On Monday, I bid farewell to my parents at the bus station in San Cristóbal and then hopped in a combi to Oxchuc. When I arrived in Oxchuc, I met Elena’s husband and her niece, Marlen. Because Elena was working with Rahul on Monday, I went with her niece to the first community I am working in (Mesbilja) to let them know that Elena and I would be coming back on Tuesday to finish our field work there. When we arrived in Mesbilja, we looked for the President of the Health Committee at the Centro de Salud, but it was closed (as usual). We decided to go to his house, which turned out to be about an half hour walk from the Centro de Salud, across fields and rivers. When we finally arrived at his house, we were greeted by a barking dog. Luckily Jacobo (the President of the Health Committee) shooed the dog away and invited us into his home. We gave him a list of the families that we still needed to interview and asked him if we could come back in the next three days to finish our field work. He agreed, and offered us to have some pumpkin soup with his family. His wife and daughter-in-law (with her baby on back) spoke to Marlen in tseltal while we ate our pumpkin soup. When we had finished, we trekked back to where there were cars waiting to take people back to Oxchuc. After arriving back in San Cristóbal, I went to go make copies of my survey and spent a few hours in a café making packets and stapling the surveys.
Elena administering my survey in Mesbilja
On Tuesday, I woke up at 6:00 a.m. and took another combi to Oxchuc. I met Elena at her little store and then we took a car to Mesbilja. We had a list of people that we needed to interview and we spent most of the day walking from house to house. One man offered us bananas and another man and his wife gave us a bag of chayotes to take with us. We also met a local partera (midwife) in the town. Although most of the surveys were conducted in tseltal, it seemed to me as though the people were incredibly receptive to our study and were keen to offer their opinions. We took a car back to Oxchuc around 4:00 p.m. and went to Elena’s house. Her family has been incredibly kind towards me and the food that Elena cooks me is incredible. Her kids are also adorable.
Elena surveying one of the husbands
On Wednesday, Elena and I woke up early and went back to Mesbilja for our second day of surveying. We were able to accomplish quite a lot – by the end of the day we had finished surveying 18 families (for a total of 60 families in Mesbijla). Elena and I also talked to one of the nurses that works in the Centro de Salud. Many of the people we have been surveying have been saying that the Centro de Salud is not open when they need it and that there is not ‘good medicine’ at the Centro de Salud. Also, some women have said that the reason they do not go to all of their prenatal care check-ups is because the health personnel is a man. One pregnant woman said that although she had received information about risk signs during pregnancy at the Centro de Salud, it was not in her local language (tseltal). I decided that it would be a good idea to hear the perspective from one of the people that works at the Centro de Salud. We learned that there are 3 nurses that work at the Centro de Salud (2 women and 1 man) and that only one speaks tseltal. There is also a female doctor that comes about once a month from San Cristóbal. The nurse told us that the Centro de Salud is open Monday to Friday from 8:30 – 3:30 (which seems strange, since it has only been open twice in the six weekdays that me and Elena were in Mesbilja). We asked what happens if a woman is giving birth in the Centro de Salud and has a complication. They told us that the woman and her family have to pay for the transport to a hospital since the Centro de Salud is not equipped to handle obstetric complications or perform cesarean sections. If the woman and her family cannot pay for the transport, they can borrow money from the Health Committee and pay them back when they receive their check from the Oportunidades poverty alleviation program. We also asked if the information the women received during prenatal care was in their local language and the nurse replied that almost all the women speak Spanish. This may be true, but I can imagine that it would be easier for the women to understand if they were given the information in their local language (tseltal). According to the nurse, the main problem is that women get pregnant too young and they have too many children.
Mesbilja, Oxchuc
On Thursday, Elena and I returned to Mesbilja to finish interviewing the remaining families. We also gave the Health Committee five bags of bread rolls and a package of soft drinks to thank them for their help and support during our project. A drive from ECOSUR picked us up around 11:00 a.m. and we drove to the second community where I will conduct my study, Tzopiljá. When we arrived, there was a giant government truck with a slogan that said “eradicating child malnutrition” and there were people unloading nutritional supplements outside of the school. Mothers and their children lined up to receive the nutritional supplements. We found one of the promotores de salud who we had talked to the last time we went to Tzopilja. We gave her a list of families that we were going to interview and asked her if it would be OK if we came back on Monday to interview the families. I hope that the people in Tzopilja will be as receptive to our study as the families in Mesbilja. I returned to San Cristóbal on Thursday night and went to salsa class, which I had really missed while doing field work!
The road to Mesbilja
On Friday, I returned to ECOSUR. One of the main problems I have been having with my study is calculating the sample size. Dr. Ochoa told me that because Mesbilja has a population of over 1,000, I should survey 60 families and that I should survey 40 families in Tzopilja (because it has a population of between 500 – 1,000 people). However, I am confused about where the numbers ‘60’ and ‘40’ came from and I do not know exactly how many women I need to survey. I have tried to have various people at ECOSUR help me with this problem, but I have had no luck (either they are not available or they do not know). This week, I finally e-mailed Dr. Huang about the problem. Originally, I was going to calculate the sample size using an expected frequency statistic from a similar study conducted in Guatemala (which found that in one year, 44% of women had heard of ‘danger signs during pregnancy’). I have included this question in my survey and all of the women I am surveying answer this question. However, Dr. Ochoa told me that I should not use this statistic to calculate the sample size. Instead, he said that I should use the “percentage of women who had a complication during their last birth” as the percentage and he told me that this percentage from a previous ECOSUR was 10%. The first problem with using this statistic is that not all of the women in my study answer the question, “did you have a complication during your last birth” (only women who have been pregnant in the last two years answer this question because Dr. Ochoa thought that other women would not remember). Another problem with using this statistic to calculate my sample size is that it turns out that this data point does not exist (when I returned to ECOSUR, I talked with Roberto Solis, who does data analysis, and it does not exist in any databases). So I feel very stuck on how to calculate my sample size. Because the topic of my study is very new (not very many similar studies have been done), it has been hard to find related statistics to calculate sample size. Dr. Huang said that the important thing is to collect the data, so for now I will focus on doing that.
Tzopilja (the second community I am working in) - women getting nutritional supplements
On Saturday, I caught up on some sleep and worked some more on my thesis. My friend Oliver from salsa class also offered to give me guitar lessons and I started learning a song called “Vivir Sin Aire” by Maná. He made me promise that before I leave, I will sing one song and play guitar in the café where he plays. We’ll see about that :-)
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