Internship Notes: Filling in the gaps

With the help from readers of this here blog, I have come to realize that I have left out a couple key components to my San Miguel de Allende summer. I am going to jump back and start at the beginning of my adventure and how I came to be involved to the state of Guanajuato for the 2009 summer.

As mentioned in the text box to the left, the masters in public health program that I am a part of requires a 480-hour internship. The internship has many requisites, but it is generally accommodating if you have a project you want to work on. Past students had gone abroad and from the beginning of my first semester at Berkeley, I was trying to make that happen myself. I had been interested in working in Latin America, so there were several professors that I wanted to talk to. Around that time, in my initial fact gathering phase, I was put in touch with María Hernández who works at the Center for Public Health Practice. She knew people in México who were doing public health work and were interested in collaborating with a student, which is how I met Juan and María.

María Aguilar and Juan Camacho both had public health careers in Alameda County, and had since retired to the town of San Miguel de Allende in Guanajuato Mexico. Although retired, both are actively involved in public health work; from hand washing campaigns to helping out a local mid-wifery school. They suggested a few possible projects that we could work on over the summer. Of them, the one project on HIV/AIDS stigma and discrimination was the most appropriate given my background. In 2006, there had been an article in the Mexican Journal of Public Health that described discriminating behaviors and stigmatizing attitudes held by some health workers. Juan and María had also received reports in Guanajuato of providers breaching confidentiality and refusing to work with patients who were HIV positive. The problem was clear, that some health professionals were creating uncomfortable environments that could possibly act as barriers to care for people who are HIV positive or at high risk for HIV.

The solution was/is not so clear. The intervention proposed by Juan and María is that we would do a workshop to sensitize providers to the issue. In short, we would make providers aware of what was happening, and hope to draw attention to the differential treatment that we had been reading and hearing about. As for my internship, I would evaluate the project by administering an survey before the workshop, after the workshop, and 3 months later. The survey asks basic demographic info: age, profession, do you work with HIV positive patients, and information about perceptions, knowledge, and behavior concernining HIV and HIV positive patients. The idea was to see a baseline of what providers thought, and then see if the intervention had any effect on them.

We wanted all hospital or clinic personnel who had interactions with patients at any time during their visit. This included the doctors, nurses, lab people, as well as security, custodial staff, and receptionist. The idea being that all of these people create the environment with which a patient find themselves, so to create a safer place it would be necessary to include everybody.

With those initial ideas, Juan, María, and I went about developing the project. During the spring semester at Berkeley, I created the survey for participants to see if there had been any impact by the workshop. At this time María and Juan spoke with health officials in Guanajuato working out the finer details of the implementation of the workshop.