In the summer of 2011 I participated in a DukeEngage Independent Project with the Range of Motion Project (ROMP) in Quito, Ecuador. ROMP aims to serve those who lack access to the artificial limbs and orthotic bracing they require. Because manual labor occupies such a significant portion of Ecuador’s job market, the loss of a limb can often lead an individual to lose his job and his family’s income. By working to help these individuals regain their independence and return to normalcy following amputation, ROMP performs a vital role in traditionally underserved communities. After completing a high school internship in a prosthetics clinic, I wanted to get hands-on experience in the field and the project offered me an opportunity to do just that.
I chose to work with ROMP due in part to their dedication to building a sustainable presence for their patients. By training local professionals, clinics develop a self-sustaining staff of experienced prosthetic and orthotic practitioners, avoiding a reliance on outside volunteer efforts. ROMP’s clinic in Quito, staffed by only 2 or 3 individuals, granted me the opportunity to work closely with experts in the field.
We worked with amputees from all walks of life who were highly motivated to regain their independence. An average day at the clinic included initial assessments for devices, casting patients, modifying molds, pulling plastic, finishing devices, and delivering them to patients. I was thrilled that I was busy each and every day in Quito. While each day brought new challenges, it was by far some of the most rewarding and instructive work I have ever undertaken.
Some of the most pressing challenges the clinic faces are restrictions on available resources. Prosthetic components are not readily available in Quito, and as such donated components are continually sought after. New components are costly for a nonprofit organization to provide to patients, especially when design adaptations are necessary to accommodate the rough terrain in Ecuador, which often decreases the life of devices. We would frequently make modifications to fit the individual needs of our patients, determined by profession or by lifestyle. For example, we created a specific hand attachment with which one patient could use a joystick to operate the agricultural machinery he worked with.
If you are not accustomed to seeing patients with amputations, the sight can often be shocking and saddening. One of the most crucial rewards of my work was a pragmatic perspective: understanding the patients I was working with and determining their needs was more important than fixating on my feelings of sadness I had for them. Learning to look past a person’s disability and focusing on how to solve problems with a patient connects the patient and practitioner in a way that builds mutual respect. I felt more empowered to enact change when I learned to treat my patients as people and not mull over their disabilities.
Success at the clinic meant paying attention every moment of the day and gaining both the confidence and the training to work on my own. By the end of my summer in Quito, I could manufacture both prostheses and orthoses from start to finish. I was proud that my work was helping others to regain function and independence. My DukeEngage project has been one of the best experiences of my life and has inspired me to pursue a career in prosthetics and orthotics. It is my sincere hope that Duke students will continue to forge new opportunities through independent projects and through them, discover the passions which will sustain and enrich their lives.
Nina Bondre graduated in 2013 with a B.S. in Neuroscience and a minor in English. She continues to keep in touch with ROMP and plans to establish her own clinic abroad in the future. Nina began a Masters in Prosthetics and Orthotics at Northwestern University in the summer of 2013.
The Mission of ROMP is to provide prosthetic limbs and orthotic braces to those who cannot afford or do not have access to these services, empowering them to actively contribute to their families and communities.
In 2013 and 2017, ROMP again hosted DukeEngage independent participants.
I had a phenomenal experience working and living with Mama na Dada, a grassroots NGO in rural Kenya, during the summer of 2011. My project consisted of field research on childhood malnutrition and cognitive development, gathering information about child-birth practices in Kunya village, serving the children in the Circle of Hope Daycare, facilitating engaging discussions with the secondary school students in the Youth Mentors Club, and providing an extra set of hands at the understaffed health clinic.
My interest in global health led to me apply to a Duke Global Health Institute (DGHI) fieldwork program in the Fall of 2010 and I spent the spring semester planning and designing a project with my team members, Ben Hoover and Ashwin Agarwal. DGHI has a partnership with Mama na Dada and I was able to communicate with the founders of the NGO to learn more about their needs and interests while designing the DukeEngage project. Our ultimate goal was to assist the NGO in learning more about important issues in the village. Thus, quantifying childhood malnutrition was very fitting because of the tremendous challenge it poses to the future health of young children. Mama na Dada was interested in evaluating whether providing lunch to 40 orphaned children in the Daycare daily after school had an impact on improving their overall nutrition.
By being immersed in a community whose practices, beliefs, and ways of life were foreign to me, I learned more than I could have ever imagined. It is one thing to sit in a classroom at Duke and talk about global health challenges after having read about them in a textbook. But, it is something entirely different to experience them yourself. There is nothing quite like serving a community while living alongside those whom you are working for. This experience really increased my understanding of the global community that we are each a part of and I feel very fortunate to have had this opportunity.
Of course, I did have my fair share of challenges, including dealing with mosquitoes that were insistent on biting my skin, adapting my diet based on the local foods, and learning to communicate non-verbally. I am really passionate about languages and being unable to directly communicate with the villagers was difficult for me. Although I focused on learning common phrases and basic words in Luo, the local language, I had to rely on a translator most of the time. Nevertheless, I became accustomed to communicating non-verbally by using facial expressions and gestures to convey my feelings.
Remaining patient and flexible throughout my stay was also key. As a motivated Duke student, I am driven to accomplish as much as possible given the circumstances and am used to living a fast-pace life. When living in Kunya village, I was confronted by a much a different environment, one which was slower-paced, easygoing, and variable. Consequently, I had to modify my behavior and remain open-minded. For example, I remember walking to a distant home in the village to interview a guardian about child-birth practices. Upon arriving to her home, she was nowhere to be found. We asked around and found out that our interviewee had gone to the clinic. Therefore, we had to be content with the situation and try back another time. In the end, our patience paid off as we were able to reach out to everyone we wanted to and that was fulfilling!
Since returning from Kenya, I have continued to explore my interests in global health by taking classes towards the Global Health Certificate, attending engaging lectures on campus, and by helping my peers plan subsequent projects with Mama na Dada through DGHI’s student research training program.
Having an excellent mentor in Dr. Sumi Ariely has been wonderful because she focuses students on how to best prepare for their international experience. You can never be over-prepared! To this end, I recommend students considering a DukeEngage independent project to find a faculty mentor who is really passionate about their specific interests and one who may have experience in the type of work they aim to do because faculty mentors can be extremely valuable. Some other tips include communicating with your community partner as much as possible before traveling so that you can get a better idea of their needs, how you can assist, and what you should be prepared for. Also, connecting with a fellow Duke students who has travelled to your country or a region nearby can lead to fruitful discussions about their experience and what they learned. Projects generally experience changes once students reach their desired location and this is quite normal. Moreover, remembering the purpose of your visit and how you wish to give back to your community will keep you focused and driven to make a difference despite the circumstances that may come your way!
Hussain Lalani is a Neuroscience major with a Global Health Certificate. He is starting medical school in fall 2013 with hopes of continuing community-based work by volunteering in local health clinics for the uninsured and immigrant populations. He plans to get a Masters in Public Health after medical school and make addressing local public health challenges an important part of his future work. Hussain continues to work with Mana na Dada to further their nutrition work and examine major trends in children’s health. Following his project, Hussain has mentored students that have worked with Mama na Dada in subsequent years, including a group of three students in 2012 and three more in 2013 through DGHI programs.
Mama na Dada is a non-governmental organization formed by and for African women to help girls and women to empower themselves. Their mission is to reduce the vulnerability of the African female child to exploitation and discrimination through education, training and research and to enable them to reach their true potentials.
Our DukeEngage project took place in Lusaka Zambia in the summer of 2012. Through our community partner, Sport In Action, we worked at three different worksites on a variety of assignments, including P.E. and life skills education, HIV education and research, fundraising projects, and coaching soccer and basketball.
We initially decided to do an independent project because it gave us the opportunity to design a project that was perfect for us. We really wanted to work with a youth sports development organization, and we knew that we wanted to work somewhere in Africa. Many organizations in African countries use sports development as a tool for tackling HIV/AIDS and other important education and health issues, so that region was the best choice for us. The first step for us was to start looking for organizations by doing online research, which began in September. We found about 15 organizations, split up the list, and contacted them all. We were really happy that we started our work early because it gave us plenty of time to deliberate and choose the perfect organization after receiving some responses. We finally narrowed it down and chose the organization that had given us the most enthusiastic response and seemed well established.
By October we knew that we would be working with Sport In Action, an NGO in Lusaka, Zambia. We were in constant contact with the programs director, Mwape, and asked him many questions. He informed us of our housing options and we decided to live in a volunteer house. He also put us in contact with a former American volunteer which was very helpful. We continued to do more research on Sport In Action and Zambia so we could learn more about the culture and setting. Knowing that we wanted to perform research as well, we met with someone from the IRB before leaving for Christmas break. This was important because the IRB process was very long and drawn-out. When we returned to school in January we submitted our DukeEngage applications and sent our research questionnaire into the IRB. The IRB approval process ended up taking us until May so it was good that we started early.
Upon first arriving in Lusaka, we were a little overwhelmed. Mwape had told us that knowing the tribal languages was not crucial, however, it seemed that everyone was speaking them. English is the national language in Zambia, but most people speak Nyanja or Bemba in Lusaka because it is easier for them. We did come to realize that we were able to get by fine by just speaking English. Another first impression was that we were a little confused with our initial work assignment of teaching P.E. classes. While we were certainly qualified for this, we had other strengths that we wanted to offer. This is when we started to ask about doing other work, such as our HIV/AIDS classes. Ultimately, we had to figure out how to adjust our schedule to fit what we wanted while still doing what SIA wanted us to do. Mwape was very helpful in setting up new placements for us.
Our work did not come without challenges. We definitely had to adjust to some cultural differences. One of the main difficulties for us was that everyone in Zambia operates on “Zambian time.” This means that everyone is always late and it doesn’t seem to matter to anyone. We are so used to being punctual, or even early, that we had a hard time grasping this. Some days, peer leaders we worked with would show up a half hour into the 45-minute class we were supposed to teach. On another occasion when we were coaching a girls’ soccer team, the team and the head coach didn’t arrive until two and a half hours after the scheduled start time. We found that we just had to accept these differences, but when we worked on our own we were able to do things punctually. There were also a few issues with communication among the younger SIA volunteers, and there were days when we were not informed of schedule changes. We quickly became extremely proactive in contacting the volunteers and the school to double check on just about everything.
Professionally, the project was a great introduction to sports development, a new and quickly growing form of youth and international development. We were able to experiment with coaching, teaching, conducting research, and more administrative tasks like preparing fundraising projects or offering skill-building workshops for our community partner. Exposure to so many different types of work made it easier to identify the kinds of career paths we would like to pursue. Working in a culture vastly different from our own also taught us so much about the importance of patience, initiative, creativity, and self-awareness. In learning so much about other people and their lives, we even learned a lot about ourselves, bringing benefit to everyone in the process. Our community benefited from our new input and skills. Each international volunteer brings something new to the program, whether it be new games for P.E. class, effective drills to use for basketball practice, or the writing skills to prepare a sound fundraising proposal. We found that our best contribution, however, was the analysis of our HIV/AIDS research and education program. With recent data and a full HIV education curriculum, our community partner can continue the education program with further insight into attitudes and knowledge of HIV in the community.
After our experience with DukeEngage, we have both continued upon the work we began in different ways:
Sarah’s interest in sports development motivated her senior thesis, in which she wrote about the impact of athletic participation on the educational aspirations of student-athletes. After graduating in May 2013, she will be returning to Zambia for a year to work with African Impact in Livingstone, through which she will be coordinating volunteer projects and potentially developing or improving African Impact’s sports coaching program.
Chrissy used the lessons she learned in Zambia through an internship with a Tuberculosis and Child Vaccination advocacy group in DC. Her work with HIV/AIDS was particularly relevant when she attended the International AIDS Conference in DC during her internship. The challenges from inefficiencies that Chrissy encountered during her project in Zambia additionally inspired her to get involved in innovative problem solving, which she will pursue when working in the Federal Services practice at Accenture next year.
Sport in Action Zambia (SIA) is a non-governmental organisation (NGO) whose purpose is to improve people’s quality of life through sport and recreational activities. Founded in 1998, SIA was the first Zambian sports NGO. With Sport for Development (the use of sport as a tool for social change) as its underlying principle, SIA positively impacts the lives of thousands of children throughout 24 districts in Zambia.
In the summer of 2011, I coordinated environmental education programs in HaMakuya, South Africa, a rural community near Kruger National Park. Although HaMakuya is located next to one of the country’s most popular destinations for environmental tourism, the community sees little benefit from the park, and many people suffer from poverty and resource scarcity. Working with a partner organization called Tshulu Trust, I set up environmental education programs at the Makuya Empowered Voices Resource Centre, which had been built by Tshulu the year before.
Unlike most DukeEngage participants, I had visited my site before starting the project. In the fall of 2010, I spent a semester abroad in South Africa through the Organization for Tropical Studies, and as part of that semester, I stayed with a family in HaMakuya and conducted surveys in the community. One of my professors, Dr. Lara Allen, was also the Programme Manager for Tshulu Trust, and at the end of the semester, she informed the entire class that Tshulu’s first official volunteer program would be taking place that coming summer. She was planning to speak with Duke Engage about the possibilities for sending Duke students. When I learned about these efforts, I saw a perfect opportunity to return to HaMakuya. By the time I boarded my plane back to the states, I had already started my Independent Project application. Over the next several months, I worked frequently with Dr. Allen over Skype to complete my application and develop my project.
When I arrived in HaMakuya in early June, I was eager to finally get started. The next eight weeks were exciting and exhausting, frustrating and fulfilling, and sometimes extremely bizarre. Every day was a learning experience. Flexibility was essential. When I woke up each morning, I had clear plan in my head for what I was going to do, but by the time I went to sleep, the day had run an entirely different course. Although I spent much of my time working on my computer in the Resource Centre, I also conducted interviews and focus groups, met with teachers and community leaders, led environmental education programs, and took time to get to know the culture and personalities of the people around me. I worked closely with Reuben Tshitangano, a HaMakuya resident who had just been hired to run programs at the Resource Centre, and over the course of eight weeks, I trained him to handle things on his own. We also became good friends during that time, and we continue to stay in touch. Even with help, planning a full agenda of initiatives could get tricky, especially when my short-term work schedule conflicted with the long-term mindset of community members (I was only staying in HaMakuya for eight weeks, but most of the community members would stay in HaMakuya for a lifetime). Reuben’s presence helped ease this disparity, but I still tried to cram a lot of initiatives into a short period of time, and it didn’t always work out.
Despite the challenges, I accomplished a lot during my project, far more than Dr. Allen expected. When I arrived, there were no environmental education programs running at the Resource Centre, but when I left, there was a strong framework that will hopefully last for years to come. To create this framework, I ran two major programs at the Resource Centre and made plans for several more, I helped six primary schools to start becoming Eco-Schools through the South African Eco-Schools program, and I conducted research that will benefit future projects in HaMakuya. I am currently analyzing the data I collected in an independent study, and I plan to write a thesis based on my findings. My project also had many impacts that were less tangible yet just as important. My presence in the community exposed people to a different culture and perspective on the world, and it gave them the opportunity to practice English with a native speaker. Tshulu plans to run more volunteer programs in the future, so my work set an encouraging precedent. On a personal level, I immersed myself in a different culture, and by learning about that culture, I gained a better understanding of my own life and identity. I also gained skills in leadership and organization that will serve me well in my life after Duke. In terms of material gains, I received a live chicken as a gift, but I didn’t bring it home because I didn’t think I could get it past customs.
To anyone considering a Duke Engage Independent Project, I would highly recommend the experience. It requires patience, flexibility, and a lot of prior planning, but in the end, it is completely worth the effort. The opportunity to plan and execute your own service project anywhere in the world is not available to everyone, so don’t take it for granted. If you need suggestions about where to go, there’s always work to be done in HaMakuya and I would be glad to help anyone interested in planning a project.
DukeEngage shaped the course of by Duke experience and continues to influnce me today. My project cemented my dedication to working with environmental issues in the developing world, and it inspired me to pursue similar opportunities after graduating.
Ben Soltoff majored in Biology and Environmental Sciences and Policy, with English Minor. Following his DukeEngage project, Ben was a Hart Fellow in Jodhpur, India, where he spent 10 months researching the effects of climate change on rural communities in the Thar Desert.
Tshulu Trust aims to enhance responsible well being and achieve sustainable livelihoods by improving the ability of community members to utilize their natural and cultural resources in an optimal and sustainable manner. In 2012, DukeEngage participant Katie Guidera partnered with Tshulu Trust, and the organization hosted two DukeEngage engineering majors in 2013.