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“Do what you can, with what you have, where you are”

                                                    by Mexan Mapouka, MD

I am grateful to be part of the Rotary Peace Fellowship and am currently applying the epidemiological skills I have learned in the humanitarian field. My summer is filled with four projects that I am conducting with colleagues both in the U.S and abroad.

First, I am working with the Gillings Humanitarian Health Initative (HHI), where I am conducting research on COVID-19 vaccination status among the immigrants and refugee population of North Carolina. I study the factors associated with their vaccination status. There is evidence that immigrant and refugee populations continue to face many barriers that prevent their access to good healthcare services in their countries of arrival such as the U.S. The COVID-19 pandemic has exposed many pre-existing barriers that refugee populations face. Those barriers fail within the category of health inequity, and some of them, for example, haven’t integrated into the local community, have language barriers, struggle with transportation, etc.

Therefore during my summer applied field experience, I am working with HHI and one faculty member from the Department of Family Medicine, UNC School of Medicine, and have designed a cross-sectional survey that has allowed me to collect behavioral and demographic data from participants in the study (after approval from UNC IRB and Office of Human Research Ethics). I have conducted the first phase of the data analysis and hope soon to finish and get the paper published.  The findings of my research will be important to understanding the barriers refugees may face and provide some policy recommendations to the State of North Carolina and Agencies working on refugee resettlement programs.

At the same time, I also volunteer and engage with the Refugee Community Partnership, an organization in Carrboro, providing them with guidance and recommendations on how to address healthcare barriers refugees may face, and how to improve their services in resettlement programs. As a native French and Sango speaker, my work consists of providing language navigation support, facilitating medical appointments, and information on drug prescriptions to Sango and French speakers refugees in the local communities.

Meeting with Refugee Community Partnership Organization in Carrboro, North Carolina USA

Besides my work with HHI and RCP, I also collaborate with medical doctors and colleagues remotely in the Central African Republic (C.A.R). Our goal is to provide basic healthcare training to nurses, midwives, and community healthcare workers to respond to medical emergencies in the context of a post-conflict situation with the personnel of the District Hospital in the City of Bossembélé, where I was born in the Central African Republic. The city is one of those most affected by the Civil war between 2013 and 2017 and more recently in 2021.

Our project will focus on medical training in the prevention and management of malaria, respiratory distress, anemia as well as other local most ten causes of emergencies. This opportunity allows me to serve my community back while studying abroad.

I hope to expand this and cover most public health issues that the C.A.R is facing today.

Finally, I have been a member of a research team at the North Carolina Department of Health and Human Services (NCDHHS) , a U.S government organization that focuses on health equity. I work with the North Carolina State Center for Health Statistics (SCHS) on Community Health Data Collection and Capacity. This project is associated with

 

Nurse, providing healthcare service to patients in the District Hospital of Bossembele, Central African Republic

 

Shaw University and the North Carolina Institute for Public Health as part of a community health data collection initiative to survey Durham County (NC) residents and assess the differential impacts of COVID-19 disease across people and places, with a focus on quantifying the association between wealth and COVID-19 disease. With this project, I am involved in survey design, sampling methods, data collection, and analysis. I also receive training on health equity and how to approach, work and collect data in the communities of the Historically Marginalized Population (HMP) of North Carolina. For example, I learned so far through meetings, collaboration, and training that the COVID-19 pandemic has not created disparities among HMP but has exposed the pre-existence health disparities that already existed before the pandemic. Those disparities confirm the existing spectrum of inequity that range from segregation, and lack of opportunities that impact the whole communities of HMP. As a medical epidemiologist, my goal is not only to complete this Applied Field Experience (AFE) but also to look far beyond how I can continue to contribute to addressing those issues.

Being a Peace fellow has been a blessing and I want to thank the Rotary Peace Fellowship for this opportunity to work and serve the communities in both USA and home from distance. I end with the following quote from US President Theodore Roosevelt:

“Do what you can, with what you have, where you are”

Dr. Mexan Mapouka

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