Leilani has been living in Teotitlan del Valle with the Chavez family and volunteering at the public health clinic. She has two weeks remaining of a four-week summer externship program that is part of the UNC Chapel Hill School of Nursing global health education curriculum. Because I work at the university, I was able to help arrange this learning experience for her and what she is learning is hands-on, on-the-ground public health nursing. The take away message: not all definitions are the same when interpreted from different cultural perspectives.
Leilani is experiencing public health intervention and education. She happens to be there during one of the three times during the year — February, May, September — that vaccination campaigns are underway. With her co-workers, clinic doctors and nurses, this week Leilani spent three days walking the hillside village of 7,000 people to administer vaccines. On another day, they drove to the highlands to remote mountain villages to see people. “We are working on keeping everyone vaccinated,” she reports. So many who need vaccines are children. Leilani noticed that people are not always eager to be vaccinated and she surmises that they don’t totally understand the benefits. Even with local health care providers doing the explaining, there is a lot of resistance, according to Leilani, who wonders how much people still rely on folk traditions to drive their decisions. In a relatively prosperous village like Teotitlan which has one of the highest standards of living in Oaxaca because of their national rug-weaving reputation , this is not really surprising. There are other barriers to accepting health care technologies — many of the older, traditional people still only speak Zapotec as their sole language.
In the last week, Leilani helped around the clinic, worked with patients who needed their vital signs, height and weight measured before seeing the health professional for a consultation. She changed out the sheets and medical instruments in the consultation rooms. Leilani reported that she cleaned the instruments using a mix of bleach and detergent, then wrapped the instruments in paper as instructed. Her supervisor explained that this was to keep them “sterile.” This was not the definition of “sterile” that she was used to working in the U.S. health care system. She wondered how the word “sterile” translates differently from one culture to another?
Her co-workers are friendly, warm and gracious. They tease her about her curly, thick hair and plaster it down with cream to make it more “work appropriate.” They laugh and sit around the kitchen table sharing stories about life in Mexico and the U.S. “I really like going to the village market,” said Leilani. “We usually make a stop there when we’re walking around the village to give vaccinations. I love the dulces, and I want to try some chapulines!”
Oaxaca dulces (sweets) are delicious, and chapulines (spicy, fried and ground grasshoppers) are a taste treat condiment that tops tacos, enchiladas and soups.
Learning Documentary Filmmaking in Oaxaca & Bringing It Home
During the week we learned how to make documentary films based in the village of Teotitlan del Valle, our instructors Erica Rothman and Mikel Barton kept reminding us that the experience was more about the learning process than in making a polished finished product. We reminded ourselves of that over and over (our instructors did, too) as we were challenged by what came our way. I learned how important it was to shift, flex, adapt, and stay focused. Others who attended would have their own experiences.
What story would I tell? Would it be specific enough? How quickly could I learn, let alone master, the editing software? Would my Spanish be sufficient to enable me to ask impromptu follow-up questions of the person I was interviewing? Would I be able to go deep enough to tell a compelling story with the help of a translator? Can I operate this hand-held video camera without it shaking? Am I going to get the right b-roll? Will this story be interesting enough? Is there enough action? How do I make subtitles?
The film we made will not win us an Academy Award. But, that was not the point! The point was to learn enough to come home and know how to create a documentary film in my own community.
Today, I met with directors of the UNC Chapel Hill School of Nursing Biobehavioral Observation & Nutritional Evaluation Laboratory to tour the facility and discuss donor naming opportunities. What they do is fascinating. In a home simulated environment, nurse researchers study the interaction between infants and mothers to determine how early cues influence feeding and early onset of obesity. Other researchers look at the interaction between depressed mothers and children and how psychiatric mental health treatment can bring about behavioral change in the quality of those interactions. Other faculty are studying the feeding behaviors of frail and/or demented elders. Nutritional deprivation in hospitals and nursing homes is significant because of the time it takes for elders to eat. Another nurse researcher is looking at obesity in children, especially Latino children, and is using the laboratory to capture and assess findings.
What is learned in all the studies will be used to train parents, patients, family caregivers, home health and long-term care workers, aids and medical professionals. Faculty and graduate students can also be trained.
This is an exploding area in health care education.
Behavior is videotaped in the Observation & Nutritional Evaluation Laboratory, then scored according to a recognition system to validate what behavioral characteristics promote or detract from good health. Researchers modify packaged systems for specific health behaviors. Video is really important, one director says. It is minimally invasive and helps to see and examine behavior and environmental interaction. They also know that there are behavioral and biological interactions. Body chemistry changes depending upon the environment. They have learned through these studies that both behavior and biology can change.
My wheels are clicking! They have videotaped footage (b-roll). They have a professional videocamera and film editing software. They have people power who know how to do this! We need to conduct interviews with faculty and subjects, and voila, we’ll have a documentary! I propose this to them and they’re excited. This is what it means for me to bring it home!
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Posted in Cultural Commentary
Tagged biobehavioral laboratory, documentary filmmaking, nursing, nutritional evaluation study, UNC Chapel Hill School of Nursing