Notes From the Field: On Elephants and String Hoppers

When Lorenna Garcia-Bochas was an undergraduate student at Fayetteville State University, she thought her future was inside a lab. That idea began to change when she organized a health fair for Vietnamese refugees in Greensboro. It was the first time in several years that some of the attendees had seen a doctor.

Garcia-Bochas went on to graduate school at Kennesaw State University, where she was part of a research project on healthcare gaps experienced by a local population of Guatemalan immigrants.

“I realized just doing lab work wasn’t my happy place,” she says. “It’s working in communities and with human populations.”

Now a student in DGHI’s Master of Science in Global Health program, Garcia-Bochas is deepening her experience with a new community. She spent the summer in Galle, Sri Lanka, conducting research on antibiotic use with Gayani Tillekeratne, M.D., an assistant professor of medicine and global health, who also co-directs the Ruhuna-Duke Centre for Infectious Diseases.

“This experience made me realize I can do foreign work, and this is the right path for me,” she says.

As she prepares to head back to Durham, Garcia-Bochas shared more about her field research, living in Sri Lanka, and why she’s grown fond of “string hoppers.”

What is your thesis work in Sri Lanka about?

I’m continuing a previous project to help create an antibiogram, a tool physicians use to find the correct antibiotic to treat patients. [Currently,] there’s a rise in antibiotic resistance in patients. It happens when they are under- or over-prescribed antibiotics or given the wrong medication to treat conditions such as urinary tract infections and pneumonia.

Antibiograms are created using microbiology data from Teaching Hospital Karapitiya where I do my field work. The antibiogram is faster to use because in some low-resource settings, it can take days to get culture test results. I’m interviewing physicians to explore their knowledge, attitudes and perceptions to determine the factors impacting the development and implementation of antibiograms. I want to understand what patients are coming in with, how they’re treated and how the medical system works here to better develop antibiogram training strategies.

Were you nervous about traveling this far?

I wasn’t because I can handle solo travel, but I was worried about my mom and younger brother. This is the first time I don’t have family around. When I’d talk to my mom, I could hear in her voice she was worried and missed me. I told her this is the career I want to have, and I’ll be flying to different places. She understood. Still, I’m excited to return home. I’ve missed my family.

Is there a memorable experience that stands out?

I went to Yala National Park, and I saw beautiful elphants, a jaguar, buffalo, and deer. One of the reserve guards said it had been three to four weeks since they had seen an elephant. The elephants must love me to have come out, and I’ve always wanted to see them. That was a good weekend because I also got to see the countryside, with rice and sugar cane fields.

What is a string hopper?

It’s a street food, it’s crunchy and you eat it similarly to a tortilla [String hoppers are a breakfast dish made of rice noodles typically served with curry and Pol Sambol]. It’s very good, and sometimes they put egg in it. Every time I saw someone selling it, I would get one. It became a comfort food here for me like how soul food is to me back home.

What has your time in Sri Lanka taught you?

To relax and let things happen. I can be very Type-A and say, ‘I have to do this, this and this.’ Being here has taught me that even if I do mess up, things will proceed and the work will still get done. I’ve learned to be more relaxed about my work, focus on the bigger goals and know that it’s still going to be okay.

What has your experience showed you about the importance of continuing global health work?

People say public health is global health and vice versa, which is true. We saw this with COVID-19 and how the virus spread across the world. We need to be more mindful about what happens in one country because it can happen anywhere else. There are no boarders with health issues because we’re all interconnected. We need to continue coming together, not fight each other, and better the world for us now and future generations.