Report from the field:
Innovation in rural Rwanda
Master of public health student Kelly Winjum arrived in Rwanda in September to fulfill the 10-week field practicum required of students in the global health department. She returned to the United States in December. Ms. Winjum plans to complete her culminating activity project—similar to a thesis—and graduate from the School of Public Health in June.
The following interview was conducted while Ms. Winjum was in the field.
What organization are you doing your internship with? What are your responsibilities?
I am working with Adventist Development and Relief Agency (ADRA) Rwanda in Nyagatare, Rwanda. The project here is called RIREP (Rwanda Integrated Rural Education Project). We have around 73,000 learners in our program, which mainly focuses on functional adult literacy (FAL). Within the FAL classes, the learners are taught about health, nutrition, sanitation, hygiene, income-generation activities, and, of course, basic literacy.
I am working on grassroots technology with another intern from Canada. Our range of activities is very large, but it includes things like teaching the learners how to make improved stoves, making homemade bread and soap, distributing improved seeds for planting, and teaching better methods for planting and harvesting. The list could go on and on.
My responsibilities include researching new technologies and experimenting with different ways of making/using the technologies, then working with the program staff to train the senior instructors on how to teach the learners.
We also spend a lot of time in the field, going to homes of the learners and instructors, or going to classes.
Our working area is very large, with the closest learners living about 30 minutes from the office and the farthest around two hours away.
Walk us through a typical workday.
There really is no typical day here, which really keeps things interesting. One day I will be in the office researching new technologies, the next day I will be in the field distributing improved seeds, the next day I will be building a stove.
Our office operates very collectively, so we often find ourselves working on a different project altogether if someone needs that. The entire staff has spent a lot of time lately doing graduation ceremonies for our learners.
In general, I am up at 6:00 a.m. and walk two miles to work at 7:00 a.m. Worship starts at work between 7:30 and 7:45, after which we have a short staff meeting to discuss the plan for the day. The work day is supposed to end at 5:00 p.m., but we often don’t get home until 6:00 or 6:30 if we are in the field.
Describe how your internship experience is solidifying or enhancing your School of Public Health classroom learning.
I see the curriculum for the global health department as building blocks. We have a yearlong course called Primary Health Care that teaches us all about designing and implementing a program. We start the year with a needs and assets assessment, then we develop a program based on the community’s needs, and finally we implement the program. We also spent three weeks in a developing country as a class over the summer (called Integrated Community Development: ICD), where we implemented other public health programs.
The field practicum builds on these things we have learned in the classroom and in our ICD experiences. During the field practicum, we could be working on a program at any stage of its development, from needs assessments to final evaluation.
In the classroom, we are given the skills we need to be able to work on a project from start to finish, and in the field, we actually get to put those skills into practice.
What was the most useful thing you learned in the classroom that you have been able to apply in your practicum?
I think the most useful thing I learned in the classroom was to not decide for a community what it needs, but rather go to the people and ask them what they think they need. It’s important to listen to their concerns and needs. If we push our ideas and programs onto a community (and they don’t think they need them), the community may not support the program—and then it can become a waste of time, energy, and money. The community members know what they struggle with and what they need more than we do (especially here).
We were taught the importance of needs and assets assessments in the classroom, and I think that these really help. This is something that I often do mentally when considering what new technology I should research and integrate into the communities here.
What life lessons have you learned during your internship?
This is my third time in Africa and every time I come, I say that Africa keeps me grounded in my life. It is easy to take so much for granted in the United States, but being here puts me in my place. I never know if I will have electricity or running water. I have no transportation here (except my two feet) and I wash my clothes by hand. I eat peanut butter sandwiches for most of my meals because I have no cooking facilities where I live.
Even though things can get pretty difficult here at times, I know how much worse it could be. I don’t fret over the little things in life because being here makes me realize just how good I have it.
When something goes wrong we always say TIA: This is Africa. It’s not going to be easy and things don’t usually go the way you expect or want them to, but in the end you will love the place and your experiences anyway.
What are your career goals after graduation?
I am considering going back to school to become a physician’s assistant. There are so many fields that interest me, and I really enjoy being in school—so I might be a student forever. No matter what I do or what field I end up working in, I think I will return to Africa often because there is so much about living and working here that I love.
How will this experience influence your view of public health?
Living and working in Rwanda has been a great experience for me. It has solidified my desire to work in underserved areas, whether that is in the United States or abroad. There is so much work in the field of public health, both in the United States and abroad, so our work is never done. We can always improve the way things are done, and there are always emerging illnesses and outbreaks. Being in Rwanda has made me see just how much public health professionals are needed and that most things in life can be related back to public health.
