Today was full of laughter, food, jokes and lastly tears as it was our last full day in Salvador and we began the tearful journey of saying goodbye to our Mães and to Salvador.

Today we had a great lunch with our Mães at SENAC, a culinary institute here in Salvador.  The food was delicious, but I must say I will not be eating at a buffet for a very long time.  Buffet style restaurants are very common here and they work very well, especially for a large group, but I am so tired of them.

We celebrated two birthdays or “aniversários,” Roman and Sonia’s.  SENAC was kind enough to provide us with a “decorative” cake which, unfortunately, we didn’t get to eat, but the buffet had all types of Bahian food and dessert so we didn’t feel too gypped.  I had two helpings of my favorite dessert or “sobremesa,” pudim de leite condensado.  When in Brazil, right?  Besides, everyone knows that calories consumed on vacation don’t count.

After significantly stuffing ourselves, we all took a moment to thank those who made this trip possible.  A big thanks to Clara whose enthusiasm and excitement made us feel comfortable in a strange land.  A big thanks to Dr. Stauber and Dr. Ramsey-White for putting this program together and pushing us out of our comfort zones in order to experience all that Salvador has to offer by insisting we do home stays.  I was a little hesitant at first because none of us knew Portuguese and what little Spanish some of us spoke we realized pretty quickly wasn’t going to help us a whole lot.

And finally a HUGE thank you to our Mães who opened their homes, families and hearts to us.  My Mãe did so much for me while I was here from preparing three meals a day when she normally only eats one to cleaning my bedroom and bathroom everyday and always welcoming me home with a big smile and motherly hug.  I will miss her so much when I return, alone, to my studio apartment back in Atlanta :'(  I wish my Portuguese was better so I could better communicate with her how much I appreciate what she has done for me and that I will never forget her.  Thank goodness for Facebook 🙂

Tomorrow we will be picked up by vans around 5:30pm or 17:30.  Now my only concerns are last minute shopping tomorrow morning and playing tetris to fit everything in my suitcases.  Three weeks has flown by and normally I’m ready to go home, but this time I wish I had another week here; the sun has finally come out, I have made some great friends and I’m finally able to semi-communicate with my family.  The old saying, “glad to come but glad to leave” certainly doesn’t apply this time.

As soon as I walked into our usual classroom, it began to hit me again that I am about to leave Brazil. I was also feeling uneasy presenting our project, especially in front of the Brazilian experts. Contrasting the definitions of public and collective health is a challenge and I was not feeling confident. Professor Eduardo Mota was the only one that came to observe our presentations (I hope he liked our presentation). The first presentation on “The Genesis of Collective Health” practically summarized every bit of information I was going to present. I am not going to lie, I felt a bit relieved to know that my interpretation of collective health was similiar to theirs. The second group also presented the same material, which got me even more nervous to present my material. By the time we presented, everything was repetitive and redundant (definitely not feeling good). Once it was our turn to present, we were very crunched on time. Despite my nerves, the presentations done by my peers were excellent and representative of everything we learned! Overall, I can confirm that every one of us had grown tremendously in our education on the Brazilian healthcare system. I felt that despite the busy/hectic schedules and lack of sleep we each had an enrichment of experiences that will turn us into AWESOME public health practitioners. The various ideas and driving force that was brought to table by each group showed the dedication we all have in making healthcare more accessible (with increased quality) for everyone around the world.

Practices in Collective Health (the only good pic I have)

For lunch we all went to “Restaurante Aconchego Da Zuzu”. Professor Mota and Clara also joined us. The meal was muito delicioso! It was a semi-buffet style, but was served in clay pots. The type of food that was served was “Bahian food”. I am already feeling sad knowing that I am not going to be eating yummy Brazilian food for much longer. Brazilian food has yet to disappoint me! The flavors and soul put into each prepared dish also amazes me. I also feel much healthier eating here than I do back in the states. Can I bring home a Brazilian cook with me?

The food was served in Clay pots

Group photo at Restaurante Aconchego Da Zuzu

I came home and took a 3 hour nap. Estou muito cansada! A good handful of us decided to go enjoy our last remaining nightlife here in Brazil. Our plan is to meet up at a Brazilian friend’s place to mingle. I am definitely excited and looking forward to this interaction. Nightlife in Brazil is definitely something I am enjoying and getting used to. There is so much culture here; I love it. I am going to miss it ridiculously. Cryfest round 2.

Turnout of the mingle event… to be continued…till then boa noite <3

-Naomi

I LOVE BRAZIL

I cannot believe that tomorrow is our final day at ISC. As I take a break from work on our final presentation to write this blog post, I feel grateful, energized, and inspired. Yet, also a bit melancholy as our flight back to Atlanta draws near. Yesterday, I said my goodbyes to Freddy, our most knowledgeable tour guide, prankster, traveler and new life-long friend. Today was my last day with Mauricio, our extraordinarily charming and patient Portuguese instructor, without whom I would still be asking for agua de cocô instead of agua de côco. (Trust me, that’s an important distinction.) Tomorrow, we’ll say farewell to the all of the faculty at the ISC who have taken the time to share their work and answer our questions. I am so thankful for all the people who have been willing to share this, the beautiful state of Bahia, with us for these three very short weeks. I have learned more than I could I have imagined—about collective health, world history, Brazilian culture, my professors, my classmates, and myself.

Freddy let us come with him while he did his grocery shopping this weekend. Mercado de Sao Joaquim was beautiful!

Today we had the opportunity to explore some of the health information datasets that are made publicly available by the Brazilian ministry of health. Carol, who has been with us throughout our time here at ISC, told us a bit about the history of these information systems, and almost glowed with pride as she described the sheer amount of information available to anyone who wishes to peruse it—“from the door-guy to the president.” These datasets, to me, represent yet another way that this nation strives for transparency and invests in its citizens. Anyone who wants to can know the prevalence of a disease in the population, who’s at risk, where the risk is highest, and how much the government is spending on it. Knowledge is power, is it not? Plus, as a data nerd, I have to admit that browsing through these databases was kind of fun.

Carol teaches the class about publicly available datasets, while students wave to the paparazzi.

The quote that forms the title of this blog post is paraphrased from the beginning of a comic book series, Praga (in English, Plague), which is one of Carol’s favorites. I suspect that Carol is a fellow data nerd, and this quote resonated with her as it also resonates with me. I think it’s safe to say that we have all seen how Brazilians love—from the inspirational NGOs working within their communities to our warm and protective host moms feeding us until we pop. In our lectures at ISC and in all of our interactions with tour guides, teachers and community leaders, we’ve seen how Brazilians work. (On that front, we could all learn a little something from Brazil on how to get things done). And—as morbid as it is—today we learned how to understand how Brazilians die. That is, at least we learned about the very complex combination of data points that can be pulled together to paint a two-dimensional picture of health in Brazil. Without every single one of these three components (loving, working, dying), I can honestly say that this experience in Salvador would have been incomplete.

Street art around Salvador. “Mais amor por favor.” (In English, “more love, please.”)

Oi ! Tudo bem? These words have become a daily greeting to everyone I encounter here in Salvador. After two weeks of constantly hearing and attempting to speak Portuguese, I think I’m actually becoming understandable.

Over the weekend, three people from our group traveled to Rio de Janeiro, Brazil. We had a schedule packed with activities including walking the ocean shore in Ipanema, riding a train to the top of Corcovodo mountain to seeing Christ the Redeemer and capturing spectacular scenery along Rio’s shorelines and hillsides. It was paradise! Rio is truly a beautiful place full of tourist and native people from all over the world

Salvador’s culture is very different compared to Rio de Janeiro’s.

Today, we had the opportunity to hear from PhD students from the Institute of Collective Health at the Federal University of Bahia about their research on various topics. The presentations were about emerging topics in Collective Health such as Dengue, Zika, Asthma and Rotavirus. Currently in Salvador, there is an outbreak of the Zika virus that is gaining attention from the municipal health system. It’s interesting to see current research being conducted to help understand and gain knowledge but most importantly how to help out the communities being affected by these outbreaks in Brazil.

Unidade de Polícia Pacificadora (UPP) is a law enforcement policy in favelas that reclaims territories that were once controlled by drug gangs. Calabar was the second favela established on the outskirts of Salvador. It is one of the poorest communities and established a UPP back in 2011 to empower the community through social programs. We had an opportunity to visit the Escola Aberta in Calabar. This school helps empower and strengthens its Afro-Brazilian identity while opening doors to knowledge.

I’ve been blessed with the opportunity to study abroad in Paris and Rio de Janeiro. I’ve been exposed to different cultures and Salvador is no exception. We’ve all created memories together and with our host families. We have been able to experience the culture first hand but most importantly we’ve gained so much. It will definitely be hard to say goodbye to friends and families we’ve gained here. It will be a bittersweet moment for all of us.

Que? Não. Sim. Obrigada. Não sei, have all been my frequented go to responses to any and every question or situation since my arrival in Brazil. My use of Não sei, came to a head this past week though. My understanding of Portuguese has made some ground so when my mãe asked me if I was having lunch at the apartment my undecided response was identical to my English response; I don’t know or Não sei. She repeated herself. I replied again Não sei. She asked if I understood and said it another way slower. I responded Sim, não sei. Mãe proceeded to holler for my sister who was chit chatting with her friend in the living room. Mãe walked me with her to the living room and repeated herself yet again. My sister’s friend who speaks English translated mãe’s question and I answered her, “Yes I know I’m just undecided. It’s ok I will just eat here for lunch.” In my haste I said in English what time is lunch. My sister’s friend immediately asked in Portuguese for me. I said to myself, geez luweez I know how to ask that.

To take things to another level I have to ask myself, how and when else can a challenge with language impact communication? My lunch misunderstanding is an ordinary example of when a breakdown in communication can create unnecessary confusion. As a public health professional I need to be able to understand information spoken and provided to me, as well as convey information in an understandable manner. Relying on the simplicity of my American vernacular is not appropriate for any and every question or situation. My audience is not always like me and I have to conduct myself accordingly. I need to make the conscious effort to be understood, and not force my way of understanding on another. Taking the time to reflect, digest, and speak more conservatively with a foreign language was a lesson learned for me.

“The struggle is real, because you make it real”- Dr. Kim Ramsey-White

I can’t believe that two weeks have already passed. It feels like just yesterday was I getting off the plane here. I got a chance to experience so many things that many people don’t get a chance to see. Knowing that I’m having an experience of a lifetime helps with missing important moments in my family’s lives. Plus my host family is awesome and has made me feel so welcomed here. With this being my first time traveling abroad I was nervous because I had no idea what to expect, but this is an experience I will never forget. I feel my perspective on different culture and health care processes have really grown from everything I’ve learned here.
Today we got to change up our routine. Instead of a lecture in the classroom we visited the university’s hospital and a mental health center. We have heard so much about the hospital and medical center that it was great to actually see them in action. Here in Brazil they have universal health care, so even if you can afford private insurance you can still get coverage through the public insurance. The Federal University of Bahia has a public hospital. We learned about some of the departments with a focus on the transplant area. Transplants are even covered under the public health insurance called SUS, but the doctor did say it could be hard to get certain organs. They even took us to see the bone marrow transplant unit. It’s crazy to me that they only have five beds for such a large city like Salvador.
I was very interested in seeing the mental health center. It was perfect timing since we just had a lecture from Dr. Darci Neves on the mental health system just yesterday. The mentality here is that mental illness can’t be cured but managed. This is impressive because many other countries try to just put these individuals into asylums, but Brazil is trying to give them a chance to live as much a normal life as they can. Centrode Atenҫ̰ao Psicossocial ADIII Gey Espinheira is a mental health center that focuses on substance abuse. There are only three centers like this one in the Salvador. At this particular center not only do people get help with substance abuse issues but they will provide you with a place to sleep and food. Then because it is a public center its free for the population. The social worker and nurse that spoke with us talked about how many of the people that come in with alcohol and drug abuse have an underlying mental illness. Centers like these could really benefit the U.S. since many people with severe mental illness and substance abuse end up homeless. It’s nice to know that here in Brazil they are trying to change that. They need more centers but a few are better than none at all.
That is all for now. As you can see today was an eventful day but as you read the other posts every day is eventful. I do feel like today was a little different because we are usually learning about the health care system in class, but we got up close with the staff and patients. Every day here we see things we haven’t seen, experienced things we haven’t experienced, and learn new things about ourselves. I now understand why people say going abroad is a life changing experience. After this I will never be the same.

When challenged by Dr. Ramsey-White to ponder the weekend in Lençóis and how everything that we experienced is related to the field of public health, a few of us were more than willing to share our thoughts. Personal health, open mindedness, and empowerment were among the answers that were given. Here is my take on the activities and how they impacted my learning and growth as a public health professional in training.

Climbing and/or descending the Morro do Pai Inacio mountains proved to be somewhat of a laboring or difficult task for some, including me. I don’t really have a fear of heights, but I was taken aback by the steepness of the mountain and the cumbersome task of trying not to slip or fall while stepping from rock to rock. But, I must say that this struggle was definitely worth while after reaching the top and being able to view the beauty that mother nature has done a good job of perfecting.
The Gruta da Lapa cave proved to be another mental and/or physical challenge for some. The mere thought of exploring the realm of a place that sits so many feet below a surface is a tad bit frightening to me (only because I have seen way to many movies about people getting lost, attacked, and crushed in caves), but like climbing Morro do Pai Inacio mountains, the day before, we all met with and accomplished the task that was set before us.

The experience at at Graos de Luze Grio was interesting to me. I did not expect it be as educational and fulfilling as it was. The project/mission that Marcio and his group are working on sounds like it is full of dedication towards the enhancement of the community’s health and educational practices. I really appreciated the stories about his ancestry, as well as, the songs that we learned and their importance to the culture and his life. This experience provided an opportunity for everyone to search themselves and to meditate on and really take in the beauty of everything that life, past experiences, and present being (especially this trip) has to offer.

Returning to Dr. Ramsey-White’s question about the relationship between the experiences in Lençóis and field of public health, the answer lies in a closer look at one’s self and things that are important for sustaining mental, emotional and psychological well being– once again, personal health, open-mindedness, and empowerment.

• First, it is imperative that we find the time and energy to take care of ourselves emotionally and psychologically. If we do not take the ample time to reflect on where we have been or what we have been through, heal from the things that have may have hurt us or dwell on the things that we have learned, we will never truly be of sound mind, and furthermore, our service and help towards others (the community) will not be at it’s full potential (in order to successfully take care of others, you must take care of yourself first).
• Second, being open to trying and learning new things is very significant to the field of public health. When dealing with masses of people, being able to communicate with, relate to and understand people of all backgrounds, colors, customs, and opinions is inevitable. It is often hard to look beyond the people and customs with which we are most comfortable, but we must challenge ourselves to learn and/or gain perspectives on a variety things, people and places to be able to better reach the public and; furthermore, promote health.
• Lastly, to be empowered is a free and wonderful feeling. This weekend, it took true courage and a feeling of empowerment for some to expend their energy and/or let go of their fears to conquer climbing the mountain or exploring the cave. You can also empower others by serving as a means of encouragment through your own experiences or lessons that you teach. As public health professionals, it will be our duty to empower people to take charge of their own emotional, psychological, and physical health. Perhaps, one of the best ways to do this is to be a living example of what it means to take your health seriously, do all that you can to maintain your well-being, and not be afraid to seek knowledge and/or help when necessary. If we, ourselves, feel empowered to take control of our lives, it can serve as a major influence for our family, friends, and community.

“And as we let our own light shine, we unconsciously give other people permission to do the same. As we are liberated from our own fear, our presence automatically liberates others.” -Marianne Williamson