Mariana Villar ’22 reflects on Marla Ruzicka International Public Service Fellowship

In the pursuit of honoring international human rights, post-conflict rehabilitation and international public service, Mariana Villar ’22 spent the summer of 2021 researching Tuberculosis in Peru and the impact a diagnosis has on the patient's caregiver. Through the Watson Institute's Marla Ruzicka International Fellowship, Villar was able to conduct her research on-site in Peru.


Anthropology and Biology

In your reflective essay, you mention developing a new understanding of numerous forms of structural violence toward TB caregivers. Could you explain what structural violence is and how it hinders the overall method of treating tuberculosis?

Structural violence is a systematic form of violence inscribed in cultural structures that is directed at anyone who belongs to a particular social order and that results in the oppression of that social order. In Peru I witnessed structural violence in the form of sexism and the gendered division of labor. Women are expected to look after the children and take care of the domestic sphere via cleaning and cooking. This form of structural violence - the oppression of women by restricting them to the domestic sphere - hinders the treatment of tuberculosis in various ways. The main way is that it prevents the adolescent from having advocates in the medical setting who will be listened to readily. Women are expected to look after minors; however, women are expected to be docile as well. Thus, frequently it is difficult for doctors to listen to and take seriously the concerns of women. This hinders the treatment of tuberculosis as women are not listened to when they go to doctors when someone they care for first presents symptoms of tuberculosis. This leads to a deterioration of health of the individual and may even prolong the healing journey while also continuing the spread of tuberculosis, since after only two weeks of treatment individuals with TB become significantly less infectious. 

Can you elaborate on the specific cultural framework that you feel might be difficult to address in Peru? How would a long-term solution impact the level of care for TB in countries where it's prevalent?

I think one cultural framework that is difficult to address in Peru is that of diet and the belief that eating poorly, i.e., eating junk food, results in getting tuberculosis. This misunderstanding of pathogenesis is difficult to address and increases the burdens of caregivers, as many caregivers feel it is their fault that the adolescent they are caring for got tuberculosis. A long-term solution for TB treatment would take into account the specific local, cultural frameworks in order to identify specific barriers to treatment that may not exist elsewhere.

In your opinion, how did the Marla Ruzicka International Public Service Fellowship impact your ability to conduct research abroad? What advice would you give to other students considering applying for funding?

It was through the Marla Ruzicka International Public Service Fellowship that I was able to conduct my research. I believe having a fellowship validates research and facilitates conversations with others. The fellowship also allowed me to focus solely on my research; I was able to work more effectively without distractions. I would encourage students to apply for funding, but when thinking of research projects, to remember to embed engagement into research. I believe engaged scholarship is crucial for the ethical conduction of research, especially public service research because to serve a community most effectively the community must inform you - not the other way around.