This post was co-written by Sammie Truong’15, Ben Ramsey ’15, and SEAD Fellow Craig Moxley’14. Sammie and Ben spent their summer conducting a program review of COPE and other global health research in rural Uganda. Craig is a co-founder of COPE and has been actively managing the organization for a year along with Nakafeero Robinah, the General Manager

Every other Saturday at 3 pm in the parish of Naama, 40-60 children convene in an empty classroom, trickling in one by one and slipping into their seats. Some as young as 10 years old, others as old as 17, all have walked the distances to attend COPE (Counseling Orphans, Promoting Empowerment). Despite their differences in age and home village, what these children have common is their status as orphaned and vulnerable children. Entering its second year, COPE is a counseling program developed through the collaboration of community members and Duke students to address the needs of orphaned and vulnerable children in Naama.

The foundation for COPE began in 2011, when Duke undergraduate Grace Zhou conducted a research project on orphaned and vulnerable children (OVC) in the 14 villages comprising Naama Parish, Mityana, Uganda.  She discovered poor physical, cognitive, and emotional health in community-based OVC compared to their peers living in orphanages. To improve the situation of OVC living in the community, COPE evolved to its current innovative model consisting of psychosocial counseling services, material support, and career counseling. The program is managed locally with a General Manager, Nakafeero Robinah, overseeing all daily affairs along with two support staff members.

Building upon six years of work through the Naama Community Health Collaboration, COPE’s success draws upon strong ties between leaders from both Duke and the Naama community. Gaining recognition and support at the district level has not only demonstrated the need for COPE, but has also enabled us to more efficiently mobilize necessary resources to further our cause.

After winning second place in ChangeWorks, a social venture competition sponsored in part by CASE, and subsequently gaining access to SEAD funding, we have been able to take COPE into its second functional year. The additional funds allowed us to double our budget for 2013-2014 and 2014-2015 from $710 to $1500 per year.  During our fieldwork in Naama this summer, we were able to make several concrete advances towards COPE’s fundamental program goals:

• Psychosocial counseling sessions: To improve mental and emotional health of participating students, each COPE session involves an hour of psychosocial counseling from a local social worker in the community. These session include activities to boost self-esteem, create a sense of community, and provide an outlet to cope with their difficult experiences.

• Material Assistance: As most children in the program live in low-income families, part of COPE’s mission involves providing them with materials essential to their success in schools. During our first few sessions, COPE distributed workbooks and other school supplies—materials most participants normally wouldn’t be able to afford.  

• Health Outreaches: Due to the prevalence of worm infection in the Naama area, primarily due to lack of footwear, we chose to administer deworming tablets to program participants after receiving guardian consent.  As it is recommended for children to be dewormed four times a year, we will continue to administer deworming medication throughout the course of the program.  We are also raising funds to purchase shoes and possibly malaria nets as preventative measures against common diseases in Naama.

Under the supervision of General Manager Nakafeero Robinah, COPE plans to implement elements tested out during its pilot year:

•   Career counseling: COPE aims to not only provide a survey of potential career paths, but to also give participants the confidence to pursue such aspirations. Several times over the course of the program, COPE will invite professionals to explain their various occupations and serve as role models.  COPE strives to facilitate the exposure of these children to a diverse array of careers that they would otherwise not encounter.

• Income-generation projects: We have also been able to jump-start an income generating project. The children, having been divided into groups based on their home villages, will manage 3 pigs.

• School and home visits: It can be difficult to effectively monitor the situation of child in the program when it is not possible to see him or her outside of the context of the sessions. Subsequently, at the start of the next term the General Manager will be making school and home visits to ensure that lessons practiced within the sessions are continued at home.

Our work in Naama not only demonstrated the great need of orphaned and vulnerable children, but also the positive impact COPE has and will continue to make in the lives of its participants. Having seen what COPE has already accomplished, we are excited for the future, but we also understand that we need to continue to test the program to evaluate its effectiveness and develop research materials for the counselors who are conducting the psychosocial components of the program. Once we make positive steps in these directions, the future of COPE and the children enrolled in the program will look even brighter.

This post was contributed by Ringo Yen, a SEAD Summer Fellow who participated in the Engineering World Health Summer Institute. 

We spent the first month of the EWH Summer Institute in Grenada, Nicaragua where we learned Spanish and took classes in medical instrumentation.  These intensive classes took place Monday to Friday for the first month, but the weekends were free time in which were allowed to travel throughout Nicaragua and visit the major tourist venues.  Laguna de Apoyo was one of the many venues that we visited.  Laguna de Apoyo is essentially a vast lagoon, where people can swim, tan, kayak and enjoy the beautiful scenery.  On this particular day, we went with the other participants in our program.  We had a tour guide take us to the lagoon, and once we were there, we all got in the water and enjoyed what the lagoon had to offer.  The lagoon had a great snack bar as well, and we had a great lunch, in addition to all the kayaking and swimming that we were able to do.  At the end of the day, we took a minibus up to the top of a hill and we were able to see a breathtaking view of the entire lagoon.  The lagoon had a beautiful, blue hue to it, and the hills surrounding it were grand and majestic.  Not only that, the palm trees accentuated the lagoon and added a tropical vibe.  At our spot, we could even see all the other tourists swimming and kayaking in the lagoon.  Since the view was so magnificent, my partner and I just had to take a picture here.  Out of all the places we visited, I will always remember the view from the top of that hill.  The clear blue waters, colorful sky and wispy clouds all combined to form an enchanting venue.

Our family, the Mercados, took care of us during our stay in Masatepe, a small Nicaraguan town known for its furniture making.  The Mercados are a very friendly and hospitable family.  Osvaldo, the father, is the Head of Epidemiology at the hospital that Lucas and I worked at.  He was always very friendly and he would always eat dinner with us and explain the different Nicaraguan customs to us, as well as the history of the country.  I learned a great deal of Spanish during the first month, but I was not fully fluent, but Osvaldo knew this and he sometimes spoke in English to help me understand what he meant when he spoke to me.  Elida, his wife, cooked and served us meals every day we were in the homestay.  

Breakfast usually consisted of gallo pinto, a rice and bean staple in Nicaragua and scrambled eggs and dinner was usually rice and chicken or fish.  Elida is a fantastic cook and was always willing to make our stay as comfortable as possible.  Their son, Ricardo, is 12 and is grade school.  He learns karate as a hobby and takes English lessons to improve his proficiency in the language.  Grace Kelly (next to Elida) is Elida’s granddaughter, and she is 8 years old.  She was very shy at first, but over time, she felt much more comfortable with Lucas and me.  In her free time, she practices ballet and learns English, along with Ricardo.  Lucas and I were extremely happy to be assigned to live with the Mercados during our second month in Nicaragua.  We will always remember our stay in their home, their generous hospitality, and the great food we were able to have each day.

This post originally appeared on the Center for the Advancement of Social Entrepreneurship's CASE Notes Blog. To read the full post and to learn more about the Center for the Advancement of Social Entrepreneurship, click here.

When people in the United States speak about healthcare, they usually focus on problems such as billions in wasted dollars, provision of unnecessary care and lack of transparency across the system. The solutions to these problems are complex, but there is a good amount that we in the U.S. can learn (and take) from the successes of various healthcare innovations around the world.

One country that has become a hotbed of healthcare innovation is India where organizations like Narayana Hrudayalaya and Aravind Eye Hospitals have found ways to provide extremely cost-effective, high quality care to people of all income levels across numerous geographies. While the Indian healthcare system has its own structural problems around lack of access and workforce shortages, these organizations and others like them in India provide a glimpse at what a transparent and efficient approach to healthcare can look like...

This blog post was originally posted on Ashoka U's blog. To read the full post and to learn more about Changemaker of the Week Katie Guidera, click here. 

Some highlights from the blog: 

How has being a college student changed the way you act as a changemaker?
As a college student, I have learned that it is always possible to think bigger, to achieve more. Through collaboration with peers who are not afraid to question one another, I am constantly inspired to take my ideas to the next level...

 How has being at Duke helped you as a changemaker?
Duke is in a really exiting place with its social entrepreneurship initiatives right now! There is an endless array of advising, financial, networking, and academic opportunities available through the joint efforts of the Center for the Advancement of Social Entrepreneurship(CASE), the Social Entrepreneurship Accelerator at Duke (SEAD), the Duke Global Health Institute (DGHI) and other amazing programs like DukeEngage. Over my last three years at Duke, these resources have all evolved and grown immensely and are currently available to students across almost every discipline and school...