School of Medicine
During the time I am proposing to spend in Puno, Peru I will be working on a randomized-controlled trial of clean-cook stoves and the impact of providing them to families in an effort to reduce the burden of cardiopulmonary disease. By working on this project I hope to further my training goals in the following ways: 1) As I carry a strong interest in understanding obstructive lung disease phenotypes, further exposure to a project working on decreasing household biomass fuels will be a key in furthering this understanding, as this contributes to a substantial worldwide burden of disease. 2) Working on this project will further my career goals of working in clinical epidemiology and I look forward to furthering my experience with study design, implementation and biostatistics. 3) Given my interest in Health Policy and Health Services Research further exposure to how health care is provided and assets allocated in resource poor settings will be an invaluable tool in refining my thinking on this topic.
For my project I travelled to Puno, Peru with a great group here at Hopkins that is doing work on understanding the determinants of respiratory health and reducing exposure to indoor air pollution. As an aspiring Pulmonologist I am excited by this research and particularly interested in understanding how the population in Puno, at an altitude of 12,500 feet, may behave differently than populations breathing at sea level in regards to changes to the lungs over time. While I came in excited about these broad but area-specific questions, I was exposed to much more during my time in Puno and have left more energized about and interested in methods of global health research as it applies to a broader topic base.
Puno is a small city in the Andes on the shore of Lake Titicaca in Southeastern Peru. It serves both as a center for trading with Bolivia (just a short boat ride away) and also as a popular tourist destination for visitors wanting to experience Lake Titicaca, which is the world’s highest navigable lake. Peru is a fascinating country in that, far more than the US, it has retained and respected it’s indigenous cultures and as such the majority of the population in Puno are Aymara and the majority speak their native language as well as Spanish. The people I met in Puno were welcoming and warm. I arrived in Puno at the end of the summer and was able to experience many great festivals filled with dancing and celebration which was a fantastic introduction to the local Peruvian culture.
In terms of the work being done, one of the first things that becomes apparent when working with this group is the dedication of it’s team members. The group is composed of a Puno office made up of mostly Peruvian workers who work on the study visits and data acquisition as well as a constant rotation of people from the Hopkins group (PI, data analysts, project managers and students.) The dedication of this group is admirable and stems from a deep desire to positively impact the health of the communities they are working in. The team is constantly learning about new techniques that will be used in research and were enthusiastic and voracious students. I was quite impressed by the level of work ethic that this group showed. Routinely people that would be working on field visits would leave the office shortly after midnight to drive for hours to implement the field visits.
One of the more meaningful experiences for me was having the opportunity to participate in field work. Field visits were a routine part of multiple studies that were happening while I was there. While the office is in Puno, the majority of research participants are from surrounding rural communities. As such, field visits would take place in these local communities, where participants would generously allow use of a communal building to set up a temporary research station. For some aspects of the study participants were then brought to this central station, whereas for other study procedures (i.e. spirometry) the subjects were visited at home.) Having the opportunity to actually see our participants communities, was key in broadening my understanding of the challenges many of our participants face in regards to poverty, and barriers to health care access. As part of my work in Puno, I worked specifically on spirometry and vascular ultrasound and was able to see the amazing persistence required to collect high-quality data in this setting. We often would have to return to a single-community to find one participant who needed repeat studies. The team members who acquire both spirometry and ultrasound have become expert in these modalities, and I learned much from them. Overall, working in Puno was a fantastic experience. I look forward to visiting again in the future.