Category Archives: BBH

Our Stellar Students: Rhoda Moise, Biobehavioral Health

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As a junior majoring in Biobehavioral Health with a double minor in Biology and Health Policy and Administration, I possess a passion for health promotion from proteins to people. As a HealthWorks Peer Health Educator, I volunteer with the University Health Services in order to advocate for health amongst the Penn State community. I also serve as the Treasurer of the Penn State section of the National Council of Negro Women Inc., where I seeks to lead, develop, and advocate for women through philanthropy, prosperity, and the promotion of educational values. I give back to my community through serving as a tutor for the Student Support Services Program, helping to provide student with the tools for academic success. I underscore and advance my mission to promote scholarship through my position as a Scholar Advancement Team member of the Schreyer Honors College where I strive to diversify the faces in the SHC.

I aspire to obtain a PhD in population health in order to conduct research that combats health disparities related to chronic disease. My research interests include health disparities affecting the underrepresented populations and the African Diaspora; attitudes, behaviors, and determinants regarding diabetes among minority and low-income populations; community/family interventions or Community Based Participatory Research (CBPR) to improve diet quality and behavior in culturally sensitive ways, and quantitative and qualitative methodology. Last summer I completed a nine week research project under the mentorship of Dr. Emilie P. Smith, as a facet of the McNair Scholars Program which grooms undergraduates for graduate education.

This summer, I have the privilege of conducting diabetes research under the mentorship of Dr. Rhonda BeLue.

Through culturally grounded narrative interviews, this research explores what exercise means to Senegalese individuals in order to help manage diabetic interventions. This approach will also contribute to the field of health promotion by advancing a theoretical framework for delivering culturally competent health in West African cultures. More specifically, the purpose of my project is to identify culturally-grounded diabetes management narratives focused on exercise among diabetic patients in MBour, Senegal. Given the increasing burden of diabetes and chronic disease in SSA, my work has the potential to improve diabetes management and resulting diabetes death and disability. For example, we came across a 67 year old male with an amputated toe as a result of his poor diabetes management.

While exhausting, my work here is extremely exhilarating and fulfilling. The interviews were home visits which lasted about an hour long; moreover, we completed about four interviews a day, totaling at 41 before the data entry process. While my work may not be able to directly change issues such as accessibility/affordability, the conversation generated through these interviews is a start.

This fieldwork also helps frame my ultimate aspirations to improve chronic disease care and management in Haiti. Professionally, this experience will help inform my personal efforts to optimize diabetes management and prevention measures in Haiti. As a first generation Haitian-American, I am extremely invested in combating diabetes disparities since the disease is no stranger to my very own family, both my paternal and maternal sides. Martin Luther King Junior once said, “of all inequality, injustice in the healthcare is the most shocking and inhumane.” His words stand as the driving force behind my personal and professional aspirations. My academic endeavors and campus involvement demonstrate my passion and commitment to positively affecting public policy and potential health outcomes.

(Sweetest nine month old baby girl found comfort in my arms… I presume, who wouldn’t? She was being pampered as I fanned her! <3)

(Large mango tree in the yard of an elderly woman we interviewed; moreover, she had her granddaughter pick some fresh mangoes off the tree for us! Delectable treat after a long interview in the sweltering Senegalese shade!)

(Not all residents of Mbour have poor diabetes management. 8 month old Mohammed, the grandson of a mid-fifty year old man we interviewed, reached for my packaged water. Of course I had to share with my Young King. The mid aged gentleman told us of the impact the research Dr. BeLue has been doing… As a result of the information he learned in the past year, he exercises every single day and has drastically improved his diet!)

Our Stellar Students: Sharmila Sandirasegarane, Post #2

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Sharmila Sandirasegarane updates us on health care in Tanzania:

Compared to the Kibiti Health Center, equipped with a few consultation rooms and an operating room for minor procedures, the Lushoto District Hospital seemed to be stocked. Tanzania has a multi-tiered, decentralized health system with facilities ranging from rural dispensaries, with minimal services, to national referral hospitals, with the country’s highest level of care. Between these levels, patients can be referred to health centers and district hospitals.

We toured the district hospital’s various departments, including pediatrics, pharmacy, ophthalmic nursing, maternal health, labor and delivery, and phlebotomy. I was told about the modest patient records systems in many African hospitals, but it was definitely an experience to see the stacks of papers that filled a room. Handwritten sheets marked the numbers of each aisle, which were cross-listed with the patient names in the computer system. I was glad to learn that there was some kind of digital system in place, but the files only connected the names to the identification numbers of the patients, not their actual records. The records only existed in paper form.

We were pleased by the stocks of equipment, especially in the pharmacy, but we learned that it was fairly common for supplies to be out of stock. The medical students and the faculty emphasized their frustration about this problem, especially at a referral hospital. They thought the issue was out of their control as they blamed the lack of government funding for this issue.

This lack of funding is especially infuriating considering the corruption that the students frequently allege of government officials. For example, government officials in all districts own V8 SUVs that they use for a maximum of six years. Two of these cars can cost as much as a CT scan, while the country only had one machine in the country in recent years. This excessive spending is especially frustrating after seeing the lack of equipment in some of the health facilities. Even though the district hospital was relatively well-stocked, it could definitely have improvements in sanitation and infrastructure.

Particularity in dispensaries and health centers like in Kibiti, greater allocation of health funds could be very impactful. The methods of transportation for patients who move through the referral system is also inadequately developed; it is near impossible for patients in rural areas to move from dispensaries to referral hospitals for severe cases because of financial and infrastructure limitations. In fact, patients have to pay for the gas used in ambulances.

There are many underfunded areas in Tanzania’s health structure, even including the salaries of health professionals, which makes the lack of funding a fundamental issue in access to care. Actually seeing these issues first-hand has made me develop a deeper appreciation of the magnitude of the problem.

Our Stellar Students: Sharmila Sandirasegarane, Biobehavioral Health

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Sharmila Sandirasegarane
Summer Abroad HHD Blog
May 30, 2014

Major: Biobehavioral Health
Minors: Global Health and Spanish
Hometown: Hershey, PA
Extracurricular Activities: Biobehavioral Health Society, Schreyer Honors College Student Council, THON, Mid-State Literacy Council
Career Goals: Aspiring physician

After months of anticipation, I was eager to go into the field in Tanzania. The challenges that were encountered during the day aligned well with the topics that were discussed during my Global Health minor classes. When we arrived at the first home of the village, I thought that we were not going to be able to survey other residents because they were working on their farms. Instead, the medical students and supervisor for the Muhimbili University of Health and Allied Sciences were working to establish a relationship with the family.

A woman from the home served as our guide, as we traveled from hut to hut to survey mothers about the vaccination status of their children under two years. If we did not have her flexibility and willingness to help, we would have never have made it through the village. Through high grasses, we walked on narrow, sandy paths to travel to each home, which were spaced at least ten minutes away from each other.

What struck me most was how the way of life was so detached from the rest of the world. I began thinking about the practical constraints with starting health interventions in the area, beginning with the challenges to travel from the village. It took the villagers about an hour to travel to their local clinics. If there were education initiatives conducted in the area, a major challenge would be the travel times for the children to meet. The concepts about individual perceptions of health became clearer to me as I considered that the locals knew what they knew, while modern medicine played a minimal role in the schemes of their lives.

After seeing a setting where global health initiatives could be implemented, I realized the essential nature of cooperating with local individuals. The village had specific needs based on its sanitation system, availability of water, accessibility of homes, and many other factors. Several of these factors could not have been observed if it were not for the cooperation with the locals. This relationship was only established by communicating with the village leaders, the woman who served as our guide, and the women that we interviewed, all in Swahili. I realized that specific conditions were necessary to study remote areas, in order to have any hope of establishing any kind of targeted program.

On a lighter note, I realized how much fun fieldwork can be. I loved observing a different, peaceful lifestyle. I had a great time speaking broken Swahili with our guide, and laughing with her as we walked on the tall grasses as we tried to avoid the water that had taken over a quarter mile of the path. I found the fieldwork experience both eye-opening and exhilarating.