Arts and Sciences
Peru- Effects of early childhood infections on child growth and development
This research placement will incorporate students into an ongoing community based study relating early childhood infections, particularly enteric infections, with subsequent child growth and cognitive and emotional development. This placement will allow for the immersion of student into the "real world" of community based longitudinal studies, and the reality of early childhood, in a popualtion living in extreme poverty in the Peruvian Amazon.
Benjamin Parker, Peru
As a student interested in medicine and Hispanic culture, I was incredibly excited when I was awarded the Global Health Established Field Placement grant to work with Dr. Margaret Kosek and her team in Iquitos, Peru. During my summer in Peru I had the opportunity to work on multiple projects investigating childhood undernutrition and malaria and their effects on health and development. The experiences I had while working on those projects are among the most valuable and positive of my college career. As an undergraduate student, especially, the award provided me with a unique opportunity to learn about the field of global health while introducing me to international development through first-hand experience in an underdeveloped community. At the same time, through my projects I had the opportunity to contribute to development efforts in Peru and worldwide.
Having never traveled to a developing area prior to my placement in Iquitos, my experiences with underdevelopment and poverty were, for me, among the most prominent experiences of my field placement. On the second day of my time in Peru, I travelled for the first time to our study site in the community of Santa Clara. As I accompanied village health workers on home visits throughout the community, interviewing families about the nutritional habits of the children enrolled in our study, I was struck by the living conditions of the families we visited. For the first time, I was experiencing real poverty first-hand. Living on meager wages, families lived in small homes, often with dirt floors and roofs of branches or metal sheets. In some areas, families lived without electricity, and I learned of families that were not always able to provide nutritious food for their children.
Through these experiences, I became aware of many of the healthcare-related issues facing the community. A member of our team once remarked to me that poverty is not the lack of wealth alone, but also the lack of opportunity. I came to realize that this statement applies well for many of the challenges within this community. Although local health posts within each village serve the village population, access to healthcare remains limited. For some, access is limited by distance. Many community members live upwards of an hour walk away from the health post, and even upon arrival at the post, patients far outnumber health workers, leading to long wait times. Hospitals are even further, making emergency care virtually inaccessible. In general, understanding of health and medicine is limited. Mothers did not always know how to address illness in their children, and after visiting the health post, patients did not always know how to ask for more information or fully understand what had been told to them. On occasion, such patients came to us for clarification about their condition and the treatment.
I also became familiar with some of the challenges of laboratory work in developing areas. Due to shipping cost and transport regulations, receiving laboratory supplies in Iquitos often presented a challenge, and sometimes protocols had to be adjusted to use reagents available in Peru or fewer pre-made supplies. Working side-by-side with Peruvian biologists and technicians and discussing our projects in Spanish tested not only my language skills, but also my understanding of our projects and of our results. In some situations, these factors made our research slightly more difficult, but overall these experiences showed me the importance of resourcefulness in conducting research in developing communities and provided opportunities for cultural and intellectual exchange.
More than anything, however, my experiences in Peru showed me the inseparability of health from the context in which it exists. Seeing this interconnectedness instilled in me the importance of pursuing health outcomes not as isolated goals, but within the economic, cultural, and social framework of the community. As such, I saw how international health as a field connects medicine and biology with cultural and social understanding, and these experiences strongly strengthened my interest in the field.
Based on my experiences, I would strongly recommend the program to other students. I engaged well with my projects and with the rest of the team, and my work in the field and in the lab exposed me to the multiple aspects of work in global health. I worked with a significant level of autonomy, directing many aspects of my project, while at the same time with the helpful guidance of Dr. Kosek. Furthermore, as part of a team with other students and researchers, I enjoyed the opportunity to learn about and discuss other projects, exposing me to a broad range of topics within global health. To future awardees, my greatest recommendation would be to become closely acquainted with the community. Get to know the people and culture of the area in which you are working, both by connecting with field workers and team members from the community and by interacting with other community members. Many of my most valuable insights and memorable experiences stemmed from these interactions.
Although I plan to go to medical school, my field placement introduced me to the idea of coupling medicine with work in global health – a field that engaged many of my interests. As a result, I am interested in considering careers in international health after medical school. My experiences in Peru were so positive, in fact, that I am currently applying for funding to return to Iquitos before medical school to continue to work for a year with Dr. Kosek in childhood undernutrition, building upon my work and experiences from my field placement.
I am incredibly grateful to the Johns Hopkins Bloomberg School of Public Health for offering me this opportunity, and I look forward to continuing to work with medicine and international health in the future.