As January (somehow) winds down, I wanted to take this time to give you a (relatively) short wrap-up of the work that HHI's Public Health Team recently completed in the Dominican Republic. Please feel free to forward to whomever you feel may be interested, be they family, friends, donors, or anyone else! We are all now back stateside, and diving into our classes, and also be putting together an analysis of our findings, so as to improve HHI's diabetes and hypertension prevention techniques. Hope you enjoy!
Last Saturday (1/7), Health Horizons International's Public Health Team departed the cold US for the warmth of the North Coast of the Dominican Republic. After journeying on planes, trains, and automobiles, all eleven team members made it safely, and on-time to Puerto Plata, well-rested from the holidays and prepared to execute the Community-Based Participatory Research project we had planned over the fall semester.
In accordance with HHI's mission to build capacity for achieving community health, we designed a project in which community members would use PhotoVoice to document the attitudes and behaviors they felt influenced hypertension and diabetes. PhotoVoice provides individuals with cameras, gives them a theme on which to focus, and finally engages them in focus group discussions with the other participants. The end goal of this technique is to facilitate the flow of ideas and empower the participants to work for change. In this case, by focusing on hypertension and diabetes, participants not only aggregated their own ideas on the diseases, but also provides HHI with formative input for its soon-to-be rolled out Healthy Lifestyle Intervention. Thus, the communities of Severet and Pancho Mateo, HHI itself, and the partnership between them, will each be empowered to stem the growing tide of diabetes and hypertension.
The project got off to a great start in both communities, as each community produced more than our target number of participants, and their enthusiasm for the project was palpable. After a first day of discussion about the most effective and ethical ways to take photographs, how the weeklong project would work, and the consent process, the participant groups of each community set off to fulfill their first photography "assignment," documenting the important aspects of their daily lives. This broad theme served as an introduction to the project, through which we could troubleshoot issues and further develop ideas, while still gaining valuable information about the lifestyle in each community.
Unfortunately, the project turned stressful as we attempted to upload and discuss each participant's photos. In order to properly discuss photos as a group, we would need to display them on a larger screen, so uploading to a computer was imperative. Despite my testing of several of the cameras before we left the US, bugs in the camera programming plagued uploading. Many cameras uploaded the pictures as plain white, others would not upload at all, and we later discovered that removing the batteries from the camera erased the entire memory card. Although frustrated with the lack of functionality of the cameras, the Public Health Team waxed creative, began taking pictures of the participants' images as they appeared on the view screen of each malfunctioning camera. The quality of each photo suffered slightly, but we were still able to use the photos for discussion purposes. A lesson about reliance on technology was quickly learned by all.
With this adaptation, each community proceeded to the second assignment, which focused participants' photos on all environments, behaviors, actions, people, and things that either prevent or promote hypertension or diabetes. After allowing the participants to take such photos, we held several focus groups to discuss what they had found. Many interesting findings surfaced, and we will be releasing a full write-up in the coming weeks to summarize them. The statements of community members, concerning both what is not known or misconstrued, but also that which health-promoting knowledge already exists, will surely be profoundly formative to the content and mechanisms of HHI's Healthy Lifestyle initiative.
On the final day of the project, community members created a poster and presented their findings to their fellow community members, and succeeded in stirring up demands for change, especially in Pancho Mateo. Throughout the week, we had seen, as we had hoped, that the project's critical thinking exercises had provided participants with a new sense of what the community's problems were, and what they could do about them. During this final presentation, that progressive energy truly came to the surface, and participants delivered rousing messages about improving quality of life. Community members called for the community itself to take action, given the support that HHI had provided them. This outcome is one of the most important of all; once the community itself is motivated to create progressive change, the work of NGOs becomes facilitated, and partnerships between the two parties function more smoothly and effectively. The empowerment of the presentation was a triumphant note on which to end the project, and each community and its facilitators celebrated with a spectacular, home-cooked lunch. After a few laughs and universally full stomachs, the Public Health Team parted ways with each of the communities. We spent a few hours relaxing on the beach, recuperating slightly before our respective homeward journeys.
Stay on the lookout for future updates from us as we analyze the results of the project. Please feel free to email me with any questions or comments!
Erik
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