From the Field

Four weeks into our Duke Global Health SRT program in Kisumu, Kenya, Afraaz, Kelsey, Skylar, and I (Sahil) have been assisting in launching a pilot study for a mobile health app designed to facilitate HPV screening and cervical cancer prevention. While our initial focus was on integrating feedback from community health promoters (CHPs) who use the app, we quickly found ourselves contributing to two other critical projects: U54, focused on HPV vaccination and screening, and Elimisha, aimed at community education and stigma reduction around HPV and cervical cancer.   Our first field visit took us to three primary schools, where we met with head teachers and the local chief to discuss an upcoming free vaccination and screening clinic. This involved securing permission for girls to attend the multi-day clinic, even if it meant missing some school. Since then, our primary contribution to U54 has been creating a one-pager to advertise the clinic, set to be distributed starting July 1st.   The second field visit,...

What had changed: Compared to our trip in the summer of 2023, Melat and I felt much more comfortable navigating Kisumu, Kenya. Sure, we were working in a different location, with new people, on a completely separate project, but the distinct uncertainty at every turn was nowhere to be found. It was a welcome shift.   What had not changed: The core reason for our visit. Mothers attending Lumumba Hospital still struggled with finding childcare while they attended healthcare appointments. This meant mothers arrived late, left early, or missed their appointments entirely. Alternatively, they brought their children to appointments which affected the quality of services when the children cried, held on to their mothers, ran around, or generally distracted both the mother and the healthcare provider. It was our hope that the childcare center we worked on over the year would ease the choice mothers often have to make between caring for themselves or their children.    We were also grateful to find another...

Babies were crying. Mothers were patting them on the back. Names were being called for appointments. “With all this information, what will you do about it?” Florence Mawere, a research technician with the Center for Global Reproductive Health, was taking us on a tour of the Lumumba Sub-County hospital in Kisumu, Kenya and specifically demonstrating her work testing samples for HPV in the lab. She asked us that question at the end of the day, referring to a different project we were working on. At that moment, though, we had a different idea.   Isabel, Melat, and I (Sydney) spent two months in Kisumu working on launching the pilot study of a mobile health app that facilitates HPV screening for cervical cancer prevention. Part of our work was to understand how Florence processes samples at her lab, hence our presence at Lumumba. In our conversations with her, she explained the barriers to reproductive health and mentioned how the lack of childcare sometimes...

In 2021 I had the opportunity to join a start-up that provided support for schools and businesses to safely reopen in the COVID-19 pandemic. We developed an app to support symptom monitoring, created a vaccine navigator program, and collaborated with local organizations to host vaccine clinics in historically marginalized communities. That was the first time I began to dream about what it could mean to center technology within local communities to bridge disparities in healthcare.   When Dr. Huchko offered me the opportunity to join her team to develop a new iteration of a mobile app, I couldn’t have been more excited. Our app, mSaada, is an integrated digital platform that provides support for community health volunteer-led cervical cancer prevention services. It seeks to improve completion of the key steps in the cervical cancer screening cascade by providing patient education and screening reminders, specimen tracking, result management, follow-up support, and treatment scheduling as needed.   I started developing the barebones of the app in...

We’re on the last week of our trip, and these eight weeks have flown by fast! Our summer trip is winding down, and we’re wrapping up our plans as we prepare to leave in one week, but it feels like we should stay a few more. The app mSaada is really coming together (go Thao!), and we’ve learned SO much on the daily challenges of global health projects. Currently we’re wrapping the Standard Operating Procedure, FAQs, and training manuals for Community Health Volunteers (CHVs), research assistants, and other members of the team. There are still many logistical challenges to work though like how to mobilize over 400 CHVs to the different communities that they serve, and how to register each CHV and their clients. We’re here only over the summer, but the team here in Kisumu does so much work for mSaada, and I’ll miss them when we leave. The best part about being in the office is being able...

Starting right where Sydney left off, I, too, just had my first experience going into the field. As Sydney mentioned, each of us will get a chance to tag along for a site visit to a sub-county, and after spending thirty days in Kenya, it was finally my turn! I accompanied Breandan, Jennifer, and Purity to the Nyando sub-county. After meeting with the MoH representative at Ahero Hospital, we conducted site visits for Ahero and four other hospitals in the county. As I quietly took notes, I couldn't help but notice the passion and dedication of every director, community volunteer, doctor, administrator, and healthcare provider. Unlike the privatized systems in the U.S., the healthcare system in Kisumu relies heavily on community involvement. As a global health research team, it is our responsibility to work closely with the community, and our meetings have created a collaborative space where all parties are enthusiastic about our proposed project.   Our collaborative efforts aren't limited to...

Flew internationally totally alone; bargained for prices; saw a male lion (pictured); saw a dead, half-eaten buffalo that two lionesses just killed (not pictured); ate smokies (a hot dog with tomatoes, onion, and a spicy sauce inside). These are some highlights from my “first time ever” list since leaving the U.S.. Novelty and unfamiliarity were our neighbors for the first two weeks living in Kisumu, Kenya. At the end of the third week, we were off to another “first time ever”: a visit to the Lumumba Hospital. We – okay, hold on.  “We” refers to my fellow researchers (and now my friends) Isabel and Melat. They are both proud Seattlites (first time ever learning that’s how you refer to people from Seattle) which has led to times where I learn more about Seattle than I do Kenya. We’ve really gelled as a unit no matter how fast I walk, how many limes Melat eats, or how many random romcoms Isabel suggests.  Anyways,...

I recently landed back home in Boston after spending most of my summer in Nairobi, Kenya researching cross-cultural early childhood development with Universal Baby. Universal Baby is a public health, caregiver coaching intervention that creates videos to share current neuroscience and child development information across the globe.   Towards the end of my time in Kenya, I visited a Maasai Village in Kajiado South sub-county, about 5-6 hours outside of the Nairobi. The Maasai are one of Kenya’s ethnic tribes, originally from the lower Nile Valley. I embarked on this journey, acutely aware of how the injustice and violence of colonialism has shaped the education systems and subsequent socioeconomic advancements in Kenya.   We stopped for the night in the rural town of Bisil before starting off early the following morning for the village, passing giraffes and ostriches on the drive there. Our first stop was Loolkair Primary School, a K-8 school with nearly 400 students and only eight teachers. As we arrived, hundreds of...