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

Category: Uncategorized (Page 1 of 5)

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!

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.


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.


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.


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,


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.


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.


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