Students and global health experts share their experiences working with communities.

Category: Hunter

The importance of a dream team

Standing outside of the rural health clinic in el Progreso after doing interviews one morning.

I came down to Galapagos worried about what my level of support was going to look like while on the island. I knew the internet wasn’t great and that cell service was spotty, so I was expecting the worst. I wasn’t wrong about my lack of access to wifi but what I found was an awesome research team to support us through our project. I’ve decided in this blog to introduce you to some of our team members, and explain how integral their role was throughout our entire data collection process.

1. U.S. Based Research Team: Our U.S. based research team has been incredibly helpful in this project. First, Dr. Clare Barrington is the principal investigator and thus, knows how everything should work. She was able to visit Galapagos for 10 days while we were doing the study, and organized important meetings with directors, healthcare providers, and community members. Her ability and knowledge of exactly who and how we should work with individuals is spot-on, and I was able to learn so much from her. For example, we were given a hospital tour on one of our first days, where we were introduced to every single physician (there are over 15 working in the hospital and health center!), taken to every single part of the facility including labs and x-ray machines, and then we arrived to the health center. Clare immediately realized that three physicians we were introduced to would be key in our project and immediately stopped them to explain our project and set up a time to further discuss. Her ability to act and know at that moment who we needed to be in contact with was key to getting the study started. Similarly, Humberto Gonzalez Rodriguez, a project coordinator for Clare’s research team, and my preceptor, visited for 10 days. His skill set was incredibly valuable, as he assisted in motivating the team with daily starbursts, encouraging us during times of uncertainty, and directing with every qualitative research related question we had. The guidance of the U.S. based team was incredible and invaluable- and working so closely with Clare and Humberto taught me a great deal about qualitative field work.

Humberto Gonzalez Rodriguez, Yearly (a rural nurse who was incredibly helpful in recruitment!) and myself at a patients property in the rural area of el progreso. Humberto executed an interview with this participant literally “in the field” while the family was collecting fruits and veggies to sell.

2. Physician and Nursing Ecuadorian team: Because of a MOU between the Galapagos Science Center (a joint center between UNC and USFQ- an Ecuadorian University) we were able to directly recruit and work through the local hospital and ministry of public health. We came across an amazing team of passionate doctors, health promoters, and nurses that were focused on their patients and willing to help us at all costs. They made us a list of diabetic patients, walked with us door to door, and organized appointments for us. Their team gave us constant feedback about our project and how different things would be received within the community. They walked us through rural sites, returned to houses three and four times if patients weren’t home, all while patiently answering all questions we had about their work and the healthcare system. Without this amazing team of healthcare workers, this project would not have been possible! We even were able to celebrate the hard work by providing the team with a cake on our last day together. The engaging community collaboration for the project was an awesome example of community assisted research.

Leading a preliminary results dissemination meeting for physicians and healthcare directors from the ministry of health for Galapagos.

3. Our Research Assistant, Paulina: Paulina was suggested to us as a research assistant by a previous UNC project that worked with her last year- and what an incredible suggestion it was! Paulina was born in Machala, Ecuador, a coastal city of the mainland, but her father moved to Galapagos over 20 years ago. She lived on and off in the islands growing up, but ended up staying in Galapagos when she met her husband 15 years ago. Now, she is studying environmental administration, but works with health projects on the side. After having experience doing surveys in a previous position, we were excited to encourage Paulina to execute interviews and assist with transcribing for our project. Paulina picked it up quickly and was a great interviewer! She is a hard worker, passionate about Diabetes, and loves working with her community. Paulina helped our project from every single aspect and quickly became my closest friend on the island. We even got to travel to another island, Santa Cruz together! I’m incredibly grateful for Paulina and excited to be able to work with her on the analysis portion of this project.

Paulina and myself during our weekend vacation trip to Santa Cruz!

4. Galapagos Science Center: It was amazing being able to work on a research project with an already existing research center. The GSC has infrastructure for projects like ours, and when it came time to meet with hospital directors and coordinators, the team at GSC was quick to assist and encourage us to make meetings with a variety of local leaders. The GSC team coordinated our offices and meetings, helped me learn how and where to print, helped us make coffee on long afternoons, and even coordinated dissemination events for us to be able to share our results with the community. Without the GSC team, our process of completing this project would have been incredibly difficult.

Through this summer research opportunity, I’ve learned the importance of key members working together in a team, and the cooperation of everyone to execute a successful project. While I have officially returned to the United States preparing to gear up for my last year of my MPH, I will continue to work on this research project and with Paulina and the community throughout the upcoming year to analyze the data we were able to collect. I learned a great deal from our research team, the community, and about life on an island while I was there, but I’m grateful to be back with my dog and family! Either way, the connections made in Galapagos are lasting and I’m grateful to have had the amazing opportunity to do research in such a unique setting with such a collaborative community.

Dr. Trajano Mediavilla (diabetes doctor), Myself, Paulina, before a radio show organized by the Galapagos Science Center team where we were able to discuss diabetes on the island and our research project, disseminating research directly to the community.

Paulina and I in the health center with Katty, a community health promoter who works both in the rural area and the city and was a major and key help in our ability to complete this project and recruit participants.

– Hunter

Research in Collaboration in Galapagos!

This summer, I was given the opportunity to work with Dr. Clare Barrington and her research team out of the Health Behavior department at UNC Gillings to execute a qualitative research study on the emotional burden of living with and managing Type 2 Diabetes among adults in Galapagos. Clare and her team have done a similar study in the Dominican Republic across three summers, and were excited to expand to a new site- with seemingly good infrastructure. Before I arrived, we had received IRB approval, prepared our interview guides, done everything it seemed we could do without being here- but everything still felt very vague. Other researchers with years doing work here assured us “it will all make sense when you land!” but I was hesitant, as I was arriving in San Cristobal before Clare to begin doing some research on the place alone. Having spent two years living in Ecuador I was fairly confident about my trip, but not knowing the island itself was daunting. I reserved a seemingly nice Air B&B with a kind family, read up on things to do in San Cristobal, and asked my Ecuadorian friends all about the best places to go. Little did I know, the motto of “it will all make sense when you land!” truly became reality! When I arrived in San Cristobal, I immediately went with my host mom on a tour of the island and realized that it really is as small as everyone says.

The town of San Cristobal and a few of the animals I share the place with!

The Galapagos Science Center, where I work and collaborate with researchers from Public Health, Anthropology, and much more.

To give a little context about where I am specifically, in the Galapagos there are 4 inhabited islands, of which San Cristobal is the farthest west and has about 8,000 residents. It’s small, so within the first week I was already running into people I know! I arrived the first day to the actual Galapagos Science Center (GSC) building, which is a collaboration between UNC Chapel Hill and the University of San Francisco in Quito, excited to get some direction. It is located directly in front of a gorgeous sea lion filled beach with large patios and beautiful facilities and truly seemed like a researcher’s dream. I walked in and was directed towards an empty GIS lab where there were really no researchers. I asked the Ecuadorian-based employees if or when other people are coming and they warned me that over 100 individuals from UNC alone were coming this summer- but it was hard to believe at that time! I got to work building connections with physicians in the community and getting to know the health landscape, while I waited for Clare’s arrival the following week. After about a week, I noticed a few new researchers trickling in and introduced myself, but still wasn’t able to believe how many people would be coming. Having little experience in research and more experience in day to day work, I filled my days with tasks like printing, editing, and making meetings.

(L-R) Meeting with hospital lead epidemiologist Dr. Juan Ochoa and Dra. Clara Rodriguez, Clare Barrington, myself, and Trisha Dant, Associate Director of the Office of Research of the UNC School of Medicine (who is here on a research site visit).

This week, I woke up Monday, went to the office and walked inside to, I kid you not, 50+ people in the science center! Overnight the place had gone from empty to at capacity! I wasn’t sure what to expect but this week has taught me a great deal about research in collaboration. Since our project has started slow (I’m on week three with no interviews!) we have had the opportunity to learn from all of the researchers who have been coming to Galapagos for 5+ years. We have asked questions, listened to presentations, and the discussion doesn’t stop when the clock hits 5! It’s been really interesting to work with Clare and learn how to begin a study of this nature and begin it at a completely new site. I’ve seen her collaboration with Dr. Amanda Thompson, who has been doing research here on health for years, and it has shown me how important collaboration across fields really is. I’m beginning to learn how important community relations are in this type of work, and realize that without the support of the Galapagos Science Center, none of the research we hope to do would be possible.

Clare and I after the 5K we ran across the Island “Yo Vivo Sin Drogas” or “I live Drug Free.” The race is on it’s ninth year of a country-wide campaign against drug use.

I’m really excited to begin our first interviews next week and continue living on this beautiful island. I’m lucky to have already started to make some great connections and have had the opportunity to participate in a variety of talks and activities on the island. Clare and I were even convinced to run a 5K last weekend! So far, my three weeks in San Cristobal have been a great learning experience in flexibility, adaptability, and learning before acting. We’ve had to patiently gather information about this community for two weeks before being able to start our research, which requires a lot of patience, but is also incredibly important. Everything really is making more sense now that I’m here, and I can’t wait to see what else San Cristobal has in store in the next month!

– Hunter