Thursday, June 29, 2017

One Month in Uganda

Today marks one month in Uganda! These past four weeks have been filled with a lot of learning, walking, and nearly 50 patient and provider surveys. Our research team is focused on exploring the understandings of human papillomavirus (HPV) and cervical cancer in Bushenyi District. Our goals also include identifying barriers patients and healthcare providers face in terms of accessibility to HPV vaccination and cervical cancer treatment. Though at first it may sound arbitrary to focus on cervical cancer in a region where diseases such as HIV/AIDs, typhoid, and malaria are rampant, the impact of cervical cancer is tremendous. In this region of the world, cervical cancer is the most common cancer among women, and its survival rate is only 21%. While we are still collecting data to help us understand why this is true, I think it’s safe to say that one of the reasons the survival rate is so low is that there is only one place in the entire country (Mulago Referral Hospital) to get radiotherapy. This single machine has not been functional for over a year. For patients, this means that they must come up with enough money to travel out of the country and continue to pay for living expenses while receiving treatment outside of Uganda.

We have traveled to a number of different health centers, both public and private, to speak with patients and providers about HPV and cervical cancer. These conversations have been the highlight of my time here so far. I’ve included a few pictures below taken with some of the healthcare workers I interviewed.





As I’ve been reflecting on my time here, there have also been some cultural differences in regards to time that have required some adaptability and understanding. For example, I am very much a planner and prefer to have my appointments for the coming weeks confirmed in advance. However, that’s not how things work best here. If we want to schedule an interview with a provider, it’s best to call them just a few hours before or simply show up to their workplace. If you try and schedule something too far in advance, it’s likely that the meeting will not happen. Additionally, things run on Ugandan Time. When scheduling to meet someone, it’s basically implied that the meeting will not take place at the set time, and you’re often left waiting for them to arrive. Due to these differences, I am learning to become a more patient person, and I hope that this trait will continue to develop throughout the summer.


Overall, this experience has been so enlightening, and I’m looking forward to what the next 5 weeks hold!

4 Weeks In..

A day trip to Mbara to eat at Café Havana. It was delicious! Can we go back, please?

Boda (motorbike) drivers quickly noticing us as we pass. 


Our humble abode this summer!

Conducting an interview with a local woman with the aid of Dan, our awesome interpreter.


My first time pumping water from a well. This is definitely a good way to get your arms right.

Wednesday, June 28, 2017

Trabajo en Fila Grande, Matagalpa y retiro en Laguna de Apoyo

Here is our delegation coordinator, Jilmer, collecting a water sample in one of the water resources of Fila Grande, a resilient community in rural Matagalpa. Later that day, we tested the water for E. coli and arsenic and then shared the result with the health committee of the community who later shared it with the community.



This was after a great day of health stations where we completed surveys, measured height and weight and tested for anemia for children under 5 years of age and pregnant women. Here I was sharing stickers with some of the kids of the community after they got back from school.



In this picture we can see Don Petronilo, the health promoter of Fila Grande, sharing some of the historic and socio-economic context of the community and to the right, Jilmer, our delegation's coordinator who translated to English for those who don't understand Spanish.


 
During our time en el campo, all the women of our delegation stayed in a classroom next to the school and the men stayed in the local health post. Mosquito nets were a must! But thankfully the temperature dropped a few degrees at night which made sleeping quite pleasant.



After our week en el campo, we spent the weekend at a hostel by the Laguna de Apoyo. The sunrise was worth the early wake up call.

Tuesday, June 27, 2017

Wishing you the best from the Island of Magic

Hey Guys!!!!

E ai or what's up!?!

So I was supposed to post last week and with the wifi at our house, it was a struggle for the computer to come on (that's an exaggeration). I can go on about my problems and the things I have to do without, however my focus here is going to be on the opportunities that have presented themselves. After all, I am on the Island of Magic. This is one of the best things that has ever happened to me. 

So what has happened since my last post?

In the above picture is Bella, my tri teammate and Mariana Andrade, a famous Brazilian triathlete. They are both with the team equipetime (team time) and how I met this fantastic team happened several weeks ago thanks to a bloody leg. For those of you who follow me on instagram, you may remember me posting a picture of the gore. I was out for a run and tripped on the uneven sidewalk. Instead of letting that ruin my fun, I got up, collected myself and continued for a 2.5 hour slow jog. 

Oh, are you asking about the lab? Yes, I forgot that's the main reason why I am here. Lets explore what is going on at the labs in Floripa.
 Oh God, what is that you ask? I would be asking the same question if I didn't take the picture. So on an off day in my lab I headed to the lab of Winter Beaton, my fellow MHIRT friend and we learned how to put rats in the holders above. Wait, don't tell me I am cruel to animals. I am a vegan-leaning vegetarian after all. These rats are SO, I mean, SO docile! They handle so much. If I was forced into a tube where I couldn't wash my face, I would be very upset. These rats dont try to bite or anything and when you let them crawl on your shoulders, they cuddle with you. I LOVE THEM.
The sad part for me is that some are used for a different purpose, all together. Their sole purpose in life is to live and grow within the walls of a lab to hopefully provide the human race more knowledge with the contents of their bodies. I witnessed a terminal rat blood pressure recording from the carotid artery. This experiment was what is called vivisection. Basically dissection on a living animal. The good thing in this experiment was that it was terminal and the rats would not have any memory or have to deal with any pain from the experiment as they would be humanely put into a slumber once the data was collected. For me, this was difficult to swallow, but hey, it's an experience nonetheless.

Wow! that was a brainload! You say I need some relaxation after all that. Yes you are right!!! So what does one do in the Island of Magic for fun?

In these pictures are shown one thing that interests me about life. EXPLORING. I can be anywhere, downtown Memphis, in the Mississippian country, or on an island in Brazil and I just love learning of the things around me. The first image is of some interesting graffiti I had to snap a photo. Isnt it lovely?
The second picture was from a relaxing day on praia Canasvieiras.

And the third, was a scrumptious chocolate cake, That pink yumminess tasted just like pink chocolate with no fruity hints.

Amazing!

In addition to the information shared here, come along with me on my journey via instagram.

 https://www.instagram.com/lizziaparr/

Look forward to seeing you there. Also feel free to message me via here or instagram.

Monday, June 26, 2017

Passions of Belem

First month of work has been sweeeeeet.  I've been hanging out with my friends and colleagues at the Nucleo (Nucleo de Medicina Tropical)  Joyce, Railson and Terezinha.  They love to practice their English and I my Portuguese so there is a lot of give and take. I have met all of their families and have thoroughly enjoyed becoming friends with them.  I also pass this homeless elderly man Pedro, who lives at a bus stop everyday on my way to work. He still remembers me too. Tomi and I had become friends with him last year.

Givago, Leticia and I talk about politics pretty frequently too. Givago explains how politicians get into power all because of corruption. To get to a certain level they must accept bribes and influences from different groups and companies. It all comes down to who they choose to get their influence from. Givago told me how Brazilian politics really reminded him of House of Cards, as it's all just different ways that people get themselves into power. He also told me that he was happy to hear that I was returning because he knew I wouldn't really be too stressful for him as I already speak the language and I wouldn't really be at risk of getting homesick and wanting to go home. Then we rolled into talking about research. First he wanted me and Tere to do a new research project rather than a continuation of last year. He wanted us to do experiments based on pyschophysiology rather than electrophysiology.  

One day after work I headed home and was just relaxing hella as it gets way too hot here when Camila, my host, told me that a bunch of her friends were coming over and that I was more than welcome to hang out with them. So later on I joined Camila, and her friends Felipe, who was from Sao paulo and a few other people. I greeted them all and then I remained quiet for the most part as I was scared to try and speak with a lot of them! I finally got up the courage to ask how they all met and I guess it was through music and playing in different stages as Camila is a singer in Belem. There was a moment in the conversation where Camila was talking about how she just couldn't identify with Samba as she isn't 100% Brazilian. I asked her if she identifies more as Japanese or Brazilian. Her response was fairly similar to mine in that we are both biracial and have a culture totally separate from that of the majority of the population so our identity can vary with the situation. 

This one guest was telling  many stories about her dreams in agonizingly perfect detail too. She said she remembered her dreams so well because they're scary. Overall I was proud of myself for keeping up with the conversations. As the night went on guitars were pulled out and people started singing more. It was fun listening to all these songs and conversations!

Moments like these happen frequently here. I am happy to be immersed in the culture of Belem again and to be able to keep honing my Portuguese skills. I learn something new and get into another adventure each and every day. Will keep you all updated. 


Saturday, June 24, 2017

Covering Grounds (Research and Literal) of Uganda!




So surprise, we reached the equator at Uganda! 



Liz, Daryl, Kinnon, and I are up bright (not quite) and early ready for our day safari at Queen Elizabeth National Park! Going to one of our many outings during the weekend is quite a treat! Especially when we get hot, running water at our safari lodges.


Tembo (Elephant) Galore! Did you really go on a safari if you didn't see an elephant? We also had a great driver. Shout out to Vincent!


Although we love our outings, research has been an exciting part of our time here as well. Here we are interviewing our new friend, a midwife at Bushenyi Health Centre IV, on her perception and knowledge of HPV and cervical cancer. 


This marks our first group interview with all the midwives in the maternity ward at Ishaka Adventist Hospital. We naturally are overshadowed by the stunning poses of the midwives. & you can barely see me. But, these ladies deserve the shine. Love getting the group together and interviewing over sodas! 

Transitional Justice and Forensic Science

It's been three weeks since I arrived in Gulu, Uganda and its been an amazing learning experience thus far. I've met prime ministers, village chiefs (rwot), and community leaders who have openly welcomed me and the rest of the research team. The people of Gulu are some of the most hospitable I've ever met. I've been living in Lou House where we have a personal cook named Oscar who has made it his personal mission to teach me to speak Lou, the local language. I have learned a few words and I hope to build upon my vocabulary along the way.  I've had the privilege of meeting a singer who advocates for equality for children born with physical disabilities and uses his music as a tool to empower and educate their families. Then I encountered a female prime minister working toward youth development and gender equality so that women are protected against domestic violence. As an advocate of human rights and equality, it was inspiring to have an enlightened discussion on how they plan to address these issues within northern Uganda.

The research project has introduced me to the world of forensic science and anthropology as we conduct interviews and focus groups to understand the implications of the war in northern Uganda. The twenty year struggle between the Lord's Resistance Army (LRA) and the government of Uganda has resulted in thousands of missing and dead, and numerous mass graves and the need for exhumation and identification of unknown remains. In the context of transitional justice and the potential of forensic investigation, the team hopes to understand the perspective of the community members on what should be done to help the nation move forward from the atrocities committed in the Internal Displacement (IDP) camps. The people are accepting of scientific methods to resolve improper burials, and a national policy to provide support to survivors in the form of education, hospitals, and cattle for farming. At the same time we are not an NGO and do not have the resources to provide services related to excavation and reburial. We are only able to collect information and disseminate our findings to other agencies/organizations who do have the capacity to provide interventions to these communities. Most people we interview understand this limitation but it is also frustrating for some who believe that we are telling them that we have the solution to their problems but fall short of supplying the needed resources. An ethical dilemma, I'm sure, many researchers face while working in under-resourced communities.

Friday, June 23, 2017

Week 2 Adventures

We spent the last week in the campo (countryside) in the rural community of Fila Grande. After spending a week in Nejapa at the AMOS campus learning about the model of community based public health care and community empowerment, I was excited to get into the field and see it in action. After an 8 hour trip on Sunday, we arrived in Fila Grande and got to meet some members of the community. Then on Monday, we got right to work. Our group split off to hike to different water sources and collect water samples for testing. On Tuesday, we saw about 75 pregnant women and children under the age of five at health stations where we checked their height and weight, as well as their hemoglobin levels (for anemia). On Wednesday, we went door to door in the community and surveyed people about their water consumption and storage habits.  Finally, that afternoon, we were able to share the data we had collected throughout the week with the community health committee. That was definitely my favorite part of this experience. The model that AMOS uses to approach community public health is all about empowering the community and allowing them to have ownership of the work that is being done. By sharing the information directly with the community health workers, we were able to see them begin the process of brainstorming solutions and implementing them to address the public health issues we presented. After only two weeks in Nicaragua,  I have learned so much about public health and have been inspired by the other students and community members I have gotten the opportunity to work alongside!

Saturday, June 17, 2017

Las primeras aventuras en Nicaragua

Hello everybody!

Let me start of by saying that Nicaragua is B.E.A.T.I.F.U.L! I fell in love as soon as the airplane started flying over Managua. The scenery made me excited to explore and know more about this country. There is so much to know about the culture that even a three hour class of Nicaragua's history was not enough. Besides Nicaragua's history, all this week we have been taught all of AMOS values with the community and how we can improve health for every member of the communities. With only one week, I have learned so much that I can't wait to apply this skills next week in the rural communities. Lastly, after a long week of learning, we decided to take a bus to Leon to explore more of Nicaragua by going volcano boarding over volcano Cerro Negro! It was an amazing 45 minute hike that was so worth it at the end because we ended up at one of the most aesthetic views I have ever seen. We got dirty and sweaty but I would have done it again if that hike wouldn't have been so much of a workout! Overall, this week has been amazing and I can't wait to see what Nicaragua and the Campo has in store for us. Hasta pronto!
On top of the volcano in Leon, Nicaragua

Before volcano boarding

Cerro Negro

Behind the truck on our way to the volcano

Saludos desde Nejapa, Nicaragua!

Our first week in Nicaragua was lecture intensive.  In just five days I learned so much about how to properly work in the communities as foreigners and how to empower the people. Our campus also has a clinic that sees local patients and those that get a throat infection during their first week of internship aka me. Outside of the classroom,  AMOS has treated us very well.  We have buffet style breakfast at 8:00am, refrigerio (snack) around 10:30am in the classroom, buffet style lunch, refrigerio (snack) around 2:30pm and dinner at 6pm so yes, I haven't been missing any meals but I am definitely sweating them off during the night inside my SansBug. The heat is unbearable and fans have become my new best friends. The other people that are doing the internship are really sweet and passionate about public health. We have nurses, veterans, med students, residents, mph candidates and undergraduates in our cohort. Getting to know them has definitely been a great part of the trip so far. Some of the fun things we have done were going to Puerto Salvador Allende and having cappuccino ice cream by the replica house of Ruben Dario, having pizza 5 minutes away from campus with a majestic view, going salsa dancing with the programs coordinators and professor and exploring the city of Leon today! The plans for this week are to leave campus at 7 am and arrive in Fila Grande, Matagalpa by 3pm where we will be checking water filters and hosting a health fair. We are all pretty excited yet scared of what el campo will be like specially since they told us that last year one of the participants woke up with a scorpion laying on top of his mosquito net. Hasta la semana que viene!

Florianopolis, Brazil update!

Olá, Oi, Hello! Wow, the beginning to my summer has been amazing! I am currently in Florianopolis, Brazil, it is such a beautiful city on the island of Santa Catarina. Despite it being fall/winter-time here, I’ve been able to get out and explore and enjoy the nearby attractions: such as the gorgeous beach, Joaquina! The first two weeks I was sort-of bummed because it rained like everyday, but as time progressed (week 3&4) it has been nice & sun shiney! So on to research stuff: my lab mentor, Dr. Elizabeth Linder is so awesome! She has openly welcomed me to her lab and has encouraged intellectual freedom with my research! She prefers to go by Elizabeth (how cool, lol). Apart of Elizabeth’s lab, I am working in the department of pharmacology, as she is a pharmacist and professor at UFSC (Universidade Federal de Santa Catarina). Her research focuses on antidepressant drugs/medications and their effects on the body, specifically the cardiovascular and reproductive systems. This is such an interesting topic, as I am a believe in the importance of self-care and mental health. With this research, we are using rats as our test subjects (scary, right!?). I am currently conquering my fear of working with rats, so closely. I previously did research in a rat lab, but it was in vitro. I have successfully changed a couple rat cages and picked up some of the rats, as well as placed a blood pressure cuff on one of the rats. Elizabeth is taking her time training me on our experimental procedure because I will be conducting the experiment by myself, although she will pop in to assist. I look forward to a long day of taking rat blood pressures, as we are observing the effect a particular drug has on their pressure levels. It has almost been one month since i’ve been in Brazil! Time goes by fast when you’re out enjoying life right!? Check out my upcoming post to see what else is up! Tchau!

Floripa!!

 Joaquina beach

 Great food at hangout coffee spot💗

 At Lagoa conceição with the girls😍

 We took a boat ride to Lagoa conceição with a beautiful view costs view

November 5th square; beautiful park to seat and relax ^^

Wednesday, June 14, 2017

Touristy Things :)

Municipal Market of Curitiba has so many unique foods. I'll definitely be coming back here to grab a few treats for friends and family back home!

Visiting the Oscar Niemeyer Art Museum on a rainy, yet beautiful Sunday afternoon

My amazing roommate, Camila, helped me celebrate my birthday weekend with a spontaneous visit to the Botanical Garden of Curitiba!  

Train ride through the mountains for another birthday weekend adventure :)

Our destination, the beautiful city of Morretes, on the coast of Parana.

Saturday, June 10, 2017

Uganda: When Life Gives You Avocados & Rolex


Agandi Sebo! My name is Hermon and I am a part of the Ugandan research team. I am also a Pisces. This week we got to settle down into our permanent summer stay in the town of Ishaka. Sitting above a 30-foot water tank, I can see a clear 360-degree view of Ishaka in the Bushenyi region. The region is characterized by its abundance of green hills adorned with houses of red, green, orange, and grey. From here, I can hear a call to prayer from a Muslim mosque nearby resonating through the cool air. No lie, first time I heard a call to prayer from a mosque was when I was in Tanzania at around 5 am and I thought Jesus was coming back. This time wasn’t a panic for my soul, fortunately.

Our accommodations are very pleasant and simple. We even have actual toilets (I was expecting a squat toilet honestly). However, other things taken for granted like running water and a washing machine are pluses. Our house is on a steep hill that give us PLENTY of exercises targeting our gluteus maximus as we walk up. Kim Kardashian won’t be the only one breaking the internet with her behind when we get home.


When we venture out into the stores, it’s no casual affair. Honestly, if I had a cow for every time we got prolonging stares from people, I am sure I could cater all of ours and even your wedding… & your cousins (unless you’re a vegetarian). I was walking down a gravel path one morning and I swear even the goats have never seen my skin color before because their eyes were fixated on me. The people I have come to know at our site have been so welcoming. From our lovely cook Moreen to my special friends Sam and Howard that I get to touch every day (we attend massage classes every evening), they have made us feel at home. Especially our friend Moreen. Girl, let me tell ya, she can cook! Her peas dishes are phenomenal and she even made us Rolex one dinner, which is like a chapati (like African tortilla) with fried eggs rolled inside; Delicious is an understatement. Our dishes often are accompanied with the creamiest and biggest avocados they offer here. 



This week we also started touring around Ishaka Health Plan (our partner) and Kampala International University with the staff. These two sites will be our main source in gathering data on our cervical cancer and human papilloma virus (HPV) research. We will use surveys, interviews, and focus group discussions as our data collection methods, pertaining to the knowledge & perceptions/opinions on cervical cancer and HPVs.

Overall, we have settled quite nicely here. Our week ended with eating & watching Nigerian Dramas & a strange American movie at our friends’, Susan and Dan, houses. Thanks to my team and our wonderful friends, hunger and loneliness is something I or my team have not known during our time here.



Friday, June 9, 2017

Uganda Highlights


The morning view from our front yard at the top of the hill.


Kinnon, me, Hermon, and Daryl running errands in town.


Kinnon picked this avocado from a tree in our backyard! Quite possibly the biggest avocado I have ever seen.




Moreen prepared this delicious vegetable stew and rice with avocado. This is one of our typical meals.


Susan, our co-worker and friend, invited us to her home for lunch. She prepared pineapple, matoke, goat stew, rice, and g-nut sauce.

Tuesday, June 6, 2017

A lovely end to pre-race anguish

When one goes into the unknown, there are no comparisons or similarities to provide the experiencer comfort in that everything will be ok.
ABOUT MYSELF
I am a triathlete and I experience this feeling when I am about to and in the water in an open-water swim. I feel anxiety over what is in the water, how can I become comfortable, will I survive, etc.? And I am afraid of roller coasters and specialize in working under pressure. With these things in mind, getting ready for takeoff was extremely excruciating. Analogous to the few minutes before going into the water, there were so many variables (some of which I may not have been able to have full control) in the days leading up to departure. There were clothes to pack (But I need to pack lightly), there is a routine I have to break (not that I have a set one) and people whom I will miss seeing (just a little). Then my phone started messing up 2 days before I was set to leave (aye, the agony) and the only appointment Apple had was the morning of THE DAY (the AGONY). I went to the store and they had no phone to replace my phone. So I left and luckily, my mom had a “phone” to replace it with or provide a backup “just in case”.
“PLANE DAY”
My mom drove my family and me to the airport so to save my car and let them keep it at home to remind them of me. On this drive I let my anxiety go. I told myself I would be ok and if I needed anything, it would be ok and I could get it once I was in Brazil.
1,2,3 TAKEOFF!
So being scared of roller coasters and having flown only a few times in my life, I was super anxious about the first takeoff. To ease myself, I took refuge in the fact that only a handful of HUMANS were in charge of the plane. I trusted humanity and my problem vanished. The rest of the ascents and descents were only a little trembling (pun intended).
WELCOME TO BRAZIL
Ahh Brazil. Home to the tropical rainforest, rapid deforestation rates and incredible human population growth and economic improvement. Blue Air is also calls this country it’s birthplace (thank you CBU MKTG class). Other than these few facts and the information I was given orally by my American MHIRT advisers, I knew little about Brazil. I came here with no expectations, on purpose, and I am truly enjoying getting to explore a new way of life.
CULTURE SHOCK
Where is the big canister of oats? Where may I find the half gallon of SILK? Where is the store that has everything you need, all in one place? What about Goodwill? Why are the people laughing when the professor said what she said?

Wow, was I in for a shocker!... (Word limit is nearing, I’ll continue in the next post)

Monday, June 5, 2017

Round Two

Staying in Belem again feels almost like nothing has changed. The only difference is that my Portuguese is better and I have a friend group here. 

These are my friends Protasio and Amanda while we were chilling at their local shopping center catching up on life over the past year.


Protasio, Amanda and I went bowling the following day


My friend Joyce and I at our lab Nucleo de Medicina Tropical.

In conclusion I <3 Belem and am looking forward to my next two months here with my Brazilian "family" and friends.
      After sustaining straight line winds known as "Storm 901" the third worst power outage in
Memphis history, I am finally back on the internet and catching up with all I have left to do in three days.  For those of you that don't know 200,000 people were without power beginning May 27 and 500 trees are no longer with us.  That number of people is down to 4,000.  It has been hot, muggy and humid but nothing like "hurricane Elvis" of 2005.  I have been pleased to see that everyone has made it safely to their destinations and started on their summer journey.  I have one too but different from yours.  While I have traveled a lot it is almost always linked with business of some kind rarely for pure pleasure.  Beginning this Thursday, I will embark on a European adventure with my BFF.  Hubby is cat sitting and working.  Friday morning I begin in Barcelona, I am anxious to see how it has changed from 2006 which was the last time I explored the city (I was their briefly in 2013 for lunch!).  So a different adventure awaits me.  My BFF is a great traveling companion and more importantly she is the planner!  When we went to China, she planned everything (this too was a meeting ISER).  So I am anxious to see what she has planned. 
Ready for our adventure!