These past two weeks have been absolutely amazing, in terms of experiences here and the work that Sarakay Johnson and I have been able to accomplish.  We have been organizing many different projects since we have arrived.  This past week we have been able to implement several of these projects.  The majority have been focused on health education, which is an area that I particularly enjoy.

One of the programs that we have been working on for some time now is the three-part workshop on survey design and data interpretation.  This project was not one that had originally been planned for.  However, once we began working with The Thoughtful Path and their various hubs, it became evident that this was an area that was ready for improvement.  The lack of a complete census in Munsieville, along with the creation of the Health Promotion Unit (HPU), has created a strong need for evidence based programs.  The Thoughtful Path is currently completing a community mapping program and they have already collected data from over 300 households using a survey created by a previous intern.  This is an amazing beginning and I believe with further training key stakeholders working with The Thoughtful Path will be able to create their own surveys and conduct basic interpretations of the data.  To this end, Sarakay and I decided to construct a workshop to address this need.

The first class was conducted this past Tuesday.  This class focused on constructing different types of surveys, developing questions, and wording the questions with clarity, simplicity and neutrality.  Our preceptor identified six volunteers that have been assisting in the mapping project of Munsieville, one member of the Health Promotion Unit (HPU), and two employees of The Thoughtful Path (one including herself) to participate in this class.  After the workshop is completed, they will be able to instruct any others working in Munsieville that will benefit from this information.  The first class was amazing.  I will admit to some nervousness about teaching a class like this.  I was using my public health skills, not in a classroom for some grade, but in a real life setting with people who truly need this information.  There was no professor with a critique afterwards, no one looking over my shoulder to help guide me in this process.  It was just Sarakay and I, using the skills gained from various classes to provide this needed information to people who will be utilizing it to affect, not just the people residing in Munsieville, but also The Thoughtful Path organization.  I feel that it went very well.  Everyone was engrossed in the topics discussed.  We spent the first hour lecturing over the topics for that day’s class and then we organized groups of three to work on a project.  The participants chose their own health topics and constructed their own short survey to obtain information.  After the surveys were completed, a member of each group presented their survey.  This part was absolutely amazing!  Everything we had discussed that day they were able to utilize in their project.  Not only were they able to use the information we gave them, but they went on to explain why they had used a particular method and not the other, why they had constructed a question in a certain way, and how they would chose to conduct an interview over administering a questionnaire. Needless to say, I found this quite inspirational and am working to make the next class even more challenging and provide more information.  I have complete faith that these individuals will use everything we can give them to make The Thoughtful Path that much stronger.

The next project we worked on was a two-fold educational class for a youth camp.  The camp was for a group called the Young Ambassadors.  These kids range from 14 to 18 and are a part of The Thoughtful Path.  Part of their work with The Thoughtful Path is hosting monthly fairs for the younger children living in Munsieville.  This camp was a week long, and during this week they attended different classes on topics such as preventing teen pregnancies, STDs/STIs, nutrition, exercise, along with creating goals and action plans for their group.  Sarakay and I taught a class about exercise, and then another about proper nutrition.  During the course of this week I was informed of something that I found to be quite surprising.  The schools that these children attend do not offer formal health classes.  So, much of the knowledge that these kids had was largely inaccurate.  Also, some of the topics discussed were something they had never heard of.  During my portion of the nutrition discussion, I talked about carbohydrates, sugar, sodium, proteins, fiber, calcium, fats, and calories.  Most of the kids had no idea what these were, and a few could accurately define one or two of them.  What I did find to be most concerning though, was their knowledge on sugar and how it affects diabetes.  These kids had heard of diabetes, but only a handful could tell me what it was, how you get it or what happens when you have diabetes.  Some of the questions were “Can you die from diabetes?” “Is there a cure?” or “I eat sugar does that mean that I have diabetes?”  And diabetes is prevalent issue here.  This culture consumes much sugar and refined carbohydrates, and very little protein and vegetables.  When we said that the recommended amount of sugar was less than five servings a week and one teaspoon equals one serving, the kids were shocked.  One even spoke up and said it was a regular occurrence for him to add at least ten teaspoons of sugar to one pot of tea.   What really inspired me though is that these kids want to learn so badly.  They had no hesitation in asking questions.  Anything they wanted to know more about, they were not scared to ask.  They definitely put my knowledge to the test.

 The other class we taught that week was the exercise class.  This class was so much fun!  We began by conducting a 30 minute lecture.  I discussed why it was important to exercise and the health benefits from a regular exercise program, and Sarakay talked about how much exercise is appropriate and the health risks from not exercising regularly.  We were adamant of emphasizing that everyone has different body types and that they should exercise to be healthy, not just to look a certain way.  Here, as it is in America, these kids have a certain body type that is upheld to them as the “ideal” image.  We were asked many questions on “fad” diets, if they really do work, and what they could do if they wanted to look a certain way.  We were sure to stress that a proper exercise and nutrition regiment would optimize their health.  After the lecture portion, we went outside for the hands on portion.  We demonstrated stretches, cardio, and strength training exercises that could be performed at home without any equipment.  After the demonstration was my favorite part: a competition between the kids to see who could either remember all the different exercises or exercise the longest, whichever came first!  So, we turned on some loud dance music, put them in a circle, and started yelling out different exercises.  After several songs had played through, we had our top three winners which we awarded prizes to.                   

The third project that we worked on was the training for the GardenSoxx.  The vegetables we will be planting are tomatoes, spinach, and lettuce.  These were chose because of their nutritional value, the relative ease of growing them, and the cultural acceptance.  We worked with two members of the HPU learn how to properly create and care for the GardenSoxx, and we will be going into Munsieville with the members of  the HPU to assist them in teaching the selected families.  This project has taken longer than I expected to get off the ground, so to speak.  This is largely due to the structuring of Munsieville.  Even after we were able to locate all the families selected to participate in the program, there is the issue of coordinating a meeting.  We can not ask the families to walk to the Children’s Embassy and walk back with their GardenSoxx.  So, Mama Safia has been attempting to identify a central location where everyone can meet, and then set up a day and time that is convenient for everyone.  This is more complicated than it sounds, considering that not everyone has a source of communication.  Therefore, much of this has to be done by word of mouth.   

This internship continues to be a challenging but rewarding experience.  I cannot believe that the time is going by so quickly.  In the next five weeks, we have many projects to complete.  Soon, time will become the biggest obstacle to work around.  There are so many projects I would like to begin, but the timeframe is just not feasible.  I know that any future students wanting to complete their field experience with The Thoughtful Path would be able to continue projects that we have started here and initiate many rewarding ventures to improve public health in Munsieville. 

Courtney, reporting from Munsieville, South Africa