For the past few months, I have been conducting research on the prevalence of community-acquired urinary tract infection and current trends of E. coli antimicrobial resistance within the Burj al-Barajneh region of Beirut. Our team, comprised of individuals from both UC Berkeley and the American University of Science and Technology, represents a diverse background of expertise. The faculty here has been more than welcoming, and is excited about working with Dr. Lee Riley on this and future projects concerning slum health realities and potential solutions among the refugee communities here in Lebanon. This is the very first time AUST has been involved in a project with an international exchange student from the United States.
Our team has made significant progress since beginning in mid-May. Despite many challenges, we have persevered, and are well on our way to collecting all the required surveys and urine samples to complete our work. One of the most challenging aspects is the high rate of antibiotic self-medication, which not only accelerates the development of hazardous antimicrobial resistance, but also reduces the number of individuals who seek conventional healthcare from clinics and hospitals where we are recruiting participants. The lack of governmental oversight allows for illegal sales of medication without a doctor’s prescription, with many individuals opting to bypass physician visits entirely. Burj al-Barajneh is plagued with slum conditions due to the massive influx of Syrian refugees since the beginning of the Syrian conflict, leading to crowdedness, inadequate sanitation, and systemic poverty. This has led to an interesting population composition, as Burj al-Barajneh is inhabited by all three populations: Syrian refugees, Palestinian refugees, and Lebanese natives.
This project has truly laid the groundwork for future academic collaboration between UC Berkeley and the universities here in the Middle East. We have established relationships with key stakeholders in the region who are invested in the health and wellbeing of Syrian and Palestinian refugees, first and foremost of which is Amel Association. Amel Association works with victims of crises residing in Lebanon, and offers healthcare, psychological care, and vocational development for its patrons. I look forward to continuing the work we have begun here in Lebanon, both for the duration of the summer and in the future.
Photo: Agatha (research assistant), Dr. Omobola Mudasiru (UC Berkeley post-doctoral fellow), and myself en route to conduct a survey at a participant's home
It’s hard to believe I’ve already been in Shinyanga for two months! This summer has been a wonderful opportunity to expand my professional/leadership skills and to gain experience working in a resource-limited setting.
I’ve really enjoyed living and working in Shinyanga. The people are so warm, but it is clear that significant barriers prevent people in Shinyanga from receiving medical care, and in particular, HIV care. A huge stigma still surrounds HIV, and this stigma deters people from getting tested, sharing their status with their partners, or seeking HIV care. Additionally, we are conducting our study at a large regional hospital, and many people avoid the hospital because it is rumored to be a death sentence. Even if people can find the money, transport, and time to receive HIV care at the hospital, they spend an entire day with 300 others waiting to see a provider. These are just a few of the barriers people in Shinyanga face, and the surveys we’ve been conducting have highlighted many more.
Since I'm not working on primary data collection (due to language limitations) but rather focusing on management and data analysis, it's tempting to occasionally disconnect from what I'm studying and feel like I have a regular office job. However, I'll be working on the survey and code a question about whether you can't make it to the clinic because your partner hasn't given you permission or if you ate less food this month because you didn't have enough money or if you've been beaten by your partner recently. In this moment I am instantly reminded of where I am and what I'm doing. On top of that, our office is located within the Regional Hospital, and every couple of days I hear heartbreaking screaming from family members who are devastated when a loved one dies. It can be a lot, but I’m so thankful to have worked in Shinyanga this summer and to now better understand these barriers to HIV care.