Public health in Peru
When the Master of Public Health program was created in 2016, then Department Chair Bill Freeman and faculty lead Mudita Dave included a 10-day international field experience as an integral part of the curriculum. They felt it was critical to allow students to apply their learnings to real-life situations. TCSPP is one of very few universities to include this component within the MPH degree offering.
“This decision was made keeping in mind the importance of helping our students connect the dots and understand the relationship between culture, history, environment, and health,” says Dr. Dave, the current MPH program chair. “In addition, a lot of countries are facing what we know as an epidemiological transition, which is important for our students to understand.
“For example, countries like Brazil, India, and China are rapidly seeing economic growth, and seeing a dual burden of diseases. Infectious diseases and communicable diseases are there, but there is also a growing prevalence of chronic diseases due to lifestyle and dietary changes. Diseases such as Type 2 diabetes, hypertension, and other mobility limited conditions such as arthritis and cancers are becoming more prevalent than before. Chronic diseases take a toll not only on individuals, families, and communities, but also on entire health systems.”
In November 2016, 12 MPH students and two faculty members traveled to Peru to learn about the public health concerns affecting Peruvians in its three areas (the coast, mountains, and the rain forest). They visited an award-winning non-governmental health organization and conducted an assessment of factors responsible for burnout among health care workers, as well as presented potential solutions.
The students were also able to work side-by-side with teams of local frontline health workers (part of the “Red Mami” network, or Mother’s Network) from Taller de Los Ninos in the slums of Lima. And they learned how to combine cultural practices and values with preventative measures against malnutrition and infection in high-risk newborns. They worked with indigenous parents as young as 15 years of age and had an interactive session with a shaman.
“Oftentimes we get so busy in our schoolwork and our personal life, and we forget what’s out there,” says Karma Lee, a student in the MPH program. “We forget to pay attention to what other people’s lives are like— understanding their struggles and appreciating the little things. Peru showed me that while a lot of differences exist—such as how a different political system can impact public health—we also are a lot alike. There are some areas too where we can learn from Peru to address issues in America.”
Seeing “The Eye that Cries: The Politics of Representing Victims in Contemporary Peru” helped the group learn about Peruvian history and how its three major regions became vulnerable health-wise. Students also engaged in extensive participant observation at Hospital Hermilio Valdizan, a large public mental health hospital, and two strong nonprofits in Lima, where they talked with experienced leaders about how social determinants affect health behaviors and outcomes among Peruvians.
For student Daniel Diyaolu, the trip was especially personal.
“What was particularly memorable was the way that Hospital Neoplasicas, a cancer research institute, treats patients battling cancer because watching my own mother struggle with cancer was my entire reason to go into the health care field,” he says. “During the end-of-life stages, they give the patient a chance to either stay in the hospital or be wherever they feel most comfortable. In the United States, in my experience, cancer patients are often limited to the hospital. That made a lasting impression on me. I was not expecting to gain as much experience as I did.”
While faculty member Holly Langmuir, M.D., MPH, had been to Peru before, she had not expected the robust experiences this trip provided.
“From an international perspective, it’s always educational to see how different places focus on health,” Dr. Langmuir says. “Personally, it was even more wonderful to see the students’ perspectives about the work involved. As someone who has done a lot of international fieldwork prior to this, I know personally the reward you can get from these kinds of experiences.”
Shamontiel L. Vaughn
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