Updated on Sep 26, 2023 | AIGH
Jeb Weisman, PhD
Jeb Weisman, PhD, is Director of Global Health Informatics. He leads the Arnhold Institute for Global Health’s design and informatics initiatives, applying unique methods, tools, technologies, and multidisciplinary and interdisciplinary perspectives to complex global health challenges. His work centers on and supports novel applications of available technologies to address health information challenges and disparities on a global scale.
In this Q&A, he discusses his career journey and what inspired him to work in global health.
Can you tell us a little bit about yourself and your background?
I was born in the Canary Islands but grew up in the New York area. I’m happy to say I’ve lived and worked quite a few places around the world. I hold a doctorate in anthropology and have more than 35 years in health information systems. Though both anthropology and computer systems have been part of my life since the late 1960s, I’ve been an archaeologist, software developer, member of disaster response teams, textbook editor, and university faculty and CIO. I also worked once as a bouncer in Hawaii.
What inspired you to get into your career?
I’ve been inspired by the lives and philosophies of friends, colleagues, and human action through history. I prefer to do things that help people, through which I learn new things, and get to make a tangible difference. And I like to repurpose existing things—objects, ideas, approaches—to address existing needs. Still, I can’t say I’ve followed a career path in the traditional sense or even had a specific career in mind.
I decided at a very young age that I wanted to be an anthropologist, but less as a profession and more as an approach to understanding the world in which I was growing up. At the same time, I had a fascination for technologies that were maturing in the 1960s and 1970s, including computer programming. I learned to apply the ideas and practices embedded in my studies and interests to the occupations that presented themselves. Today I combine all the things I’ve studied and worked at into a useful and flexible skill set that serves the work I do every day.
What do you like most about working at the Institute?
The list is extensive, but here are a few. I like that my work and the work of my colleagues can have a direct and lasting impact on the quality of life of the people with whom we work, as well as the challenge of scaling this work. I like that I work with smart people who truly lead with a desire to make an enduring difference. And I like that working at the Institute forces me constantly to evaluate assumptions, and to adapt theory, knowledge, and skills to the work.
What led you to work in global health and what do you like about it?
I had done international work in disaster preparedness and response technology, archaeology, and cultural and forensic anthropology for a number of years before joining the Institute. So, the transition was fairly organic. All the pieces were in place waiting for the opportunity to present itself. As for why I like it, for the same reasons I like working at the Institute: enduring impact, smart people, scale, and constant challenges to my world view.
Can you tell us more about your research and how it has affected your work?
My work tends toward the applied, though sometimes it is in support of the academic research of others. One of the paths that led me here was translating social science to action. What we now call Translational Social Science (TSS). One of the best examples of TSS, for which I can take no credit, is Social Determinants of Health—which is now pervasive.
Combining TSS with informatics, I’ve developed and taught TSS courses, particularly in the context of digital health interventions. These interventions cover everything from EHRs and telehealth to all the devices we use to monitor our health and well-being. How do they shape us? What aren’t we seeing or misunderstanding when we use them? What are the unintended consequences and how do we think about and anticipate what we don’t yet understand? Social science, information systems and technology, and global health have come together in a way that lets me contribute to the global work that the Institute and Mount Sinai are doing in places such as Guyana and our other global partners, from Nepal to New York City.
What is some advice you would give someone looking to go into informatics?
Informatics is an enormous field with many, many sub-specialties, some very technical, others organizational, and still others process oriented. As you find the facet of informatics that most interests you and matches your skills, connect those skills with your unique life experience. Through this approach you can extend the value of your informatics work to the social, lived world. Hopefully, one result is that you create the basis for change and inspire new ideas and ways of doing things. And don’t worry if your path is not a straight line.
Sep 26, 2023 | AIGH
We are currently in the midst of a global crisis in child and adolescent mental health. The COVID-19 pandemic put a spotlight on the significant barriers youth and their families experience to accessing quality, evidence-based mental health care in all settings, including those that are otherwise considered to be resource-rich. In Kenya, the 2021 National Adolescent Mental Health Survey found that 12.2 percent of Kenyan adolescents (10-17 years) met criteria for a psychiatric disorder. However, of those, only 11.1 percent had accessed any form of support for their mental health concerns in the prior year, in part because of a lack of available services.
Mental health plays a critical role in the development and overall well-being of young people, which is why efforts are being undertaken at the MTRH-Rafiki Center for Excellence in Adolescent Health to improve the availability of mental health services for youth in western Kenya.
Florence Jaguga, MBChB, MMed, and Brittany McCoy, MD, are working together to lead progress towards the mental health-related care, research, and education priorities set out by the AMPATH Adolescent Working Group at the AMPATH Adolescent Summit earlier this year.
Brittany McCoy, MD
Dr. McCoy is the new Adolescent Mental Health Team Lead for AMPATH, a T32 Postdoctoral Research Fellow in Psychiatry, and an Instructor in the Departments of Psychiatry, and Global Health and Health System Design at the Icahn School of Medicine at Mount Sinai. She is a recent graduate of the Mount Sinai Triple Board Residency Program, where she trained in general pediatrics, general psychiatry, and child and adolescent psychiatry, and completed the requirements of both the pediatrics global health and global mental health residency tracks.
Dr. McCoy has a long history of engagement with AMPATH Kenya, starting in 2016 when she served for a year as the Indiana University School of Medicine Pediatric Global Health Research Scholar working with Rachel Vreeman, MD, MS. She has completed AMPATH clinical rotations at MTRH and continued to work with Dr. Vreeman and her team on research projects related to the mental health of youth living with HIV throughout her subsequent medical education and residency training.
More recently, she completed a study funded by an Pediatric Research Scholars Award at Icahn Mount Sinai to adapt a battery of mental health measures culturally and developmentally for Kenyan youth living with HIV. In her new position at AMPATH, Dr. McCoy hopes to use the unique skillset she has gained as a “Triple Boarder” to inform research, care, and education initiatives aimed at increasing adolescents’ access to evidence-based, culturally and developmentally appropriate mental health services in western Kenya.
Dr. Jaguga is a psychiatrist at MTRH and Head of the Alcohol and Drug Abuse Rehabilitation Services. She is co-chair of the AMPATH Adolescent Health Working Group. Dr. Jaguga has conducted research projects to evaluate the feasibility of a peer-led substance use screening and brief intervention program for youth at Rafiki. Her research findings support the feasibility of this program.
Florence Jaguga, MBChB, MMed
Dr. Jaguga has worked to integrate mental health and substance use screening for youth into the AMPATH electronic medical records system. The tools included in the screening are the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7) scale, and the Substance Use Screening to Brief Intervention (S2BI) tool.
Next steps include training peer counselors to conduct screening for mental health using the tools. Youth screening positive will be referred to the psychologist that is currently stationed at Rafiki Clinic. Rafiki now also runs a weekly mental health clinic led by an MTRH psychiatrist, and youths who screen positive for a mental health concern will also be referred to this weekly clinic.
Over the coming months, Dr. Jaguga and Dr. McCoy will work together with others in the adolescent health and mental health initiatives at AMPATH to continue to grow the mental health services offered by the Rafiki Center and support adolescents’ mental health.
Sep 13, 2023 | AIGH
Hilda has served as a peer navigator at the MTRH-Rafiki Centre for Excellence in Adolescent Health at AMPATH for six years, working with pregnant and parenting adolescents.
Approximately 15 percent of Kenyan adolescent girls 15-19 years old have either had a live birth or are pregnant with their first child. Globally, evidence suggests an estimated 14 percent of adolescent girls and young women give birth before the age of 18. Across Kenya, many women deliver at home without skilled birth attendants, increasing their chances of birth trauma, hemorrhage, infection, and maternal or neonatal death.
Many adolescents lack supportive communities both throughout their pregnancy and after their child is born due to stigma associated with pre-marital sex and adolescent pregnancy. Findings demonstrate that fears of becoming pregnant are motivated by worries that their community will find out that they are sexually active.
Without supportive relationships in the home or community, adolescent girls in resource constrained and rural communities frequently face challenges in receiving basic pregnancy care.
In African countries, peer navigators have been shown to provide connective care for adolescent pregnant and parenting people. Adolescent peer navigators are young people who, through lived experience, are able to connect and collaborate with adolescent in need of care.
Peers serve as a necessary bridge between patients and clinical providers, often working to alleviate the stigma associated with their lived experience. Peer navigators work within clinic systems and in the community to increase patient care, engage them in needed services, support medication adherence, and provide social support, among others.
Hilda has served as a peer navigator at the MTRH-Rafiki Centre for Excellence in Adolescent Health at AMPATH for six years, working directly with pregnant and parenting adolescents. Hilda is studying counseling and psychology, and has a passion for developing mental health resources for this population. Hilda sat down with Ashley Chory, Global Youth Health Senior Program Manager, to discuss her passion for helping others and advocating for more resources for pregnant adolescents.
What does the day in the life of a peer navigator working with look like?
I have been working as a peer navigator at the Rafiki Center for six years. A peer navigator is someone who works as a link between adolescents and the clinical team. It really helps the adolescents because the peer navigators work as a liaison to eliminate barriers between them and the clinical providers. Often times, adolescents do not feel comfortable opening up to a nurse about certain topics.
As a pregnancy peer navigator, I do retention work, which entails taking the client documents, holding one-on-one sessions, conducting support groups, and following up on those who come to the clinic. When adolescent girls take a pregnancy test, if they are positive, the clinical team hands the pregnant adolescent to me. I advocate for pregnant teenagers’ rights, safety, access to care, and referrals. Immediately, they are transferred to the Maternal Child Health facility where they deliver. I also work with pregnant adolescents who are not doing well; there is a lot of stigma around adolescent pregnancy, which is seen as a consequence due to having sex before marriage. They do not have the support needed because society views pregnancy in adolescence as taboo. Sex is a taboo subject for young people; however the reality is that adolescents are engaging in sex. Because of this stigma around pregnancy, adolescents drop out of school, but they do not get the necessary financial and psychological support needed. I believe it is crucial to have adolescent peer navigators who have been through similar experiences to support them. They might even need a psychologist to step in and assist them through this difficult period.
How has being a peer navigator changed your life?
Being a peer navigator has significantly improved my self-esteem. Now I feel like I can contribute to society. I can connect adolescents to the services they require, which has enhanced my overall skills. As a psychologist, I used to be shy, but now I perform at a professional level. I can now speak to large crowds without feeling anxious.
What are some of the challenges young people who you work with face?
Adolescents need to have access to a social support program because it allows me, as a peer navigator, to understand what kind of advice I can give by learning from their lived experiences. There are general support groups for anyone who is HIV positive, but there is a need to have groups for pregnant girls only. The pregnant girls I work with lack financial assistance, and their mental health is a contributing factor. Pregnant girls also experience postpartum stress since they are unsure of what to do because they have dropped out of school, are unable to take care of themselves, and have been disowned by their parents. This is an extremely difficult time for these adolescent girls and I want to help them.
When you see a young child, there needs to be a visible connection between the parent and the child. The girls may not be properly taking care of the child because they did not realize the responsibilities were much more significant than expected. At the Rafiki Center, there are no longer services available to teach the girls what they need to know on becoming a parent. There used to a program which included support groups and chamas, but it stopped due to COVID-19. Some of the topics included parenting practices, self-care, mental health, empowerment after childbirth, and how to assist the child.
What motivates you as a peer navigator?
My motivation is helping adolescents. If the adolescents are happy, and I can see that I did something good, that greatly inspires me, regardless of my personal problems.
How would you describe yourself?
I am patient, a people’s person, and have the ability to be accommodative.
What do you want the world to know about young people and young people in Kenya?
I want the world to know that young people are unique. They must be heard, listened to, and given a safe space to express themselves without being judged.
If you had three wishes, what would they be?
I would like to earn a higher wage and become a well-known psychologist. I wish to create an entire center dedicated to assisting adolescents regardless of their HIV status. Finally, I want to highlight peer navigator programs because they play an important role in demonstrating that it is possible for adolescents to pursue a career in this field.
Sakshi Sawarkar, MPH is an Associate Researcher, Arnhold Institute for Global Health and Department of Global Health and Health System Design
Ashley Chory, MPH, is the Senior Program Manager, Global Adolescent Health at the Arnhold Institute for Global Health at Mount Sinai and the Department of Global Health and Health System Design.
Updated on Sep 13, 2023 | AIGH
AMPATH Nepal recently hosted its first strategic planning workshop with stakeholders from the Icahn School of Medicine at Mount Sinai, Dhulikhel Hospital-Kathmandu University Hospital (DH-KUH), Kathmandu University School of Medical Sciences, AMPATH Kenya partners, and members of the AMPATH Secretariat. This process strengthened a shared vision and defined strategic priorities for work together over the next five years.
Rachel Vreeman, MD, MS, Chair of the Department of Global Health and Health System Design and Director of the Arnhold Institute for Global Health at Icahn Mount Sinai, led us in an exercise to envision together how the partnership can indeed bring “quality health care for all.” We reviewed AMPATH’s vision: “a global partnership to ensure health for all,” which aligns well with DH-KUH’s vision of “quality health care for all.”
Our connection related to care stood out for all of us: Ampath’s motto of “leading with care” and DH-KUH’s motto of “we care” makes care the center of all we do within our partnership. To reach quality health care for all, we wanted to consider together in each of our priorities how to think across the health system from the community to the referral hospital and across the lifespan of the population to holistically address the health needs of the populations we serve.
Leading up to the strategic planning workshop, we identified priorities in care, education, and research based on burden of disease in Nepal, strengths of all partners, and priorities of our Nepal institutional partners and communities. This led us to prioritize noncommunicable diseases (NCDs), attributing to more than 70 percent of deaths in Nepal. Our work over the next five years will start in the community to develop a comprehensive care model to screen, link, treat, and retain patients with NCDs and incorporate guidelines for referrals. With this, we recognize the need to provide the highest quality subspecialty care within DH-KUH to care for those with complications from NCDs.
A drawing Rachel Vreeman, MD, MS, made during the strategic planning meeting in Nepal
Another care priority includes women’s and child health. While there has been success related to antenatal care and increasing institutional births, we still recognize gaps within ongoing postnatal care and child health. We hope to expand some of the Institute’s prior work using the community health worker model in Dolakha to improve outcomes in these areas. Additionally, as DH-KUH develops high-risk pregnancy services, we will work together to support increasing the number of normal deliveries in community facilities, screening for high-risk pregnancies, and guidelines for referrals. The partnership will also include important women’s health issues beyond reproductive health, such as cervical and breast cancer screening and treatment.
The education team meet in Nepal to discuss multilateral exchange programs.
Over the next five years, we will develop adolescent friendly health services to support the needs of adolescents in the communities served by DH-KUH. AMPATH Nepal is already supporting a population-based needs assessment among adolescents. With this data and input from adolescents, we will support trainings and development of adolescent friendly services in the community and at DH-KUH. This will complement the work AIGH is doing globally related to adolescent health.
For each of these care priorities, we need education and research to support their progress and inform future direction. Both our education and research teams worked together to consider how to grow the infrastructure to support multilateral exchanges, workforce development, and research training and capacity.
We not only strengthened our shared vision and defined priorities for the next five years, but also continued to build relationships and trust. We learned from one another and will always remember the wise words from our AMPATH Kenya colleagues—words of encouragement, reminders that, “Sometimes we will win and sometimes we will learn,” and of course, “If we want to walk fast, walk alone; if we want to walk far, walk together.” So, as we consider the first of many strategic plans, more than anything, we are committed to a long-term partnership of walking together to ensure health for all.
Rose House, MD, MS, an Associate Professor of Emergency Medicine and Pediatrics, has served as Nepal Partnership Director since September 2022. She works alongside Nepal colleagues to develop and support our global health partnership between Mount Sinai, Kathmandu University School of Medicine, and Dhulikhel Hospital in Nepal. She also provides education and clinical care in emergency medicine and pediatric emergency medicine.
Aug 21, 2023 | AIGH
Shurnette Henry
Shurnette Henry is a Senior Finance Manager at the Arnhold Institute for Global Health and the Department of Global Health and Health System Design at the Icahn School of Medicine at Mount Sinai. In her role, she provides financial portfolio management and assists investigators with all aspects of pre-award proposal development, finance, and post-award grants management. She has worked for the Institute for four years. She previously worked at Columbia University Irving Medical Center.
In this Q & A, she discusses her career journey and what inspired her to work in global health.
Can you tell us a little bit about yourself and your background?
I came to New York in 2000 from Toronto and began a career in finance as a stockbroker. I continued in various financial roles over the next 20 years, serving both corporate and individual clients with a broad spectrum of financial products and managing corporate financial portfolios. Over time, I found myself gravitating toward the relationships and aspects of my career that helped people on a personal level.
What inspired you to make a change in your career?
As I progressed through my career, I found that my personal interests for adding value to people’s lives was misaligned with the corporate demands of building wealth. The incentive for wealth generation was more advantageous for the institutions I worked for than for the individuals I wanted to help. Therefore, I left corporate finance and began looking for opportunities that were better aligned with my desire to help people who perhaps didn’t have access to essential information or tools to help themselves. I came onboard to fulfill the Institute’s need to find a grants and finance professional who could develop its inter-departmental grants process and financial management of accounts, and I was looking to work with a team that shared my care for people, and desire to impact people’s lives in a personal way.
What do you like most about working at the Institute?
I love that what we do at the Institute as it affects the lives of people locally and internationally, especially individuals who represent underserved demographics. It’s also an added bonus that the team within Global Health consists of a collection of talented people who all share a common goal of working from a place of mutual respect and appreciation, and work collaborative to make an impact.
What led you to work in global health and what do you like about it?
I’ve always been fascinated with macroeconomics and understanding how different socioeconomic systems affect different people’s lives. Therefore, when I was approached with the opportunity to work in global health, I loved learning about the Department’s mission and the steps it was taking to achieve it. Global health is a field that focuses on improving the well-being and health of people around the world. It goes beyond borders, races, and cultures, aiming to ensure that everyone has access to quality health care, regardless of their socioeconomic status.
The impact that we’re making at the Institute can be transformative as we work with our domestic and international partners to establish health systems, reduce suffering, and improve the quality of life for numerous people. We bring together professionals from diverse disciplines, governments, non-governmental organizations, and communities to find innovative solutions to complex health problems. The contribution that I bring to the team at the Institute allows me to fulfill my desire to contribute positively to the world, make a meaningful difference in people’s lives, and work towards a more equitable and healthier world. It makes me feel really good that I’ve added value in a small way toward a greater goal.
What are some of the most challenging aspects of your career?
One of the most challenging aspects of my career includes dealing with the complexities of funding and budgeting in a constantly evolving and unpredictable environment. Our projects often operate with finite resources, and we are constantly competing within the global marketplace for funding. As a global health department, we regularly collaborate with institutions in other countries that have their own set of financial regulations and compliance requirements. Ensuring adherence and managing cross-border transactions can sometimes present challenges. During these times, it becomes essential for me to work on a deeper level with individuals at our collaborating institutions. This also makes the challenging parts of what I do that much more enjoyable because, depending on the situation, I’ll find myself speaking with dynamic people who are half way across the world.
Finance is undeniably a crucial and necessary part of any business or body of research, and it is true that many people may find it intimidating or overwhelming. I personally believe that, in many ways, the budget informs the important research work that is done, therefore I make it my goal to work with our Principal Investigators to build strong budgets that will support the important work that they do.
What is some advice you would give someone looking to go into finance and grants?
I would encourage anyone seeking a career in finance and grants to pursue relevant training and education in finance, accounting, economics, and business administration, since it touches all of these skill sets. Develop your financial analytical skills, including modeling, budgeting, and forecasting; and stay relevant on shifting trends. Communication is also key because you are continually creating and translating budgets to people who don’t necessarily manage budgets on a regular basis. Finally, try to always be adaptable and resilient so that you can successfully navigate through changes, overcome obstacles, and always be open to learning something new.
Updated on Aug 15, 2023 | AIGH
Peer navigators play an integral role in connecting adolescents with clinical care at the AMPATH Rafiki clinic, but what happens to peers as they transition from adolescence to young adulthood and beyond?
The peer navigator program has immense benefits; it provides many young people with a first job that is fulfilling and rewarding, with opportunities for skills building and learning, as well as career exploration. However, peer navigators eventually age out of the program, as it is only for so long that they are of a similar age as the adolescents they are supporting. These peer navigators are trained and perfectly poised to continue their important work at AMPATH in another capacity.
To maintain involvement in AMPATH and transfer and grow skills, some former peer mentors/navigators turn to getting involved in health and HIV-related research at AMPATH as peer researchers or as part of the Adolescent and Youth Research Advisory Board (AYRAB).
Some peer mentors aspire to become investigators who may lead their own research portfolio. On this path, some peer mentors have transitioned to the role of peer researcher to gain experience and build new skills that will support their career development.
Several of the peer navigators at the AMPATH Rafiki clinic have contributed to research being conducted, and have co-authored several papers with Mount Sinai researchers on topics such as sources of perceived stigma, the impact of multimedia teacher trainings on HIV related stigma, and the prevalence of COVID-19 infection among HIV-infected youth during the pandemic.
Dennis is a peer navigator turned peer research assistant whose first contact with AMPATH was as a patient. He became a peer navigator in 2016, and in 2021 transitioned to being a peer researcher after he aged out of the program.
Dennis has very strong relationships in the community, making him excellent at youth recruitment for studies. He has a pulse on the activities at the Rafiki Centre, as well as in the broader Eldoret community, which also helps to inform our study ideas and procedures. As a peer research assistant, Dennis is also very helpful in picking up on the needs of our participants, and the best ways to engage them. His research focuses on engaging children and adolescents living with HIV, and he has co-authored publications concerning adolescent stigma and ethics.
He sat down with Lonnie Embleton PhD, MPH, an Adolescent Health Advisor at the Arnhold Institute for Global Health at the Icahn School of Medicine at Mount Sinai, and Assistant Professor, Department of Global Health and Health Systems Design, to discuss peer mentors and peer researchers at the Rafiki clinic.
Tell me about what a peer mentor does and your role at Rafiki and AMPATH as a young person?
My role as a peer mentor is linking adolescents to clinicians, especially finding out the things that are hard for the adolescent to tell people, like in school and to other adults. These are topics like stigma in schools, relationships, positive health, dignity, prevention, and how to adhere to medication. The role of a peer mentor is to help them tackle challenges to adherence. Because I’ve walked through the same journey, I have tricks up my sleeves about how to survive and can share those. At the AMPATH facility, we can talk about advocacy, an adolescent’s personal role in their care, and resource mobilization.
So now you’ve transitioned from being a peer mentor to researcher?
Yes. As a peer researcher, I am engaged in recruiting participants, consenting/assenting, and evaluating. In this specific study, we are evaluating and doing interviews with adolescents, and scheduling them for research visits. I also do some data entry, storage, and visualization, mostly within the sphere of research.
What does it mean to be an adolescent/youth peer mentor in Kenya?
During [a community level stigma reduction study study], we trained teachers on how to impact stigma reduction in schools, and created training modules with school teachers. We taught them how, if they find an adolescent living with HIV in the school, they can create a safe environment in the classroom where students feel free to talk about the challenges they face, their relationships, and even feel comfortable enough to disclose their status.
It means a lot that the peer mentors are a part of the research process. Involvement of young people in medical research, such as the introduction of injectable drugs for HIV, often doesn’t happen. Having a peer navigator involved in research allows for that perspective to be present in the development process.
[Another study] looked at some of the challenges that adolescents are facing throughout the COVID-19 pandemic. As a peer researcher, adolescents feel free talking to me; during the pandemic adolescents would open up to me about lacking food or transport and couldn’t travel [to clinic], etc. So being a peer researcher, I understand the challenges that adolescents face easier than a clinician who is checking their viral loads, for example. I bring friendliness to the adolescent, and they are more honest with me with their thoughts than with the others.
What does the day in the life of a peer mentor or researcher working with adolescents living with HIV look like?
We get to impact a person’s HIV care at the clinic, affecting their treatment adherence and their status from not being virally suppressed to being suppressed. It’s satisfying for a young person to go through that journey with the adolescents and find solutions. Just assisting with an adolescent through the journey, helping an adolescent stay negative, who is already infected, is enjoyable.
Nothing about us without us. Working at Rafiki, I get to understand the needs of the adolescents and channel those concerns forward. Whenever the researchers are making policies or programs, they can see what the adolescents need. With this knowledge, we can create adolescent services to fill their unique needs. So, that is most enjoyable. There is also an advocacy aspect—I get to interact with the outside population and understand and correct myths and misconceptions [about HIV].
How has being a peer mentor and researcher changed your life?
I got to learn a lot about how research is done and some of the priorities I need to make for my own future career. I was mentored on how to write an abstract and manuscript, and I got to travel to the 2019 International Conference of AIDS and STIs in Africa to discuss my work and learn from others. It is interesting and empowering to sit down with policymakers at a summit and tell people what would work, and what would not, and what should be prioritized, based on my experience and knowledge. The journey is great, and is helping me figure out which line of medical research I want to work with. I am currently interested in mental health.
What do you envision in your future career?
I am interested in research and, as a peer in research, I want to answer some of the questions and knowledge gaps I see. I think research will empower me to answer questions I have myself. Research tells us why and how we can improve. I am early in my education, and much more interested in those young people, who have not yet graduated with degrees, and how they can implement innovative ideas they have.
What is one thing that you wish people knew about the role of youth peer mentors?
That it’s hard. It is not as simple as it seems to be a peer mentor. You have to understand mental health, medications, BMI and nutrition; you are partly a social worker for adolescents one-on-one to understand what is going on at home. You are a mini-bit of every role in the facility.
People think peer mentorship is simply a young person talking to another young person. But you have a role in everything. With viral load, for example, you know the person’s value and we have to understand what this means; how this pattern reflects the client’s health. Because we do, we can figure out if they need to see a clinician, nutritionist, or a social worker. So, you need to understand all of the aspects of care for a young person to know how to support them and help link them to the care they need when they confide in you.
What are some of the challenges of being a peer mentor?
The challenges are lack of training. In the world of HIV, information is constantly changing. We get stuck with the old recommendations and need updated information. Young people have to look for the information themselves. We need a structured way to get the most up-to-date information as quickly as possible, and a structured way of training. If you are not constantly looking for updates, you will get stuck with the old information because there is no standardized reporting tool. For example, nevirapine [a medication to treat HIV] is still there, but in the process of being phased out.
What motivates you as a peer mentor?
Getting to walk on the journey with young people, because I’ve been there myself. Getting to assist a young person, it feels good to have impacted someone’s life for the better. Now I have networks, and networking with other people gives me insight into what is currently going on, and what I can do in the facility to get on that level and help. Most of the peer mentors are in the community, but we are in the facility, so we are limited in engaging with what other organizations are doing. I’m also motivated by the linkages to attend conferences and HIV workshops–funded by AMPATH.
Outside of being a peer mentor/researcher, what do you like to do?
I play chess, I play football, I like going on trips, taking walks, and long road trips. I enjoy engaging with community-based organizations and other organizations to see what is being initiated and what can I do to facilitate programs that will work in our facility. Some examples include safe spaces, mental health spaces, safe environments for young people, new [treatment] drugs being rolled out, etc. I am also passionate about using digital platforms to empower young people to advocate for healthy behaviors.
A lot of my interests circulate around health. I am also passionate about creating an adolescent camp. It would be interesting; a peer mentor adolescent camp/club, where we could engage for a week or four days outside of the clinic and talk about their challenges. It would be great to have the chance to debrief among peer mentors—we hear and see a lot, but who sees us?
What are three words that best describe you?
Enthusiastic. Self-driven. Creative!
What do you want the world to know about young people and young people in Kenya?
They have the push and the drive to find solutions for themselves. Kenya is a competitive country, every young person has something unique about them. They have grit. Young people are mostly self-driven, with an explosion of ideas to implement. Getting the ability to implement them is a challenge, figuring out how to take their ideas to fruition, so they can make a difference in the community.
Lonnie Embleton, PhD, MPH, is an Adolescent Health Advisor and Assistant Professor, Department of Global Health and Health System Design.
Ava Boal is an Associate Researcher, Arnhold institute for Global Health and Department of Global Health and Health System Design.
