It was really rewarding to be able to share my experiences with my fellow colleagues, and be able to discuss a little bit about my experiences in Manaus, where I had a truly enriching experience conducting my focus group there.
Tuesday, June 7, 2011
ICICT Final Presentation.
Yesterday I gave my final presentation on my research, to my institution at Fiocruz. The crowd was filled with researchers within my group, other groups in my institution, as well as some researchers from other institutions across Fiocruz and the director of ICICT.
Friday, June 3, 2011
8 months.
I can't believe it, but I've been in Rio for eight months now. I know that my time is ending here, and I'm trying to prepare myself to leave, but it's incredibly difficult. I've gotten used to the pace of Carioca life.
I can easily transition into and out of Portuguese, and I think that marker--my ability to speak and converse-- is perhaps my greatest indicator of how much I've changed since I arrived here. I feel comfortable giving presentations in Portuguese, and I can converse with people on many different topics. I'm far from completely fluent, but I would say that I'm conversationally adept.
There's still so much to learn about Rio and Brazil, and each day I find myself wanting to take the time to learn a bit more. It's a pity that I didn't read enough books during my past seven months-- I was too busy trying to be outdoors enjoying the sunlight.
The weather has somewhat come full circle-- I arrived wearing jackets and jeans, using my sleeping bag as a makeshift comforter. I pulled those all out again. I'm starting to think about the places I want to revisit-- I never really fell into a routine here in Brazil, with all my traveling in and out of the city, but I feel like I established some internal favorites-- my go-to farmers markets, what I like to do when it's sunny, when it's raining....
I haven't really got a bucket list, but I know I'm going to try to spend as much time outdoors as possible, soaking up the last of the South American sun. Then I'm off to India and back to New York in a sort-of whirlwind summer.... if you can believe.
Thursday, June 2, 2011
Wednesday, June 1, 2011
manaus.
Through the help of my institution at Fiocruz, ICICT, I was able to apply a part of my questionnaire of health workers in the city of Parintins, a city in the interior of the state of Amazonas.
The objective of the focus group was to gain a perspective on the types of health information sources used by residents, as well as access to these sources of health information. This information will be recorded and used when adapting the questionnaire I used for my Fulbright research project. Eight participants, all from different areas of the interior of the state, were selected to participate in a one-hour session, with me as the moderator.
It’s difficult to get a comprehensive look at how the public health system works in the Amazon, as well as how people access their health care information (and health care in general) there, but this focus group provided some interesting input to consider when adapting this questionnaire—what options to provide for the closed-ended questions, how to format the answer choices, etc.
Highlights from the conversation:
• Some places in the Amazon take 22 days to reach Manaus (by boat), the closest city with tertiary level health care.
• There are several communities with no SUS community health agents, and many communities with only one community health agent in a community of 3,000 people. This agent only goes once a month to Manaus to report to the public health workers there.
• Many of these communities have no public health infrastructure (family health clinics, UPA, etc.)
• There is a high trust in benzadores and midwives. This isn’t even considering the indigenous populations.
• Towns in the interior of the Amazon, including Parintins, have no access to printed information material, including newspapers and magazines.
• There are no libraries in the interior.
• Prior to Internet, residents received information through local radio (weak and not very good health information) and TV.
• The idea of passing information and medications from one person to the next is common in these areas. Using the medicine that was given to your aunt, heeding the advice of your grandmother’s sister—high frequency.
• The Internet has become their door to the world (the residents). All of a sudden, there is a huge overload of information. Many of these focus group participants stressed the need for filtration of information, and expressed concern about Internet literacy among the non-educated.
• Participants mentioned the use of books—an uncommon source among university students in the pilot study.
• The focus group participants tended to be more health information-seeking savvy, choosing scientific literature and websites like SCIELO versus random Google searches.
• Participants mentioned the use of family members for health information.
• Concept of family member as a health professional—asked what they consider first—them as a health professional or a family member. First they are health professional (how to consider this during a future questionnaire).
• Main health problems encountered in the interior are vector-borne diseases like malaria, as well as digestive problems and respiratory problems (from creating fires for homes and building).
• Participants mentioned the lack of UPA-24 hours, Family Health Clinics. Mention the North (Ceara) as the reference for good healthcare. (Cariocas/Rio mentions the south—Curitiba, Porto Alegre as references for good SUS/public health care).
• Same problems with rural health care in the US, the intensity is much greater. The US has telemedicine, incentives for medical students to work in rural healthcare, etc. These problems are becoming a focus in Brazil. (Side note: medical students going to Argentina, Bolivia to get their license and coming back to work in Brazil. No one wants to work in primary care.)
• My own observations. In addition to the lack of newspaper stands, I noticed some things about living in a small town that make it inherently healthy—people use their bikes everywhere, there are rickshaws… now it is changing, more people are using motorcycles. Wonder what this means for the future.
The objective of the focus group was to gain a perspective on the types of health information sources used by residents, as well as access to these sources of health information. This information will be recorded and used when adapting the questionnaire I used for my Fulbright research project. Eight participants, all from different areas of the interior of the state, were selected to participate in a one-hour session, with me as the moderator.
It’s difficult to get a comprehensive look at how the public health system works in the Amazon, as well as how people access their health care information (and health care in general) there, but this focus group provided some interesting input to consider when adapting this questionnaire—what options to provide for the closed-ended questions, how to format the answer choices, etc.
Highlights from the conversation:
• Some places in the Amazon take 22 days to reach Manaus (by boat), the closest city with tertiary level health care.
• There are several communities with no SUS community health agents, and many communities with only one community health agent in a community of 3,000 people. This agent only goes once a month to Manaus to report to the public health workers there.
• Many of these communities have no public health infrastructure (family health clinics, UPA, etc.)
• There is a high trust in benzadores and midwives. This isn’t even considering the indigenous populations.
• Towns in the interior of the Amazon, including Parintins, have no access to printed information material, including newspapers and magazines.
• There are no libraries in the interior.
• Prior to Internet, residents received information through local radio (weak and not very good health information) and TV.
• The idea of passing information and medications from one person to the next is common in these areas. Using the medicine that was given to your aunt, heeding the advice of your grandmother’s sister—high frequency.
• The Internet has become their door to the world (the residents). All of a sudden, there is a huge overload of information. Many of these focus group participants stressed the need for filtration of information, and expressed concern about Internet literacy among the non-educated.
• Participants mentioned the use of books—an uncommon source among university students in the pilot study.
• The focus group participants tended to be more health information-seeking savvy, choosing scientific literature and websites like SCIELO versus random Google searches.
• Participants mentioned the use of family members for health information.
• Concept of family member as a health professional—asked what they consider first—them as a health professional or a family member. First they are health professional (how to consider this during a future questionnaire).
• Main health problems encountered in the interior are vector-borne diseases like malaria, as well as digestive problems and respiratory problems (from creating fires for homes and building).
• Participants mentioned the lack of UPA-24 hours, Family Health Clinics. Mention the North (Ceara) as the reference for good healthcare. (Cariocas/Rio mentions the south—Curitiba, Porto Alegre as references for good SUS/public health care).
• Same problems with rural health care in the US, the intensity is much greater. The US has telemedicine, incentives for medical students to work in rural healthcare, etc. These problems are becoming a focus in Brazil. (Side note: medical students going to Argentina, Bolivia to get their license and coming back to work in Brazil. No one wants to work in primary care.)
• My own observations. In addition to the lack of newspaper stands, I noticed some things about living in a small town that make it inherently healthy—people use their bikes everywhere, there are rickshaws… now it is changing, more people are using motorcycles. Wonder what this means for the future.
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