(packing for orientations.  Lord help(ed) us.)

(Bear with me, this happened about a month ago :)  But I should be keeping a better record of what I’m doing research-wise, so here ya go!)

Quick recap:  my main Fulbright research is a Department of Health-funded study on worm infections in adolescent females and pregnant women.  My role in the project is volunteer research assistant, while my advisor is the principal investigator.  Because our project requires the parasitologic assessment (read: looking in poop for signs of worm infection) of thousands of participants (4,750 to be exact), we need a lot of assistance; hence we have to train and orient local health workers in each of the six project sites across the Philippines to do the field work necessary for the study.  

The first two training/orientations for the project were scheduled for May 12th and 13th in Tacloban, Leyte and Cebu City, respectively.  The other two research assistants and I stayed up till 10 the night before preparing the materials necessary for the training and orientation.  It’s an epic task, since we also have to prepare the materials needed for the duration of the fieldwork.  Thus, we had to distribute laboratory materials, consent forms, reference materials, etc. to separate bags for the medical technologists and nurses, then pack the bags in a balikbayan-sized box.  It’ll be a miracle if I ever learn how to tie crazy-good knots like Filipinos do here.

I got up at three in the morning the day we left for Tacloban.  The other research assistant and I lugged the cargo to a taxi and headed straight for the airport to meet with the rest of the team.  After a sleepy flight, we were met at the Tacloban airport by Mr. Olobia, the soil-transmitted helminth (STH, or worms) program coordinator of the region.  It was pretty cool; after all those months of helping with preparation, I was finally sitting in the back of a pickup, heading for the first orientation and talking to DOH higher-ups.  Oh and I saw MacArthur’s landing, but I didn’t have my camera ready at the time (Doh!).

Fast-forward to the orientation itself; it was a bit nerve-wracking at the beginning, as everyone on the team is multitasking their butts off.  My main role for the orientations is MC, but I’m helping out whenever I’m not MC-ing:  preparing reference materials, answering participants’ questions/requests, debating on the sequence of activities with the rest of the team, etc.  And the heat was in full-force, which cast a sleepy air over the proceedings.  

But things kicked into high gear quick.  The orientations/trainings generally unfold as follows:

1. I (the MC) welcome everyone to said orientation/training and introduce the STH coordinator (in this case, Dr. Olobia)
2. The STH coordinator makes some welcoming remarks, then has everyone introduce themselves
3. Dr. Belizario (my adviser and principal investigator for the study) leads the orientation portion, followed by a summary of data collection activities given by Dr. Doy, an associate professor on the team.
4. The participants are then split into two groups:  the nurses and the medical technologists.  The nurses receive training on collecting stools from study participants and obtaining height and weight data (metrics for nutrition), while the medical technologists receive training on preparation and examination of stool samples for worms.
5. Participants reconvene for a logistics discussion led by the STH coordinator, in which they hash out how everyone will work together for the next few months.
6. Closing!  Everyone goes home with enough data collection materials to last a few months.  The whole shebang doesn’t take more than 3-4 hours.  Oh, and there’s lunch and merienda (Tagalog for snacks).

(Dr. Doy explaining the informed consent form, using visual aids I helped design)

(Dr. Doy, assistant professor, guiding nurses on proper height-measuring technique)

Not all of these things were in place at Tacloban; #5 (the logistics discussion) was a particularly brilliant bit of improvisation on Dr. Olobia’s part.  And we were still working on the transitioning from #3 to #4.  But things went off without a major hitch.

After the orientation, we made a quick pasalubong (read:  the Filipino practice of bringing back goods/souvenirs from the places you’ve traveled) run at the grocery, where I bought some sweets for my relatives, before catching the afternoon flight to Cebu.

(Dr. Doy and Fidel, co-RA, lookin’ tough.)

[insert flight nap here]

We got to our hotel in Cebu; once we settled in and grabbed a yummy Filipino dinner, Dr. Belizario called for a debrief meeting over a couple of San Miguels (ok ok, I had a banana shake — I don’t really drink hehe).  He paid me and the other research assistant a high complement — I forget the Tagalog word, but it means “light bodies.”  In other words, we were always working and anticipating possible needs, which he very much appreciated.  

The next morning we headed to the Regional Health Training Center in Cebu for the next orientation/training.  The series of activities basically followed the nifty outline I wrote out above, but the transitions were much more fine-tuned.  The other RAs and I became better acquainted with each other’s working styles.  And it was fun to assist Dr. Doy walk the nurses through the data collection process.  The nurses were clearly amused as they role-played in pairs, getting familiar with the process of explaining the study and consent to potential study participants.  And outside of the issue of obtaining “fresh stools” for the training of the medical technologists, the Cebu orientation/training went over smoothly.

(The kind and charming Dr. Erasmo, STH coordinator in Cebu City, leading the orientation.)

(role-playing!  so good.)

What struck me most about the orientations/trainings were the nuances of regional identity inherent to each place’s healthcare infrastructure.  Huh?    Basically, Tacloban/Leyte health workers go about things in a much different manner than health workers in Cebu City.  Healthcare in the Philippines is highly decentralized, which means that, while there is a central Department of Health issuing administrative orders and the like, local government units have a lot of flexibility in how they implement said orders.  At the orientations, it was clear that the medical technologists and nurses had their own region-specific preferences when it came to working together; even group personalities and qualifications were different from place to place.  The variety is definitely in keeping with the kaleidoscope of colors that is the Philippines.

After the Cebu City orientation/training, there was another pasalubong run.  I look for my prized Cebu mangos (tasty and cheaper than if I get them in  Manila) and bond with the other research assistant about the past few days and work in general.  And that was that: dalawang bagsak (Tagalog for “two down”), four more training and orientations to go!