STUDENT SPOTLIGHT: Connie Chen & Krisztina Szabo

Interview by Aisha Shaheen

"Be the change you wish to see in the world" - Mohatma Gandhi

For two students with a dedication to global health and a passion for helping others, Connie Chen from Weill Cornell Medical School and Krisztina Szabo a graduate of UC Berkeley’s School of Public Health, the change they wished to see was in a small corner of world: Pau da Lima, one of the favelas, or shantytowns, in the coastal city of Salvador, Brazil. Connie discovered Pau da Lima during a journey to Brazil to study leptospirosis, an infectious disease endemic to the area.  During her time there she observed the lack of preschool education and prenatal health care in Pau de Lima and knew she wanted to get involved. In May 2005, she found Krisztina who had been working in the area on a similar goal of community capacity-building. A collaboration was born out of their mutual desire to open opportunities to the local children, most of whom, despite being citizens of Brazil, are unable to attend public schools due to their poverty and lack of documentation. For Connie and Krisztina, the way to begin making a change was to open an escolinha, or small school, in the heart of the Pau de Lima. In a Q&A with these inspiring women, Global Pulse learned more about their journey to Pau da Lima, their current progress on the Pau da Lima School, and their hopes for the future of the area and its children.

GP: Tell Global Pulse about how you become involved with Pau de Lima?

Connie: In the summer or 2005, I had the opportunity to travel to Salvador, Brazil on an overseas fellowship from Weill Cornell Medical School to study the infectious disease leptospirosis in the shantytowns of Salvador. In Pau da Lima, Cornell and Brazilian researchers were already studying the disease and starting public health interventions. When I came to Pau da Lima to conduct research, I had the chance to hold hypertension screenings and to begin a little bit of health education. One thing led to another, and I began to meet more and more people who brought me closer and closer to Krisztina. Together we were able to use our experiences in Pau da Lima to frame our vision for the school. While the impact of our long-term research in leptospirosis will be tremendous, the immediate impact is less obvious. We wanted to assits the community in accessing an even more powerful tool—the ability to build human capital. It was also a way for us to access a community lacking basic health care and to get them plugged into a health care system.

What global health issues are you hoping to address through your involvement with Pau da Lima?

Connie: There are a number of health issues that face the population of Pau da Lima. Infectious diseases is top on that list, along side chronic diseases such as hypertension and diabetes. Basic education about dengue, leptospirosis, meningitis and how to prevent these infectious diseases is where we have started. Other global health issues in shantytowns, such as diarrhea, dehydration, and malnutrition, have also been of paramount importance in our health campaign. Health, however, in the broadest sense is not only prevention of disease, but also the promotion of wellness and wellbeing, through good nutrition, exercise, and hygiene... Through prevention, early diagnosis, and treatment, we hope to improve long term health outcomes in Pau da Lima. Our goal is to use the school as a gateway for basic health education among mothers, who are often serve as the nucleus of the family, as well to use the school as a site for health screenings for diabetes, hypertension, cataracts/glaucoma. We have a number of physicians and medical students from Brazil and the United States who are planning health fairs, screenings, and basic health classes for mothers, children, teenagers and those who are interested in entering the health care profession. The Pau da Lima School is a multidisciplinary school that with time will mature with the population it serves.

GP: How has your background in the medical field influenced and aided your efforts in Pau de Lima?

Connie: My medical field background has helped me understand the health needs of the community and the key points in disease transmission and progression, and where prevention can play a role. I discovered that there is a key difference between teaching patients what is best for their health and empowering them to take charge of their own health. To achieve that, it’s important to integrate health and medicine in a way that is reasonable and accommodates the demanding lifestyles of those that in the favela. This is a constantly evolving process that no doubt will take a tremendous amount of energy and time. These are the challenges that I also grapple with in the hospital and it has been invaluable learning experience figuring out how to translate that to Pau da Lima. Krisztina has a lot of experience in the Pau da Lima community and has really been instrumental in community recruitment. The enthusiasm that Pau da Lima volunteers had for the school and the involvement they had in constructing the school makes me believe that we can succeed in this community.

GP: What have you learned from your involvement with the Pau de Lima School?

Connie: I've learned a lot about nonprofit work and how to navigate problems with limited resources. This sort of learning has come through a trial and error sort of approach, especially since working trans-continentally has proven to be much more difficult than we thought. Much of what I've learned about the nonprofit sector has come from Krisztina, who has a sincere passion and talent for this sort of work. She has perseverance and passion, two things that have carried her very far.

Most of all, I've learned from those in Pau da Lima itself, how despite one’s poverty, an individual can still have so much optimism and perseverance. There is an unbelievable strength in this community.

GP: Describe some of the challenges faced in working in Pau de Lima and rebuilding the school?

Krisztina: In the last six months as a current Fulbright Fellow I have been closely involved with the community of Baixa Fria, where the school is located. The school is close to an open sewer, down on a muddy hill with a narrow passage and high vegetation. When we started the second phase of the construction in late April of 2006 using our capital from three fundraisers, only the foundation and walls were standing for almost one year. Without our help the community did not have enough power to continue the construction or even receive help from the government. One must understand how difficult it is to walk into a community, gain trust from locals and become an integrated part of their lives. Many times we have our utopian visions how through grass-roots organizing, people will come together, volunteers will help to finish the rest of the construction and how smoothly programs will run. This is far from reality. In poverty where people struggle for a day-to-day survival, the community doesn’t necessarily understand the idea of volunteerism, even if eventually their own children will benefit from the school. To achieve change, to understand the underlying root causes of low social capital, low social cohesion, we must take one step at the time, one day at the time and mobilize people. There is a lack of organized leadership in the community and we must help to develop peoples’ skills to organize, to mobilize and to ultimately achieve change from the inside out.

GP: Where do you see Pau de Lima school 10 years from now? What are your short and long-term goals for the School?

Krisztina: What started as a school rebuilding for children in this community two years ago became a symbol of hope by having adult and children programs simultaneously. There is a very high rate of illiteracy among adults who also would like to learn to read and write. Currently we still do not function as a school-daycare center, simply because the construction is still not complete and it would not be safe. We also do not have the infrastructure to provide basic care for 50 children daily. We have to finish a second room, install water, electricity and provide basic care for the children. We still need at least another year to finish the construction completely because we do not have any help from the Brazilian government although I have been actively procuring help for six months now. Although we are currently registered as a non-profit in Brazil as a Mothers’ Club (Clube de Maes), we won’t be able to get any public help to provide education for the children. The government simply does not think they are in any shape or form responsible helping us to finish this school, which is the only one in several square kilometers for children.

Our short-term goals are simply to run community-based programs, events, teaching reading and writing both to children and adults in the safe space we already have while simultaneously continuing the construction and finishing the school. Currently we function three times a week with Dona Nivaldina, our community leader and teacher, and two volunteers. We teach reading and writing to children twice a week and we also provide lunch three times per week. In late November I am planning to start English classes twice a week on a "time-dollar" basis, which means that anyone who will attend my classes must use their skills in the community and interchange. One hour of my time will be equal to one-half hour of their time dedicated to volunteering as well.

Our long-term goals are not only to function as a community center (which is important since the community starts to see the building as an asset to their community), but to have a sustainable and safe infrastructure which will provide basic health care needs, elementary education, art, theatre, and any other classes not only for children, but for adults. Through community interviews, we’ve learned that people are very interested starting a co-op, expanding the construction by building a story on top and starting a community-bakery, a community garden or any type of community activity, which could potentially bring profit to the community. This could also help to maintain the school and community center, empower people, and increase both social and human capital.

GP: What advice do you have for other health professional students who want to become more involved in global/international health?

In international public health, local governments, politics, and bureaucracy is intimately intertwined with one’s work and effort. To achieve any change one must be patient and learn daily from the mistakes we all make, which battles we need to pick and which are the ones we need to fight. Community empowerment is by far the most challenging, difficult, complex, yet fulfilling work I have ever attempted to do.

GP: What are you proudest of regarding the Pau de Lima school?

Krisztina: Several members of the Mothers’ Club and myself made invitations as we tried to mobilize the community for our first school-center meeting in early August. As six people climbed the hills in the Salvadorian heat for hours by going door-to-door inviting everyone to participate, this led not only to a successful and large first meeting and the creation of a directors club, but also to other subsequent community events. On August 12th we painted the walls of the school from donated paint as nearly 30 children and about 20 adults lined up, patiently waiting for their turns. It was an all-day event with food and festivities at the end. It was a success and brought the community closer together. At the end, we formed a large circle and thanked everyone for their effort and presence.

To learn more about Pau de Lima School and how you can get involved, visit www.brazilreads.com

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