirm the patterns with each other and try to fill in gaps. We also highlight the limitations (Eurocentric, language barriers, publication biases) of the project and challenges of mental and emotional exhaustion of burning through the news after new and social media posts. Lack of resources, violence on health care workers, racism and health disparity, protests and solidarity are some of the themes we have been playing around with for the past couple of weeks.

A break from the box. I broke my ankle while learning to bike more than a year ago. I finally mustered up the courage to learn again this summer. Resilience is the goal – especially during a global pandemic.

A break from the box. I broke my ankle while learning to bike more than a year ago. I finally mustered up the courage to learn again this summer. Resilience is the goal – especially during a global pandemic.

Every day we wake up to new information around the world and play catch up to encompass what stands out to us in our data collection. We have begun to create a virtual working meeting to hold each other accountable as we work from our couch/bed/kitchen counter. (I have also retired my desk at this point – I resent my office desk.) The designated times, however, does allow for some normalcy and routine, which was extremely helpful. [Resume metaphor] Creating boxes of time for productivity and a sense of solidarity, again within a box- my apartment. And within that solidarity, among my colleagues, peers and friends in Chapel Hill, I am beginning to create a new sense of comfort and home.

Alpha

Finding strength in adaptation

This summer, I am completing my practicum with NARAL Pro-Choice NC. I have been working on developing more concise and compelling messaging for NARAL’s awareness and educational campaigns on reproductive health access and the harm of crisis pregnancy centers (CPCs). CPCs are organizations (typically non-profits) that pose as full-service reproductive health centers but only offer pregnancy tests, and sometimes an ultrasound and select STI testing, and exist to persuade women to not obtain abortions through manipulative language and tactics. Through my work, I’ve been fortunate enough to chat with many of NARAL’s stakeholders and equity partners about their views, experiences with, and thoughts regarding CPCs, the reproductive healthcare access – or lack thereof – in their communities, and what they think equitable reproductive healthcare access looks like. I’ve also been learning more about the policy and advocacy side of public health work, and I have taken to following Supreme Court decisions – it’s been quite a surprising month. I was definitely lucky that I was able to work remotely with NARAL with relative ease. While I wish I was able to work in their office and hang around my colleagues more often, I have been learning so much from our weekly staff meetings and conversations with my amazing preceptor.

My porch/gym/office

My porch/gym/office

To add some physical activity to my days, I’ve converted my porch into an outdoor gym, which has been made even more beautiful by my roommate’s newfound horticultural skills. I’ve also been able to continue teaching live group exercise classes twice a week on UNC Campus Recreation’s Facebook page. I sincerely miss being able to feel the energy from the super hard-working participants of my HIIT and Core classes, but I’ve been taking this time to gain more fitness and wellness knowledge to enhance my classes when I am able to teach in-person again.

This has been an anxiety-ridden and tense time for all of us, but undoubtedly, we are witnessing a necessary and overdue revolution. While my practicum experience looks a little different than I imagined when I first came to Gillings, I am incredibly grateful to have the opportunity I do and to be able to play a tiny part in fighting for reproductive health and justice for all.

One of my favorite graphics showing the multi-faceted and intersectional nature of reproductive justice

One of my favorite graphics showing the multi-faceted and intersectional nature of reproductive justice

Stay strong,

Rachel

A Shift in Priorities and the Rewarding Results

I was busy applying for international practica when COVID-19 still seemed like a distant threat. Having a “boots on the ground” experience was very important to me, and an international experience was something I had been looking forward to since accepting UNC’s offer of admission. At the end of February, I was thrilled to be offered an opportunity that would allow me to put my nascent public health skills into practice in Guatemala. With one week to consider whether I wanted to accept or turn down the offer, I primarily focused on weighing my own personal and professional growth opportunities. After thoroughly thinking through the pros and cons, I decided the day before my deadline that I would accept the offer the following morning.

It was right at that time, however, when my awareness of the true threat of COVID-19 grew tremendously. I wasn’t terribly afraid for my own wellbeing, since I am a young adult and at the time the general sentiment was that the disease was not incredibly dangerous for people like me. But it occurred to me that there I was, intentionally choosing to work in an area with poor infrastructure and limited healthcare services. How was potentially introducing a deadly infection into an already underserved area in any way serving the best needs of the community? Although the school had not yet announced travel restrictions, I turned down that offer and focused on applying to positions within U.S. borders, then within N.C. borders as the severity of the situation became clearer and the school issued new mandates.

My remote work station would not be complete without a good view of my roommate/houseplant, Steven. Yes, he has a name.

My remote work station would not be complete without a good view of my roommate/houseplant, Steven. Yes, he has a name.

Ultimately, I was incredibly fortunate to be offered an opportunity to work with the Disaster Research Response Program at the National Institute of Environmental Health Sciences. While it is nothing like what I had imagined I would be doing when I first started my practicum search process, there are numerous benefits. My project involves working alongside program leaders in the United States, Japan, and Canada, taking steps towards developing a similar disaster research response program for countries in the ASEAN region. Not only am I being exposed to several countries and their health systems, but I am also having multiple opportunities to network with international partners. Additionally, because I am doing my work from my home in Carrboro, I will be able to continue on this project into the next academic year, giving me a richer and more in-depth experience than I would have had in a 5-10 week practicum abroad.

This is not the practicum experience I had expected, but as COVID-19 has taught us, public health is not a great field if you are uncomfortable working with the unexpected. The work I am doing now is incredibly different, but there have been just as many positive changes as negative changes. I am still getting valuable experiences for professional growth, and I can rest easy knowing that I did not put my desire for a novel experience or my education before the best interest of a vulnerable community.

Tamara

Unprecedented Times

This summer I am working as a program intern for the North Carolina Institute for Public Health (NCIPH). The primary aim of the NCIPH is to promote collaborative based solutions to population health issues within North Carolina and beyond. As a response to the COVID-19 pandemic, the NCIPH is developing a curation project, Behind the Numbers, which focuses on the documentation and analysis of the lived experiences of frontline healthcare workers. The Behind the Numbers project serves to deviate from quantitative approaches and relies on qualitative techniques to effectively collect the stories and feelings from those affected by this unprecedented time.

Ironically, this specific practicum experience would fail to exist without the surge of this pandemic. I would have never guessed my practicum would be linked to the one of the most extraordinary and defining moments in modern human history. I am absolutely honored to be a part of an organization that recognizes this impact and chooses to center itself on a humanity focus. The objective and numerical data will always be there. However, if we do not capture the stories and collective feelings of those most affected, then we lose the spirit of public health: to improve the health and lives of people.

During one of my walks through Carrboro, I encountered a BLM poster. As a Black man, the Black liberation movement has always served as a central focus in almost every aspect of my life. I thought it would be important to share this as constant reminder of the appreciation and preservation of Black lives.

During one of my walks through Carrboro, I encountered a BLM poster. As a Black man, the Black liberation movement has always served as a central focus in almost every aspect of my life. I thought it would be important to share this as constant reminder of the appreciation and preservation of Black lives.

A typical day involves researching various hotspots in the United States with a relatively high number of COVID-19 cases. Once I pinpoint my desired location, I peruse social media and any relevant articles that detail the stories and accounts of frontline workers in healthcare settings (i.e physicians, physician assistants, nurses, surgeons, etc…).  Aside from my practicum responsibilities, I try to keep myself occupied in this new social distancing reality by checking in with family & friends (virtually of course), going for walks, binge-watching my favorite shows on at least four different streaming platforms, and meditating. As an introvert who prefers their own company, this quarantine has forced me to embrace the power, comfort, and necessity of community. Although this is such a destructive and unpredictable time, one can still seek the light of positivity in times of darkness.

Brandon

On the Flip Side…

Right before spring break, my practicum plans fell through, so I rode the wave of disappointment earlier than everybody else and for reasons unrelated to the virus. With the possibilities for practica suddenly narrowed down, finding a position became a somewhat simpler task.

A forest floor covered in bärlauch, wild garlic that leaves a pungent scent in the air in the summer.

A forest floor covered in bärlauch, wild garlic that leaves a pungent scent in the air in the summer.

An opportunity matching my interests soon presented itself in the form of a collaborative project between Gillings and Chronic Care International, a non-profit based in Omaha, Nebraska, to assist in designing an evaluation for a diabetes peer support program in the Dominican Republic. I am currently working from home in Basel, Switzerland to develop a literature review describing the evidence base for the program and to compile a list of instruments that have been used to evaluate similar programs in the past. For now, I am mostly working independently, apart from a weekly afternoon meeting with my preceptor, so the time change has had minimal impact on my experience. I am learning to grapple with the unpredictability that seems common in low-resource settings. In the grand scheme of things during these tumultuous times, it is much easier for me to be relaxed when dealing with these manageable ambiguities as they present themselves.

A field of poppies overlooking Basel.

A field of poppies overlooking Basel.

For me, the pandemic has produced some positives. I had assumed that my practicum plans would inevitably conflict with my ability to spend the summer in my hometown with my family, which I try to weave into my summer plans as much as possible. When not working, I spend my time reading, exploring the hills on my bike, playing intense ping pong matches with my mom, taking walks through the forests and fields with my family, catching up with friends from home, and making the most of having an easily accessible piano to play (a true luxury!). I am grateful for the extra time I get to spend here in Basel, a place that I know I will not have the privilege of calling my home forever.

Marlena

Different Set of Skills

When I connected with my practicum preceptor in December, I was elated to have found an opportunity to gain field experience in the field of infectious disease prevention. Naya had set me up with a meeting with Dr. Ross Boyce, a researcher and infectious disease physician here at UNC-Chapel Hill. I would have had the opportunity to travel to Uganda to meet his collaborators in Bugoye and conduct my own research project on the ground. As I began preliminary research for the project, I was reminded of my passion for treating infectious disease spread through basic medical support and low-tech solutions such as bed nets.

When the global COVID tides began turning in February, we were able to have a discussion about what to do in case of restricted travel. I was lucky enough to be able to easily transition to a backup plan working with a different data set collected by the Bugoye team. My project is now working with data from a household survey investigating bed net use by children and their malaria status from over 2000 households in 36 villages across 6 parishes. So far, I have conducted an informal literature review to bring me up to speed on bed net use in Sub-Saharan Africa and have begun the basics of working with the data. I will soon be beginning work with Dr. Boyce’s colleagues in Health Geography who will aid me in developing a statistical analysis that incorporates proximity to health centers and map-making using GIS.

My home workspace.

My home workspace.

I am very disappointed that I am unable to travel to Bugoye myself. I was drawn to UNC largely because of the opportunity to pursue a hands-on practicum where I got to meet and work with public health researchers from different countries. However, work from home has forced me to learn an entirely different set of skills than I would not have learned spending the summer on field work. Working from home has forced me to teach myself all sorts of data handling skills that are all the more useful because I had to learn them on my own. I am also looking forward to working with researchers in geography and exploring geography as a public health tool.

In the meantime, my roommate and I have been quarantining in our home in Carrboro. We’ve been taking turns making meals and I have taken the time to practice baking. (I’m 100% that annoying friend who got way too into making sourdough.) My favorite thing I’ve made so far might be sourdough crêpes, which was a great way to use discard from the starter. Other quarantine hobbies have been biking, birdwatching, and growing tomatoes and herbs on my deck. (Seriously though, reach out if you’re into birds). I’ve also been able to explore the Carolina North Forest. It has been a great opportunity to get to know my immediate community better without the pressures of the semester timetable.

Rachel and Hannah from Global Health checking in families receiving free food at PORCH.

Rachel and Hannah from Global Health checking in families receiving free food at PORCH.

The highlight of my week is volunteering with the food relief organization PORCH Chapel Hill distributing food to nearly 500 Orange county families every Wednesday morning. I’ve even got a number of other Global Health classmates to join me. As the weather has gotten hotter it’s been even more difficult to wear a mask, but I hope we can all stay committed to preventing the spread of COVID even as states try to open up prematurely.

Filling up food boxes at PORCH at the Chapel Hill Public Library.

Filling up food boxes at PORCH at the Chapel Hill Public Library.

Stay Safe,

Claire

Global Research From A Local Office

The time of Covid-19 has brought unprecedented challenges to all aspects of life. Coming to Gillings and being in the global health concentration, I knew from the start that I wanted to go abroad for my practicum. To me, it was meant to be a learning experience in research in another culture and how public health campaigns are approached across the world. With the travel restrictions brought on by the global pandemic, going abroad was no longer an option but as disappointing as that was initially, my practicum has brought me the experience I had once hoped to get.

My work for the summer is focusing on HIV partner testing in Zambia. The study I am a part of is researching methods of partner testing in order to encourage male partners to get tested for HIV with the long term impact of reducing HIV prevalence and improving treatment. As the nature of my work is mainly qualitative, I am learning not only about the HIV partner testing method but about the cultural background, challenges, attitudes, beliefs, and approaches to HIV testing and care for people in Zambia. In addition, I am strengthening my skills with Nvivo, a software for coding data- a definite benefit for future jobs and research prospects.

My summer office.

My summer office.

Like any good learning experience, the practicum so far has not been without its tough moments. Zambia is six hours ahead of North Carolina, allowing for a narrow window in the morning for me to conference with my team. Unfortunately, it usually means either some team members have to stay later in the office or I have to wake up much earlier. Luckily, I work with a wonderful team and the coordination of schedules never feels burdening. With regards to reading transcripts, I went through moments of ‘culture shock’. The approach of HIV care with respect to social structure and norms is quite different there, with aspects I’ve never seen in both the US and India. My first reaction was automatically to question “How is that even acceptable?”, but with the firm reminder for myself in concepts of cultural humility and global practice, I have really taken it as a learning experience and I am continuing to enrich myself through this practicum.

Overall, the practicum so far has been amazing and I feel lucky to have been trusted for taking on this role. I look forward to working with my team and learning more!

Aditi

Thoughts About WFH (Work From Home) Colleagues

This summer I am interning at Curamericas assisting with the design of a program questionnaire and baseline evaluation, the results of which will help guide the direction of a Maternal, Neonatal, and Child Health program to be implemented in Port-au-Prince, Haiti. So far, I have focused on developing an evidence-based list of indicators for the participant questionnaire.

As was most of my classmates, I was devastated to learn that I would be working from my couch all summer; the same couch on which I stayed up way too late tweaking my 713 poster last December, the same couch on which I pretended to re-watch Biostatistics lectures in preparation for an exam when most of my attention was actually going toward an old episode of Brooklyn 99 that I “had on in the background”. As sad I was that I would continue to sit on this same couch for the summer (sure, I have a desk, but find me a desk chair that is as comfy as a couch!), there is something to be said for the Work From Home (WFH) colleagues that you would not otherwise have the privilege to hang out with…All. Day. Long.

My Work From Home colleague and me.

My Work From Home colleague and me.

I have a special relationship with my WFH colleague, but we are very different. While I sit all day in front of my laptop researching the state of maternal health in Haiti, he sleeps all day. While I brainstorm the best indicators to measure maternal mortality, he bites and licks his nails. Sometimes, I find it nearly impossible to stay focused when my colleague and I have such disparate styles of working:

I read about how the 2010 earthquake in Haiti halted massive nationwide immunization campaigns in their tracks. My WFH colleague yawns and stretches and yawns and stretches.

I determine whether healthcare facility delivery or the number of antenatal care visits during pregnancy would be a better indicator of neonatal death. My WFH colleague mouth-breathes fish breath directly at my face.

I examine the prevalence of exclusive breastfeeding for 6 months as an effort to prevent child malnutrition. My WFH colleague sits beneath me as I eat my work snacks to catch the inevitable crumbs, despite having refused a full bowl of food in the other room!

I encounter Imposter Syndrome and wonder if I have enough knowledge and experience to be in this position. My WFH colleague chews on a stick.

I should focus on the positives too. It is nice to hold myself accountable for taking walks throughout the day – otherwise, my WFH colleague would go stir-crazy. My WFH colleague LOVES to snuggle and I can wholly appreciate this personality trait. While I sometimes get jealous of my WFH colleague’s relaxed (read: lazy) lifestyle, I remain grateful to have this opportunity to impact global maternal and child health while abiding my necessary and sound Coronavirus restrictions. I think I can safely say that as annoying as he can sometimes be, I will be sad to leave my WFH colleague at home once summer is over and we return to a new normal.

Jordan

Locally Located but Globally Connected

While in danger of sounding repetitive, my summer practicum experience was not exactly what I had originally imagined. To be honest, I felt a sense of disappointment not being able to spend the summer in Johannesburg, South Africa working directly with the amazing team at the Anova Health Institute and their peers at Wits University. However, as soon as I began my practicum my attitude completely changed, and I couldn’t help but feel such appreciation to still be included in the incredible work that Anova is doing for their community. The fact the Anova was still willing to invest time and energy into my professional and personal development in such unprecedented circumstances was humbling.

The project I am currently working on is part of the UNC-Wits University Implementation Science partnership. As part of this program, I am working with the Anova Health Institute, a leading organization in the implementation of HIV care in South Africa. Currently, I am analyzing data from patient file audits in order to identify gaps in care, especially in regard to a new HIV treatment protocol that was rolled out across South Africa in December 2019. The goal of this project is for Anova to develop recommendations for quality improvement within their partnering facilities in order to be able to best support the health of the patients they serve.

Finishing up a Zoom meeting with some of the amazing staff at the Anova Health Institute.

Finishing up a Zoom meeting with some of the amazing staff at the Anova Health Institute.

Although I’m completing this practicum remotely, the team at Anova has made me feel included even thousands of miles away. For example, last week I was sitting in on a staff meeting where each person took the time to welcome me and explain the projects they were working on so that I could follow along with their conversations. This small gesture highlighted how global connectedness can transcend great physical distances. I am overwhelmingly grateful to still be able to engage in this important work in the face of such difficult circumstances for many across the world. Quality HIV care is especially vital during this pandemic. I am honored to be growing and learning from incredible professionals in the field who are committed to improving the health and well-being of those living with HIV.

Hannah

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