Q&A with Fulbright Scholar and Epi MPH Claire Rater

Claire Rater holds Master’s degrees in Epidemiology and Social Work and was awarded a Fulbright scholarship for the 2024-2025 term. Her research is on rural health management of snakebite envenoming in the Andean mountain range. Colombia, home to the world’s most diverse reptile population, including the highest number of venomous snakes, provides the backdrop for her study, where Claire is interviewing healthcare professionals and community members in rural Colombian communities. Alongside her research team, she will also provide education on snakebite prevention and treatment. Their ultimate goal is to bring attention to the issue of snakebite envenoming and to highlight the strengths of Colombia’s rural health systems. 

Can you talk about some of the research you’ll be doing in Colombia? 

I’ve always been really interested in neglected tropical diseases. These are diseases that have been and can be eradicated in a lot of places around the world, but some communities don’t have the resources to eradicate them. Diseases like malaria, dengue fever, chagas.   

Another interest I have is in rural healthcare and the role of community health workers in these systems. I met with a few researchers based out of Colombia and did some informational interviews. The two researchers both work in the Bio Medical Engineering Department at the Universidad de Los Andes, and they do research on snake bites and envenoming. We were able to combine my interests in rural healthcare management and studying community health workers and neglected tropical disease with their experience in snake envenoming, because snake bites have been designated as a neglected tropical disease. It’s a developing field in public health and global health: how to manage snake bites in these types of communities.  

I will be working in Carmen de Apicalá, a rural community outside of Bogota where there’s a large number of venomous snakes. I think Colombia actually has the largest population of venomous snakes in the world, so they have a real problem with snakebite envenoming. The work they do is really quantitative modeling, and it’s more the biological side of snakes and envenoming and how they interact with humans. I’m bringing my qualitative research lens with my social work background to do surveys and interviews of people in this community.  

We’ll be working with the local health facility, local health workers, and the community to kind of understand what current management systems and prevention systems exist. We’ll be interviewing community members, healthcare workers, and firefighters in the area to learn more about how they interact with snakes in their communities. Then we’ll use that information to kind of tailor an intervention for further education on how to prevent and manage snakebite envenom. I think the project will develop, but for now that’s our plan.  

How did you first become interested in public health and rural health systems? 

I just finished my master’s in public health and the Epidemiology program, and I also got a master’s in social work. So, I was a dual degree student, and I also got a certificate in global health. I went to undergrad at the University of Wisconsin and got a major in community and environmental sociology, and a minor in global health and environmental studies. I was sort of an undergrad in global health before it was a field you could really pursue as an undergrad. 

After college I did a couple of years as a community organizer for public health and environmental policy. Then I went into the Peace Corps in Senegal for a little over a year as a health volunteer, and did a little over a year as a health volunteer. We left during the pandemic, so I was there for about 13 months. Then I went to Alaska to do an Americorps term in Juneau. So, throughout my career and academic experiences, I’d become interested in rural healthcare and neglected tropical diseases. I was always interested in public health and knew that I would eventually get a master’s in public health, but I think when I was in the Peace Corps working more directly in communities and with communities, I realized I really wanted to make sure that was cemented in my career, which propelled me to pursuing a master’s in social work, so I could have that kind of direct community involvement. 

What drew you to the Fulbright program when it comes to the research you’ll be doing? It sounds like doing research and global health work abroad isn’t new for you. 

Yeah, I think I’ve learned that it‘s something I find to be really fulfilling and interesting, and something I’m passionate about. I was based in really rural and isolated communities in West Africa and Alaska. I found the health challenges and barriers in those communities to be really interesting and unique, and wanted to continue studying it. I find such value in being able to actually connect with those communities and be there with people. 

A really important part of research is actually building connections with the people that you work with or are doing research on behalf of. That is something I’ve always wanted to continue to do, and I think those early experiences were great in teaching me about and giving me exposure to these types of communities. 

I was inspired to do Fulbright because I really wanted to try to solidify some research experience for myself. I’ve never been to South America, so I wanted to expand my breadth of global health experience to that region. Also, when I was in the Peace Corps, I learned a local language and really enjoyed that. I realized I really like language learning, and saw so many benefits to being able to speak the language of the people I was working with. I was thinking of, after graduate school, just moving to a Spanish speaking country regardless, so I could really master that language.  I just feel like I have so much Spanish language in my head, but I don’t speak it yet. I was able to find something that was aligned with my research interests and some personal goals of expanding my research experience to South America, which inspired me to apply to the Fulbright program. 

What research questions are you looking forward to exploring while you’re there? 

One thing that’s really interesting about Colombia is that they introduced universal healthcare very recently. It presents a whole different slew of pros and cons for accessing healthcare in rural communities. They scaled back and pretty much eliminated the role of community health workers. In rural communities, community health workers are pretty integral. So one of the questions I’m looking at exploring is: What does it look like for a rural healthcare facility to manage a neglected tropical disease without having designated community health workers, or at least under a healthcare structure where community health workers are not baked into that system?  

I think we’re also looking to understand what role the community at-large has in preventing and treating snake bites because there’s likely a lot of traditional knowledge that we aren’t aware of with regard to this prevention and management. One of the only ways you can find that out is by asking people and immersing yourself in that community. We’re hoping to understand that and then use that to answer the ultimate question of how to better prevent and manage snakebite. 

There’s also a piece that our project isn’t really going to dig into, but really affects this issue, which is just that snakebite anti-venom is really inaccessible globally. It’s really expensive, and it’s just not common for health facilities to stock a lot of anti-venom. Global pharmaceutical companies are not producing a lot of it, and they’re producing it at exorbitant prices. It’ll be interesting to learn more about this prevention and management, because there isn’t really medical treatment for a lot of snake bites. Prevention is kind of the best method for treatment.  

What do you think someone would find the most interesting about your studies on rural health systems? 

A lot of times folks have to travel really far to get to a health facility. Having to factor in the cost of that transportation can be really overwhelming for people. Additionally, there’s a lot more focus on community leaders who are involved in both the health facility and in- community development. They play this role of what I see as kind of a social worker and a healthcare professional. Not only are they trained as a doctor or as a nurse, but they’re also trusted people in that community. They’re friends and family members. They speak that language, or they have that cultural understanding. There’s strong community care and holistic care for a patient. Understanding their medical needs as well as their psychosocial needs and their community needs is really important for treatment of anything. I think urban healthcare facilities could really do a lot more to integrate that into the healthcare system.