Lumen Scholar learns to adapt as she explores community health care in Uganda

Elon Lumen Scholar Samantha Perry ’18 is researching the challenges that Village Health Team volunteers face in delivering health care in Uganda. 

By Madison MacKenzie '18

Samantha Perry ’18 arrived at Elon in 2014 with a passion for international studies, drawn to the university because of its focus on global engagement and her interest in humanitarian aid. A Periclean Scholar, she’s majoring in human service studies and now as a Lumen Prize winner, she is studying how global public health issues play out at the community level in Nakaseke, Uganda.

“I’ve been able to develop a more nuanced understanding of what it means to really partner with communities and to do work that is beneficial to them and to the greater body of research,” Perry said. “That’s what sparked my interest in looking at international human rights and taking a systems perspective that doesn’t just look at policy, but seeks to really talk with community members, to understand their day-to-day lives and interactions about what is meaningful to them.”

As a Lumen Scholar, Perry is researching strategies that Village Health Team workers in Uganda employ to overcome challenges as they strive to provide high-quality care with attention to patient rights. The Lumen Prize provides selected students with a $15,000 scholarship to support and celebrate their academic and creative achievements. Lumen Scholars work closely with faculty mentors to pursue and complete their projects.

A desire to put theory into practice and apply concepts of community-based work in a novel setting inspired Perry to pursue research interests that would eventually take her to Uganda. Her sophomore year, she sought out Cindy Fair, professor of human service studies and chair of the Department of Public Health Studies, to create a research proposal focused on the integration of human rights in health care in Africa. Working together, they narrowed their line of inquiry to the prevention of mother-to-child-transmission of HIV in Ethiopia. But political turmoil in that country forced a shift of the research to Uganda.

“Our collaborators pulled their students out of Ethiopia, so we had to pivot pretty quickly to find another context,” Fair said. “That required a huge amount of work on the part of Sam, including recrafting her research question and seeking new approval of the research she wanted to pursue.”

“We had to adapt my research question because the context of looking at HIV/AIDS and sexual reproductive health didn’t look the same way in Uganda as it did in Ethiopia,” Perry said. “We really had to shift the question to Uganda.”

Once the shift was made, Perry examined the structural and contextual factors that influence the integration of patients’ rights into Village Health Team services through an examination of how these workers perceive their roles and client rights. Village Health Teams are made up of volunteers who work alongside the health care systems in their own communities in an attempt to support connections between the community and health care facilities.

“I was interested in the understanding that volunteer health workers have of patient rights and how they use that understanding in their work related to sexual and reproductive health,” Perry said. “After interviewing Village Health Team workers in Uganda, I found that they do have an understanding and respect for human rights.  My question now has shifted to examine the challenges they face and the strategies they use to overcome those challenges in their work.”

Fair, who has conducted extensive research on the HIV/AIDS epidemic, helped identify partners from University of California – Berkley and Touro University to form a research team. The collaboration with new colleagues and funding from the Lumen Prize aided Perry as she traveled to Uganda to work with Dr. Robert Kalyesubula, the founder and executive director of ACCESS Uganda, a community-based health organization.  ACCESS utilizes the Village Health Team model to expand medical care to vulnerable groups. Perry conducted interviews with Village Health Team workers and had the opportunity to see, firsthand, the passion that these volunteers bring to their work.  She developed a more nuanced understanding of what is required to work in a low-resource across cultural and language differences.

“I think it’s one thing to talk about community development and human rights in a classroom context,” Perry said. “It’s very easy to talk about policy, what the best practices are, and to have this super-optimistic save-the-world attitude. But to go to the community — to live with them, to eat with them, to talk with them— brings a whole other greater deeper understanding of what it means to do community development work.”

Once she completes her research, she will send her findings back to Kalyesubula and she hopes the impact from her work won’t be limited to just that village. Uganda is one of the first countries to adopt a plan that uses Village Health Team workers, so Perry’s hope is that her research into the effectiveness of this approach will help expand the program elsewhere in sub-Saharan Africa.

“I’m hoping that my research findings will catch the attention of people within the field of health care systems to offer some recommendations of how they can upscale their programs,” Perry said.

Formal products from her research will include submission of an abstract to the International AIDS Society conference held in Amsterdam in July 2018, as well as an article for publication in the journal Culture, Health & Sexuality.  She has applied for several national and international fellowships, as well as graduate programs. Perry hopes to continue her work in the field of social justice partnering with communities to develop authentic relationships and spur sustainable change.