Anta

My second day at the Cusco office I got to take a field trip just outside of Cusco city to a rural field site in Anta. The group is setting up a 5 year cohort study to look at the burden of fasciolosis in children. Fasciola is a fluke that grows in the liver when the eggs are ingested, typically from water greens or other water plants. It is generally associated with poor sanitation.

The group has been working from the top down to get community buy in for the project. First the regional and community officials, then community health workers, school principals and finally parents of the children. That morning there was discussion about when they were going to be able to meet with the school principals one on one to discuss the study. When the Anta community nurse didn’t answer here phone, the head doctor, my boss, decided we would just get in the car and go to Anta right there and get it done.

Now I have a love hate relationship about this process of getting things done here. I’ve found that one needs to be in person to effectively facilitate communication and accomplish any goal that require cooperation. On one hand I love the approach that if I want to get something done, I go and bug someone until it’s finished. On the other hand, it goes against my nature of having a plan. The system work for us that day though. Everyone got in the car, we showed up at the Anta clinic and somehow convinced the nurse to leave the clinic for the day to introduce us to the principles at each of the schools. Whatever she had planned for the day went right out the window to take care of our needs. I will get more and more use to this I am sure. Or perhaps I won't.

One elementary school

Anta

Overall it was a successful day. I got to get out of town and see a bit more of the beautiful valley. It was really interesting to learn about this project. Hopefully I will be able to continue to be involved while I am in Cusco. This is really the first time I have been on the ground involved with the set up of a study and data collection. All of the information from school about the right and wrong way to conduct a study is running through my head. 
I know cognitively that it’s extremely difficult for every aspect of the study to go perfectly by the books, but I am still the eager grad student, fresh out of school holding impossibly high ideals. This team is doing everything in the right way, but on the ground it doesn’t go quite as smoothly one would hope. The principles don’t attend the district meeting where you originally present the project, or maybe the community health workers don’t pass on any information to parents about the study. Welcome to the real world of research. The take home message for me is the value, as an epidemiologist, of really understanding how the data was collected and not just what the data set looks like. As frustrating as it can be, this will be a great learning experience so that in the future I am more prepared to problem solve and have hands on experience to reference. Yeah for the complexity of research!!

Below are some picture form Anta, one of the schools and some kids playing on stilts. One the way back we stopped to get fresh cheese. Two pounds of cheese for a little more than $3. FANTASTIC!!