This question has an infinite number of answers, but I will try to answer what it means for me to do research here between the crisp, high-elevation city of Tecpán and the hot, tropical town of San Antonio, Suchitepequez. I work on a project studying the prevalence and risk factors for Chronic Kidney Disease of Unknown Etiology (CKDu) in each of these areas. It is especially interesting for me because of the possible ties to agricultural work, pesticide exposure, and NSAID use (like Ibuprofen and Aleve).
I landed in Guatemala six short weeks ago. In that time I have learned a lot about what health means here, what research means, and what it means to explore a new town while gathering good data in a place where the importance of research is not widely understood.
Research here means explaining consent to people with diverse levels of education and literacy. Not only is literacy a barrier to consent, but many people have an intense distrust of institutions, especially when asked to sign forms. From my understanding, this stems from the civil war that Guatemala suffered from 1960 until 1996 and the institutional discrimination and persecution many indigenous people suffered during this time, which continues today.
Research here for me means navigating family dynamics to recruit subjects in a professional and culturally humble way. Sometimes this means waiting for the male head of the household to come home. However, since the entire study is done in the home, many times the woman is more eager to participate, and can successfully recruit her husband and children.
My research team has had success thus far because of our ability to work both independently and as a team, while capitalizing on each of our strengths. In our first two weeks, we visited households and recruited patients. My team teaches me to be patient when trying to recruit a participant. I mirror them to ensure I am being polite and non-intrusive while in a person’s home. I am mastering how to explain that, although I am a gringa, I am not a doctor, and have next to zero clinical training. Every day, research reminds me of the importance of working with people who are familiar with the town and a part of the culture. Good research could not be done, good data could not be collected, without locals being an active part of the team and in important leadership positions.
Research here for me means traveling on packed school buses for hours, it means walking around an unknown town looking for specific geographic coordinates, it means not knowing when the next bathroom will be available, and it means working with the kindest and most patient research team. My team and I will continue to recruit patients in San Antonio while navigating the daily rain downpours and the frequent power outages. I love participating in research because it gives me the opportunity to meet new people, be a part of a team, and to participate in projects that will have real-life implications for the country I now call home.