Reflecting on what it means to work “alongside” not just “with” the community

Changemaker Catalyst Award recipient Arielle Hartz (Ari) spent the summer in Nicaragua to conduct Community Based Participatory Research (CBPR) with the non-profit, AMOS Health & Hope, to make a positive and sustainable health impact in the most vulnerable communities. This post describes the community nutrition fair aspect of her chronic disease project project her team and she put together.  It is a excerpt from her personal diary.  Ari is a masters student pursuing her MPH in International Health and Development.

I spent my summer in Nicaragua working with the non-profit, AMOS Health & Hope, which strives to improve health outcomes in the most rural areas of the country.  My time in Nicaragua consisted of both a practicum experience and internship. 

The practicum consisted of coursework to help us understand the organization’s approach to its research as well as relevant contextual and historical information.  My research internship was on chronic disease management, specifically diabetes, obesity and hypertension.  The project focused on sugar consumption and strived to conduct a behavior change analysis to decrease the amount of sugar consumed within the local community, Nejapa, particularly the clinic’s chronic disease patients. 

One major component of the internship was the community nutrition fair that we held. The goal was to increase awareness and knowledge about healthy food/drinking options.  There were multiple booths with various activities and informative posters to engage community members with.  Each booth operated with one member of my internship team and had a local Community Health Worker. 

My booth was a drawing activity to promote reflection to convey the idea of prevention.  It was structured with guiding questions to make participants think about their body and abilities today and what they like now and want to maintain in the future.  Overall it was a great experience.  Additionally, my booth had posters with quotes of inspiration from local community members who practice healthy living or believe in healthy dietary practices.  They are portrayed as models as “positive deviants” within their community.  I had the honor of interviewing these two people!

Diary Entry:

What a week! We had the nutrition fair today and it was great & tiring! I ready had a special day.  I am so happy I did the activity I was envisioning after all… the prevention drawing activity where adolescents/adults can reflect on themselves today and how they want to be in the future based on things like body image, physical capabilities, skill set, ect.  I was so honored to have people open up to me from the community.  People would really open up, it was truly beautiful.  The quiet women who opened up about her sadness in life really struck me.  The fact that she was asking ME (a gringa with no sense of her life routine & day-to-day) for advice on how to overcome her sadness was just amazing.  This exchange was beautiful to go through despite my inability to truly relate and the language barrier…I think overall I helped…just by listening and giving her the opportunity to feel heard.  Her situation sounded interesting where she sought support from non-familial people in her life rather than family because they hurt her.

My internship team and I with the Consejeras de Salud.

Quotes of Inspiration:

These two photos are of model local community members that I interviewed.  There words of inspiration were shared at the nutrition fair on a poster with their pictures so other community members could relate to them.

This is Don Juan, chronic disease support group member, who has adopted healthy behavior change practices to manage his chronic diseases.

 

Don Juan, chronic disease patient and support group member.

Inspirational Quote:

“I would like to see the new generation that is not contaminated with the same nutritional disorders, to have lifestyle changes and be responsible. A healthy life is the best!” [in response to question about his wishes for the future of his community of Nejapa]  

This is Ana Gertrudis, local venta owner, who aspires to sell fruits and vegetables to help make her community healthier and increase availability of local affordable fruit and vegetable options.

 

Ana Gertrudis, local venta owner. 

Inspirational Quote: “The problem is with the people because if I offer fresco [local homemade fruit drink] without sugar, they don’t buy it, therefore we are very sick.” [in response to why she doesn’t sell fresco simple [local homemade fruit drink WITHOUT added sugar] 

The future goals of the chronic disease project I worked on are to expand the chronic disease support group outreach and to partner with local venta (convenience stores in the community of Nejapa) to make fruits and vegetables more available. 

“Go to the people.  Live with them.  Love them. Start with what they know. Build with what they have. But with the best leaders, when the work is done, the task accomplished, the people will say ‘We have done this ourselves.”  — Lao Tzu (Chinese poet) 

This quote best describes the CBPR methodology and values of AMOS Health & Hope.  It was repeatedly shared by the organization directors and supervisors during my experience.  I love this quote!