Tuesday, June 23, 2009


Hey y'all

I had my first encounter with a Texan cowboy on campus today, he had the hat, the boots, and even said "howdy" to me. :)

Yesterday was the third part of the Monday Lecture Series. Dr. Blanca Restrepo spoke on the correlation between Diabetes and Tuberculosis. Texas has 10/100,000 TB cases and the state of Tamaulipas in Mexico has 45/100,000 TB cases. TB is a disease without borders and needs to be controlled on both sides of the border. The Rio Grande River may provide a boundary between the US and Mexico, but it doesn't prevent the spread of disease.

A few TB stats:
-there are 8.8 million new TB cases a year;
-every 19 seconds someone dies from TB;
-1/3 of the world population is infected with TB.

Diabetes is the first non-contagious disease to be given a pandemic level title. Diabetes occurs across the world and has only hightened due to urbanization. Movement from rural to urban creates health altering lifestyle changes. Individuals who used to farm and live from the crops off their land are now purchasing food in grocery stores. Also individuals who used to depend on walking as their key mode of transporation now have urban transportation.

Dr. Blanca Restrepo's research shows that Diabetes is a contributing risk factor to TB. She is researching whether individuals with Diabetes are more infectious and also if individuals with Diabetes are more prone to TB. An interesting finding is that individuals with Diabetes and TB are more likely to have Multiple Drug Resistant TB, but not because they're not compliant with drug therapy, there's something unique to Diabetes.

I understood everything thus far, then Professor Restrepo started talking about flurochrome, primer, loop, stem, target, PCR, mutation, strains, isolates, beacons, CAC, TTT, GTC, and GAG... I got lost somewhere amongst all of the microbiology terms and figures.

By the end, all I got was "those who are naive are more likely to be susceptible to TB." Hum, I think I missed something, there were some letters before "naive," but maybe this is why health education is so important. So there ya have it, the correlation between Diabetes and TB proves the importance of health education, ta-da!! :)

This lecture in combination with the diabetes class for patients that I've been attending on Tuesdays at the Health Center have made me realize the extreme importance of understanding, preventing, and maintaining diabetes!

Monday, June 15, 2009

Tu Salud ¡Sí Cuenta!

Your Health Matters!

Today's Monday afternoon lecture was on the Community Based Participatory Research (CBPR) method. "CBPR focuses on involving researchers and community representatives in all phases of a research process. The joint effort engages community members, employs local knowledge in the understanding of health problems and the design of interventions, and invests community members in the processes and products of research. In addition, the collaborative is invested in the dissemination and use of research findings to improve community health and reduce health disparities." [CDC-PRC Program, 2007] Working with the community, the two major issues that were raised as a part of were physical activity and healthful eating.

Brownsville, TX is a very unique community. In the city I grew up in and many other cities, individuals going door to door is generally not receptive in the community. At home, people going door to door are either Avon sales ladies, the newspaper girl asking for her dollar, or religious groups such as Jehova's Witnesses. For the first two groups you may answer the door to say thank you but you're not interested and for the last group, at least in my home, we'd turn off the lights and pretend no one was home. This community is different though, much of the door to door interactions are accepted here which makes for a great health education method. Promotoras (community health promoters) go out into the community with various health materials as a part of the Tu Salud ¡Sí Cuenta! project.

Tu Salud ¡Sí Cuenta! is involved beyond the door way also. They run television health segments, radio novelas, newspaper articles in the Brownsville Herald, and monthly newsletters that are passed out door to door as well as at health centers. All of these materials include healthier food options, ways and locations to exercise, community role models, and public health professions and experts.

Here's some health stats that has come out of the research that's been done here... this shows how much there is to do with health here, and if these problems are now, that means things will more than likely get worse for a generation before they'll get better. 37% of the U.S. average is obese compared to 52% obese in Cameron County. The county has a 9% extreme obesity as compared to the national average of 4.5%. Only 16% of Cameron county is normal weight. Interesting stat: 27% of Texans speak only Spanish, here in Brownsville 87% speak only Spanish.

Also interesting is the high unemployment rate here, which has been fairly recession resistant, due to the lower paying jobs, works to encourage health here in the Valley. Since such a high number of women do not work here, they are more easily reached by health educators. They and their families, since most of the women are in charge of the health of their family, can take advantage of health improving activities and trainings that occur mostly during the day time or early evening.

And final side note for this posting... Theories make so much more sense in context and when they can be seen in use within community health programs. I finally understand the importance of being theory based. This internship is really helping my to apply this past year of classes... I guess that's the point of an internship :)

Thursday, June 11, 2009

I'm Moving!

To Historical Brownsville!!

Before I moved here to Texas, I'd been looking for housing, something other than the dorms, but found relatively few possibilities. The dorms here on campus are fine, although quite creepy and never lacking in bugs, but they're very expensive for a little room and no access to a kitchen. But exciting news... someone down here is looking for a house sitter from June 24 to August 14, which is perfect!! So I'll be moving into their home with two other interns and enjoying the high life, we'll have a washer and a line to dry clothes on, a dishwasher, a kitchen (complete with stove and sink), a screened in porch, and a bathroom with a jacuzzi. We're living there for free in exchange for keeping an eye on their place, taking in the mail, and watering their plants and trees. I couldn't have found anything better!

FYI... Texas has way too many creepy-crawlies, I've seen way too many cockroaches, a scorpion, and lots of large spiders, gross!!

I'm now trained in anthropometrics. Ooooh ahhh, yes it does sound impressive, but really it's just that I've been trained how to take height, weight, hip, and waist measurements correctly. I know, i know, not as exciting but as far as research goes it's fairly important to measure people correctly. And a fun side note, I've grown. I'm now 162.6 cm tall, yay 5 feet 4 inches. I'll be collecting all of this data from individuals in the community in the near future for a study that one of the professors is doing here.

Also this week, a friend from University of Michigan and I met up for dinner here in the Valley. She's been living in the Valley for a few years now, working down here. It was great to have someone from home here. I'm beginning to really enjoy my time here in the Valley, all of the unique cultural, linguistic, and even temperal differences here.

Well y'all take care, it's a beautiful Saturday here and I'm headin' off to the beach to do some swimmin' and sunbathin'. FYI... Texans talk funny :)

Tuesday, June 9, 2009

From Texas to Mexico and back again

Today started with the second session of a Diabetes class. This class focused on nutrition for individuals living with diabetes. We focused on the importance of eating balanced food (el plato balanceado). This focuses on a 1/4, 1/4, 1/2 plate portions. Bread, starch, and grains should fill 1/4 of the plate, meat and other proteins should fill another 1/4, and lastly vegetables should fill the 1/2. Fruit and milk/calcium should should also be eaten. We also discussed the importance of reading food labels, watching especially the sodium (sodio), carbohydrates (carbohidratos), fiber (fibra), protein (proteina), fat (grasa), and calories (calorias). Along with the plastic fruits and vegetables on the table were vials filled with the fat, sugar, and sodium in commonly eaten food.

Wow were some of those disgusting!! Especially the double cheeseburger, the vial was filled to the top with a very gross spoiled milk colored, pudding consistancy, yuck that was supposed to represent fat. After discussing what not to eat, we turned to what is good to eat, including fiber, omega 3, and the importance of water (especially down here in Texas!).

For the afternoon, I headed over to Mexico, which is really just a hop, skip, and a jump away (and maybe a few steps too). We went to a filming studio to watch as they filmed sections of a morning talkshow that happens on channel 7 (here at least). These sessions are a part of the Tu Salud, Si Cuenta! (Your Health Matters!) promotion which focuses on healthy food and proper food portions, exercise, and general healthy living. They bring in professionals and community members to share their health stories. It was really cool to see the filming of these shows. Following we went to eat gorditas. They are quite delicious, mine had queso and nopalitos (cactus) in it. Cactus has 5.6 grams of fiber in it, who would have known. This is more fiber than a banana (2.4 grams), bran flakes (4.0 grams), and shredded wheat (3.0 grams). Though Fiber-One beats it with 11.9 grams. But cactus is much more tasty than Fiber-One.

For those interested, cactus tastes a bit like a mix of green pepper and okra and kinda like canned green beans. It's slightly slimy, but not enough to be disgusting and has a crunch to it as cooked green peppers do. It's often cooked up with other spices and vegetables. If you have the chance to try it, I certainly encourage it, yum!

Monday, June 8, 2009

Texas Sun


Friday, after finishing our first week as interns, all of the interns and I went out for some local dinner. We've been asking around for the best, local restaurants and different foods to try. Recently, I've tried nopales (cactus) and it's quite delicious. We still have a list of restaurants that we've been told to try, both in Brownsville and "on the island." "On the island" refers to South Padre Island, which is about a 30 minute drive from Brownsville. It's a rather touristy area, but many people in Brownsville go there for the beach.

Saturday, I went to see the Brownsville Farmer's Market. The School of Public Health (SPH) just started this Farmer's Market this year as a way to educate the community in an attempt to change the city's and county's growing rate of obesity. They are also able to offer $10 vouchers to encourage lower-income families to eat healthy and create healthy lifestyles as a part of the Tu Salud, Si Cuenta! (Your Health Matters!) program. The Farmer's Market wraps up for the season at the end of June, since the major crop season here is coming to an end as it is getting hotter and hotter. Afterward, a group of the interns and I decided to check out the beach "on the island." Let's just say that the sun is much hotter down here than it is in Michigan, and my Michigan-wintered skin didn't handle it too well, more sunscreen next time, until then... Sun 1: Me 0 :(

Today at work, I translated a lot of a powerpoint slides (of which there are still a lot to go) from English to Spanish. These are a part of the Teenage Pregnancy Prevention Program that will be used. For the young girls, the presentation will be done in English, but the mothers presentation will be done in Spanish. A great part of the day was the Flu Presentation by Dr. Susan Fisher-Hoch, a professor at the SPH (check out her CV, I guess by the time you do everything she's done, you are allowed to have a 15 page CV). The presentation was all about the flu virus and its unpredictability as it moves, shifts, travels, and drifts and manages to stay one step ahead of vaccine creation.

Brownsville has been at the center of the recent H1N1 Influenza A (Swine Flu) outbreak, so the school here is involved in a lot of research within the community, on a grant from the National Institute for Health. The county, health officials, and SPH faculty have been involved in reporting and surveying individuals with flu-like symptoms, while the lab on campus checks for positive swine flu cases. Houston is running a similar study; however, they are working within a hospital setting, preventing necessary follow-up. The study in Brownsville is unique as it reaches more cases that aren't reported in hospitals or medical facilities, with the help of many Promotoras and community workers who go house to house administering surveys. This method has allowed researchers to see neighborhoods where the flu is more prominant and spreading more rapidly and health educators can perform real-time interventions in these areas.

Tomorrow should be interesting as I go-->

I'll be going to see the recording station in Matamoros, Mexico where the radio-novelas are recorded. Matamoros is Brownsville's sister city, I can see it from my dorm, we're that close.

Take care yall and keep reading, there will be more stories to come :)

Thursday, June 4, 2009

Technical difficulties...

Hey all, I've been in Brownsville, TX since this past Friday. Today is the 7th day without on my computer. First I was unable to access internet on campus, not having the correct log-in student status and all, and yesterday as soon as I received access my computer decided to up and die. I'm getting to know the IT guy at the School of Public Health here and he said he's hoping it will be back among the living by tomorrow. So that accounts for the past week of not blogging. Que lastima! But onto the good details:

I started working at the School of Public Health on Monday. I have two long-term projects set up. The first will be designing and helping to implement a Teenage Pregnancy Prevention Program for mothers and their "tween-age" daughters here in Brownsville. This program was pre-tested this past year and they are looking to change some parts of the sessions and add new material on "sexting" (here's a link to a news article) and cyberspace privacy. The sessions will run at the end of July and beginning of August. I'm excited to still be here in Brownsville at that point, so I can help with the sessions and see the final product.

Secondly, I'll be working on developing an evaluation for radio-novelas which are being aired on various radio stations here in the Brownsville/Matamoros area. Radio-Novelas are Spanish soap operas done over the radio, these are becoming frequently used throughout Public Health. Some of the radio-novelas I'll be working on discuss diabetes and prostate cancer within the form of a soap opera.

I am one of 10 interns working for the School of Public Health this summer. We are all split up among various projects, some working in the lab, some working on H1N1 Influenza A (Swine Flu), diabetes surveying, High School Science Promotion Project, and other community focused projects. I'm quite amazed at how active this school is within this community.

Just this week, I've taken part in surveying individuals from a diabetes cohort, data input from the swine flu outbreak, a diabetes patient education program, a tour of the County Health Department, a tour of the Clinical Research Unit, and met way more people than I can remember names for (but I'm trying). The school is very involved in a Farmer's Market here in Brownsville, which I'll be going to check out this Saturday. This week has been a wonderful introduction to many of the programs that the school is involved with.

The weather here is gorgeous, nice and hot, with a little bit of rain. Today's high was 94 degrees, yes that is Fahrenheit :) Ok, so I can't lie, it does get very hot here, sometimes even a little unbearable for me, but as compared to the Michigan winter extreme, it's great!

This is already too long, if you've made it this far, thanks! More details to come on the city and the school itself. Although I will say, I'm sitting in a computer lab in the School of Public Health and I am two blocks away from both bordercrossing points here in Brownsville. In order to go anywhere I pass signs that say "TO MEXICO" or "Carrying firearms into Mexico is not allowed." I am constantly reminded by the proximity to Mexico from street signs, food, stores, language, and mostly the stares that I get from a lot of people. Many more stories to come with pictures too, keep reading!

Here's also a blog that I wrote Saturday, May 30th.

Welcome to Brownsville, TX!!
I’ve made it,
1,644 miles
112 gallons of gas
31 hours
And countless billboards
And I’m finally here.

I’m all moved in and only found 3 cockroaches (my mom thinks they’re only palmetto bugs, but we all know they're really roaches) in my room… ewww, gross!! My mom and I cleaned my room from top to bottom, quite literally last night, so now they should all be gone. Oh and I have a pet, isn’t he cute! Supposedly he’s a duck, but he looks a bit like a rooster too. He sits outside of my door, I’ve named him Bob.
I’m living in the dorms here on campus, which when someone described them as a motel room, I thought they meant small room, bed, dresser, and bathroom. Instead they really meant motel room. These are old motel rooms that the university took over and made into dorm rooms, they even still have the metal tissue holder by the sink, the hairdryer on the wall, and the connector doors between rooms.

My mom and I have tooled around for the past two days and I’m starting to get a bearing of the city. The university is one block from the Texas/Mexico border. On our way to the grocery store we passed right by the border check point.

Today, we went to South Padre Island; it’s about 30 minutes from Brownsville. It is a little, primarily tourist island, i.e. nice beach and good food.

My mom is flying home tomorrow, it’s been fun spending the last week with her and I will miss her lots. Hi Mom, I love you!