By Susan Gallagher
Each year, the Duke Global Health Institute hosts a photo contest to encourage students to reflect on their global health fieldwork and showcase some of the compelling photos our students capture during these experiences. This year, 22 students submitted a total of 60 photos, which were judged by a five-person faculty/staff/student panel. In addition to the judged competition, DGHI held a People’s Choice contest on social media, with the winning photo being the one with the most “likes” on Facebook.
Assistant professor Sumi Ariely announced the photo contest winners at the Global Health Research Showcase. In her comments, she told students that their art is an invitation for all of us to push the boundaries of our thinking and to push our understanding outside of our comfort zones.
Pictures are another source of information. Just like quantitative data, images are another type of reality that persist across time and help shape our understanding of the world. —Sumi Ariely
FIRST PLACE
“A New Pursuit,” by Rinchen Doma, Junior Biology Major
Judges Said ...
One judge commented that the health worker’s head not being shown highlights the fact that so much global health work is done by people in the field who are anonymous to the world but well known to their local communities. They—not the “big names” we read about—are the true heroes and heroines of global health. Another judge liked the photo because it doesn’t show people’s faces but communicates emotions with powerful colors.
About My Photo
Female community health volunteers (FCHVs) in Nepal primarily specialize in maternal and child health, so working on a hypertension project was a new experience for them. Nonetheless, after receiving training, they quickly adopted the techniques and used their extensive network to start a conversation regarding this non-communicable disease in their respective wards. As the FCHV was checking this woman’s blood pressure, local community members eagerly awaited their turn. Their presence can seemingly be felt through the peripherals of the photo.
Why I Captured This Moment
I simply wanted to capture a moment where an FCHV was confidently able to use the blood pressure machine and collect data. As FCHVs weren’t previously trained to take blood pressure, they were sometimes hesitant and confused while in the beginning stage of data collection. However, after some practice, they were able to successfully understand and use the machines. At this point, we did not need to step in and were only observing. I thought capturing the beginning of this journey would be valuable.
In global health, photography allows one to take a second to appreciate and highlight a certain moment or key people that are integral to executing a project or program that, due to the fast pace and constant adaptations, may be lost in the process.
About My Fieldwork
This Bass Connections project is based in two municipalities in Kavrepalanchowk district in Nepal. The long-term goal is to develop a digital-based mobile solution to manage blood pressure in hypertensive patients in rural Nepal. The goal of this fieldwork in particular was to gather data from the target population to understand the needs and challenges in the communities.
The data showed a high prevalence of hypertension as well as phone use in the areas. A majority of the participants were also eager to receive health education/awareness through their phones. However, due to the local context and abilities of the people, we noted a preference for a digitized voice call/message mechanism instead of a “smart phone application.”
Pictured at left: Rinchen (third from left) and her team.
SECOND PLACE
“Child Welfare Clinic Day,” by Maya Stephens, Master of Science in Global Health Student
Judges Said ...
Several judges commented on the brilliant colors in this photo. One judge remarked, “The composition and beauty of this photo cover the whole topic of immunization. The presence of provider and consumer of vaccine is well captured in a very natural environment. On the other side, you see the medical record process, which is very important for evaluating any global health project.”
About My Photo
The photo was taken at a monthly Child Welfare Clinic Day in one of the sub-districts where we collected data. Being able to observe the work of community health workers (CHWs) and community health nurses was the highlight of my fieldwork, as it allowed me to contextualize my research, interact with community members and truly observe the work these astounding women and men do for the community.
To the left, two CHWs are adding information collected from the Child Health Record into their community health records book. To the right is the community health nurse preparing vaccinations for a baby boy being held by his mother. As we sat observing, many mothers, fathers and family members brought their under-five children to be weighed and vaccinated. What you’re seeing here is true community health work!
Why I Captured This Moment
I was inspired to capture this moment because of its beauty and its embodiment of global health. From having a cold box to keep vaccines at the appropriate temperature to not having amenities common in the U.S., such as a computer or gloves, this day gave me a birds-eye view of everything I heard throughout my first year in the global health program. At this moment, my camera was able to capture the reality that health does not wait for development. To me, this photo tells a story of the reality of their situation but also the reality that global health is a necessary field.
About My Fieldwork
My research partner and I spent 11 weeks conducting research with Millennium Promise Ghana in order to examine the role of community health workers (CHW) in family planning provision in the Amansie West District of Ghana. To elicit personal-, household- and community-level factors associated with uptake, we collected 280 surveys and 33 in-depth interviews from community women and 30 in-depth interviews with CHWs.
I’m examining the perceived role and value of CHWs in promoting and sustaining family planning usage in this rural district. Preliminary data analysis has revealed that the perceived role of CHWs has been to deliver family planning as part of a broader health care package through household visits in an effort to link community members to government health services. The community values CHWs for their accessibility, confidentiality, approachability and impact on improved health outcomes. With further quantitative and qualitative analysis, I look forward to expounding upon these two main themes and more.
Pictured at right: Maya at one of her fieldwork sites.
THIRD PLACE
“Bringing Light to Birth,” by Beth Eanelli, Master of Science in Global Health Student
Judges Said ...
One judge noted that the stark contrast between the environment and this tiny new life under a light highlights the dangers and risks for neonates. Another judge remarked that this photo reveals the reality of health facility infrastructures in most low- and middle-income countries. Examining newborn babies is crucial, he said, but it’s almost impossible to conduct an examination without proper light.
About My Photo
In this photo, a health worker named Omar, who is the officer in charge of the Fatoto health center, inspects a newborn who was delivered an hour prior to this photo. The baby was born with asphyxia and the bright light of the We Care Solar Suitcase allowed him to assess her color as he provided air to her in her first few minutes of life. The Fatoto health center is located almost 50 kilometers on a dirt road from the nearest referral center and is one of the health centers furthest from the capital.
Why I Captured This Moment
When I took this photo, I had been traveling in the Upper River Region for almost three weeks, sleeping at clinics and observing night deliveries with the We Care Solar Suitcase. This case was particularly moving because the impact of the suitcase was apparent in how Omar, the health worker, was able to care for the newborn in assessing her and providing care. I was also moved by Omar’s attentiveness and his work ethic in the clinic, where he lives and attends to all patients in the district who come at any time of day or night. (NOTE: I waited until the baby was stable and breathing normally before taking the photo.)
When photography is ethical, it has the power to share a narrative of health disparities that may otherwise never be seen. There are issues of health inequity as well as triumph over these inequities globally and it is not until we share these stories of challenge and success that we can begin to close the empathy gap and ensure that all people, everywhere, understand health as a human right.
About My Fieldwork
I spent my summer looking at the potential impact of the We Care Solar Suitcase, an innovation targeting maternal and infant mortality by providing reliable light in labor wards. I was based in The Gambia, and I traveled to various regions and clinics that had the Solar Suitcase to interview the health workers who were using the technology and investigate how it impacted their quality of care and work. In observing the suitcase, it was apparent that the impact of light on a health workers’ quality of care is incredible and health workers consistently used the Solar Suitcase as a reliable source of light, even when a clinic was located on the electric grid.
Pictured at left: Beth and Omar, a community health worker who was her counterpart during her Peace Corps service several years ago, where they worked on maternal and child health interventions in a community about 30 kilometers from Fatoto. He currently works at another health center nearby, and he came to visit Beth in Fatato.
PEOPLE’S CHOICE
“Comfortable with Being Uncomfortable,” by Stephanie Jaffe, Junior Global Health and Public Policy Major
About My Photo
This photo was taken during a workshop in which we were explaining the concept of “being comfortable with being uncomfortable.” Sexual and reproductive health can be an uncomfortable topic to discuss, and even harder to market to strangers. Aside from being a fun bonding exercise, the goal of this activity was to purposely make participants uncomfortable to mimic these conditions and give tangible form to this concept. Amidst the more serious conversations about marketing strategies and reproductive health information, these ambassadors seemed to have fun after overcoming their initial shyness. The other coordinators and I had fun as well!
Why I Captured This Moment
I was inspired to capture this photo because I was proud of my ambassadors for putting forward so much enthusiasm and bravery in stepping outside their comfort zone. While some of the students were naturally more outgoing than others, all gave their best effort, and the activity ended up being a fun bonding moment as well as a learning experience. Afterwards, all of the ambassadors were more open to participating and sharing their ideas on how to market askNivi, and my hope is that the activity improved their experience in talking to their peers in school about sexual and reproductive health.
Photography is an effective way to give visual context to a global health project. Photos can help humanize a subject across the world and remind viewers that global health is not just about numbers and statistics, but individuals. Giving a face to an intervention can help connect people to the situation on a personal level and remind the audience of our shared humanity.
About My Fieldwork
This past summer, I was based in Nairobi, Kenya, and I worked for a company called Nivi, co-founded by Duke Global Health Institute assistant professor Eric Green. I was involved in marketing the product askNivi, an online platform for providing free information about sexual and reproductive health and free family planning screenings. I helped to create a trial campus ambassador program to market this product to university students and designed workshops in which we provided leadership training and marketing training and facilitated conversations about the importance of sexual and reproductive health.
Pictured to right: Stephanie facilitates an AskNivi training session.