Carter Center Internship, Uganda
by Amy Lee, C'16
My summer internship was at the Carter Center, Uganda. Positioned in the Carter Center’s Neglected Tropical Diseases (NTDs) control/elimination programs, I engaged in national tropical disease surveillance activities as well as data management and analysis. My work was specific to river blindness, a disease caused by a nematode and transmitted by black flies. The signs and symptoms of river blindness include itching, rough skin, and blindness. River blindness, onchocerciasis, is said to “begin where the road ends”; therefore, I traveled from the headquarters in Kampala to rural communities to perform data collection and health education.
River blindness has been eliminated in many parts of Uganda but still persists in several foci. In areas where the disease has been eliminated, treatment and vector control has stopped; however, people are still requesting the medication, Ivermectin. To understand the perceptions of these communities, we devised a questionnaire. The questionnaire is written in English; however, there are many local languages throughout Uganda. To administer the questionnaire, we held trainings with two representatives from each community. Throughout the training, the participants stated the question and answers in English and then in the vernacular. The group decided if that is the best way to translate the question, and if not they discussed a better way. These representatives then went out to their respective villages and performed interviews at households that we randomly selected. The surveys were then collected, the answers were entered into a computing program, and the data was analyzed.
In addition to the surveys, we integrated qualitative data through community meetings. These meetings were active discussions about local perceptions of river blindness. Participants were free to express themselves, and appreciation was extended to each speaker. If we found through community meetings and data surveys that areas did not understand what river blindness or where to get treatment if an individual has symptoms, or were requesting medication for reasons other than river blindness, we provided health education.
Working in these rural communities has exposed to me the lack of health care and how NGOs supplement the infrastructure not present in developing countries. While I have decided that I do not wish to pursue a career in public health, I developed a clear understanding of the field and deep respect for those who dedicate their lives to tackling these challenges. I do want to return to NGOs as a physician and help supplement the health care. In this role I will bring with me some of the lessons and skills I have acquired during my internship at the Carter Center. As a foreigner coming to work intimately with members of the community, I found it important to express my desire to work collaboratively with community and not dominate our meetings. This experience has helped developed communication skills that overcome cultural and linguistic barriers. I plan to use these skills as a future physician. I now understand the patience, rephrasing, and discussion necessary to establish clear communication when working in diverse settings with diverse people. Ultimately, this experience has given me new perspective on ways one’s environment affects one’s health and has opened my eyes to health care needs on a global scale.