Thursday, July 13, 2017

Neap --> El Bambú

Five weeks into my internship and I am so heartbroken it is almost coming an end! My time here has truly been a learning experience .Not only because of all the fieldwork I have been doing but because of the things I am learning about myself. My biggest discovery so far is how passionate I am about public health and how this is the only type of work I see myself doing in the future.

 After the three-week practicum, last week we officially started our projects. After an 11-hour truck ride, 1 exploded tire and helping a fellow truck go up a steep, muddy hill we made it to our destination, El Bambú, an ultraconservative rural community in La RACCS (South Caribbean Coast Autonomous Region). For the week, we stayed at one of the health committee member’s house, which is also used by the Ministry of Health (MINSA) doctor and nurse to sleep over and for the health promoter to follow up with the community. The project I have been working on is based on positive deviance to identify the nutrition and health practices that keep babies healthy for the first 1000 days, which is from the time of conception to their second birthday. We are focusing on this critical period because it is when most change regarding malnutrition can be accomplished.
The day after our arrival, the nutrition team (my team, the best team!) hosted health stations where we completed surveys, tested anemia and weighted and measured all infants less than 5 years old and pregnant. This data is the baseline for our positive deviance (PD) study on underweight and anemia. Unfortunately, there were certain limitations to the data and we had to change the standards of PD and include children that wouldn’t be included in a classic PD study in order to have a big enough pool of children to proceed. The following day, we split into groups of a community member, an intern and AMOS staff to visit our positive and negative deviants to complete the interviews. Although I was quite nervous, the interview went great and I even stayed almost 2 hours after I finished just talking to the family about my childhood, my family and my aspirations. The owner of the house to whom I talked to the most and has a reputation of being very serious and hard to be friends with, says hi to me and shakes my hand every time he sees me and greets me with a smile. That helped me cope with the feeling of being a foreigner in a vulnerable community which I was struggling with during my first few days. The days after that we spent them analyzing the data and presented it to the Madres Voluntarias (volunteer mothers). We identified the practices of the positive deviants and what was lacking in the case of the negative deviant. From that data, we were able to identify themes which will be training the Madres Voluntarias in and they will be leading the sessions to their care groups. On our last day, we hosted a cooking competition where each of the Madres Voluntarias created a recipe for a child younger than 2 years old rich on protein and iron to tackle the overwhelming amount of cases of anemia. Then the mothers shared their recipes and while the interns shared the calorie, protein and iron levels per plate. Everyone (the community, the interns and AMOS staff) was very satisfied with how the activity worked out and made us very excited about the upcoming weeks.

This week we have been working on developing lesson plans for each theme we identified with the community and flipcharts for the mothers to use with their care groups. Our lesson plans are filled with activities and questions to keep the participants as involved as possible. Next Sunday, we will be heading out to El Bambú again and will be there for two weeks. I can’t wait to see the Madres Voluntarias teach all the knowledge we are going to share with them!

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