Learning about Global Mental Health, and Teamwork, in Haiti

by Megan HuchkoNo Comments
Blogpost by Alex Lichtl, T'19 During the summer of 2017 I traveled to Léogane, Haiti where I, and a team of student researchers, spent two months collecting data on women’s stressors in the community through a Duke SRT program. As a team, we had very little global health research experience, but after one week of orientation we were left on our own to recruit community leaders for interviews and organize focus groups for a project entitled "Mental and Reproductive Health Interventions for Haitian Women: Adapting strategies from community input on coping with stress." At first we were extremely lost, but with the help of our translator team and a lot of perseverance, we managed to reach our data collection goal. We were also fortunate because the women and men we worked with in the community were incredibly welcoming and open to sharing their life experiences regarding reproductive health. Overall, we asked women and men in the community about women’s stressors and coping...
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Community Impacts of Maternal Child Health Care in Kigali, Rwanda

Community Impacts of Maternal Child Health Care in Kigali, Rwanda

by Megan HuchkoNo Comments
Guest Blog by Suzanna Larkin, T21 The Iranzi Clinic is a pioneering medical clinic in Kigali, Rwanda that focuses entirely on maternal and child health services. As an intern through DukeEngage-Rwanda this past summer, I worked directly alongside the midwives, doctors, and administrative staff that have made Iranzi Clinic their home. Only opened one year ago, the clinic is situated on the edge of the impoverished Nyabisindu neighborhood. Many of the women who visit the clinic are unable to pay for their services, and thus the clinic relies primarily on support from the Christian Life Assembly Church and donors. The commitment that the midwives and staff hold for their patients and clinic is clear. Every Monday, the clinic has a devotions session followed by a tea time, and the scene is joyous­–any observer can notice the deep and genuine friendships that grew between the staff members as they built the clinic from the ground up. Their anecdotes about the clinic’s history, from...
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Ensuring Health Care for All in Kenya

by Faith OtewaNo Comments
According to the World Health Organization (WHO), Universal Health Care (UHC) is aimed at ensuring that all people are able to receive medicine and treatment without suffering financial hardships. Kenya is working to implement this healthcare strategy, with the goal of allowing more Kenyans access to healthcare in public health facilities. Additionally, Kenyans will be able to access the same services in private hospitals without digging very deep into their pockets. Despite this bold move by the Kenyan President to create affordable healthcare for all, human resources, finance, essential medical products, technologies and service delivery remain challenges. The story of a woman under the alias of “Dorothy” exemplifies the financial challenge in assessing care at treatment sites. Dorothy was enrolled in a study looking at integrating HPV testing into community health campaigns, and was ultimately referred to a selected health facility in Kisumu where she was booked for treatment. After she received treatment, she further was referred for biopsy testing. But,...
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Notes from the Field: Dissemination Meeting for a Community Health Volunteer Study

Notes from the Field: Dissemination Meeting for a Community Health Volunteer Study

by Faith OtewaNo Comments
The Center for Global Reproductive Health's Research Coordinator, Yujung Choi, and I held a dissemination meeting on October 19th to share the findings from one of our studies. The study describes the characteristics, motivations, and experiences of community health volunteers (CHVs) in Kisumu county, and looks to understand CHV knowledge and self-efficacy of reproductive health counseling and services. The purpose of the meeting was to share the study outcomes with key stakeholders and elicit feedback in order to inform future interventions to measure CHV performance and increase CHV retention rates. Among those who attended the meeting were CHV supervisors who had participated in the study, Sub-County Community Health Strategy Focal Persons, a former study staff, and a Program Officer from the NGO Community Initiatives Concerns. We summarized the study findings on various topics, including: -CHVs’ reasons for becoming CHVs -CHV level of comfort in teaching health topics such as family planning -child care and nutrition -HIV, malaria, and cervical cancer -challenges in carrying out daily tasks -relationship...
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Embracing My Role as a Researcher – Sharing My Small Slice of the HPV Research Pie

Embracing My Role as a Researcher – Sharing My Small Slice of the HPV Research Pie

by Megan HuchkoNo Comments
Guest Blog: Carissa Novak Throughout my recently completed Masters in Global Health Science, Duke’s Global Health Institute faculty regularly stressed the importance and potential impact of disseminating research findings. Therefore, I felt presenting the research findings from my thesis at the 32nd International Papillomavirus Conference inSydney, Australia, this fall was not only appropriate but necessary. Due to ongoing conversations regarding HPV vaccination coverage and HPV screening for cervical cancer communities are witnessing a tremendous increase in screening rates, especially in low-resource settings, where cervical cancer is most common. However, most programs still face significant challenges in addressing HPV positive women’s low rates of follow-up and treatment. My attendance at the conference was an opportunity to share the findings of my thesis work, in which we found that in western Kenya, a setting where resources were limited for all HPV positive women, stigma and isolation were the main differentiating features between women who accessed follow-up and those who did not. Interestingly, I presented...
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Notes from the Field: Equipping Kenya County Health Facilities Remains a Challenge

Notes from the Field: Equipping Kenya County Health Facilities Remains a Challenge

by Faith OtewaNo Comments
Cryotherapy is a method used to destroy precancerous cells to keep them from turning into cancer later on. According to medical experts, early detection and treatment of cervical cancer has demonstrated to dramatically improve the chances of survival. This is good news, as cervical cancer remains the most prevalent form of cancer in women in many developing countries, Kenya included and worst more to HIV+ women who are more likely to suffer from this type of cancer due to compromised immunity. There have been concerted efforts by both the Kenyan government and the private sector to raise awareness and scale up screening and treatment services across the country, which has led to a steady rise and improvement in treatment facilities. The ability of a patient to attend a screening clinic and to return to clinic follow-up evaluation and possible treatment is an important component to the success of a screening program.  Once she surpasses the myriad barriers she may face in understanding...
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Notes from the Field: “If only I stepped up to the gate of a school” life could have been better

by Faith OtewaNo Comments
Reproductive health remains a health problem in Sub-Saharan Africa, Kenya included. Unless efforts to reduce maternal and newborn mortality and morbidity, improving access to family planning, and preventing HIV infection are scaled up, the majority of Kenyans remain at risk for poor health outcomes. Women face unsafe abortions, early marriage, and various forms of gender-based violence. They suffer silently from sexually transmitted diseases that make them vulnerable to cervical cancer and infertility, without access to the simple preventive measures like screening and vaccination. My experience working directly in the community and in health facilities has given me the opportunity to interact with various partners and many disadvantaged young men and women. Listening to their stories of teenage pregnancy, their beliefs in myths related to use of contraception, and experiences with HIV has made me keen to understand and try to address issues related to reproductive health. I met "Aisha" (not her real name) when her child was enrolled in a study I...
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Reports from the Field: Freedom House, a Safe Space supported by KMET

Reports from the Field: Freedom House, a Safe Space supported by KMET

by Faith OtewaNo Comments
By Faith Otewa: One of our goals of the Center is to highlight some of the important work in Sexual and Reproductive Health taking place in Kisumu and Nyanza. We were thrilled to sit down with the Director of KMET (Kisumu Medical and Education Trust), a Kisumu-based NGO working to promote innovative and sustainable reproductive health and education programs among underserved communities. KMET works in the areas of Maternal, Child, Adolescent and Child Health, livelihoods and nutrition, education and youth/adolescent empowerment and quality healthcare financing. The organization has adopted an integrated model to provide a holistic care to women by offering specialized diagnostic services like Family Planning Services (FP), Immunization, and HIV Testing, Cervical Cancer Screening and Laboratory services. A well-stocked dispensing pharmacy is also in place. KMET also houses a Youth Friendly Clinic for its youthful clients of reproductive age. The services offered at the center are affordable. With growing evidence that a substantial number of girls, children and women in Kisumu...
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All in a Day’s Work: Engaging the Community through HPV testing in Kisumu

All in a Day’s Work: Engaging the Community through HPV testing in Kisumu

by Yujung ChoiNo Comments
Blog by Faith Otewa In my role as site coordinator of the Kisumu Center office, I’ve had the opportunity to oversee the “Hybrid Study,” in which we are looking at integrating HPV testing into community health campaigns providing multiple other disease services, including HIV testing, family planning and TB testing.  Many of the experiences will linger on with us for many years to come; while some illustrate the challenges encountered in conducting research and community-based care in Africa, others show the power of community mobilization and knowledge. It is the 10th week out in the field and the study team are getting ready to recruit at the 3rd set of campaigns. However, as if often the case in western Kenya, and certainly when we are working in tents set out in the middle of fields, the climate has had a big impact on study.  The harsh weather and copious rainstorms experienced in the month of May this vastly affected recruitment. There has...
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Health Systems Barriers to Cervical Cancer Prevention in Kenya

Health Systems Barriers to Cervical Cancer Prevention in Kenya

by Megan HuchkoNo Comments
Blog by Charlotte Page, Ob/Gyn Resident: This is a follow-up post to “Patient Barriers to Cervical Cancer Prevention in Kenya”. I’ve realized while in Kenya that there are a lot of things I take for granted in bathrooms in the US: running water, a toilet that flushes, toilet paper, soap, and electricity. If you’re missing one of these things, the restroom is that much more uncomfortable – or perhaps even unfunctional. Similarly, small systems issues here in Kenya can inhibit women from receiving the healthcare they need. For the HPV-positive women in the study I’m working on, such problems can significantly increase the amount of time and effort required to get treated with cryotherapy, to the point that some women don’t obtain treatment at all. To paint a picture: yesterday I was at Migori County Referral Hospital (MCRH), one of the sites where cryotherapy is provided in our study. This procedure uses compressed gas to freeze precancerous cells on the cervix, thereby preventing them...
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