Global Health Travel Blog

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

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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

The Balancing Act of a Global Public Health Practicum Amid a Global Public Health Crisis

The COVID-19 pandemic has challenged us to change our attitudes and behaviors radically, as both students of public health and members of society.  Together, we are bound by our collective anxieties and feelings of uncertainty.  As students of the field, many of us have been frustrated with the shortcomings of our country’s infrastructure and feel overwhelmed as we take note of areas which call for improvement.  Some of us have felt a personal sense of responsibility to contribute to the response at home, whether that be to volunteer at our local health department or learn how to make DIY face masks from Pinterest.  Regardless of which emotion is most predominant on any given day, each of us feels a great sense of confidence as we see how necessary our skills are during these trying times.

The shared workspace of my husband and I.

The shared workspace of my husband and I.

Like other students planning a global practicum, I was disappointed when I learned that my position in Zambia would be shifted to remote work.  However, I am grateful that through the UNC Gillings Zambia Hub under the mentorship of Dr. Stephanie Martin, I am able to work with an issue which I am so passionate about.  I will be working with the Scaling Up Nutrition Learning and Evaluation project (SUN-LE) which provides survey, research, evaluation, and dissemination services to Zambia’s Scaling Up Nutrition (SUN) program.  SUN aims to reduce childhood stunting in Zambia through nutrition-specific and nutrition-sensitive interventions.  I will be working to provide quantitative and qualitative analyses of the cross-sectional baseline survey as well as key informant interviews to identify key indicators of childhood stunting.

My four-month-old puppy, Tanooki, enjoying our post-lunch routine of frolicking through Merritt’s Pasture.

My four-month-old puppy, Tanooki, enjoying our post-lunch routine of frolicking through Merritt’s Pasture.

By establishing routines, setting internal deadlines, and scheduling virtual check-ins with my preceptor, I hope to make my practicum experience feel as “normal” as possible – but that’s not to say that it won’t come with challenges.  My wily four-month old German Shepherd/Lab (mutt) puppy named Tanooki forces me to break up my day with periodic sprints to the mailbox and back – but I’ve been relishing in all outdoor activities.  From running and biking on the American Tobacco Trail, to fishing (so far, without success) at Jordan Lake and swinging in my backyard hammock, I have come to appreciate now more than ever how essential fresh air and movement is for my productivity and overall sense of wellbeing.

Grace

Global from Local: Compiling Best Practices from Afar

By Ellery Walker

I know I echo the sentiments of many others when I say that 2020 sure has been a year full of the unexpected. When I traveled back to Michigan to visit my family over Spring Break, I had no idea just how much would change in the coming months. Though I had not yet secured a practicum, I had been pursuing opportunities across the nation and globe. I wasn’t sure where I would end up, but I was quite sure it wasn’t going to be anywhere near Chapel Hill. However, as the COVID-related travel restrictions grew, I shifted my search to anything that I could do from North Carolina. I stumbled upon Family Health Ministries (FHM), and, lo and behold, here I sit in my Chapel Hill condo. That’s the first piece of unexpected irony in my summer.

FHM’s Carmelle Voltaire Women’s Health Center in Tom Gato, Haiti.

FHM’s Carmelle Voltaire Women’s Health Center in Tom Gato, Haiti.

The second bit of irony comes in the work that I’m doing. FHM is a small, faith-based, community-directed, outcome-focused, partnership-oriented, and relationship-driven global health nonprofit based in Chapel Hill that has been working to “support Haitian communities in their efforts to build and sustain healthy families” for more than 20 years. What began as a commitment to reducing cervical cancer and maternal mortality among Haitian women has expanded to include several clinics, an orphanage and school, educational opportunities, and substantial community development. Earlier this year FHM opened a new birthing clinic at the Carmelle Voltaire Women’s Health Center (CVWC) in Tom Gato, a rural area in the mountains of Haiti. The clinic is managed by two Haitian midwives, with oversight from a local OB/GYN physician, and they have delivered about 20 babies thus far. Since the clinic is still a fairly new operation, this summer I am conducting a literature review on birthing centers and intrapartum care in low resource settings, and compiling recommendations for best practices for the CVWC.

Now, I mentioned that my work is somewhat ironic… so where’s the irony in a lit review? Well, I am the daughter of two OB/GYNs, and I have spent the last 24 years trying desperately to NOT engage in conversations surrounding maternal and infant health. And yet, here I am, dedicating my summer to learning as much as possible about childbirth. It all comes full circle, and yes, my parents are thrilled. This summer is ironic and unexpected, but I think it’s unexpectedly just what I needed.

Working remotely does have some nice perks… like this view!

Working remotely does have some nice perks… like this view!

Before I ever knew exactly what I would be working on this summer, I was drawn to FHM by the way that they empower and equip Haitian communities and leaders through intentional and respectful long-term relationships. As I think and learn more about global health and my role as a practitioner, I want to be committed to developing true relationships characterized by listening and learning, and working with the FHM team is a great opportunity to practice just that. As much as I wish I could be on the ground in Haiti, I am grateful that working remotely has forced me to rely so much more heavily on collaboration and trust with the FHM team and the Haitian staff. I have to rely on the input of the physician, midwives, country director, and my preceptors because I’m simply not there. I like to think that I would be engaging them in the conversation and prioritizing their thoughts even if I was physically there, but the truth is that it’s so much easier to become the expert as soon as we’ve experienced something. So, for now, I’m glad to be working from afar. I’m compiling best practices on something I’ve never experienced in a place I’ve never been. I cannot fall back on my own understanding, which means I must trust that of those who live, work, and have spent substantial time in that setting. And that’s how it should be anyway, right? Sure, global from local is a challenge, but it’s good practice, because whether I’m walking through a clinic on my own two feet, or just seeing it on a computer screen, my role should never be to dictate, but to amplify the voices of those I serve.

Musings in a Global Pandemic

I was in the process of finalizing my summer practicum in early March when COVID-19 began to rapidly spread in North Carolina. Today in early June, I find myself working remotely at my parent’s house in Chapel Hill. To set the scene: the farthest place I have traveled to in 3 months is the Carrboro Food Lion, and I now have “day” sweatpants and “night” sweatpants. And I never would have guessed I’d be starting my practicum from my brother’s childhood bedroom.

Despite the unexpected circumstances, this work has already begun to be incredibly meaningful and I am glad to be working from home. For my practicum, I am working under Nikki Behnke at the Water Institute at UNC, to explore environmental health in healthcare facilities in humanitarian settings. These first few weeks of initial readings and mappings have already opened my eyes to the devastating experiences of refugees- the majority of which are women and children. Their situation will be exacerbated by the pandemic, as lack of clean water and sanitation facilities and overcrowding will heighten the spread of infectious diseases like COVID-19.

My kombucha fermentation station

My kombucha fermentation station

My work schedule consists of a weekly zoom call with Nikki, and many hours glued to my laptop reading literature. I break up my days by going on walks, making kombucha, and learning TikTok dances like a child. While working from home has its own set of challenges, it has given me some real insight and gratitude for my own situation. It’s easy for anyone to get depressed when watching the news in 2020, and seeing the world become a dumpster fire before your eyes. But I am truly fortunate to be safe, healthy, and secure with my family. This pandemic is so much larger than me, and impacts millions more on a more severe level. Black communities who face institutional racism, violence, and have less access to healthcare are especially vulnerable.

Going on walks

Going on walks

The nature of this pandemic has reinforced the interconnectedness of global health, and has stressed the need for global cooperation. Seeing the public health crises of a global pandemic and systemic racism all bubbling over reminds me why I want to do this work in the first place. Finally, it underscores how important it is to take care of yourself so you can show up for others.

Stay safe,

Kendall 

Learning to make the best of a virtual internship

By Janet Okraku- Mantey

At the start of the Spring semester, my aim was to secure a global focused practicum. The thoughts of working directly with researchers impacting change through public health research in settings similar to home influenced this. As the semester progressed, we were hit with a global pandemic and chances of international travel gradually faded.

I successfully secured a practicum with Kybele, a non-profit organization, assisting with an ongoing research in Ghana to identify the gaps in obstetric service delivery by assessing patient satisfaction level to care received using survey instruments. I have been tasked with conducting an in-depth literature review to identify evidence-based methods used by researchers to assess patient satisfaction. Additionally, with the help of my preceptor, we will conduct a quantitative analysis of data from previously conducted surveys and compare our findings to those in recently published studies.

Securing the practicum was a bittersweet experience as I was faced with the canceled possibility of having to have practicum in my home country and not being able to be present. Though the pandemic took away the possibility of that experience, it gave room for me to learn to be helpful without being present.

My outdoor office.

My outdoor office.

Over the past few weeks, I have connected remotely with the librarians in the UNC Health Sciences Library to identify appropriate search terms to identify recently published literature on various databases such as PubMed, Scopus and Google scholar. I have successfully read and reviewed about 150 articles and in the process of completing my literature review.

I am still bummed I was unable to do this practicum in person in Ghana and get the opportunity to spend some time with family back home, but I have learned through this pandemic to take a day at a time and appreciate things around me.

I am thus grateful for the friends I have here in North Carolina and appreciative of the time I get to spend with them after work hours. We have spent time together cooking, baking, exercising and hiking and having great conversations.

My Remote Practicum Experience During a Global Pandemic

Working from home.

Working from home.

I was beyond excited when I was able to secure a practicum with the UNC Gillings Zambia Hub. As this was going to be my first time in East Africa, I could not help but count down the days. I looked forward to my trip, the practicum experience and spending the rest of my summer holidays with my family (I last saw nine months ago) back home in Ghana. I went as far as checking on flights and almost booked a ticket. So, you can just imagine my shock and disappointment when the news of the rampant spread of the pandemic and the possible closure of the borders was all over. This probably has been the time when I have prayed the most in my entire life for normalcy to resume. I have had mixed feelings ranging from anxiety, uncertainties, boredom, and loneliness.  The good news is that I have been able to make adjustment to my daily routines and faced the reality of working remotely from home.

Zoom check-in from my preceptor, Dr. Martin.

Zoom check-in from my preceptor, Dr. Martin.

For my practicum, I am working with my preceptor, Dr. Stephanie Martin, on the project “Engaging partners and families in HIV-focused postnatal care” in Lusaka, Zambia. This is a qualitative, formative research study aimed at examining the feasibility and acceptability of engaging male partners, grandmothers, and other family members to support HIV-positive mothers to practice recommended infant care and feeding practices, and to continue antiretroviral therapy. This qualitative study employs the use of Trial of Improved Practices (TIPS) methodology, a formative qualitative research approach. For this study, data collectors will need to be trained on TIPs and to counsel women and their families on infant feeding, care, and stimulation, and women’s ART adherence. TIPS involves an interviewer and participant together reaching an agreement on a solution or solutions having analyzed current practices and how they could be improved upon. Participants are given a trial period to assess the feasibility and acceptability of the intended practice. I am, however, helping to prepare the documents for the upcoming data collection activities and participate in secondary analysis of qualitative interviews with women and their male partners in Zambia and Malawi to understand the role of male partners in the prevention-of-mother-to-child transmission of HIV (PMTCT).

Regular check-ins from Dr. Martin and faculty mentor, Dr. Sian Curtis, have helped me stay focused and encouraged. To stay productive, I have a work schedule that I try to stick to taking breaks in between. In order to keep sane, I have been going for walks, visiting the lake, and recently started baking.

Visit to Crabtree Lake.

Visit to Crabtree Lake.

Amidst the uncertainties, I am grateful for good health, loved ones both far and near, practicum and the opportunity to be working remotely. I would say this pandemic is a blessing in disguise because it has made me realize that tomorrow is never promised and has taught me to adapt to situations, making the most of every opportunity. A note to my future self would be that “I am stronger than I seem, smarter than I think, and I am capable of anything that comes my way,” because at the end of the day, it always works out!

Doreen

When Global Has to Be Local

In March, I signed an offer letter for a practicum position in Zambia, hoping to fulfill my bucket list item of moving to Africa. The day after I signed that letter, the announcement came that international travel would be prohibited for the summer of 2020. My goal is to attend medical school after earning my MPHand to then focus on surgery/oncology, so the position tending to women with gynecological malignancies at the Cancer Diseases Hospital in Lusaka was the perfect fit. I was anticipating a personalized internship in which I could follow patients throughout their treatment process, and work on the multidisciplinary team to implement an online dashboard system to better track patient progress. I am now doing all of this…from the comfort of my living room. The issue is, I didn’t want comfort. I decided to get my MPH at UNC specifically for the hands on practicum experience, but the world had other plans.

Throughout this process I am learning that the interconnectivity of the world due to globalization and technology allows global work to happen locally. It is quite amazing how a girl in Chapel Hill, North Carolina in the USA can be reporting the status of a patient about 8,000 miles away. These circumstances make me wonder about the future of global health, though. Will we be more inclined to take a comfortable seat in our living room directing the work of others across the globe? I believe there is inherent value in traveling to the locations and communities you mean to serve. It is necessary to do so to learn their genuine wants and needs instead of being holed up in the American South telling them what they should want and need. I believe this is an attribute of being a global citizen, one whose care is not restrained by national borders. It is my hope that this pandemic shows us how interdependent many countries are, especially with regards to public health and disease.

Through my work for the Zambian hospitals thus far, I have seen an example of a team of doctors who have a goal of following through, not letting patients slip through the cracks, efficiency, and executing quality medical care. It has impacted my career path because I am now affirmed that the job I have dreamed of since I was 16 is a reality. I plan to travel underserved communities to serve global populations by setting up a sustainable, efficient infrastructure and system of care. I am still grateful for the opportunities UNC has afforded me, even if they are remote.

Katerina

My Global Health Practicum Experience During a Pandemic

Just another day at work!

Just another day at work!

I was excited when it was confirmed that I would be working with a critical stakeholder in the fight against malnutrition in Nigeria, the National Primary Health Care Development Agency (NPHCDA). I looked forward to traveling to field offices and communities to witness first-hand the implementation of programs targeted at tackling malnutrition in Nigeria, particularly among children aged 5 years and below. This excitement was cut short due to the unprecedented occurrence of COVID-19 pandemic and the social restrictions it brought on the global community – many have referred to this phenomenon as the “new normal”. For now, I will have to be contented with virtual interaction until travel restrictions are eased.

Prior to the start of my practicum, my travel tickets were canceled as a result of border closures. Adjustments were made to accommodate remote work hours before the reopening of borders. These unprecedented times give a literal meaning to the word “global” in my opinion. It is interesting to see how the world can be affected by a viral outbreak in a city. It demonstrates how the world is connected and makes it look somewhat “small”.

State nutrition officers of NPHCDA meet to review plans on improving Vitamin A supplementation in children under five across the 36 states in Nigeria.

State nutrition officers of NPHCDA meet to review plans on improving Vitamin A supplementation in children under five across the 36 states in Nigeria.

Despite the work changes imposed on us by the pandemic, I have been able to formally interact with stakeholders working on Scaling Up Nutrition (SUN) in Nigeria, thanks to one among many of the features of the new normal called “zoom”. These interactions have further fired my appetite to learn and contribute to the goal of improving nutritional status of vulnerable subpopulation groups in Nigeria. Under the mentorship and tutelage of Dr Nneka Onwu, who is the director of the department of community health services at NPHCDA in Nigeria, I support the nutrition division of NPHCDA. The nutrition division of NPHCDA facilitates implementation of nutrition service delivery at local government and community levels. It works on promoting adequate food supply and proper nutrition through education, assessment, counselling and support, community sensitization and mobilization.

I am thankful that I can still learn and support this ongoing program in Nigeria aimed at improving child health despite the challenging times. Interestingly, I always look forward to waking up very early due to the time difference, to attend zoom meetings. It is encouraging and really inspiring to see the passion to improve child health from the technical officers, program managers and other participants.

Even as we adapt to the new normal, I am encouraged by the knowledge that I am not alone and we are all in this together.

Stay safe!

Maureen

Using a Pandemic to Prevent Future Pandemics: My Experience with a Preparedness Practicum

The first day of my practicum started bright and early with a 7 AM video conference. As I logged in, I began to see faces and names of individuals from dozens of member countries and multilateral organizations as we gathered to discuss the Global Health Security Agenda (GHSA) in the midst of the COVID-19 pandemic. Typically meeting in person somewhere across the world, the GHSA was having its first virtual Steering Group meeting to discuss how it can tackle its mission to improve countries’ abilities to prevent, detect, and respond to infectious disease threats at this time.

The current crisis we are facing with the COVID-19 pandemic is a crisis of preparedness, and highlights the urgent need for prioritizing global health security. Too often, our world has amnesia after facing a public health response and fails to invest in the necessary structures to prevent future outbreaks and epidemics. As the world is currently laser-focused on the response and recovery phases of COVID-19, my practicum with the US Department of Health and Human Services’ Pandemic and Emerging Threats team aims to assist countries with making the case for investing in health security at this critical time and setting up sustainable and long-term approaches to public health preparedness.

My coworker Theo, who loves taking walk breaks and resting his paws on my laptop.

My coworker Theo, who loves taking walk breaks and resting his paws on my laptop.

As a current MPH student in Applied Epidemiology at Gillings, my professional and academic career to date has focused on using data and information to understand and combat infectious diseases. Now, as we see a global pandemic unfold and reach almost every corner of the world, epidemiology curves are a regular part of the daily news and disease modeling predictions are debated on social media. This has only further fueled my passion for infectious disease epidemiology, as I plan to spend my career improving detection mechanisms and strengthening health systems to better prevent and respond to emerging threats. However, this response has also shown how quickly protectionist politics can interfere with our ability to support the most vulnerable populations and effectively fight a virus like SARS-Cov-2, so I hope that my work as part of this practicum can help further a global, collaborative, and equitable approach, even if I’m working from my kitchen table here in North Carolina rather than on the frontlines of the response.

Kirsten

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