There's Still Work To Do

Before anything else, I’d like to begin by thanking the AMOS staff and MHIRT for giving me hope during this seemingly never-ending pandemic. When I first found out our team wouldn’t be going to Nicaragua this summer, I was honestly heartbroken and gave up on things I shouldn’t have. I stopped taking my Intro to Spanish course seriously (which backfired when I had to introduce myself in Spanish), almost deleted Duolingo, and thought there was absolutely nothing I could do to help in Nicaragua from my house.
As cheesy as it may sound, AMOS reminded me there’s still work to do. There’s always work to do, even if we’re 3000 miles away. In just a few weeks, we’ve already completed a literature review, written an annotated bibliography on mobile health (mHealth) technologies and practices, and participated in the Global Health Practicum which included lectures on topics such as Privilege and Cultural Humility, Community-Based Participatory Health Care (CBPHC), and Community-Based Participatory Research (CBPR). Community involvement and feedback is an important goal for this project to ensure short-term and long-term success and a significant change in education and behavior.
Our next objective is to formulate a strategy to implement an education and communication-focused mHealth technology in the rural villages of Nicaragua. We need to keep in mind, though, that many parts of Nicaragua may be low in resources and may lack network coverage. We will rely on Community Health Workers (CHWs) to relay feedback to and from the villages.
While we’re still figuring out which mHealth platform to use and the strategy for its implementation, I think it’s time for me to start practicing Spanish again. I’ve been practicing a few phrases I think I’ll be using a lot. Unfortunately, my go-to line is still “Lo siento porque no hablo. Pero, puedo tratar.” But, I’m active on Duolingo again. Here are some screenshots of Day 1 back on Duolingo. My goal is to keep the streak alive until the end of the internship and reach a crazy number of crowns. Maybe 500? Let's see.

First few weeks in the virtual Global Health Practicum

The first two weeks of the Virtual Global Health Practicum has introduced me to deep and
challenging structural problems in healthcare within Nicaragua, but it has also shown me what
Amos is doing to improve healthcare and what I can do to contribute. The first hand responsibility
as well as the detailed education I have been given during  he past two weeks has helped me
stay positive and focused during a time when all of the world's problems seem so out of my
control.  During a global pandemic, when I should have my feet on the ground in Nicaragua,
I am sitting in my room staring at my laptop and being constantly reminded of the devastating
impacts of the coronavirus. I am reading and hearing every day about the oppression and
destruction caused by systemic racism in our country. Now, I am learning in incredible detail all
of the challenges that women face in accessing maternal and neonatal healthcare in Nicaragua.
Yet, everyone at Amos has been positive, upbeat, and most importantly, focused on what we
can do and how we're going to do it. This ability to know I am actively working towards a greater
cause  is refreshing and rejuvenating in times like this. I am grateful to be part of it, and the fact
that there is such a hardworking international team innovating to keep fighting for healthcare
has been uplifting to say the least. Despite being in Indiana, despite the coronavirus, despite
the divides in our country, I am confident in saying that I am helping, even if it is from my room
in my parents house. 

As of right now, my team is working on a literature review of different Mhealth technologies
that have been created and used to better maternal healthcare in rural communities. Through
this research, I have learned a great deal about the challenges that Mhealth technologies pose
as well as the benefits they have on healthcare. I hope to try and work through how we can
address some of these challenges while still reaping the benefits of Mhealth technologies.

Here is a picture of my dog. Even though we are not in Nicaragua, at least we are with our dogs. 

My First Taste of Nicaraguan Food

When I first introduced myself to the MHIRT/Amos community on Zoom, I felt the need to mention my love for food and music. Truthfully, I was excited to go to Nicaragua because of the experience of working within rural Nicaraguan communities and learning to conduct research, but beyond that I was also excited and humbled to be able to enjoy the beauty of the culture; whatever food, music, customs, traditions, and relationships I would be exposed and drawn to. With remote learning going on right now, I still hope to dive into whatever bit of recommendations I can get. On the first day, I was given links to recipes on how to prepare Indio Viejo and other Nicaraguan dishes, was recommended Ceshia Ubau and Elsa Basil as artists I should listen to (who I am loving, by the way), and given the names of many towns and mountains I hadn't heard of before. As a result, my blogposts will likely revolve around food or the arts in some way.

This week though, I had the pleasure of trying out a dish from a local Nicaraguan spot recommended to me by a good friend, Liz. This is the first time I order out from a Nicaraguan restaurant and I'm considering this to be my first exposure to the food. I was very excited to try it and... spoiler alert: I really enjoyed the dish. It put a 'yum' in my 'tum.' I would love to try more dishes in the future and to keep on receiving recommendations on food, music, movies, books, and anything else to look into. I am looking forward to sharing more about my engagement with things I've really enjoyed.

The Beginning of My Remote Nicaraguan Experience

We have completed two weeks of the global health practicum already! Time is flying by quickly. Although it has only been two weeks, we have been lectured on some very interesting topics relating to positionality, privilege, the mission of AMOS, and basic global health and community-based participatory research methods. Our research project is looking to implement mHealth technology in rural Nicaragua to improve communication between the community health workers and the community members, as well as improve various health outcomes. Searching through the literature, I have found a lot of interesting information on the usefulness and positive effects of the implementation of mHealth in remote/rural communities worldwide. 

In addition to the MHIRT program, I am currently taking an American Society of Tropical Medicine and Hygiene course through my medical school. What I have learned thus far in the course has been very relatable to the MHIRT program, and it has provided additional background information on many global health topics. I have also continued to read a book that I purchased a few months ago, Open Veins of Latin America, which has been providing an in-depth understanding of struggles faced in Latin America for centuries due to colonialism. While learning about global health, I think it is important to also be educated on culture and language. If people want to work around the globe, it is important to communicate and build a relationship with the communities in which they want to conduct research.

Although I wish that I was in Nicaragua, getting a fully-immersive experience, I am still grateful and excited to have the opportunity to work with AMOS and to see what our project will yield. This is a unique time in global health, and this experience is providing all of us with a chance to practice global health in an adaptive manner, which could possibly become the norm in the future. 

p.s. If anyone is looking for culturally-relevant books on Nicaraguan history during the Somoza dictatorship, read Death of Somoza and Sandino's Daughters. I have previously read both of these books during a college course, and they provide an engaging way to learn about Nicaraguan history through testimonial narratives.

The three books that I recommended in the blog above.

This is my view for the summer from my apartment (trying to imagine the Nicaraguan countryside in its place).