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Nydia Palacio

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My typical day of working in TB starts with venturing to my patients houses or other locations of their choosing (even including a Burger King parking lot) where I administer Directly Observed Therapy (DOT). This requires me to watch the patient swallow every dose of the prescribed drugs, which is often harder than one might think. Many patients try to hide their pills, so to ensure that protocol is followed, I hold a conversation with the patients for at least five minutes after the pills are taken. Because treatment for standard patients is six months, these conversations not only allow me to get to know my patients better, but also create a trust that is essential for good contact investigations. These extra five minutes often create a world of difference! Even though there is sometimes a slight language barrier, I quickly picked up different languages and even have come to know the Spanish slang. After DOT is administered to various patients, my day could include anything from conducting interviews with patients, tracking down contacts, evaluating the quality of medical follow-ups for immigrants, writing up consults, or working on our outreach efforts with the Dominican community.

This has all been an invaluable experience for me, because getting your hands dirty and working with your supervisor to correct and learn from your mistakes is exactly what PHAP is all about. This kind of experience is essential to effective public health practice. It's hard to know what kind of solutions to come up with when you don't know what the problem on-the-ground is. You may also have unrealistic expectations of what can be achieved if you've never done the work yourself. These experiences are useful later when you are making large scale decisions that may affect many different program areas.

Nydia Palacio

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