EL SALVADOR

BUILDING BRIDGES
Mapping Childhood Malnutrition in
Chiapas, Mexico BY MAGGIE COCHRAN
I love global health. I love
to travel, I love learning new
languages, and I am passionate
about providing health
care to underserved populations.
Thus, the opportunity
to do hands-on pediatric
research in rural Mexico this
summer sounded perfect.
However, what I thought
would be a summer of inspiration
and enlightenment
became an internal struggle
to find purpose in my work. I
found myself questioning the
value of global health, and my
role in its mission. Instead of
clarity, I often encountered
overwhelming ambiguity.
Maggie Cochran with a child; Chiapas landscape
THIS SUMMER, I WORKED AS A
researcher with Compañeros
En Salud (CES), a sister organization
to Partners in Health.
It provides high-quality, primary
health care to the Chiapas
region—one of Mexico’s
poorest and most isolated
states. I sought to assess the
prevalence of chronic and
acute malnutrition in children
under five and to make
comprehensive maps of this
information for future health
care interventions. Each week
I traveled to a new mountain
community with a GPS and
measuring tape in hand; I
hiked home-to-home weighing
and measuring children,
interviewing parents about
food security, and plotting this
data on virtual maps of the
region.
Most days were inspirational.
The community-members
were incredibly warm
and open, offering bottomless
cups of coffee as they told
me their deepest fears about
money, food and family. As a
second-year medical student,
I am still getting used to the
privilege that comes with the
white coat; I am humbled
by the fact that strangers are
willing to reveal so much to
me about their personal lives
and inner reflections—and I
hope this humbling feeling
never goes away.
I also felt as though I could
truly be helpful. Almost half
of the children I encountered
suffered from chronic malnutrition.
Chronic malnutrition
may be caused by poor diet,
frequent infections and/or
poor maternal nutrition while
the child is in the womb. If
left untreated, children who
suffer from chronic malnutrition
may not grow to their full
potential, mentally or physically.
My goal was to intervene
during this critical period, to
inform parents of their child’s
illness and motivate them to
act. Many parents seemed to
really listen to my nutritional
charlas, asking thoughtful
questions about their child’s
diet. A majority of parents
immediately visited the local
doctor to engage in more personalized
conversations about
their child’s health.
But many days I felt hopeless.
Many days I didn’t want
to go to work, because I knew
I’d have to tell twenty more
starving mothers that their
children were starving, too.
And what were the mothers
supposed to do with this
information? They have no
resources; they have no options.
I began to question the value
of my work. Without reform
at the highest level—national
and international governments
enacting real social
change—how can individuals
like me hope to improve the
health outcomes of these suffering
families? I felt myself
starting to crumble under
an overwhelming feeling of
helplessness.
When I spoke to my mentor
about these alternating
feelings of empowerment and
despair, he responded that
these were staples of the global
health experience. On the
one hand, the work is meaningful
and often life-changing
for patient and physician; on
the other hand, global health
delivery can feel hopeless
when larger social structures
work against it. While organizations
like CES take both
a bottom-up and a top-down
approach in an attempt to
address health care at the
individual and societal level,
my mentor still emphasized
that as an individual global
health practitioner, one needs
to hold on to the good days
during times of self-doubt. So
I am choosing to hold on to
the good days—the days full
of inspiration and love and
hope—and I am excited to use
the data collected from this
summer to design interventions
that will make Chiapas a
happier, healthier place. And
today, that is good enough
motivation for me.
Maggie Cochran is a student
at Harvard Medical School.
She graduated from Harvard
College in 2011 with a major
in Psychology. She used her
DRCLAS Summer Independent
Internship Travel Grant
to study childhood malnutrition
in Chiapas, Mexico.
100 ReVista SPRING 2016 PHOTOS COURTESY OF MAGGIE CPCHRAN