Department of Epidemiology of Microbial Diseases (also joint-degree with Physician’s Associate Program) at YSPH
Downs Fellow

Career goal: To improve the health status of my community through clinical medicine and research epidemiology.

Internship outline: My project examined dengue fever transmission in the urban slum community of Pau da Lima in Salvador, Brazil. This assessment is needed to provide a descriptive analysis of dengue in the community with regard to geographic space and time. I seek to identify the when, where and whom of dengue transmission in Pau da Lima. This type of basic analysis will be helpful to direct limited vector control efforts and to generate future studies of dengue transmission in this community.

Value of experience: The project, funded by the Downs Fellowship and the Latin American and Iberian Studies Department at Yale, allowed me to create, execute, and analyze a research project in a developing country. In addition to the academic value of the experience, I was able to gain a better understanding of this community and its residents. The consideration of the social and cultural context is imperative to effectively approach research and implement interventions. Before my work in Pau da Lima, I did not completely realize the specific barriers to dengue control that are present in this community. Examples include the limitation of basic resources of the residents and community agencies, social barriers such as gangs and accessibility of researchers and the infrastructural challenges of unplanned urbanization. Although I knew of many of these barriers, I did not fully appreciate their significance before my experiences. I now have a better grasp of how valuable these social and cultural understandings are in this and other settings.

Best moment: My field experiences while georeferencing residences of dengue patients. Immersion in the community and the language were the most valuable aspects of the project because they would have been inaccessible to me without the relationships previously constructed by fellow researchers. I recall one moment in particular: My colleague and I were standing at the bottom of a residential valley on a dirt path parallel to an open sewer from which children had just retrieved a soccer ball. I stopped for a minute to let my eyes follow a colorful butterfly, and then noticed a banana tree, several birds, and luscious green plants surrounding the stream of sewage. At this moment I realized the contrast between the natural beauty and the unfortunate social circumstances that this community faces.