Adie Ramirez has always been one with a passion for global health. She’s visited several countries in Central America, noting the importance of understanding the communities she could one day serve as a physician.
This past November, with the support of the Office of Global Health Education in the Institute for Global Health and Infectious Diseases, she wrapped up a three-month trip to Guatemala.
During her time there, she partnered with Fundación Para la Salud Integral de Los Guatemaltecos (FunSalud), a research institute that responds to the needs of the Guatemalan population. Ramirez and the team researched malnutrition in the country, revamping the program to shift from addressing acute malnutrition to chronic malnutrition.
“It was really important work,” said Ramirez, a medical student in the class of 2026. “It could potentially change the way that we treat malnutrition as a whole, particularly in a worldwide setting and in countries who have higher rates of chronic malnutrition.”
Now, in her final year at the UNC School of Medicine, she recounts the highlights from her time in Guatemala.
What did a typical day look like?
For the majority of my trip, I would go out with the field teams. The malnutrition program used tuk tuks to go visit families. Our main goal was to help change the nutrition of these kids. I worked with a nutritionist as she went out to the field, providing nutritional education, anthropometric measurements of the kids, and general advice.
A lot of our research ended up changing that flow, seeing the information and bringing in specialists who were able to change the way the information is created and curated for families so that it was more responsive. On our way back, I would sit with the leadership team and talk about things we could change. There was a lot of data collection and going through that as well, which is not the fun part, but I think it’s just as important.
What did your research look like while you were there?
When I initially got there, there was an internal analysis of the program, and we found that the kids weren’t really improving while they were in our program. We’d see them, and they would still be in a really chronic state of malnutrition. That was hard for us to grapple with, especially because we’re spending a lot of time with these families. We realized something needed to change.
We added more field workers, we added new vehicles, and we added lectures for the team to be more knowledgeable about the things that we would be seeing. I was in charge of organizing the planning process. It was a shift in the program with how we responded to the families, and it gave us more time with the families. At the end of the day, that’s the most important thing. We want to make sure that these moms understood that we were there for their families and were there for their kids. We wanted them to be better and feel better and set them up for success.
Why was this research particularly impactful?
A lot of research has shown how important nutrition is in the first 1,000 days. It impacts your neurodevelopment for the rest of your life. Our goal was that we don’t want to capture kids that are two years old. We want to capture them younger and make sure we can get them the nutrition needed in order for them to be successful later on in life. As of now, the program itself has been incredibly successful. We are seeing kids improving. Families are more interactive. We are spending more time with the families. We truly think that it can change the scheme of malnutrition treatment and research.
Were there any moments from the trip that really stood out?
I was there long enough to see kids really be able to turn in their care and how they were responding to the program. That was particularly magical for me. I can think of one kid in particular. When I got there, I was terrified because we’re trained to look for alarm signs and red flags. When I first set my eyes on him, I was concerned that he was not going to survive. I was more vigilant about making those visits and being out there with him. By the time I left, he was responding in a way where I said, ‘OK, I can leave and feel really comfortable and really safe that he is going to thrive in a way that he wasn’t before.’
How was this trip different from other trips you’ve been on before?
I think the biggest thing and what I’ve always called for in global health is that the community knows what it needs. The community knows what it wants. It’s our job with our knowledge to provide the hands to get them where they want to be. This program did an incredible job of doing that and listened to what the people needed. FunSalud is an amazing program. The research being done out there is state-of-the-art and revolutionary. I’m really excited to keep talking to everyone about it all the time.
Some answers were edited and condensed for clarity.
To help support future SOM student global health programs, donate at: www.unchf.org/globalmeded