Friday July 1st (Mental health issues)

Friday July 1^st

Third day of collecting household surveys and we are super tired. I feel like I am a lot flexible but I am glad that we have started collecting our data. We have almost finished 1/3 of San Martin in 3 days. Isn’t that amazing? We have really hustled and bustled in the hot sun. The weather seems to be holding its wrath from us but the skies are turning gray so maybe they are slowly going to let loose and prevent us from doing any work.  I woke up at 7am and left the house at 7:50am for a meeting at 8am. I was the first one there and Dr. McKay the dean of nursing and Roberta who has been a tremendous help throughout the entire process discussed how the project was going so far. When Elizabeth, Debby and Caitlin arrived Dr. McKay discussed what she wanted from them by the 8^th of July, which included their experiences, feedback to improve and any other comments. At 11am we then headed out into San Martin. I went to Tita’s home and she wasn’t able to aid in administering the survey in the beginning part of the day so I walked around by myself. I was not nervous and continued on the street we had began the previous day.

            Today the house that stood out to me was a house with a lady who told me she had paranoid schizophrenia. She was very open with me and told me her story of the abuse she tolerated as a child mainly from her mother. She said her mother used to listen to her sister who was her mom’s favorite. At the age of 15 her mother decided to wed her to a guy she was not in love with because her sister had seen that she was interested in another guy. Because her mother really valued her sisters opinion they married her to a guy who was also in love with her but who she was not in love with at all. She said she did not want it but did not have any where to go and so she married him. She said her husband who is now her ex-husband loved her but she did not love him. She says she would fight with him and they would fist fight and she ran away periodically but would return in the end. Eventually her husband was frustrated with the entire process and would stop fighting with her and try to find out what was wrong. She says she would tell him “I don’t love you” and he would be hurt and leave. During this period she became more depressed and then became pregnant. She says she really was depressed and would start to hallucinate and have an inner voice tell her negative things. Her family thought she was crazy and she said something was wrong but the hospitals here were the worst. She also said no one would diagnose her they only were willing to put her in a mad house but she says she is convinced she had paranoid schizophrenia. As we talked some more she told me she was diagnosed and then had her second child. After her second child was born she started going to church a whole lot more and she credits that with helping her to heal. As she told me her story she would start crying and would tell me I have never told anyone this. I was touched and as I listened to her story I was drawn to tears. We ended up speaking for over 2 hours about her experience and I was touched. Why is there a lack of mental health services in the developing world? Why is there still that stigma?

Things need to change.

Thursday June 30th 2011

Thursday June 30^th

Last night I literally put my head on the pillow and feel asleep within 2 minutes. I worked out last night so that was a plus (for me at least). Well-being involves, physical well being. This morning we were out of the house and by 9am we had began to survey the remainder of the St. Matthew street and had started on the next street. As we were surveying I got to talk with Tita a lot more and she opened up about her family and all the problems that she faces especially since she is one of the only siblings who is working currently.  It must be especially difficult if everyone relies on you and also blames you for not helping them when they are in need. She told me that sometimes she feels like she cannot go on and that she sometimes feels like giving up but she wont give up yet. She also wants to visit the U.S. one day and I told her she should. At lunchtime I took her to Ice point where we had lunch and talked a lot more. She told me about schools here in Belize and the lack of resources. After lunch we continued to survey the houses and were able to start on the next street. At 5pm I was burnt tired and Tita and I departed ways. When I got to UB, Caitlin and Debby were there. We waited for an hour and Elizabeth was nowhere to be seen. We then left the campus and headed home where we found a little kitten that was blind. After trying to take care of it with the help of our neighbors, we fed it and prepared for bed. No workout tonight.

I am exhausted.

Wednesday June 29th (The beginning of data collection)

Wednesday June 29^th

We all woke up today at 7am and were out of the door by 8am. Today was the first day of surveying. We decided to split the group up as follows:

Stacey (me) + Tita Balona

Elizabeth + Alicia

Debby + Caitlin + Roberta

That way each group had a Spanish speaker with them. We also split each street into 3 sections and we each had 8 lots to complete on each street and we will be doing that per street visited. The first house I visited was right by the UB gate. A blue house with a brown smaller structure in front of it. I was a little nervous, maybe not nervous just nervous excitement. After saying good morning the male head of household approached the gate. His wife and other family members followed him. I remember thinking “Oh man, this will be interesting”. I then introduced myself, told him what I was doing and asked him if he was willing to participate. He then looked at Tita and spoke in Maya and Creole for more information. She explained more in Maya and I think the exchange was just to assure him that I was not a con. He then looked at me, smiled and said, “Come in”. After a flurry of words in Maya, a family member rushed in and came out of their house to present a chair for me to sit. I thanked them and then we talked a little where I further explained what I was doing and then read the consent form to him. He then signed and we began the survey. After completing the survey in 18-20 minutes we proceeded to talk about San Martin and he told me how much appreciative he was that we had decided to come to San Martin to do something with health because he said there was a lack of it in the community. It is very interesting because he also talked about having the health center in San Martin but seeing that it was closed which did not make sense to him. After a few minutes he proceeded to ask Tita questions about City Council and what they were doing and she answered and made small talk. After staying with them for about 45 minutes we proceeded to the next house, which was comprised of women. We found them in the middle of making flour tortillas and the head of the household was around the hearth flipping the tortillas. After introducing myself, she agreed to take the survey and we sat around while she cooked with other women. As I went through the survey questions she and the other ladies would laugh and then she would answer the questions. As we went through she I got the sense that the other ladies were her daughters or family members. Once we reached the end of the survey it began to rain and by then it was approaching 11:30am, we continued and it began to rain harder. Soon we were joined by another Belizean woman and man who came to buy tortillas. After they talked she looked at me and said that she did not like foreigners asking intrusive questions. I smiled at her and she continued talking to the lady we had just interviewed, telling her how she had some researchers come and ask her information about her home and how she did not like it. I know it wasn’t us but I understand where she is coming from especially if people come and ask you questions and then do not do what they say they will do. It does get old and if I was in the same position I would be over it.

            After the rain had subsided I thanked the ladies of the household for their time and went to the next house, which coincidentally was Tita’s house. Tita introduced me to her common law husband, her daughter, son and grandmother. We then went to the kitchen located in the back of her compound in a separate structure where the sweet smells of home baked breads and stewed chicken wafted through the air. After sitting and talking to her daughter who also wants to become a doctor like me, Tita volunteered her grandmother to do the survey. We proceeded through the preliminary consent form and survey while Tita enjoyed an early lunch. Her grandmother is pretty awesome and agreed to teach me how to cook Belizean food if I ever wanted to learn and with time permitting. After thanking her for her time, Tita and I went to the next house. For the rest of the day until 5pm we visited each of the houses in my zone made small talk and performed the survey. Despite one break to get lunch at 1pm the only time I got to raise my feet up in the air was later in the night when I returned home at 5:30pm.

            Today was exhausting but very exciting. I have heard very interesting stories. One story that sticks with me is the story from a housewife who has not seen her husband in more than 10 years because he has abandoned her. The story broke my heart because I wish I could help her or give her information on how to track her. He literally can be anywhere in Belize, in Central America or in the World. Public Health is hard because this field covers many aspects of health including mental health, emotional health, chronic health, maternal health, community health, communicable disease etc. It’s so broad and now I understand the dilemma PH practitioners are faced with when you get an answer that you cannot change or make better. I wonder how many other situations we will encounter such as this one.

Tuesday June 28th

At last...... 

 

Tuesday June 28^th

I woke up very optimistic today. We were approved yesterday. Although the sun was very brutal its exciting because we will be able to collect data soon. Today we set out at 8:30am and were in San Martin by 9am to finish the remainder of the mapping. Yesterday it was mostly Caitlin drawing the maps but today I will be doing the mapping while Debby is taking pictures of each house. Caitlin will then be matching each house with the descriptions of the houses so that we have a visual map of everything around us. As we began mapping the sun was out and it wasn’t too hot but by 11am the sun was a little stronger and we were all sweating. We definitely want to finish mapping today because we don’t want to be ut doing this tomorrow. We would rather start collecting data. At 12:30pm we were all starving but decided to push on since we had a little more left to map. By 2pm we had finished the entire San Martin community. Drenched in sweat, tired and 2shades darker we decided to capture the moment of relief and excitement by asking a few passing young men to take our picture. After that we all headed to Ice point for lunch and then home to get our computers and then headed to the UB library where we each finished homework from our other online classes, socialized through Facebook but mainly to bask in the cool AC which was a relief compared to the sweltering hot sun outside. In the evening we headed home and decided to finalize the notation for houses to indicate to us how many times they had been visited. As I have mentioned earlier in other blog we have decided to visit each house twice because we will be limited in the number of people being able to actually go out into the community and administer surveys. I AM EXCITED!!!

Monday June 27th

 Its going DOWN

Monday June 27^th

Today morning is the day that either breaks everything or makes everything come into place or better-said fall into place. I woke up this morning pretty anxious about whether we had received approval or not? And what that would mean if we didn’t= more work for me=more stress for me. After going to Dr. McKay’s office and having a brief meeting she told us she did not have any idea as of yet and had not been contacted. Already I was feeling queasy about the idea of tackling all the work by myself for a while. Wouldn’t it suck if Suzie did not come then I would be really –ish out of luck. To kind of motivate us in a direction we all agreed to get the community mapped since we hadn’t been able to do it in the previous week. As we headed out it was as if the sun was taunting us and it got hotter and hotter and hotter. At one point I caught my mind wondering, “what’s the point? We wont get approved anyway” I had to remind myself that this was also a learning process and that I was getting something out of it even though I did not yet understand what this message was. As we walked around San Martin we were able to get a better sense of the community, gauge safety, receptiveness etc. Most people were curious at what we were doing as we would stop at each house and stare and try to describe them. We would then take a picture and would use this to match it to the houses. In the afternoon we headed back towards campus and then walked to Dr. McKay’s office. By then I was really hoping that she would have something for us to go off of and yes she did have something for us:  We get the Okay, MOH has approved our work. The painstaking work of compiling the survey, pilot testing, etc is worth it all and will soon bear fruit. Since the sun was setting by then we decided to finish the mapping the next day. I am definitely a lot happier now.

Church in Belize

Saturday June 25

I woke up at 7AM this morning almost bursting out of my seams with excitement. Since this Sunday Dr. Corvin is returning to the U.S. the other girls have decided to take her to San Ignacio so that she can do an iguana exhibit and a homeopathic tour of medicinal herbs and plants. They will also do some shopping and visit a local pool that we discovered when we went to San Ignacio weeks ago. I on the other hand will be going to church with the couple I met yesterday. Because we had not shared the exact time that Chris would be coming with her family to pick me up and I didn’t know if church times here were different I decided to be up extra early and wait. After getting dressed, Sunscreen-ing myself and creating my bug barrier with my handy dandy Deet I was ready to go. Within minutes Chris called for directions, which I shared over the phone with her and waited. After about 5-7 minutes they pulled up and I headed to their truck. I introduced myself again and we made small talk about what I was doing here etc. This morning they are going to St.Thomas a small village outside of Belmopan city limits where the church is located. The landscape of Belize definitely reminds me of some parts of Kenya and I do appreciate the clean air and empty spaces. Within 15-20 minutes we were approaching the church a small stone structure with no windows but so many children and a few adults. The adult to child ratio was definitely large and I wondered where all the children had come from.

            Sabbath school was good, but I definitely felt like the outsider because I was stared at a lot. I guess I do look different and I also act very differently from Belizeans here. After the church welcome we began singing a few hymns. I noticed that there was no piano and so we sang a few hymnals that the children knew. It was very interesting, the children all seemed to know each other and the older children would look after the younger. When a break was announced Chris introduced me to a woman holding a newborn. The woman was definitely the reason for the children. She had an orphanage; I think the only one here in Belmopan that she had started in the 1980’s. Chris and Rich then told me that they along with many others were in the process of building a new and bigger orphanage and that they would take me to the orphanage both the current and new one this afternoon. 

I didnt have my camera and i wish i did but the orphanage is definitely bursting at the seams. They need space. When we got to the orphanage most of the kids were in their rooms taking afternoon naps and i was able to wander around and make small talk with the cook. I will return later with a camera in hand.

It Gets Better (Friday June 24th 2011)

It gets better.....

Friday June 24

I woke up a lot more optimistic today. We have some sort of data to look at and I’m glad that we get to participate in the data collection process. It also feels extremely awesome to have something that we have worked on for such a while bears us some fruit. This morning after settling in at UB we began going over the activities of the previous day. We decided to go over each question and comb over each slowly. A few questions had to be changed into simpler terms because they were confusing and questions had to be moved around to help with the overall flow of the survey. We also discussed the optional questions dealing with domestic violence and I shared with the group that I actually did not feel awkward to ask those questions since by the time I had gotten to them I had already gotten into a conversation with the individuals I was interviewing and they were opening up. Roberta also mentioned that sine domestic violence was so prevalent in Belize she was surprised that majority of respondents had not indicated that it was an issue in their household. Maybe we were lucky and got the people who did not have physical abuse occurring in their house and maybe they were lying. I think to gauge a sensitive subject such as domestic violence you have to get into a very comfortable rapport with the person you are interviewing so that they can open up to you. Maybe when we actually do the survey we will have people tell us what goes on behind their closed doors in terms of domestic violence. Only time will tell.

            After combing through the questions we were happy with what we had and then headed for lunch. In the evening we headed to another local expat coffee shop PerkUp, where I had their amazing frappucino as a reward to myself for all the hard work. It was a welcomed chocolate cool relief . While I was waiting for my order to be filled I got into a conversation with a couple next to me and inquired about why they were here in Belize. Long story short they had come here to share G-d’s word. Something inside me tickled and I decided to ask, “What is your religion/denomination?” I think I was also alerted by something about them, maybe an aura? I don’t know but the answer I got back was “Seventh Day Adventist” (SDA). I almost burst out of my seat as I also told her I was an SDA. She then introduced herself and invited me to church tomorrow. After exchanging phone numbers she left and I couldn’t wait. After they left I shared bean creating the Epi-Info database with the new corrected questions. This week has definitely turned out into something very positive.