July.28.2023

As I am writing this, I am back in my room in Houston, Texas, having completed the 20-something hour journey home. I’ve probably said this in almost every single post, but now that I am back in Houston, it is so surreal how fast our time in Dar flew.

On Wednesday, the interns and Christine had a final presentation session, where we showcased some of the work and findings we had accomplished throughout the summer. I really enjoyed learning about the projects that Annika and Ojas are working on. Although we had many work sessions in cafes, it was great to understand the full background to their projects and to learn about the amazing work they had done in the summer. Although this was our final meeting in Dar, all three of us are planning to continue our projects remotely, back in Houston, throughout the school year! I am extremely excited to see what we continue to accomplish.

I wanted to use this post to extend immense gratitude to our gracious mentors in Tanzania, including the entire NEST360 team, as well as the Rice360 faculty who made our trip smooth and successful.

I also wanted to say that I am so fortunate to have had such an amazing cohort of interns this summer. From sharing pictures to video calls, we have been keeping each other in the loop despite being hundreds or thousands of miles apart. Once school starts, we plan to have an intern dinner, where we will exchange souvenirs and catch up, and I am extremely excited and hope this becomes a tradition for future interns as well!!

As part of our final work for the internship, we were asked to create a final reflection blurb. I have included mine below:

“I truly realized the irreplaceability of on-the-ground work after I first stepped foot into a NICU in Dar es Salaam, Tanzania. I noted the sights, the smells, the temperatures, the interactions – all things that might have slipped past me, otherwise. My stay in Dar has allowed me to explore many such stories. From the interviews that I conduct with healthcare professionals, I learned about the impact of infrastructure on the delivery of care. From talks with my in-country mentors, I better understood the state of public health initiatives in the country. From team dinners with Rice360 and NEST360, I heard about different motivations and pathways in global health careers. Participating in the Rice360 internship this summer has provided me with an unparalleled chance to extend beyond the classroom and into the field, and it has solidified my interest in working in global health in the future.”

That’s it for the blogs, but I know that my learning journey in global health is far from over. I am excited to continue working with professionals from all across the world and hope to be back in Dar one day!

Thank you for following along this summer 🙂

Shrutika

July.22.2023

Yesterday, July 21st, was the official last date of our internship abroad and I could not be more sad that our time in Dar es Salaam is coming to an end. This past week has been a whirlwind, packed full of tying up some loose ends on our projects and saying goodbye to the amazing people that we have met. On Friday, Dr. Jasmine Nejad from Rice360 came to Dar es Salaam from Houston! We had an afternoon meal, explored the area around our apartment, and then met up with Christine and Cate for a farewell dinner.

 

 

Some pictures!

Dr. Nejad was also my professor for GLHT 201, the introductory course in the global health sequence. Through this internship, it was really great to connect the topics that I learned from that course with real world work that we were doing in Tanzania. I remember lectures on NEST technologies, on health disparities in the global context, on infectious disease, and more. Being able to relate these in-class talks with on-the-ground work is an irreplaceable lesson for me.

Next Wednesday will be the interns’ final presentation, and then we will head back to Houston later in the night. I am excited to reflect more on our journey in the next post!

Shrutika

July.15.2023

Hi everyone, and welcome back to the blog!

On Tuesday, July 11th, we had the wonderful opportunity to visit the Dar es Salaam Institute of Technology, where Dr. John Msumba cheerfully gave us an introductory presentation and a tour of the facilities. We were able to meet so many new people and learn about some of the incredible projects that DIT students are undertaking. Dr. Msumba’s presentation explained to us the type of curriculum that DIT students engage in. Specifically, he described the project-forward engagement approach, in which students actively work on projects outside of the classroom to better understand their coursework. One such project, which I found fascinating, was students participating in the renovation of one of the roads nearby campus; Dr. Msumba described how students were involved in every part, from designing the plan to even making the concrete mixer! This approach was so unique to me, and I definitely am hoping to take more project-forward classes at Rice, including the other courses involved with the GLHT minor.

After the presentation, we took a tour of DIT facilities, and it was great to see the many projects that students were working on. One theme that Dr. Msumba emphasized was how all students, regardless of major, were able to draw from the DIT design studio, using materials and resources there to refine their work. We drew parallels to our previous work at the OEDK at Rice, and enjoyed seeing how the students’ projects worked. Dr. Msumba put together this amazing graphic that I would love to share!

Infographic put together by Dr. Msumba!

 

Front of DIT campus

 

View from one of the buildings we toured.

Apart from our tour of DIT, this week has been spent on making progress on our projects. I have begun to learn how to use ATLAS.TI, a qualitative analysis software tool. Below is a sample picture of the initial process of the interview coding process. I went through the set of interviews (both ones that I have conducted and those that have been previously conducted by Donat), and identified themes and quotes that stuck out to me. Afterwards, I grouped them together into “buckets.” I am currently working on translating these written notes into the software tool, by creating different codes and going through interviews line-by-line. The codebook will definitely also need a lot of refinement and feedback from others before finalizing! I have also been working on some statistical analysis of the data that I extracted from the floor plans gathered by the NEST360 team. In the meantime, I am also enjoying learning about the other interns’ projects!

On the social side, we have had some great eats and experiences this past week, including some delicious momos and great coffee! Later in the week, we met up with a few members of the NEST360 team for dinner. I learned a lot about different public health initiatives during our conversations, and also gained some insights into the hidden politics that can accompany public health in our world. I especially enjoyed hearing about the NEST360 team’s history, and how they came to work at NEST360, along with projects that they have worked on.

Great momos! Will definitely be recommending for future interns :))

 

At Sawa Sawa Beach, where we met up with some NEST360 colleagues for dinner!

As I say in almost every post, time has flown by so fast, but I am incredibly grateful for the lunches and dinners that have provided the space to slow down and really reflect and learn on the work that we are doing. In the next few weeks, I will continue my work on both the qualitative and quantitative analysis, and also start preparing for a final presentation of my work. Until next time!

Shrutika

Hello from Dar es Salaam! We arrived late in the night on June 21st and Dr. Christine Bohne’s driver, Josh, picked us up. Although we were exhausted after a full day of traveling, Josh took good care of us, relaying Christine’s words of advice and keeping the energy up on the drive to our airbnb. He taught us a few essential vocabulary on the way, explaining that “Karibu” means welcome and “Asante” means thank you. Once inside, we were greeted with a kind note and snacks from Christine, welcoming us into our new home for the next several weeks.

The next day, Josh helped us exchange cash and buy SIM cards before we met with Christine for the first time at lunch where she told us about her background, the incredible work she has been doing with NEST360, and general tips for living in the city. Together, we shared our reasons for working in global health, leaving me more resolute in my decision to pursue my Master’s in Public Health and work with like minded individuals. One of Christine’s suggestions was to become comfortable navigating within the city, which led to calling our first Bajaji, or rickshaw, to take us home!

 

We met up with Christine again for dinner where she introduced us to the Slipway, her favorite evening spot. It was a lively place with an international crowd and music and conversation in every corner. In the background were the lapping waves of the Indian Ocean. Christine encouraged us to try a Tanzanian dish called Urojo, or Zanzibar Mix, which is a hot potato stew made with various spices. All of us remarked how comforting the dish was, reminiscent of an Indian kadhi, creating a sense of familiarity in a new environment. We also tried fried cassava with masala seasoning, introducing us to a root vegetable we would soon find across several restaurants.

 

On Friday, we attended the 11th annual Muhimbili University of Health and Allied Sciences (MUHAS) Scientific Conference. Partners with the Tanzania Health Ministry spoke about their efforts at addressing maternal and neonatal health at a large conference hall packed with people. Some of the speakers were from NEST360, like Dr. Nahya Salim, who spoke about how most technology is not validated for newborns so by creating linkages with manufacturers, they can create quality improvement policies in this context. Her presentation was made even more meaningful by her introductory words about approaching care, it is “not about few of us, it’s about all of us together,” which I took to mean in the context of a global landscape. It is not just about the possibilities we can achieve in a high income country, but our ability to bring all people up to the same stage, low to middle income countries included.

Feeling curious and enthusiastic,

Annika

July.8.2023

It is somehow so difficult to believe that we are already into the month of July! The days fly by quickly, with much to do both at work and after. This past week, I have fully dived into interviews. I am mentored by Donat, a NEST360 and IHI team member who has spearheaded the infrastructure project thus far. Donat is an incredibly seasoned researcher who has guided me through the qualitative interview process, and I am so grateful that he has been taking the time out of his busy schedule to accompany me in the interviews. On Monday, July 3, I piloted my interview guide at one of the regional hospitals in Dar. My first set of interviews with nurses at the hospital were amazingly perceptive, and I learned so, so much in just a short period of time. My interviews focus on hospitals that have undergone neonatal unit renovations in recent years, so I honed in on learning challenges and improvements from both pre- and post- renovations. I also gained a lot of valuable feedback for my interview guide in terms of prompts and question order, that I implemented over the next few days in preparation for my second set of interviews later that week.

After my interviews, I worked on the transcription and a basic level of thematic analysis that will inform my future qualitative analysis. With more limited experience in anthropological research methods, I am leaning on Christine’s expertise and learning much from her. Apart from interviews and transcription, I have also been making headway on the data analysis portion of my project. David, a Rice360 Fellow, has made a template for floor plan information, into which I have been extracting from the Tanzania drawn plans. In the near future, I will be confirming and refining this data. I do not take photos of the hospital work, but I will include some pictures of my thematic analysis in the next post!

At the beginning of the week, on Sunday, July 2nd, we visited Haruka Maruyama, a Rice alumna who is the Tanzania country director of ICAP. Christine, who graduated from Rice actually just a year after Haruka, invited us to join their meetup on Sunday. It was great to make Owl connections halfway around the world, and learn how Rice was a decade before our time there. Haruka was also involved with Rice360 as a student in building devices, which was an amazing connection to the work that we have done in previous classes at Rice.Meeting with Haruka has reaffirmed my interests in connecting with the wider Rice alumni network, and learning about different pathways through there.

Photo: Rice meetup in Dar es Salaam!

Apart from the work that we have been doing here, we have also enjoyed some delicious food and gorgeous views. As the time flies by, I can’t help but notice what I will most definitely miss when I return to the U.S. On the top of the list is the convenience of calling a bajaji on the side of the road to easily get to my next destination. Another is definitely Slipway, with its gorgeous views of the ocean, beautiful architecture, and amazing food. A third will be the many work and study locations available, from the Ifakara Health Institute office to the plethora of cafes within walking distance.

Photo: Cafe at the Slipway, where we got some work done on Friday!

 

Photo: (Fake) elephant at one of my new favorite Indian restaurants.

In the next week, my interviews continue at hospitals in Dar. So far, I have been interviewing doctors and nurses who have been at their neonatal units pre- and post- renovation; I will continue this, and also interview one of the NEST360 data clerks in the upcoming days. Additionally, we will be visiting the Dar es Salaam Institute of Technology for a tour and to meet students and leaders there!

See you next week,

Shrutika

July.1.2023

Welcome back again to my blog, and I am excited to share updates from our second week in Dar!

Bright and early on Monday morning, we visited the Ifakara Health Institute (IHI) and met various members of the NEST360 and IHI team. It was such a pleasure to meet everyone and learn about their unique contributions to healthcare in Tanzania; QI specialists, statisticians, clinicians, and qualitative method masters were all present in the office, and they detailed the amazing work that they did at NEST.

Photo: With the amazing NEST360 team!!

 

Photo: My meal at the IHI canteen – it was delicious, and incredibly filling!

After introductions, we discussed our respective projects and outlined our immediate next steps. On the forefront was creating an interview guide, which will direct my upcoming interviews. Additionally, I am working on the extraction of data relevant to my project as well. We also scheduled a visit at a nearby hospital, so we could learn more about the neonatal unit there.

Thus, on Tuesday, we left for Mwananyamala Regional Referral Hospital, where we met up with Dr. Robert Tillya, a clinician from IHI and NEST360 (whom we had also been introduced to the day before). One of the aspects in particular that I internally took notes on was the infrastructure and overall space layout of the hospital. As this is also one of the hospitals that I will be conducting interviews at, I wanted to gain some perspective into the spatial advantages and limits of the current layout. Our conversations with the doctor-in-charge were incredibly insightful into this matter, and others as well, including challenges like hypothermia. One challenge the doctor noted was the lack of space for mothers to stay with their babies; they had to stay one floor up, due to limited space on the neonatal ward. Afterwards, we had the chance to speak with the biomedical technician on site, and learned about some of the issues causing a build up of unusable equipment in facilities, as well as many of the improvements taking place in the facility.

The visit to the neonatal unit was very informative, and it was interesting to expand on the literature that I had read online through an in-person example. It was also a great primer to a lot of the work that we will be doing this summer, and it helped with the development of questions for my interview guide. After the visit on Tuesday, we had the next few days to work on our project. As my first interview was coming up quickly, being scheduled for the following Monday (July 3), I focused on creating the interview guide and seeking feedback from the NEST360 team, as well as data extraction.

Among all of the new learning and new connections this week, Annika, Ojas, and I have still had tons of time to explore Dar! Our residence is located just a few steps away from tons of bustling cafes and restaurants, and we have had a blast exploring all that Dar has to offer. One of my favorite activities is to spot small differences from the overall culture in the U.S. versus in Tanzania, which I believe definitely shines through in restaurant life. In Dar, everything feels much slower-paced and calm; for example, the waiters won’t bring you the bill until you explicitly ask for it, and you can spend hours upon hours just chatting at your table after you finish eating. I’m not sure yet which “system” I prefer, but it’s definitely been fun pointing out small transitions in culture that we’ve noticed during our time here!

Photo: View inside Wild Flour Cafe, a greenhouse-style place to sit and work while enjoying some delicious coffee!

Next Monday, July 3, I will start conducting interviews at Temeke, one of the regional hospitals in Dar. Our time in Dar has moved incredibly fast so far, and I have truly enjoyed it and am excited for the next several weeks that are to come!

Shrutika

June.24.2023

Karibu! This one word, spoken so warmly, has followed us around our time in Dar thus far. Whenever someone enters a new location, they are promptly greeted with this word, which means “Welcome” in Swahili (it also doubles as “you’re welcome” after someone says thank you!).

Welcome back to my blog, and I am coming to you from Dar es Salaam, Tanzania! We said our goodbyes to Dr. Taylor on Tuesday afternoon, and departed for Dar es Salaam later that night. After speed-walking through our layover airport, watching approximately five-and-a-half movies in-flight, and experiencing an eventful stopover in Zanzibar, I finally made it to Dar at 1 AM on Thursday, June 22.

Photo: The beautiful view from the airplane: window seat always!

In the morning, we promptly began becoming acclimated, heading to the currency exchange and SIM card offices to get situated. We then met with Dr. Christine Bohne, the Director of Quality Improvement Systems and our in-country mentor in Tanzania. Christine warmly welcomed us with our first meal in Dar at Woodberry Cafe, a beautiful cafe that has quickly become a favorite spot to work! We spent our lunch introducing ourselves and learning more about Christine’s work with NEST360, and had some amazing discussions on global health.

Photo: Entrance to Woodberry Cafe

I was definitely fighting off jet lag afterwards, but I tried to power through because we also went out for dinner with Christine later that night. She took us to The Slipway, a shopping and restaurant strip on the waterfront of the Indian Ocean with beautiful views and even more gorgeous food! Our first dinner meal in the country was a hearty soup called Urojo, or also known as Zanzibar Mix. Urojo was incredibly fascinating because it has roots and influences from so many cuisines, which you can taste when you dig in. From the fried bhajias, to the coconut broth base, to the spicy habanero spice served on the side, there was so much represented in just one meal.

Photo: Urojo, or Zanzibar mix!

After dinner, we headed back home to get some rest, as we had a busy day on Friday. On Friday, we had the amazing opportunity to attend a scientific conference organized by the Muhimbili University of Health and Allied Sciences. We were able to listen to NEST360 experts present their work on reducing maternal and neonatal mortality. Additionally, we were able to listen to presentations by other esteemed members of the community, including a representative from the Ministry of Health and a representative from M-Mama (an innovative app connecting emergency care services to pregnant women).

One of my favorite parts was during one of the final presentations; the speaker tied together all of the previous work presented, describing the “perinatal care continuum.” It was fascinating to not only understand the work being done, but also seeing how they all linked together across space and time. Some focused on gathering research information, while others focused on the implementation based on that information, and yet others focused on gathering feedback from the implementation. This provided me with a more thorough view of the full spread of work on maternal and neonatal mortality.

Thanks for tuning in!

Shrutika

Dear reader, 

Welcome to the beginning of many musings! My name is Ojas and I am a rising junior at Rice studying cultural anthropology on the pre-med track with minors in global health technologies and biochemistry and cell biology. I know—that’s a mouthful. The point is that I am a prospective physician with a deep interest in the social elements of medicine. 

Honestly, I did not come to college with any background in global health. But, I was passionate about decolonization and dedicated to cross-cultural exchange. As a child of immigrants from India, a low-income country, I am familiar with many of the structural barriers to accessing care in some resource-constrained settings. But, in humility, I still have so much to learn and am learning every day. 

After discovering Rice360, I felt that I found my home. I found the place to gain unparalleled perspectives on health disparities and collaborate with scholars around the world.  Continue reading “0. Introductions” →

June.17.2023

The second week of orientation flew by just as fast as the first, and I am continuously awed by the wealth of insights that each of our group conversations bring. These past few days, I dove deeper into the history of the region and organizations that I will be working with. Prior to this research, I had never really stopped and thought about the background of a group that I was to work in, so I really appreciated this activity.

On the project forefront, I have been conducting a literature review on the impact of infrastructure on healthcare. The primary director of my work has been a toolkit co-developed by NEST360 and UNICEF. Dr. Christine Bohne, the in-country mentor for my project, pointed me towards an incredibly informative overview on infrastructure (linked here if you would like to read). I have used the abundance of resources available on the toolkit to understand my work, and I have also supplemented this knowledge through literature searches. Apart from the literature review, I have been familiarizing myself with the existing materials for this project. Overall, I hope to step into Dar next week with a more thorough background that can inform my field work here.

Finally, on the more social side, Dr. Taylor, Dr. Nejad, and all of the Rice360 interns enjoyed a very eventful team bonding activity at an escape room (we did not escape). I will definitely be missing the whole team as I prepare to go abroad with Ojas and Annika, but we’ve all promised to stay in touch and send updates (and pictures!!) throughout the summer. In my downtime, I’ve been packing and preparing for our departure next Tuesday, June 20th, which means a lot of paperwork and begging that my suitcase closes shut. I don’t have too many pictures from this week, but promise to include more in the future! Stay tuned for more parts, but next in Dar!

Shrutika