How rural health promoters and participatory research models can help bridge healthcare barriers in the Napo Province in Ecuador
Year: 2015

In 2000, the Ecuadorian Congress established a National Health Care System and passed health care reform measures. By 2007, however, access to healthcare services was still limited for many Ecuadorians, with nearly one third of the population lacking regular access and two thirds without health insurance or adequate resources to pay for health services. This lack of access to care is a serious issue that must be addressed if Ecuador is to continue to promote the development of its citizens. The goal of this research was to identify key health issues regarding health needs, practices, and access in three communities in Timmy Global Health's catchment areas in the Napo province of Ecuador in order to gauge how a rural health promoter program could address these key health issues and supplement Timmy's current medical brigade efforts in the area. First, a quantitative health survey was used to identify basic socio demographics, sanitation practices, and the most commonly reported health concerns for Timmy's adopted communities. Next, a more qualitative, participatory approach toward research in the form of individual interviews and focus groups was employed. The surveys showed that the majority of questionnaire respondents have only completed up to primary school, make less than $50 per month, and do not have insurance. Information collected also displayed a great lack of basic health knowledge and problems with water sanitation in the communities. It is the hope of this project that findings of the this project and the recommendations created as a result of these findings can be utilized by Timmy Global Health in order to accomplish their goal of moving towards a Rural Health Promoter program empowers communities to take charge of their own health needs and promotes sustainable local knowledge in these same communities.  Gabriela Moriel Degree and Year: Preprofessional Studies University of Notre Dame, 2011 Capstone Project: Empowering the Napo Province for a healthier future: A partnership between Rural Health Promoters and Timmy Global Health  Timmy Global Health is an Indianapolis based nonprofit organization with a hybrid mission: to expand access to healthcare both locally and internationally and to empower Timmy Global Health is an Indianapolis based nonprofit organization with a hybrid mission: to expand access to healthcare both locally and internationally and to empower students and volunteers to tackle some of today's most important global challenges. Over the past year Timmy has been working to increase access to healthcare in nine adopted communities in the Napo Province through primary care medical brigades that travel to each community every 2 3 months. Over the past year, August has been slowly developing the Rural Health Promoter program with 8 out of the 9 communities that Timmy currently resides. The research aims were to design training materials for the two rural health promoters in Napo. Surveys results showed the flu (83.02% diarrhea (22.64% and fever and body pains (15.09% were most prevalent in the community. Each of these illnesses or symptoms are usually related to some underlying issue within the community and are rarely caused by more chronic infections such as HIV or TB. The goal was to use the rural health promoters as the key communication link between medical brigades and the community, by targeting health issues at their roots and preventing many of these preventable and commonly seen illnesses from occurring in the first place. Two resource cards were created to be distributed to rural health care providers in Napo Province. One card focused on hygiene and sanitation information and another on disease Name: Melissa Baranay Degree and Year: Behavioral Neuroscience Yale University, 2011 Capstone Project: Polyandry and longevity in Aedes Aegypti: Implications for Dengue transmission and control Abstract: Dengue fever is currently the world's most devastating arbovirus and it is rapidly Dengue fever is currently the world's most devastating arbovirus and it is rapidly becoming one of the most far reaching and impacting diseases. Its incidence has increased 30 fold in the last quarter century and continues to spread at an alarming rate. The disease is spread primarily by Aedes aegypti mosquitoes and is a serious, endemic threat in more than 100 countries worldwide. Due to the lack of effective vaccine protection against dengue viruses, the only available preventative measures lie in the vector realm, specifically control and/or elimination of the vector. There are several ongoing efforts involving transgenic and sterilized males and females, however, these methods cannot be realized to their full potential until the vector itself is fully understood. Chiefly among these unknowns are the mating behaviors of female Aedes aegypti and the lifespan of both males and females. This paper examines the techniques available to analyze the presence or absence of polyandry, multiple mating, in both lab reared and field collected mosquitoes in addition to exploring the longevity of a lab reared strain believed to be longer living than average. Both of these factors, polyandry and longevity, have the potential to greatly alter the perceived effectiveness of current control methods and may lead to the development of new and more advanced vector control programs. Through longevity studies of birthing "granny" mosquitos, DNA extractions, and spermathecae dissections, we showed that the lifespan of both male and female Ae. aegypti is considerable longer than anticipated. This information should greatly improve people's study of dengue. My study also revealed several new techniques that can be used in the study of polyandry, including the lab methods I used in study. My research may improve the processes of people studying dengue throughout the research community. "Overall, I had an amazing experience with my project as a whole and with my field placement. Going on field excursions to help on other projects were easily some of my favorite days during my field experience and I will always remember the crazy island roads, secret swimming streams, and critters I encountered along the way!" Name: Michael Burton Jr. Degree and Year: Psychology and Preprofessional Study University of Minnesota, 2012 Capstone Project: Investigating the development and breadth of Quinolone resistance  Quinolones came into existence during the process of designing an antimalarial drug known as chloroquine (Andriole, 2005) A byproduct of this research was the discovery Quinolones came into existence during the process of designing an antimalarial drug known as chloroquine (Andriole, 2005) A byproduct of this research was the discovery of nalidixic acid. The initial function of nalidixic acid was treatment of urinary tract infections (Dalhoff, 2012) Over time, however, a collection of quinolone antibiotics emerged from this drug. The reliance on the class of Quinolone antibiotics has contributed in part to an emerging trend of antibiotic resistance. The following literature review will explore the evolution of quinolone antibiotics, mechanisms of activity and the various classes of quinolones and derivatives. This launching point will inform a discussion on the rise of antibiotic resistance in quinolone drugs. Included in this discussion are the multiple pathways of resistance employed by numerous bacteria and the rates of resistance in various pathogenic bacterial species. A focal point of this review hinges on analyzing the emergence of quinolone resistance in Neisseria gonorrhoeae. This species, responsible for gonorrhea, has clinical relevance due to its insidious presentation in women, and long term health consequences for millions of people. Additionally, in acknowledgment of the increasing globalization of the world, developing countries face a disproportionate burden of infection and resistance. Synthesizing the literature on quinolones, quinolone resistance, and Neisseria gonorrhoeae provides global health experts, researchers, physicians and laypeople an overview of a current crisis and its immediate implications. Furthermore, this body of literature heightens alarm over the possibility of an additional super bug in Neisseria gonorrheoe. Through this extensive literary review, I have found that further study of quinolone antibiotics could greatly advance the treatment of Neisseria gonorrheoe. At present though, as antibiotics are developed, communities must better their technology communication to inform the public and health care providers on sexually transmitted disease. "My time in Ecuador challenged me to reflect on the systemic problems that lead to poor health. The culture enriched my life."  Stephanie Cripps Degree and Year: Preprofessional Studies University of Notre Dame, 2012 Capstone Project: An assessment of community health promoters in Ecuador's Napo Province  The purpose of this study is to understand the role of TGH community health promoters The purpose of this study is to understand the role of TGH community health promoters in the Napo Province, in order to help TGH choose the best way to run their community health promoter program. TGH's health promoter program in the Napo Province has never been evaluated before, and this exploratory study can act as a baseline to compare future evaluations of the health promoters and their impact on community health. Because there is such wide variation in community health programs, there is no standardization or one size fits all approach to evaluate community health worker programs. For the purposes of studying TGH's Napo Province health promoters, qualification, outreach engagement, motivation, community recognition, and community perception of community health promoters were chosen as areas of interest by TGH to be examined in order to gain a thorough understanding of the role of a health promoter and possible areas