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ICD Travels to Peru
By Arti Desai
[dropcap]I[/dropcap]ntricate Incan ruins, magnificent Machu Picchu, heartwarming homestays - from the capital city of Lima to the historic site of Cusco and to our field site in Tuni Grande; Peru is filled with mesmerizing contrasts between traditional and modern influences. My experience in Peru this past summer as part of the Global Health Integrated Community Development (ICD) teaching team was a journey that neither classroom nor books could teach. As a recent graduate of the Global Health program I had the unique opportunity to serve as a course facilitator in Peru. I saw the inner workings and details of what it takes to plan an international trip for 20 plus students: coordinating travel arrangements, flights, lodging and site visits, all of which serve as a unique hands on opportunity to learn.
The ICD course is a chance for students to practice what they have learned throughout the school year and apply it in a real world, international setting. It is a chance to let the world be the classroom. Language barriers, cultural differences, climate, food, clean water, and toilets are all challenges that are encountered throughout this trip.
In Peru we were faced with high elevation and altitude sickness. We began our trek in Mira Flores, Lima (5,080 feet above sea level) where we experienced the luxuries and modernities of Peru such as Starbucks, paved roads and traffic. After lectures and informative meetings with a former medical epidemiologist of Peru, personnel from USAID, and CARE Peru, we flew to the beautiful city of Cusco (10,800 feet) in an attempt to acclimate to Peru’s varied geography.
A train ride later we arrived in Aguas Calientes, the closest access point to stunning Machu Picchu (8,040 feet), where if the hiking does not take your breath away, the sight of the mountain embraced by swirling clouds surely will. One of the most meaningful experiences for me was the trip to Los Uros, a floating island in Lake Titicaca, Puno where a handful of us spent Sabbath morning at Los Uros Seventh-day Adventist Church. As the little church gently swayed back and forth upon the layers of reed keeping it afloat, I was reminded of the simplicities of life.
Surrounded by the crisp air and rich, sharp colors, I felt like the world around me had stopped as I viewed nature as it should be - pure and magnificent. Following our cultural emersion and acclimation, the student group that Dr. Belliard and I worked with traveled to a small village by the name of Tuni Grande. One of our tasks was to validate previously tested levels of Arsenic in the water wells that surrounded this village.
We also did assessments on hand washing and oral hygiene to view barriers and test knowledge among the villagers by way of door-to-door surveys, and held gender-specific focus groups to get an idea of what men and women of Tuni Grande thought were the top needs in their community. These necessities were later prioritized to one main problem which was discussed in-depth as to why it is a major issue and what its effects are. This was then followed by a session where possible solutions were ascertained by the community members.
This whole process of talking with the community members was done in Spanish and Quechua, an indigenous language, which was translated back and forth for the ICD students. Our week long field project in Tuni Grande included homestays in which each Global Health student was assigned to a family and we lived, ate and talked with our “host” family as Tuni Grandians. My family was comprised of a mother and father in their early 30s along with two young boys and their grandmother. We ate all our meals together and talked about our respective lives.
One day my host mother asked me, “You live in America, that’s further than Lima, right?” With this question I realized that the sum of all of my life experiences, both locally and globally, has broadened my knowledge and made me more aware of life outside my community, my comfort zone. For my host mother, her life, work, family and everything she knows is in this community that we are trying to understand and improve. “Yes, I am further than Lima, just a 14 hour plane ride away,” I tell her in Spanish as she looks at me with wide eyes and surprise.
This was not the first, nor was it going to be the last time I received such a reaction. Upon near-completion of the multiple assessments in Tuni Grande, the last task included debriefing our new families and community on our findings.
Our Arsenic tests confirmed high levels of the chemical in the water, as high as seven times the safe level of 10 parts-per-billion as determined by the EPA and WHO. As a result of this revelation I began to wonder, “Why? Why does such a nice, hardworking community, bustling with young children have such a problem in their village? What is the root cause of such high levels of contamination seeping into their drinking supply? What can we do to help them? What can we do to help them, help themselves? Do we tell them the harsh reality of what we discovered without being able to deliver an instantaneous solution?”
When working with people and communities, especially as we starts putting public health into practice, we are faced with challenges and struggles that makes us question, “How else can I help?” and “What more can I do?” For me, their burden becomes my burden and only when we empathize with our fellow man can we truly begin to understand them. This understanding and respect is pivotal in fostering a partnership and positive change in the future. Throughout my experiences and interactions with my family and other Tuni Grande community members, I was thoroughly humbled and struck with admiration for each and every community member.
My insight into what public health entails, whether it is through observing communities and collecting data or serving as a health educator, continues to be broadened on a daily basis. My experiences, purpose and personal goals at Loma Linda University, specifically the School of Public Health can be summed up by Mahatma Gandhi. He states, “The best way to find yourself is to lose yourself in the service of others.” Personally, this is exactly what my journey and transformation at Loma Linda University has been; as a student, teaching assistant, facilitator, and leader I cannot wait to see what the future holds for me next.
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ICD Travels to the Philippines
By Annie Coriolan
[dropcap]I[/dropcap]t was with enthusiasm and anticipation that eleven of us embarked on a three-week journey in the Philippines this past summer quarter. As part of the Integrated Community Development (ICD) course we work in partnership with local organizations. During this course, students are expected to apply skills that they have acquired during previous quarters—such as conducting needs assessment, program implementation and evaluation, and report writing—all into real life situations.
We collaborated with the International Institute of Rural Reconstruction (IIRR), an organization with a location in Silang, Cavite. We were assigned two projects: one dealt with teenage pregnancy and youth empowerment, and the other with maternal nutrition and infant health.
For a week after our arrival, we visited several organizations such as Save the Children, World Vision, Plan International, the Department of Health, the Cavite Health Office, and the Adventist Development and Relief Agency (ADRA). These site visits enabled us to learn more about the Philippines’ health system, and the different development projects taking place by these organizations. It was an opportunity for us to ask questions relevant to our respective projects.
Along with five other students, I was part of the team working on the teenage pregnancy and empowerment project in Rosario, Cavite. There, health leaders had identified teenage pregnancy as an issue. Our task was to assess whether teen empowerment could be used as a means to decrease teen pregnancy in this community. As we learned in class, we conducted a mixed-methods assessment comprised of focus group discussions, key informant interviews, and surveys with the community leaders and inhabitants of two barangays (villages) in Rosario. Although we had already done similar assessments with different organizations in Southern California, the challenges seemed to intensify when applied in a foreign setting. From our first day in the field, we found ourselves constantly adjusting our methods in response to the barriers that we came across. It started during our first assessment, which took place in an open room still under construction. We were competing with crowing roosters, the sound of men playing basketball in a nearby court, while struggling to understand the little English that our participants spoke and making ourselves understood. Some of our focus group discussions were very active and participatory, while others were extremely difficult to get through. Due to the language barrier from both sides, even with the help of a translator, we had a very hard time communicating with our participants. This gave us a serious nosebleed, as the Filipinos would say, but we learned from it when preparing for our next focus group discussions.
Conducting the surveys was also an interesting aspect of the needs assessment. People in the community were very friendly, they would invite us into their home and answer our questions, they would introduce us to their families and even vent to us about their recent unpleasant experiences with the health system. As an elderly woman recounted how her teenage granddaughter was rejected from hospital to hospital due to some complications, the visit lasted longer than we wanted. We soon realized that at this pace, we would not be able to collect 115 surveys in three days. From that day on, we found that the best way to conduct the surveys was to stand outside with them while collecting the data. Our findings were then compiled into a report that we presented to IIRR and the Rosario health officials. With this information they can decide how to move forward to address the issue of teenage pregnancy in Rosario.
This whole experience has taught me how to be flexible and how to deal with unexpected situations when they arise. Knowing how to work effectively with a team is also important in the field of public health. With the added stress of working in a foreign country, personalities may clash, disagreements may arise, but you have to learn how to work effectively despite those impediments. It was an experience that I will always remember. I am very grateful that I had the opportunity to get some experience abroad during my studies at Loma Linda University.
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