Wrapping Up

We've been working on our mHealth project for almost 7 or 8 weeks now, and as we are approaching the final weeks of our MHIRT internship, I'm excited to see what the final results will be. The AMOS staff recently finished administering our questionnaire to the community health workers in Nicaragua, and now the MHIRT team and I are working on the data analysis. Soon after, we'll write the final report and give a presentation on our findings. In doing so, we share the data with the Nicaraguan community, and together, we determine the next steps in implementing an mHealth intervention in Nicaragua (this is one of our CBPR approaches!!).

Also, jumping on the bandwagon, I made a Nicaraguan dish! It's called Indio Viejo, which translates to ‘old Indian’ in Spanish. According to the blog post I got the recipe from, there's actually an interesting origin story behind the name of the dish. In the post, the author writes "It is said that the name of this dish comes from the lie of an indigenous leader to two Spaniards who passed through a tribe located in Ometepe. The Europeans saw the indigenous eating and when asked what they were having, one replied that he was enjoying an old Indian... The Spaniards, in the end, decided not to try the dish. But, the truth behind this legend, is that the leader of the tribe told that lie because he did not want to share the food." Later, the author explained that the indigenous leader told this lie because he knew the Spaniards were trying to take advantage of the "hospitality of locals, whose culture demanded they provide food to all who ask for it." Whether or not this legend is true, the dish was still delicious.

I made this dish with my dad's help at his restaurant. Because I was raised vegetarian, instead of beef, we used potatoes and cottage cheese. Aside from that, no changes were made. Below is a picture of the dish, and some other food in the background.

Blogging on the Road

Hey everyone,

I am currently typing this message from a hotel room in Georgetown, Kentucky. It's been a long day of traveling and catching up with a childhood friend. Although I am not at home in my apartment, I am typing this blog with excitement. Our project is coming together, and we are almost done with our internship! The time has flown by, and we have learned so much. We fully administered the CHW questionnaire, and we have been working on the data analysis portion of the project. We are also writing the final report, which will be accompanied by a presentation during the upcoming week. I am anticipating the final product to see what we have done and where the project can go in the future. The main reason that I am curious to see our results is because I am currently in the process of filling out an application for a Fulbright scholarship, and I want to apply to spend time at AMOS either furthering this project or working on one of their other projects. I know that applying at this point may be considered short notice; however, I would rather gather the materials needed quickly than regret not applying at all. 

With all of that being said, I am extremely grateful for the experience that I have been provided by the MHIRT program and AMOS, and I will surely use this training in many projects that I work on in the future. As my second year of medical school starts in approximately 2.5 weeks, I will think back on this experience and the CBPR methods that we used. Even if I am not doing research, the CBPR approach can be applied to patient treatments and medication regimens by including their needs and desires in their treatment plans as well to make them feel that they are in charge of their healthcare.

P.S. for inspiration. In this tough time, find what makes you happy and pursue it! The pandemic won't last forever, and social justice will be achieved. We are a resilient generation with good intentions and big hearts.

Below is the town that I am currently in. It isn't Nicaragua, but it is interesting and quaint. It is near Lexington, and this area has some amazing landscapes.

I made Baho! (Vaho)

This week I finally tackled a Nicaraguan dish. As I discussed in my previous post, the dish is baho (or vaho depending on the website, but they are spoken the same). Anyway, the dish is a fun meal that requires multiple days to finish, and is usually served on Sunday afternoons. In the video below, you can see three steps. The first step was marinating the brisket with the vegetables, garlic, and orange and lime juices. The next step was creating a steaming contraption and then wrapping the brisket, plantains, yuca, and vegetables all in banana leaves and steaming them for four hours. The last step was making the repollo (coleslaw salad with spices) and then placing that on the finished meal and eating!
I loved making this for a few reasons.  The first is that I got to stop by Flamingos, a local Latin American groceria, and buy interesting and new foods like hojas de platano (banana leaves), as well as practice my Spanish. However, after a brief struggle in translation with the butcher at Flamingos, I determined they did not have the brisket and had to go to whole foods (where I spent 3 times as much money than I did at Flamingos for literally one item at whole foods).
The other reason I enjoyed this recipe is that, after marinating the brisket all night and then steaming everything for four hours, I appreciated the entire process of making this meal. Its truly an all day, multi day affair, and the work and the wait was definitely worth it. My family loved it, and it was very new for all of us. The brisket had awesome citrus flavors that I have not ever tasted in meat before. The only things I would change is adding more yellow plantains and not adding any green ones, they ended up a little dry.  Overall, my family described it as wonderful, healthy, new, and wholesome. I particularly liked the added flair of serving it on banana leaves, it made it feel like I might be in Nicaragua, where I imagined I would be right now, but am still determined to get to someday.

Finding Time and Staying Thankful

We're halfway through the MHIRT experience and it feels like I'm getting the rhythm of how to tackle balancing online research work and my own personal endeavors. At this point in my summer, I realized that if I was in Nicaragua, I would probably take any chance of adventure that came my way as a means of learning and experiencing beauty that I wouldn't get from staying at home. As a result, I decided to go out into my city for a long run this week. I almost felt like a tourist in my own city; running around any major landmark I could find, taking pictures at different points throughout the miles (I had a friend tag along), and being conscious of the quarantine guidelines as I peered into empty restaurants and tourist attractions.

I'm already very thankful for the experience at MHIRT and am starting to understand that making the best of an unforeseen situation can still make up for not being able to travel to Nicaragua. In an unusual way, I still do feel more connected to Nicaragua now than before I started this program, despite not stepping foot in the country itself. I may even feel more inspired to try learning about more cultures from the comfort of my home, seeing that distance can't keep me fully away from engaging in something I'm curious about. I'm looking forward to the weeks to come.

Half Way There

With week 4 of 8 of the MHIRT internship coming to an end, we are officially crossing the halfway mark of the program. Looking back at it now, it's amazing to see how many new things we've already learned and how many tasks we've already completed. Just a quick recap, so began the internship with a series of lectures relevant to global health and research methods. More recently, we completed tasks related to what we learned in the lecture. Collectively, we have finished a literature review and journal club and have also written an Introduction/Background section, evaluation questions, SMART objectives, the study description, a questionnaire, community-based participatory research (CBPR) approaches, and an ethical considerations statement. Basically, during the entire first half of the program, we set up the framework for conducting research. During the second half of the program, we will be collecting data, completing data analysis, and then writing final reports and conclusions.

It's crazy to think that the internship is already halfway done, though. The weeks are really flying by. I don't really know how to describe the way I feel right now: I don't want to stop researching and trying to help out, but I also am very very ready to finish the project and get some results out. Really, I don't want to stop learning about Global Health and finding ways to help communities in need.

Also, I'm still trying the DuoLingo challenge I made for myself. My goal of 500 crowns may be a bit difficult to reach, but I'm still going to try! I also really like how there's those cracked levels telling me that I mastered the topic in the past but still need to brush up on it. Below is a picture of my progress. And finally, I think I'm going to hop on the trend and attempt to cook a vegetarian Nicaraguan dish. Let's see how it goes...

Finishing up the questionnaire as a team

This past week we have been creating and finalizing the questionnaire designed for the community health care workers. This questionnaire will help us understand the challenges, strengths, and details of what an Mhealth application might hold in these communities. Many of our meetings so far have been us researching, learning, and absorbing knowledge. This week, I felt like we are starting to do something tangible that will have a measurable impact on our work. This questionnaire, after all of the research and knowledge that we have gained, is our first real step toward our goal of implementing Mhealth in the community. This is really exciting and I am looking forward to seeing the responses and results of the evaluation. After being home for so long and looking at such increasingly depressing news about the corona virus, the feeling I am going to do something with a real life positive impact in the world is liberating.

I have also gotten to know my team members more throughout the past few weeks as we have worked together to complete our growing responsibilities. It is a bittersweet experience as each person is unique and fun and brings something different to the group, but it is hard not to imagine how fun 8 weeks in Nicaragua would have been with the Mhirt team. I am happy we are becoming friends, but I would be lying if I was not disappointed in missing out on the opportunity to have  become friends in person. Maybe we will all meet in person sometime and have an adventure, but for now, I am happy that I have gotten to know them as well as I have. 

Jeremy's videos  have inspired me to make some Nicaraguan food, and I'll be making vaho next week. This is a picture of what I hope mine will look like! Please let me know if you have tips on how it should turn out or any recipes you think are great!

Trying Nacatamales - MHIRT Blog Post 2

Growing up around tamales my entire life and knowing they varied depending on the region/country of Latin America they're from, I knew I had to try one from Nicaragua. One thing I've always found incredibly interesting about food is how one basic concept or ingredient can be interpreted in so many different ways by different cultures. In this case, tamales at their most basic state are: masa (corn meal) wrapped with a corn husk or banana leaf. This allows variation in what is used to season the masa, the type of wrap to use, and what goes inside as the filling (meats, vegetables, sauces, spices, and even other grains/starches).

I'm always taken by the element of surprise of trying something new, and this was no exception. I am only used to eating variations Peruvian tamales and Mexican tamales (both of which are very different). The nacatamale I tried offered ingredients I'd never had in a tamale before, as well as offered a flavor profile I didn't know tamales could have. The nacatamale came with pork, tomato, olives, a date-like fruit that I still am not familiar with, and the two shockers: rice and potato. Additionally, this tamale had a sweet-tasting masa. I assumed it was because the banana leaves had given it a hint of its sweetness but it also makes me wonder what goes into making the masa - perhaps a sweetener is added into that as well.

I'm excited for more food to come. I'd really love to try a Nicaraguan soup. Any recommendations would be appreciated!!

it's the 4th of July in Tennessee

Since we're doing our work remotely this year, I think it's important to blog about what is going on locally as we're working on the mHealth project. Today, it's Independence Day in the United States, but I won't lie, the 4th of July feels very different this year.
First off, I have to mention that I always viewed the 4th of July as an interesting holiday because:

1. It was solely the day America declared independence. The country didn't actually gain independence on July 4th, 1776. 
2. Not everyone was independent at that time, or now, so can we really celebrate a holiday when everyone wasn't free? 

Don't get me wrong, I love any excuse to have barbecues and sunny pool days (especially during Tennessee's brutal July heat), but that second point stuck with me. Sure, the holiday isn't factually a real Independence Day, but the idea that so many individuals in this country still lack real freedom makes me wonder if we really should be celebrating today.

Working on the mHealth project and completing the Global Health Practicum, especially during a year where there is a collective realization of racism for so many individuals, makes this year's Independence Day hold a new significance. Not everyone in this country is completely free yet, and there are also many individuals who do not have independence or basic human rights.

Tying that back into global health, I've been thinking today about the people who aren't able to live independently solely because they lack access to basic healthcare that more privileged people are able to receive. These lessons on global health inequalities combined with a new, collective understanding of America's deep roots in racism made more people realize the need for more work, care, and education. Not just in the United States, but around the world as well. That way, we can make the world a freer place for everyone- not just a select, privileged few.
Then, in the future, we can celebrate an Independence Day where everyone can celebrate being independent. That's a holiday I'd be excited to celebrate annually.

Here are a few podcasts and books that I read and listened to lately. They've been helping to educate me more on current events, and maybe they can help all of us too as we're getting through the quarantine.

La semana del Día de Independencia.

Another week completed! Time seems to be flying by in this program, but we are slowly progressing towards our goal. After searching the literature for hours, we have completed our annotated bibliography and have worked on the research proposal, completing the first draft of the introduction and objectives. I am excited to see what we will be able to accomplish by the end of the summer. I am equally interested to see the results of the survey that we will administering soon in order to better understand the perspective and interests of the community health workers.

 

In other news, the U.S. is still continuing to fall behind all of the other developed nations in the world in regard to combatting the SARS-CoV-2 outbreak. It is saddening to see, but Americans tend to have a special type of opinion when it comes to efforts that concern people other than themselves. For this reason, the future course of this virus in this country in questionable. However, I am hoping that at least one of the vaccines that are currently in clinical trials will be effective and safe. 

 

Personally, I have been spending a lot of this quarantine trying to learn another language when not working on our MHIRT program. I chose to start learning Italian because it is another Romance language, and it has many phonetic and phonologic similarities to Spanish. Southern Italy is one of the options available for a rotation during my fourth year of medical school, and if I learn to be conversational in the language, I can apply to go there. 

 

Overall, this experience with the MHIRT program and AMOS has been great so far, and I am learning a lot about the processes required to start a research project. Previously, I have done research, but I have only ever worked on projects that were beyond the proposal portion. 

Until next time.

 

Que todos tengan un buen Día de Independencia y que hagan algo para disfrutarles. 

A day in the life: Quarantined MHIRT edition

This has been a really interesting time, and I know you all agree. 6 months ago, I would've never imagined that we'd be having our MHIRT experience remotely. This year has brought in many unprecedented situations; honestly, as the pandemic got worse, I started to believe that we'd be stuck in this weird, bubble-like life... like I've seen in the movies.

Yeah. Like these people in the photo.

As someone who cannot think straight without leaving the house, I thought that the best way to use this blog post would be to talk about my thoughts so far, and how I've been spending my MHIRT days inside my own little bubble of an apartment.




Date: 6.21.20. Temperature: about 92 degrees (or at least it sure feels like it). Location: Knoxville, TN.

Okay, y'all. I have a bad sleep schedule so I just woke up at noon, but I tried to pretend I could see the sunrise and feel the crisp, humid, summery air through my window. Mainly because I was rudely awoken by the dry, sandpaper-like tongue of my cat reminding me that she needed her breakfast. I'll include a picture of her. Her name is Bella, she's 2 years old, and she likes to eat everything in sight. Literally... everything. 

Here is a photo of her next to one of her favorite things to munch on- flowers. The other photo of her is when she's doing her favorite activity- sleeping. As of right now, I'm pretty sure she's trying to eat some dust off the ground. 

The time is now 4:42 pm, and I've been studying and doing other work (for MHIRT, especially). Definitely underestimated the power of the MCAT, but I think it's better to just take this studying process day by day. I thought I'd take some time off to just listen to music and clean, though. Mainly because my apartment really needed to be cleaned, but also because I love listening to music, and cleaning gives me an excuse to listen to it. :) I've included some screencaps of some of my favorite songs right now (one of them is in Spanish, too!).

I've also been thinking about the topics we've been covering so far during the global practicum. Considering that it's now the final week (I know, it moved very fast), I thought that I could include some of my own thoughts on those topics.
As the COVID-19 pandemic is hitting the world with full strength, I felt this wave of cynicism throughout my community.

"There's no way this can be fixed in the near time future." 
"There's no point in wearing a mask because we'll all end up getting it at some point."

Normally, I'm a pretty big optimist; in this situation, however, I felt an immense lack of hope. I was excited to learn more about community health work and mobile health through the global health practicum, but I didn't just gain knowledge through this program- I also gained hope.
I noticed the work that community health workers have been constantly doing to better the areas that they are working for, and I saw the number of programs that existed to better the overall health of people in the areas that needed healthcare most. These lectures, tagged along with being a part of everyone's collective work on their projects, reminded me that there is light in the darkness of everything that's been happening lately. It also reminded me that there are some amazing individuals out there doing amazing work- even in these times, and I'm lucky to be working with everyone right now (even if it's remotely). Now that the practicum is coming to an end, I'm looking forward to making our mHealth project develop and go forward. I'm even more excited to see how projects like ours can create hope in communities not just in Nicaragua, but around the world.

It's almost midnight now. I had pizza for dinner because quite frankly, I am a horrible cook. Maybe for my next blog post, I can try to cook something and see if it turns out well. But, for now, I'm going to try to sleep so that I don't wake up at noon again tomorrow.