“Olympic Games” in a small Peruvian town
This summer I went to Peru with my research group to conduct 10 weeks of field research examining the influence of family income and food prices on obesity rates in the country. We visited 11 communities, conducting household interviews and surveying food market prices. However, those 10 weeks were about far more than research. We travelled to different areas to experience local life and communicate with local people, learning first-hand many valuable things that provided insights for my research.
One particularly interesting week was at the end of June, when our research group drove for 8 hours to the small, remote town of Itahuania. We stayed there for a week, managing, as the locals do, with limited tap water, no electricity, and no cellphone signal. We ate the same locally-cooked food every day, bathed in the river and slept on the floor of the clinic. Despite the circumstances, it was a wonderful week which I will never forget. We visited the primary school and the kindergarten in that town during the day, teaching students how to wash their hands and brush their teeth. We explained the components of a healthy diet, and distributed toothpastes and toothbrushes to students. At night, we collected mosquito samples to monitor dengue fever.
What impressed me most during that week was the annual sports event at the primary school, the “2015 Olympic Games”. We arrived in town two days before the meet started. We saw hand-written banners and posters around the town advertising “Itahuania 2015 Olympic Games”, but we had no idea about these games until the nurse in the clinic told us that there would be a sports meet on the weekend and students from other towns nearby would also come to join in.
These “Olympic Games” are one of the most important community events in the area. Hosted by a different primary school each year, to our luck this sports meet would be hosted in Itahuania this year so that we could experience it ourselves. Everyone in town, children and adults, had been preparing for the sports game for months.
By Friday, the Olympics had become the only topic that people in town talked about. All student athletes and teachers from other towns came one after another. They camped beside the playground, cooked simple food that they had brought with them, and bathed in the river. Most of them wore plastic slippers. They ran, sang, danced and laughed loudly, even though the living conditions were harsh. All members in my group were excited by their happiness and could not wait for the event to begin.
In the early morning on the day of the event, we went to the playground at the primary school. What surprised us was this so-called playground. The school used tons of sandy soil taken from along the river to grade the land into a temporary playground. The soil was mixed with stones, sticks and even dead fish. Most of students ran without shoes because they could not afford to buy a pair. We also tried to run without shoes on that playground so we could understand how painful and uncomfortable it was, but it seemed that nobody cared about the playground or shoes except for us.
Every player was so confident and tried their best. For local players, all their family members came to school to cheer for them. There were only different running races that morning, but my group members joined in an informal soccer game before we left. All girls, boys, women and men played together excitedly, making gender, age or nationality meaningless at that time.
These “Olympics Games” not only showed me a picture of local life, but also gave me a new idea on how to promote a healthy lifestyle. I was impressed by how a child-focused event could provide physical activity for the whole community, and how children could have positive influences on the whole family. It may be a good research and intervention method in global health to take the family as a unit, focusing on children and encouraging children to affect the whole family. In addition, more public sports activities should be organized for communities, considering their interests and availability and reducing disparities between genders.
Unfortunately, I also saw some “unhealthy” practices at the event. For example, foods sold at races were mainly candies, sodas, ice cream and fried chips, foods usually associated with excess calorie intake and obesity. Food availability has great impacts on food consumption in these remote towns. So one of solutions of reducing obesity is to provide communities with more affordable healthy food.
Doing household survey with field workers
Our group also visited another small town named La Pampa, one of Professor William Pan’s research sites. Prof. Pan has established a research network there, cooperating with a local hospital and is working on the relationship between mining, environment and health. Our main task during that week was to join the field workers to conduct household surveys and collecting blood, hair and nail samples from family members. All of the field workers are local Peruvians in their 20s or 30s, with relatively high education levels. Some of them speak limited English. They knew this town and each family very well and had a good relationship with them.
I joined a group of two field workers, and I learned a lot from their tremendous fieldwork experience and admired them very much. However, I was a bit impatient with their pace on the first day because we did not visit any families until 5pm. When we visited the first family at 5pm, only the wife and two young girls were at home. We introduced our research to the wife and wanted to begin the interview, however the wife insisted on waiting for her husband to come back home to begin the survey because she thought her husband was the one to represent the family. So we waited until 5:20 p.m. for him to come back.
The husband was very kind and talkative, so our survey went smoothly until we tried to collect blood samples from their two daughters. Both of the girls were very scared and did not want to cooperate with us. The father was a bit angry and required the two girls to participate in the blood sample collecting. The older girl agreed but the younger girl cried loudly and tried anything she could to escape. We spent about 20 minutes comforting the younger girl and she finally agreed reluctantly but was still crying.
It was about 6:30 pm when we finished this family survey. When we left, the field worker asked me whether I could understand why they went to families so late. I said yes. In the following few days I gained a comprehensive understanding of a field workers’ difficult schedule. They need to visit households in early morning (perhaps 6:00 a.m. or earlier) or at dinnertime, during which time most family members are at home, especially the head of the household who usually goes to work during the daytime.
However, their difficult schedule was not the main reason why I was impressed. What impressed me most was their enthusiasm about the fieldwork. They were happy and enthusiastic about their fieldwork every day. As a Global Health student, I know the great importance of field workers, so I tried to understand the reasons for their job satisfaction. I may be the PI for a project someday, so I am interested in understanding how to build a strong team of field workers. After talking to some field workers and my team members, I realized the great efforts Prof. Pan had made to build a such good team. First, he pays field workers a relatively higher salary and provides all the necessary trainings. Second, he visits his research sites regularly and communicates with his field workers. He is serious and professional, which earns respect from field workers. However, he is very easy-going outside work and maintains an equal relationship with field workers. They eat, drink beers and watch soccer games together. Prof. Pan also began to learn Spanish years ago.
This week not only refreshed my understandings of Global Health fieldwork, but also aroused my interests on some specific issues. For example, how can we truly inform and respect children during our research? Informed consent is always required before we conduct the family survey, and we usually talk to adults and get permission from them. However, sometimes adults ignore children’s opinions and assume they can genuinely represent children, which brings pressures and even pain to children. I suggest we highlight the necessity of reading and explaining the inform consent to children who have basic cognitive ability, and empower them with rights to make decision for themselves, rather than being represented by their parents.
By Wanbing Gu, Master of Global Health, Class of 2016