TFH team members Kris Coontz, Matt Hickey, Kathy Hamlin, Caroline Christian and a group of 9 other UCSF students led by Jason Nagata traveled to Guatemala in March 2010 to evaluate a health education video project by the Guatemala Health Initiative at the University of Pennsylvania. Santiago Atitlán, located at 5,105 feet, is a predominantly Mayan community on the shore of the stunning Lago Atitlán in a volcano-laden mountainous region of Guatemala. The team focused their evaluation on a T’zutajil language video targeted toward community members with Type II diabetics.
Evaluation methodologies included a focus group with diabetic patients from a hospital serving the region, reviews of grammatical correctness by T’zutajil speaking interpreters, and 40 interviews with randomly selected community members, key informants, and health officials. TFH and partners are still analyzing and interpreting the data collected, but it is clear from what we have learned so far that stand-alone health interventions can be problematic in terms of retention, acceptability and providing ownership or secondary benefits toward community members.
We were blessed to work with an incredible kind grandmother – granddaughter team of interpreters, friends and guides. The trip was an interesting experience for us methodologically, ethically, and culturally. From a methodological perspective, it was a pleasure and challenge to implement random sampling with GPS units, show videos on laptops at people’s homes and record interview responses in small sections on digital recorders for greater ease of data analysis. Ethically, we learned a great deal abou
t the importance of adequate needs assessment, using multiple modalities and follow up from the responses to the video project. Culturally, it was great fun to learn about the history of the region, try the local food, spend time with our T’zutajil friends, and explore the town, located in the shadow of a 10,000 foot volcano.
What we found only strengthens our belief in the primacy of meaningful community partnerships and maximizing participation to the greatest extent possible. I’ve seen programs where outcomes are sacrificed at the expense of process, or process sacrificed for improved outcomes, and I’ve seen projects where both have been sacrificed, at the expense of what I’m not sure. But it is a rare thing indeed to find a project that strives and succeeds at maintaining focus on both. We’re a long way from achieving that with any of the projects we’re involved in. But I feel like we are least oriented in that direction.
