Global Health Interest Night at UCSD

On October 17th, Voces y Manos partnered with the International Affairs Group, Student Sustainability Committee, and the UCSD School of Medicine’s Global Health Initiative to coordinate the Global Health Interest Night.

The event is part of Voces y Manos’ commitment to create learning opportunities with a people-centered approach to Global Health for students in higher education. We first developed the idea as a way to help create greater collaboration between student groups, and to show students the growing academic and service opportunities available at UCSD.

Various global health-related student organizations, professors, the Global Health minor, and the UCSD School of Medicine’s Global Health Initiative were excited to participate. The International Affairs Group provided the facility and logistical coordinating.

It was a huge success! Students packed out the venue, nine student organizations participated, and there were presentations by the Global Health Minor program, Dr. Maria Zuniga from the Global Health Initiative, Dr. Yarris (a visiting professor from UCLA), and the nurse from the travel clinic at Student Health Services. Fair Trade coffee and tea, and catering were provided through the Food Co-Op. It was inspiring to see so much passion for Global Health from such a diverse group of people and organizations.

This was a great way to start the year for our organization. Not only was it a great event, it gave us a chance to build key relationships with other groups. Our interns are now re-starting the student organization at UCSD, and it is exciting to see all the ideas and opportunities available for the coming year.

Meet our interns!

We are excited to introduce our Voces y Manos intern team!

Our Voces y Manos Global Health Internship program has just started. This is a unique opportunity for students in the San Diego area to learn about global health issues, while gaining practical experience working with a nonprofit. Interns play an integral role in solidifying our organization’s core programs and building its future. Meet our amazing interns:

Isela Martinez

Isela Martinez is a senior at UCSD pursuing a B.A. in International Studies and a minor in International Migration. Her focus on Latin America stems from her roots and her experience as an immigrant to the United States with her family as a child. Her need to understand why her own and so many other families migrate around the world have made her eager to learn more about Latin America. She is especially interested in development and indigenous issues. Her wish is to put to practice what she has learned at UCSD, but more importantly to make a difference. Being part of Voces y Manos is a perfect opportunity to help; to have a real-life, close look at the issues that matter the most to people and that make it possible for the social, cultural and economic development of an entire country.

Nicolette Kalic

Nicolette Kalic is a senior at University of California, San Diego with a major in Communications while also taking on a minor in Global Health.  She has always been passionate about the human body and grew up thinking she would one day become a surgeon. However, over the course of the years, she has found her true calling lies within the realm of global public health and all that it encompasses. After returning from her summer at the Yale School of Public Health interning for a NIDA funded HIV study, she has been itching to continue her role in the public health community. She is thrilled to be part of the Voces Y Manos team as a student intern, and looks forward to learning more about the culture and history of the populations we are aiming to help!

Allison Van Vooren

Allison Van Vooren is a third year Human Biology major and Global Health minor at UCSD. As a bilingual San Diegan, she is very passionate about the Latino populations around the globe. She loves learning about indigenous medical traditions and their impact on the local communities. Particularly, she is interested in the social and structural elements of health, especially involving infectious diseases like tuberculosis, cholera, and dengue fever. One day she hopes to work with disenfranchised populations as a pediatrician, creating trust and building relationships to improve the health of the community. She is thrilled to be a part of the Voces y Manos team and can’t wait for the opportunities ahead for Rabinal!

Update from Anshu!

Buenos!  My name is Anshu Abhat and I was fortunate to participate in the 2008 Voces y Manos summer trip to Rabinal, Guatemala.  I am currently taking a year in between my 3rd and 4th year of medical school at the University California, San Diego (UCSD) to pursue a Masters of Public Health in Health Policy at Harvard University.  My experience with Voces y Manos and the PRIME-Health Equity program at UCSD were important influences that led me to pursue an MPH.
Voces y Manos allowed me to work with the health community in Rabinal, Guatemala to understand how a community can come together and achieve goals related to public health.

I am continually impressed by Voces y Manos’ relationship with the youth in the community.  I am now seeing my Guatemalan friends become nurses, physicians, and leaders in their community.  Those I met in Guatemala continue to inspire me, and I would love to return to Rabinal after finishing medical school.
I hope to translate some my experiences in Guatemala to work with local communities in California.  I hope this work can eventually be translated into policies that affect underserved communities in the US and eventually abroad.
Ahhh vaya!
-Anshu

Visit to an Aldea Clinic

Today was a rude awakening for my young naïve aspiring-to-be-a-doctor self.  I’ve been beautifully blessed to have good examples of compassionate doctoring in medical school and more specifically through my involvement in the free clinic.  I guess it was about time that I ran into some of the realities of how health care functions in the world.

The way that it works for the indigenous people who live here in the aldeas of Rabinal is that there are two NGOs which split and canvas the entire region.  Each aldea receives one visit a month from a doctor and their 4 person vaccinating/health educating team.  If there are any health problems between these monthly visits, the patients have to wait out their sicknesses or travel to the Centro de Salud (a 3-4 hour walk to reach Rabinal before the Centro opens at 8 in the morning, only to get a spot to wait for a doctor’s visit).

We, the NGO health workers workers and I, arrived in Las Ventanas after an approximately hour long drive on the not-approximately, but most definitely, gnarliest road that I have ever ridden on.  Outside the cinderblock clinic at the top of a ridge sat 50ish Mayan women in their brightly colored skirts and huipils, their babies slung on their backs and their other children toddling around.  And boy, was I excited to return to clinic.

But I didn’t expect that the first thing the doctor and I would encounter when we entered the door was the community midwife lamenting the loss of an infant in childbirth on Sunday morning.  I didn’t expect the doctor to sit down and talk to the family about the baby’s death without every offering a word of solace.  I didn’t expect her to immediately scold them for not making it to all of their prenatal checkups.  The father said that the reason they didn’t call the community’s emergency committee for a ride to Centro de Salud when things started going wrong with the delivery was that they couldn’t afford to pay the pista for the ride.  And I didn’t expect the doctor to once again scold him for thinking that anyone would be so cold-hearted to not loan him the money to take him to medical care to save his baby.  Least of all, I didn’t expect for her to only ask for the names of any of the family members so that she could write them on the official report finding them at fault for their baby’s death.  Hour One.

Then the physician’s official consults began and I was able to do many things for the first time.  I performed an abdominal exam on a pregnant woman and felt the positioning of her baby, I made my first child cry in a doctor’s office, and I heard my first cases of pneumonic lungs.  I also saw my first (through eighth) cases of child malnutrition.  And it was most interesting what the doctor did in these interactions.

“Escucha” [Listen] she’d say overtly to me.

“¿Cuantos años tiene usted?”  [How old are you?] she would direct to the patient.

“Viente” [20].

“¿Y cuantos hijos tiene?” [And how many children do you have?]

“Tres.”

And each time I would get the imploring and incredulous gaze, the gaze which made the mother look down in shame, the gaze which preceded another round of scolding about how each mother should be feeding her baby better.  Often this conversation would be followed by one in which the doctor attempted to cajole the mother into birth control because “No puede llevar otro bebé a este mundo que no puede dar alimentacion” [You can’t bring another baby into this world that you can’t feed].  At this point, the patient’s conservative beliefs, cultural background, and the machismo restrictions of her husband would lead her to refuse and lead both women to end the consultation, shaking their heads in disbelief.

As the day wore on I grew more and more disenchanted and incised with the doctor and her attitude toward the patients she was supposed to be serving with compassion and care.  Why and how can/does someone treat people like this?  Could compassion fatigue cause you to demean your patients?  Could the frustration of having the smallest supply of approximately 10 different drugs in your medicine cabinet make your efforts feel pointless?  Are the days just too long when your 44th patient of the day at 3pm is another malnourished infant?  Is there every a point where personally blaming someone for their consequences of their poverty is an acceptable practice?  I left my day of doctor-shadowing in Guatemala with far more questions than I had entered it with.
I hope that this experience remains a reminder of how high a level of patient care we’re able to offer in the US, even in our little free clinic at UCSD.  May it be a distinctive forewarning against discriminatory medical practice because of a patient’s cultural background.  I pray that the path that I enter as a doctor will never lead me here.  And I wonder as I sit on my thin wire bed in my dirt-floored room, if maybe this is the space I’ve been looking for, the medical niche where I fit, living in rural Guatemala.

~Liz Berryman, first year medical student at UCSD School of Medicine

Week Prepatory to the Health Fair

My husband Eric and I had the privilege of seeing the Voces y Manos volunteers in the final week of preparation before the fairs. Each had an individual role to play, yet they all worked together, touching base in their planning to ensure that the processes were coordinated and in synch with all the local organizations and health department officials. It was awe-inspiring. Can you imagine planning a health fair for 400 plus people in a community an hour and a half away accessible only by pick-up trucks? Providing food for 90 volunteer doctors, nurses, promotores, comadrones and students? Providing medicines for all of the medical visit patients with various diagnoses? Planning for the youth to put on their own scripted play on the importance of hygiene, while also playing games with the kids ? Setting up kiosks for 4-5 NGOs to present information about preventative health topics (AIDs prevention, Mayan medicine, water sanitation and others)? Preparing for weather: hot sun or torrents of rain? Providing transportation (along with the necessary contracts) for all that needed rides? Figuring out how to communicate with only Mayan Achi patients? Giving out toys and health related coloring books and crayons to all of the children?

And this is only for the first fair, with 2 others following close on the next week.

They did it all, with humor, tremendous energy and intelligence, mutual respect and of course all in Spanish.

And around the edges they laughed, cooked great meals, supported one another, and went out dancing!

Anshu drew the flow plans and summarized the healthfair goals for all of the leaders of the involved organizations at the local health department office. Amy bought the food for the women to cook in the village for all of the volunteers and coordinated that effort and looked lovely even when all of her clothes were splattered after helping push the truck out of the mud.  Mike drew up the contracts for all of the transport and lined up marimba players. Rani worked tirelessly with the students, teaching them leadership, hygiene and facilitating their play. Hannah negotiated to acquire all of the medicine needs for the fairs from the health departments, ASECSA, and local pharmacies and revised several times the form to be used at the fair for each attendee. Shaina collated the coloring books, sorted out the crayons, celebrated her 19th birthday and contributed greatly to the broader mission of Voces and Manos. Jessica opened up the big meeting with the “officials” with her newly learned Spanish. She carried on with her organizational skills in her gentle way, on the website, with the money and general coordination. Miguel (Bakal), the inspiration behind all of this effort, pitched in on every aspect of the work, his Spanish not only fluent and Rabinalesque but also constantly diplomatic, without showing impatience or frustration. I have barely touched on the vast number of chores each had to do in preparation.

Mike’s Mum and Dad came to town. Artie learned quickly how to adapt his medical skills to third world settings and Debbie prepared a delicious vegetable spaghetti sauce, with WHOLE wheat bread and beans, touched off with brownies and ice cream for desert.

It was difficult leaving the day before the fairs. These 8 volunteers will have great impact on the health and knowledge of the people attending the 3 fairs. I look forward to hearing the details.

~Dr. Bron Anders