Final Thoughts and What's coming next

 This MHIRT experience has been quite the unique one, but I'm still incredible happy to have been a part of it. I'm even more in shock that these past 8 weeks have flown by us so quickly, and that my knowledge on global health inequities and mobile health has grown since the start of this internship. 

First off, having to navigate all of this online was an experience in and of itself. I was so happy to see the internship run as smoothly as it did, even though we had to conduct our project and all of our meetings online. Not being able to see everyone in Nicaragua was definitely upsetting, but being able to still communicate and work with everyone virtually made the experience worthwhile. 

On top of this, conducting the study gave me new insights on global health that I didn't know existed originally. The technology barrier that exists in rural Nicaragua for community healthcare workers plays immensly into the overall issue of providing valuable healthcare for the individuals that live within rural communities not just in Nicaragua- but throughout the world as well. The study also provided me insight on how tedious research projects can truly be; there are so many steps and intricate details that need to be noticed and paid attention to. On top of this, there are many cultural and ethical concerns that lie within each community that is being researched- and it's incredibly important to take note of those things. 

In the future, I am planning on taking my MCAT in late September, and then applying to medical schools so that I can attend in the Fall of 2022. I am also going to start work as a researcher with a startup in San Francisco called Ambience Healthcare, and our project involves creating an artificially intelligent scribe to work in emergency departments alongside trauma physicians. During or after medical school, I want to continue my career in medical anthropology, so that I can combine research work with clinical work. Taking part in the MHIRT internship taught me how interested I am in global health/ethnographic research, and it introduced me to the field of internal medicine/family practice so that I can involve myself with broader healthcare ideas in the future.

I'm so thankful for AMOS and Rhodes College for letting me be a part of this program, and for opening my eyes to a field that I am even more keen on being a part of in the future. I hope that in the future, I can continue working with AMOS or other organizations like AMOS as a knowledgable physician and medical anthropologist. 

In the meantime, before I take my MCAT and start work, I'll be studying hard and playing with my cat. I'll include a picture of her because she really is kind of cute (at least in my opinion). :) 

Final Reflection

 The past eight weeks have passed by in the blink of an eye, and I am already beginning my second year in medical school. I have learned so much about the initial processes involved in the development of a research project in public health. Throughout this project, I have gained a lot of insight into what a future in global health may entail. I found the results of the study to be enlightening in many ways. Most of the community health workers agree that their use of WhatsApp has been beneficial in their job, but many of them are also not very literate with technology. Some of the barriers to the implementation of mHealth include access to service, this is a problem in many places worldwide. For this, we are going to have to be resourceful and think of innovative ways to overcome this problem. Two of the community health workers said that they have to walk an hour or more to receive signal to use their phones, which to the average American probably sounds crazy. 

Moving forward with my career in medicine and global health, I will take with me what I have learned about the CBPR model. I found this approach to research to be very exciting because it more accurately aims to assist the communities with their specified needs. This process also ensures that the community members have a stake in the research, and I find that to be very important. Overall, this experience through the MHIRT program with AMOS as our partner has been great. I can now say that I have a little bit of experience with global health, and I am looking forward to continuing to do work abroad in the future. It's my hope that I can stay in contact with AMOS and possibly work with them in the future as a physician!

Also visited St. Louis during the past week! It was cool to see how I can do global health from anywhere, which means heading into the future, I may not have to be abroad to make an impact abroad.

Picture of the arch that I took on my phone below (it may or may not show up, I am not sure why, so I included generic image from internet too).

Some MHIRT takeaways and tamales with family

    My second blog post consisted of me trying out Nacatamales for the first time and reacting to them. Needless to say, I was impressed but also intrigued by how different Nicaraguan tamales were than Peruvian ones. I took this conversation further and brought it up to my family, who were amazed to hear that Nacatamales had rice and potatoes in them. They asked me to stop by and grab some that day to eat for dinner -- they were a hit. As a result, my mom brought up that it had been a while since we last made tamales as a family. That same weekend, we decided to grab supplies and have a day at home to prep some Peruvian tamales at home (it takes many hands to efficiently make enough to last a week). 

    During our prep, my mom, sister, and I all had different jobs and as we worked, we had conversations about our culture, music, family, and what's going on in today's day and age. I realize more and more the unity that food is able to create. I find that this is what draws me toward trying new foods and understanding distinctions between how different groups of people interpret their cuisine and gastronomy. The tamales we made were a representation of the conversations had at that table; our stories, music, struggles, and love. That being said, this gave me a different outlook on the foods of other cultures. I'd love to have an insight as to what the food means to the people making it and what it's a product of. This experience makes me realize more and more why I would love to live a life of travel and experience more than a life of being settled and growing too comfortable to a routine.

    I am thankful, to say the least, about the people I've been able to work with throughout my time at MHIRT. While the experience may have been different in person, that's not to say I won't take friendships, mentorships, and lessons with me from the interactions I have had with the staff and my colleagues. 

Finishing up my Mhirt experience

This week we gave our final presentation of the internship that covered all of our research and findings. We gave an hour and a half long presentation that was in English and Spanish and illustrated the challenges and benefits of mobile health in rural Nicaragua. We summarized the 24 interviews conducted with community health workers with a series of informative graphs and commentary. The primary findings were that access to signal and not enough technological training are the principle challenges to implementing mobile healthcare in these communities. However, the benefits could be far reaching and transformative. The community health workers said mobile health could aid them in a variety ways, including:  having a healthcare database to become more knowledgable about health issues in the community, communicating with experts and AMOS instantly, being able to access normally unaccessible patients, giving medical reminders, and other issues that could potentially save lives.

After we presented the material, we received a flow of thanks and encouragement about our work. The AMOS team assured us that this data and our analysis will be extremely helpful in moving forward with mobile health in rural Nicaragua. After 8 weeks of research, analysis, meetings, and work, it felt incredible to hear this. The hardest part about this internship has been missing out on seeing the impact of our work. We should be in Nicaragua meeting people, learning from them, and seeing first hand what our work will contribute to. However, hearing the thanks and encouragement from these AMOS workers on the ground made it feel real. I hope to get to Nicaragua someday and meet some of these incredible people, but for now I will settle with the knowledge that I played a small part in furthering healthcare in some of these communities.

I am adding this picture, the final slide of our presentation, as we received so much help and guidance throughout this entire process.

It would have not been possible without all of them and their selfless efforts.

Final Presentations and Goodbyes

We've come a long way since the beginning of the internship. It's a bittersweet moment for me. On the one hand, we just finished our final presentation last Friday and all that's left now is some finishing touches on the paper. After that, we're pretty much free for the last few weeks of summer! On the other hand, it'll feel really weird not meeting with the team after this week to continue researching and learning from each other and finding ways to help successfully implement an mHealth program in rural Nicaragua to address the communities' barriers to health access. 

Over the weeks, I've grown closer to the other MHIRT interns and our AMOS staff members, and I honestly don't feel completely ready to say goodbye just yet. I want to thank everyone I worked with for all the guidance and support. Our research and presentation went well only because of their never-ending help. And I'm really sad we were never able to meet in person and explore Nicaragua together. But I think we all still went through a unique, and (hopefully) once in a lifetime experience together as we worked remotely during a global pandemic. I wish all of the MHIRT interns, AMOS staff, and communities in Nicaragua happiness and success, and I'm grateful for the opportunity I had to work alongside everyone during this research!!

Below is a picture from one of our first meetings together as a team. It's a "Rio de la Vida." It was used as a team bonding exercise. If I remember correctly, we first mentioned why we wanted to participate in mHealth/Global health research, then we all spoke about the personal obstacles that we've faced, and finally, at the end of the river, we talked about what our goals were and what we hoped to get out of the work did together.

Thank you all again for the support and guidance. I hope we'll get to work together again in the future! Goodbye :)