Saturday, July 23, 2016

A Doomed Trip

I'm a planner. Spontaneity and last minute decision making as well as deviating from the plan give me anxiety. This is one of the aspects of my character that has really been tested in Brazil, because normally even when I begin the day with a plan it usually gets deterred by a new adventure, a language barrier, or any other countless things that can happen while traveling.

This is all to say that planning our weekend trip to Foz do Iguacu was an absolute anxiety enducing nightmare for me. Everything last minute. Everything going wrong. Every problem solved produced a few more. I really and truly thought it was just not something I was meant to experience.

Even after ATM debacles, debit card denials and finally successfully booking the bus tickets just 6 hours before their departure, sometimes the bus breaks down in the outskirts of Curitiba at 11 PM and you anxiety reaches an all time high as your brain races to figure out a way to shelter for the night. (Another bus came for us about an hour later, no worries)

BUT the good news is, that even despite all this challenges and tests, you may just end up in the most beautiful place you've ever seen enjoying a free capirinha at "capi hour" at your hostel that's built out of storage containers wondering how it all worked out without meticulous planning execution.

So, my aniexty-ridden friends, take the 18 hour bus ride though rural mountainous Brazil and try not to fret about things that are out of your control because you still may end your day with a free capirinha in hand.

And some pretty great new memories:

Iguazu falls!

Although kind of cute, these animals are lowkey dangerous
Brazilian side of Igauzu falls
Got a bit wet for this picture but totally worth it! Another picture of the Brazilian side

Hola Again!!!
                We (Abrania, Jennifer, and I) have been here in Nicaragua for almost seven weeks, and we have completed four of the total six weeks of the previously mentioned Women’s Empowerment internship.

                The research of the Women’s Empowerment internship centers around the rural community of La Danta, La RACCS, Nicaragua which is about a 10-12 hour trip from Managua.  We are specifically interested in the prenatal care practices of pregnant women in the sectors of El Cerro, La Mona, and El Santa Fe. Using Barrier Analysis, a research method created by Tom Davis, we are trying to discover the barriers that hinder women of the community from attending 4 or more prenatal health visits; prenatal care is one of the first steps in helping to prevent infant/maternal mortality. The Barrier Analysis method requires that 90 surveys be completed with 45 being doers of the behavior of interest and 45 being non-doers of the behavior of interest. In the past 2 visits to La Danta we were able to obtain two thirds of the needed total through hiking to the homes of all three sectors, going to schools, and having health stations.

                Another goal of the Women’s Empowerment internship is to decrease infant and maternal mortality through empowerment of the women of the community. The past week in the community featured two levels of the empowerment through trainings. We had a one-day training for the general women of the community that featured education about nutrition and prevention/combating anemia. The other training (2 days) was for a group of women that volunteer to help improve the health of the pregnant women and other mothers of the community; the group of women have the title of “madres voluntarias.”

 We are currently preparing for the fifth week which will be spent in the campo* (La Danta). As this is the third and final week that we will spend in the campo, we will strive to complete the research and trainings that we started during our previous weeks in the community. We are exactly on schedule with the amount of Barrier Analysis surveys that we need to have conducted, so I am pretty hopeful that we will be able to obtain the remaining third (30 surveys) during the upcoming week.

In closing, I am super excited to say that I have really been enjoying the internship. The time that we spend in the campo is challenging, but it also allows us to better understand the barriers that the women of the community face on a daily basis. The final two weeks will be both amazing and bittersweet.

Hasta la proxima vez,

Kayla Somerville

*campo means countryside or rural area in spanish

Friday, July 22, 2016

Our 2nd Week in La Danta, Nicaragua

The Ambulance
This is the “ambulance” and our form of transportation to our community en La RACCS. We pack as much of our supplies, mosquito nets, mud boots, and bags on top and hope we have enough room for ourselves below.

La Danta: Presentation of Nutrition Information to El Cerro
We traveled to a distant part of the community during our second visit. Some of the community members were nice enough to lend us horses to make the journey. We presented the statistics we collected from our health stations during the first visit and discussed portion size and food groups with a group of women from this sector of the community. We also reviewed danger signs during pregnancy and discussed the steps to take if one of these danger signs occurs to oneself or a neighbor.

La Danta: Women’s Empowerment
This is a picture of Kenia, a nurse from AMOS who works specifically with the community of La Danta and a few communities nearby. We were going house to house on this day gathering data for our barrier analysis. We are currently looking for barriers to pregnant women in the community completing at least four prenatal checkups during their pregnancies. We will be leaving tomorrow to go back to the community for further training with the “Madres Voluntarias” and to collect more data from the women in the community.

Tuesday, July 19, 2016

Ugandan Medicine

After almost 8 weeks in Uganda my view on medicine has shifted drastically. Through our research we have had the opportunity to spend time in a variety of clinics around Kabale and in the Kigezi region. Upon coming to Uganda I had the idea that we could improve Ugandan healthcare by implementing systems similar to ours in the U.S. However, I have witnessed there is no “right” way to practice medicine, and we have a lot to learn from the rest of the world. There are many diverse ways to practice medicine depending on the circumstances. The key is then to find the best practice in the place where you are.

In Uganda I have noticed many unique forms of medicine from the herbalists to the regional referral hospitals to the small, rural clinics. In the referral hospital we visited they had the capability to treat trauma cases, take x-rays, and perform surgeries using anesthesia. This hospital was similar to the type you would see in the U.S. On the other hand, the rural clinic headed by a nurse could provide simple out-patient curative services. Despite the amount of supplies or staff available, I have noticed a common theme among all of the healthcare settings in Uganda- the personal care is wonderful. Each health worker strives to help in the best way they can with what they have. They work long hours and rest very little (if at all) to ensure that each patient receives the best possible care. For example, one of the clinicians we met tirelessly works in the clinic six days each week for at least 12 hours each day. In addition, he is on call when he isn’t on site. I look at the Ugandan healthcare workers, and I admire them hoping to one day be just as hard working and compassionate as they are. They put their heart and soul into their work and are constantly battling obstacles of limited supplies, electricity, or funding. I can say with confidence we have a lot to learn from them and the selfless care they provide.
The beautiful view from one of the clinics looking onto Lake Bunyonyi