Understanding A Community's Needs

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Understanding A Community's Needs

A staggering 85% of the world’s Young People Living with HIV (YPLWH) live in Africa. While HIV is a treatable disease thanks to antiretroviral therapies (ARTs), only 50% of YPLWH in Africa are virologically suppressed. This is largely due to huge stigma surrounding the disease, which results in mental stress and prevents people from seeking help.

At the Duke-KCMC (Kilimanjaro Christian Medical Centre) collaboration in Moshi, Tanzania, 3^rd year Duke-NUS medical student Dana Chow works with youth leaders to change that.

“There is a link between mental health and ART adherence,” said Dana. “The large burden of mental health issues in Tanzanian youths, compounded with the lack of mental health resources available, leave YPLWH in a vulnerable position.”

Dana is spending her Year 3 research term in Tanzania as part of the Sauti Ya Vijana, or The Voice of Youth. This is a mental health intervention that aims to improve health outcomes in YPLWH. It does so by providing support for affected youths to improve mental health, increase antiretroviral therapy adherence, and therefore decrease HIV viral load.

The Duke-NUS Kilimanjaro Christian Medical Centre

Being in Tanzania was something like a dream come true for Dana, whose long-time experience in community service led her to an aspiration to pursue medicine and humanitarian work.

“I truly believe that when trying to help a particular community, it’s important to be immersed with the people and the culture first to fully understand the context and their needs,” she said. “I wanted to avoid the whole White Saviour* element that is so common in Global Health, and that’s why it was so vital to me that I was able to be here physically with the locals, whom I can meet and learn from.”

While looking for a project on her joint interests in Global Health and Paediatrics, she managed to reach out to Dr Dorothy Dow from Duke University, who agreed to take her on as a mentee.

“You have no idea how much I’ve wanted to do this,” said Dana. “After securing a position in Dr Dow’s project, I had to seek the relevant approvals from both Duke-NUS and my mom. I honestly can’t tell which one I was more afraid of!”

The gratitude she feels at being able to be part of this project is clearly felt in the way she speaks about her mentors and her family. “Everyone was so supportive of my interests,” she says, “and I really am so incredibly thankful for that.”

“When trying to help a particular community, it’s important to be immersed with the people and the culture first to fully understand the context and their needs.”

- Dana Chow, Duke-NUS Medical Student

Dana’s enthusiasm for the cause is equally infectious as she details the issues that Sauti Ya Vijana (SYV) is tackling. Adolescence in general is a complex period of huge hormonal and physical changes and ongoing brain development. During this time, adjusting to social environments, peer networks, and fitting in become priority. On top of the many changes that youths experience during adolescence, YPLWH have to cope with the added burden of living with a hugely stigmatising disease with minimal familial or social support. In the SYV intervention, Dana works to listen to and provide support to such youths, studying the relations between mental health, HIV stigmatisation and increased antiretroviral therapy adherence.

When asked about how life is in Tanzania, Dana cites how things are very different from Singapore, but also notes that these differences have been a great source of learning and reflection. Conversations with Tanzanian youths have given her added perspective into their struggles with employment, but has also inspired her with the creative ways in which they make a living. Working with doctors in low-resource settings has taught her to be grateful of the resources available in Singapore, and more conscious of disposable waste in medical settings.

“While there have been several emotionally heavy days after encountering certain patients or situations, it amazes me how much doctors are still able to do with so little,” she said.

Dana’s experiences doing a Global Health-focused research project have shown her that public health policy work can have far-reaching impacts in global settings, and that compassion is crucial to transforming someone’s life for the better.

The youth leaders Dana works with at the Sauti Ya Vijana

“I hope to bring compassion with me to every patient I meet in the future, whether in Singapore or elsewhere,” said Dana. “At every corner if we just pay attention, there are always opportunities to give a little more to others and take a little less. I’m sure that this is just the beginning of my global health journey, and I’m excited for what’s to come!”

* White savior complex is the term used to describe privileged people providing aid to communities they deem disadvantaged. It can refer to any person or group – regardless of race – possessing an imbalance of power or privilege.