Student conducts research to address issues of HIV in South Africa
When Sindhu Ravishankar first came to N.C. State University four years ago to major in biology and international studies, she thought she might like to become a doctor. But by the time she met a boy in South Africa, a different future – one spent addressing community health through anthropology research – was unfolding.
Two years ago, Ravishankar spent a semester studying at the University of Cape Town and volunteering at a nearby hospital. At the hospital, she spent much time with a 3-year-old patient whose parents never visited. Ravishankar lavished time and gentle attention on the boy, who had tuberculosis and meningitis. She became so attached to him that when he was transferred to another hospital, she went with him, soon becoming known as the boy’s “other mother.”
That experience – and others that would follow in Cape Town — confirmed for Ravishankar that her ability to forge meaningful relationships with all kinds of people was an asset – one that she could use to make a difference not only with individuals but with whole communities.
Ravishankar is now a senior pursuing the Rhodes and Marshall scholarships for graduate study in medical anthropology and development studies in England. Her academic and professional goal is, as she puts it, “to bridge the gap between science and social science, quantitative and qualitative, anthropology and public health.
“I want to do research that not only results in knowledge,” she says, “but also has a community health impact.”
And already, Ravishankar is doing just that. She’s undertaken two HIV-related research studies in Cape Town, and she’s preparing to follow up with more research and with a community service project to address a problem she found.
It was her volunteer hospital work that sparked Ravishankar’s interest in HIV and its impact on communities. When she finished her semester at the University of Cape Town, she went to work as an intern with Wola Nani, a nonprofit group addressing the needs of people with HIV. She helped the organization coordinate activities for at-risk youth and oversaw adult HIV support groups.
As Wola Nani explored whether to bring in outside experts to bring more structure to the groups, Ravishankar proposed something different: She saw value in the fact that Wola Nani was making use of their own clients as support group counselors, and she proposed a research project to get to know more about clients’ needs and recommend ways to structure the support groups to best meet those needs.
As she delved deeper into the research and into the relationships she made, she knew she wanted to contribute more. She decided she would return in the summer of 2011 and extend her research. With funding from N.C. State’s Undergraduate Research office, the University Honors Program and the Caldwell Fellows program – plus the help of professors at N.C. State and at the University of Cape Town — Ravishankar devised a qualitative anthropology field research project studying stigma’s impact on HIV patients’ anti-retroviral treatment adherence.
What she found once she started her research stood at odds with what she’d been reading in the literature.
“As I talked to people, I began to realize that my view on HIV before I got there to do this research was about five to 10 years outdated,” she says. “What I heard all the time when I started this research was, ‘Well, my brother in 1996 had HIV, and there was stigma back then, but now it’s always on the TV. People are disclosing in church. There are posters everywhere.’ ‘All of my family knows.’ ‘Everyone supports me.’
“I was able to see how stigma had evolved to become less of a factor, so I wanted to find out what other factors could be involved in adherence to anti-retroviral treatment,” she recalls.
“If stigma doesn’t play as big a role, then what does?”
In the end, Ravishankar identified alcoholism, domestic abuse, the market for ARVs as recreational drugs, and poverty as significant factors. Without much money for food, patients would sometimes take medications without eating – which can lead to hallucinations and other significant side effects, she says.
This realization spurred Ravishankar to begin working toward a community development project to resolve impoverished patients’ need for food: With a service grant from Mercy Corps, a U.S. nonprofit organization focused on helping people build secure, productive and just communities, she plans to implement neighborhood gardens in townships where people with HIV can grow their own fruits and vegetables.
Ravishankar also wants to continue to do research on HIV in Cape Town. Her next possible topic: how people disclose the fact that they have HIV.
“Just as the reasons behind anti-retroviral treatment adherence were much more complex than I had thought, so was disclosure,” she says. “Disclosure isn’t just a one-time thing where people say, ‘I have HIV.’ It’s an ongoing process, and I want to learn more about that.”
As she talks about these projects and about the possibility of studying international development, public health and medical anthropology at Oxford University or the University of London’s School of Oriental and African Studies, Ravishankar can’t help but return to that 3-year-old boy she met.
“Seeing that my being with the boy at the hospital was helping him recover, I felt it was my responsibility to continue there. And this is the way I feel about the people I met through Wola Nani, as well,” she says. “When I think of going back to Cape Town, I have an image of specific people in my head. They are more than HIV positive people to me, and I don’t want them to think I’ve forgotten them. I want to take what they’ve said and continue to develop and to learn and ultimately to empower them to address the needs of their communities.”
– Dee Shore