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Protecting Health, Saving Lives—Millions at a Time

Courtney Danielle Rackers

Courtney Rackers

Recipient of MPH Field Experience Fund Award in January 2009 - Community Health Project of Dona Antonia, Dominican Republic

I returned to the small, rural community in the Dominican Republic where I served for two years as a Peace Corps Volunteer. The purpose of my trip was to collect follow-up data in order to determine the effectiveness of three years of health interventions and programs conducted in the community.

The community, Dona Antonia, is located in the northwest corner of the country and consists of approximately 1,000 people. The members of the community are warm-hearted and welcoming to all visitors. I lived and worked for two years with a dynamic group of 25 women who participated in the community’s Women’s Center. This group provided me a network and team of workers that helped me become part of the community and participated in the health programs I implemented.

Upon arriving in Dona Antonia three years earlier as a Peace Corps Volunteer (PCV), I worked with these women to perform a community diagnostic in order to define the primary health needs of the community. Together we conducted 125 interviews with the females in the community who were considered the head of their household. After analyzing the data I developed health programs that addressed the primary health needs of the women of the community. These programs included but are not limited to nutrition, hygiene and sanitation, reproductive health, breast cancer prevention, diabetes and other chronic illness education and prevention, as well as STI/HIV/AIDS awareness and prevention. Upon completion of these programs, I trained a group of ten women who participated in the above programs to become community health educators. This training capacitated these women with the appropriate skills to share their knowledge with others and to lead health programs throughout the community. An important benefit of this program was that these women were able to continue the work I started in the community long after I completed my two-year commitment.

Since I left Dona Antonia in October 2007, the community health educators maintained the existing programs and continued to provide new health programs for the community members. In an effort to determine whether the overall health of the community has improved or has been impacted in any way, follow-up interviews needed to be conducted. With the funds award I traveled to Dona Antonia for six days to work with and train the ten health educators to conduct the follow-up interviews. Because of time constraints, I was not able to stay long enough to conduct the follow-up interviews, so instead I trained the women to do so. I was confident that the women would be able to conduct the interviews without me since they assisted me in the baseline interviews and gained much experience and understanding throughout the process. I met with the women for 2-3 hours each afternoon after they finished cooking lunch and preparing their children for school. They were so excited and enthusiastic about working with me again and also to learn about the effectiveness of their efforts.

Our time together consisted of discussing the projects and programs they have provided the community over the past year since I had left. We reviewed the original baseline interview and the results and discussed what were hoping to discover from the follow-up interviews. I trained them on the proper methods of data collection, ways to avoid bias, and the ethical concerns they need to keep in mind while working with human subjects. They also learned the importance of obtaining formal consent of the participant. The women practiced mock interviews with each other to ensure proper completion and comfort. They began working in pairs the day after I left with the plan to complete 104 follow-up interviews and send me the interviews and consents via mail for me to analyze.

This research project has many benefits. This opportunity will allow the women and I to learn whether our three years of health interventions has improved the overall health of the community, mainly of women and children. Most importantly, the results of this research will show us which health programs and interventions have been successful and which ones have not. This is essential because the health educators are dedicated and committed to providing community health programs for the years to come. It is important that the efforts of the women are effective and are benefiting the community. I want to ensure that their current efforts, programs, and outreach are making a positive difference. The results of this project will help us to make adjustments and modifications to the teaching materials and methods in order to guarantee effectiveness.

The women in Dona Antonia are a unique group and are a rare community asset. The community of Dona Antonia is in great need of health interventions and health education since they suffer from many preventable ailments and do not have a local clinic or access to other programs. Dona Antonia is blessed with these dedicated women. Without the Capstone Fund Award, the completion of this project would not have been possible nor would I have the ability to support the women in the wonderful work they are doing. It is not typical that a PCV has the opportunity to assess the effectiveness of his/her efforts. Furthermore, it is not typical that a PCV has the opportunity to work with such a dedicated community group that vows to continue and sustain the programs and work the Volunteer began. Because of the Funds Award I was able to work once more with this incredible group to assure that their hard work is making a difference in Dona Antonia. These women deserve to learn and to have opportunity to increase their health and quality of life. With this Award I was able to provide snacks during each meeting, interview materials, calling cards for them to call me in the event they had questions or problems, money for transportation to the post office and money to mail me the interview materials. Furthermore, I was able to share with each of them remuneration for their dedication, time, and hard work. We were all extremely grateful for the experience this opportunity provided us!