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PHD Public Health, Epidemiology, Nicaraguan

As a historian of Latin America and someone who lived for years in Nicaragua, helping the following applicant with her Personal Statement of Purpose in Epidemiology was a special privilege for me:

Born and raised in Nicaragua, and now completing a master’s degree in Public Health at the University of XXXX, I hope to find the necessary funding to pursue a Ph.D. in Public Health with a concentration in epidemiology. It is my life’s goal to return to my country to help improve health care for my people. The doctoral degree is both knowledge and power, which are both necessary to be able to successfully take on the intractable public health challenges that afflict my poor little country that has brutally suffered for so long, warfare and natural disasters leaving us the poorest country in Latin America beyond Haiti—and not that far behind. More than anything, a doctoral degree is for me, the leverage needed to undertake leadership positions. In my country maybe one in five hundred Nicaraguans has access to decent health care and those are the ones that can afford to pay for treatment at our outstanding private hospitals or seek treatment in countries with better health care. In many cases public hospitals are a death trap with little medication available, overworked and underpaid physicians, and supporting staff with abysmal levels of training.

At only 23, especially for someone from Central America, I have made great strides in my education - especially because my institutions have funded me all along. I have worked hard out of love for the children of my country, since so many of them die each year from an array of vaccine-preventable diseases such as whooping cough and pneumonia. My undergraduate choice of microbiology as a major with a minor in chemistry were a result of my experiences growing up in my country and anticipating graduate study in public health. I will be completing my M.P.H. this coming April of 2011.

As a clinical microbiologist intern at the National Diagnostic and Reference Center in Managua I was able to get an in-depth look at the health system in my country. We were in charge of processing samples from all public hospitals in the country. These hospitals shipped their samples to us since they could not undertake the task of diagnostic microbiology because they lacked the most basic diagnostic tools. There are extremely high levels of antibiotic resistance in our public hospitals with strains of Escherichia coli, Staphylococcus aureus and a notoriously high prevalence of multi-resistant Pseudomonas aeuruginosa. In these circumstances people go to the hospital only to die. I saw hundreds of patients come in sick and undernourished just to face further insult from nosocomial infections. Yet, I have learned as a graduate student in public health is that these problems can be resolved through simple interventions such as encouraging health workers to wash their hands to block the transmission of microbes from one patient to the next. I was excited to learn that the incidence of dengue can significantly be reduced by eliminating standing water and therefore blocking the reproduction of the Aedes aegypti mosquito

I want to learn how to design and direct research so as to be able to address the complex array of public health issues facing my country. With a Ph.D, I can become a leader in improving my nation’s health system by translating research into interventions in hospitals. These interventions may range from attempting to wane the prevalence of antibiotic resistance in health centers to implementing new diagnostic tools. With no research staff to go to the field and collect data, epidemiologic analyses can only be done in hospitals and every patient that comes in becomes a data point. I am convinced that a Ph.D. from your highly esteemed program will allow me to fulfill my goals and assume an instrumental role in the development of more effective health care systems for Nicaragua. The University of XXXX has a wide array of international missions and research in underdeveloped countries, for example, Dr. XXXX is working on waterborne diseases in Ecuador. This will allow me to build a strong network of knowledgeable people in the field. I already had a chance to interact with faculty and students who are developing projects in Latin American through the Center of Global Health in which I am a student associate. People working in these places can also elucidate how epidemiologic data can be gathered in underdeveloped countries which lack extensive databases and registries.

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