Viva Argentina

15 05 2012

My time in Argentina has ended and I thought it best to reflect on all the things that I have learned through my time there. Things really picked up the last couple of months. Patient recruitment finally started in full-force and I was happy to be busy. I left Argentina with data on 325 children. While I had hoped to reach 500, I knew that this was not going to happen after the first month (see last blog post) and was pleased and proud of topping 300. Data collection for the manuscript will continue until early June to assure enough patients for publication acceptance. The anemia prevalence rate detected was around 40%, and the adherence rate to iron supplementation was 53%. The vast majority of mothers that reported non-adherence did so because of adverse effects of the medication or because of forgetfulness. The numbers shows a significant relationship between adherence and the presence of anemia.

While the project and results did not turn out perfectly, I feel like the project was a success. I was stretched more than I was expecting during my time there, but I appreciate the vast lessons I learned about functioning in another country and clinical research in general. I learned of the unending frustrations of bureaucracy in a developing country and the harsh reality of lack of funding for global health projects. Because I personally participated in much of the patient recruitment, I spent many, many hours in health centers and hospitals speaking with mothers about their children. As part of the questionnaire, the mothers and I tried to identify problems in the home that could impede the mother from actively participating in the child’s development, and then I would lead the mother in exploring options to overcome these difficulties. I heard plenty of heart-breaking stories from mothers as they described unimaginable hardship. But I also heard determined women who had overcome the odds to try and provide for their children. Their stories inspired me and reaffirmed my faith in humanity. The stories also seemed to add to the guilt I commonly felt each day as I took the bus back to the wealthier city center where I lived or especially as I packed all my stuff and jumped on a jet to come back to the States.

Standing in front of the city’s Children Hospital where I recruited.

 

I had the opportunity to volunteer with the NGO Conin in one of their local Malnutriton Prevention centers. Located in one of the villas (slums) in the outskirts of town, the center works to identify and helps families at high risk for malnutrition, through doctor’s visits, infant stimulation and maternal education. One of my last weeks in Argentina, I was asked to present a workshop on anemia and iron supplementation. I was able to give the workshop and lead a discussion about hemoglobin, anemia, iron-rich foods, and the effects of anemia on the body. I am a very strong advocate of patient education and felt great satisfaction as the mothers began to understand the need to follow the physicians’ instructions. They even commented on how they wish someone had explained this earlier so that they would have been more compliant with their medication. Unfortunately due to the structure of the study, we were unable to assess maternal knowledge of anemia as part of our study but I feel that this identification will be important to help improve iron supplementation adherence in Rosario.

Teaching the workshop at the NGO

I am very grateful for CREP and DGHI for granting me the opportunity to participate in the study in Rosario. I enjoyed the people, the culture, and the work. It has definitely inspired me and recharged me as I enter into my final year of medical school.

The other field workers and good friends of mine, Daniela and Virginia.

And I can’t finish my last post about Argentina without a Che Guevara quote:

If you tremble with indignation at every injustice, then you are a comrade of mine. – Che Guevara

 

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