CUSLAR, Global Health and ANDA: Service-Learning in the Dominican Republic

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Presentation at Cornell University Latin American Studies Conference
February 19, 2016

Tim Shenk, Julia Smith ’16, Michelle Valentin ’16, Anshu Gaur ’17.

Tim Shenk

Good afternoon. Julia, Michelle, Anshu and I will share briefly about the summer service-learning collaboration in the Dominican Republic involving the Cornell Global Health Program, CUSLAR, the Committee on U.S.-Latin American Relations, where I am the coordinator, and our primary Dominican partner, ANDA, a holistic health clinic run by Dr. Angel Pichardo in the marginal Simon Bolivar neighborhood of Santo Domingo. For eight weeks, Cornell students do clinical shadowing, work on research teams with Dominican students, engage in critical reflection and live with host families. My co-presenters participated in the program last summer, and Julia is the TA for this summer’s group.

I’ll start by sharing about the origins of the program. Julia will speak about service-learning, and Michelle and Anshu will discuss their summer research.

Our collaboration is entering its third year, but the relationships that have made the Global Health program in the DR possible go much further back. I insist on telling this part of the story because getting the history right can give others a more realistic picture of what it might take to develop other community-engaged student programs.

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This program, then, began with relationships that Alicia Swords, now at Ithaca College, and I have nurtured and been shaped by — in her case for 20 years and in my case for more than 10. Alicia’s summer sociology program in the DR, which ran from 2007 to ’10, has provided essential lessons that we’ve used to build the current program. Our colleagues in the DR, Angel Pichardo and Lucero Quiroga, have been central protagonists as well, mentoring us, sharing their connections, and developing shared values and commitments in working together over many years. In my view, trusting relationships with partners are fundamental to programs’ success and longevity, especially outside the US.

Another key is institutional support. Becky Stoltzfus and Jeanne Moseley at Global Health have been phenomenal in building this program with their expertise and putting a significant emphasis on reciprocity, which Julia will touch on.

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Alicia and my work in global service-learning has been shaped by a concern that US student programs in the global south can easily turn into a sort of intellectual resource extraction. Her work with Cornell’s Richard Kiely has produced the concept, “movement-centered service-learning,” which acknowledges the importance of stakeholders beyond our students and our learning objectives. If we’re committed to transforming inequalities in the world, we must consider how our programs can strengthen the capacity of communities and partner organizations to achieve justice and equality.

Julia will speak to how we and our Dominican partners have begun to put this objective into practice.

Julia Smith

When I first applied to this service learning program, I was certain I would have plenty of opportunities to learn— but it was unclear to me what service would mean. Before my involvement with this program, I always pictured service as something tangible—a contribution that that would leave a lasting mark of my commitment to help.

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All the student participants in this program have a similar desire to help. The global health minor attracts students who see the global status quo as unjust and want to work in a field where the focus is in people, not profits.

Although Tim led us to define and redefine service in the months preceding our trip, I did not truly understand what service we were achieving until we were well into our eight-week stay.

In the context of our young program, a significant part of service is contributing to the strengthening of our existing relationships and the building of new ones.

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We see “service as relationship building” as a central theme of our program. Without these strong relationships and a deep understanding of community needs, other acts service would have been superficial—serving the egos of the volunteers instead of the true needs of the community.

However, we also view service as something transformative. This year, we want to expand on our model of student action research in a way that will truly benefit the community of Simon Bolivar. We will select topics that reflect community needs and include educational events and workshops as part of the projects.

We continue to ask, how can we ensure that our partners are benefiting from this program as much as we are?

This past fall we invited 12 of our undergraduate research partners from Santo Domingo to Cornell to begin this journey of reciprocity. During their 10 day visit we aimed to return some of the immense hospitality they had offered us in Santo Domingo.

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I used to see service as something that would leave a lasting mark. Although unconventional to the mainstream understanding of service, the relationships we are continually building through this program are certainly a lasting mark of our commitment.

Michelle Valentin

As a student researcher at La Universidad Autónoma de Santo Domingo, I designed and conducted a qualitative research project, focused on the effect of nutrition on the progression and treatment of cancer in female patients. The patients that we interviewed for our project described themselves as having a “Dominican diet” high in saturated fats and carbonated drinks, revealing that a person’s culture can affect their eating habits and expose the body to disease.

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Interestingly, we observed that once a patient is diagnosed with cancer, their physicians rarely advise them to modify their diet, and suggest dietary changes only if the patient has co-morbidities that affect their digestive system.

From these findings, it can be seen that more health experts and physicians are needed to provide the general population with the necessary tools and knowledge to improve their lifestyle and avoid preventable diseases. The findings from my research project could serve as a stepping-stone for the development of culturally appropriate dietary interventions and hospital policies that underscore the importance of an improved dietary regimen rich in fruits and vegetables.

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Anshu Gaur

Our research project on diabetes began as a common interest among 4 people. Myself and Julia from Cornell. And our Dominican counterparts. Scarlett, a pre-medical student and Shaila, who studies architecture.

We met at the local university for a class on Community Based Research taught by Dr. Pichardo. We started with a concept map on diabetes, an illness that affects 11% of the Dominican population. Our research was on Lifestyle Factors and Perceptions about Type 2 Diabetes in Santo Domingo.

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The chance to work with Dominican students was a huge advantage.  Not only was their familiarity with the region and culture helpful – in terms of how to get around and communicate with others – but also their relationships in the community.

After conducting interviews, we found that patient’s knowledge about diabetes correlated with their delivery of care, with those receiving private care that provided education having a greater understanding of the disease. Most people did understand that lifestyle factors such as nutrition and exercise do play a role in diabetes, however people had different ideas about the optimal diet for recovery. Economic constraints and food accessibility were also a factor in people’s dietary habits. People tended to understand long term complications mostly in terms of what they had experienced personally.

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Through our efforts, we learned how to communicate in a foreign context, but most importantly how to listen. As we spoke with people, we found the richest conversations were not the ones in which we stuck to the script, but the ones in which we moved with the flow of the conversation. It is amazing to think that when our research group  first met, we struggled to hold a conversation, speaking in fragments of English and Spanish. Coming up with a comprehensive research question was a milestone in our progression, as our different ideas clicked into one cohesive theme. This was the first sign that we could collaborate and work together, no matter how different our backgrounds may have been.

Looking ahead, we look forward to collaborating more across Cornell to continue to improve global service-learning for students and partners.

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