Moving Forward: COVID-19, Peru and Higher Education.

Last week we heard from our Bass Connections Pocket Colposcope team leaders about their experience in Peru this spring. We also learned about the ways that COVID-19 has quickly impacted the healthcare system and is opening new doors to re-thinking healthcare efficacy and delivery.

Today we are checking back in with our Bass Connections Team to hear about the impact of COVID-19 on the Peruvian economy and higher education in the United States.

Our team includes members from the healthcare sector such as the HOPE Ladies in Peru, and researchers and educators at Duke University and policy makers such as Andrea Thoumi, Research Director at the Margolis Center for Health Policy. This week Andrea started off our conversation by providing input on the way that COVID-19 has impacted the Peruvian economy.

Andrea: With regards to the Peruvian economic recovery, I believe the mining and manufacturing sector should be the first to recover. During the economic growth period in the past 20 years, this sector has had the highest investment. In fact, Peru is one of the largest producers of gold, silver, and copper, among other minerals. There are many long-term projects already in place that should facilitate the growth of those sectors.

COVID-19 Testing Site in Peru. Retrieved from: usnews.com

On the other hand, the tourism economy might be one of the slowest sectors to recover. The Peruvian tourism economy is very large; sites like Machu Picchu are known globally. However, tourism has taken an obvious hit. This is in large part due to logistic barriers: the airport has been closed for months and may continue to be closed, and there will likely be less travel around the world and less global tourism in general for some time. In Peru, June through August is tourism’s typical high season, so that economy will be missed. This doesn’t just include hotels and restaurant; it also includes artisans, local craftsman, etc. Losing out on the busy season will definitely have a large impact on the economy.

Employees of the Ciudad de Dios market wait to be tested for COVID-19. Image retrieved from The Guardian

Libby Dotson, Research Associate at GWHT and Duke 2018 Alum, has been working with Duke Undergrad students. She provided her input on the impact of COVID-19 on higher education.

Q: People are projecting that top-tier universities are recovering quickly and could actually benefit from COVID. Many students are considering gap years or community college, which opens up spots for people lower on the waiting list. Additionally, large classes will need to move to online teaching, which allows for a larger student body. Middle-tier schools may suffer, because their typical students could move to top-tier universities or community colleges. How do you think COVID will affect universities like Duke and other top-tier universities, and well as middle and low-tier universities?

Libby: There are several factors at play here: top-tier universities have a larger portion of their student bodies that travel to attend school. While other schools, with student bodies closer to home, have been able to release information early about what the fall schedule looks like in the face of COVID-19, Duke and other top-tier schools had to wait longer to release that information, I think because there are a lot more considerations.

Universidad Peruana Cayetano Heredia

Another interesting point is that a friend of mine who is attending East Carolina University (ECU) on a tennis scholarship called me last week and said that, because of the pandemic, they cut the tennis teams at ECU. There are just so many considerations, and many differences between public and private universities.

Marlee: Student athletes will definitely be affected if those programs don’t run. Another consideration is international students. These are students that usually pay full tuition, and travel is precarious. While higher-tier universities may thrive, it may be at the cost of international students.

Enakshi Sunassee is a rising second year Ph.D student from Mauritus. Many of the international students at Duke only travel home once a year, due to COVID-19, several students have not seen their families since last summer.

Andrea: Top-tier universities may be more nimble to adapt their business models. I wonder if moving to a virtual-based learning will still support the revenue stream that universities, especially top-tier universities, have grown accustomed to — essentially, I wonder if that name brand will still be enough to support current levels of tuition. This question represents what all sectors are going to have to do in terms of rethinking their models, delivering their product, and engaging with people.

We ended our conversation with Marlee, Libby and Andrea by thinking about next steps for our students and for those in the academic sector.

Q: Higher education can definitely be a political issue. What political issues should people within the US and students, like those that attend Duke Universities, be thinking about during the pandemic?

Andrea: In both countries, the pandemic has exposed structural inequalities including uneven distribution of resources, including social and health services. In the case of Peru, COVID has really highlighted the fragility of the health system from an infrastructure perspective, including chronic underfunding issues. An example of this is in the amazonian region of the country. The hospitals are practically at collapse at this point, and they don’t have access to essential medicine or treatments, such as oxygen for COVID patients. Because of these logistical issues, people are dying. We need to focus on how to invest in health and social services in both countries.

Employees of a market waiting to be tested for coronavirus by workers of the Health Ministry in Lima. Image Retrieved from NY Times

Food insecurity is another political issue that COVID has highlighted, and that is an issue that will require a long-term national response. I think there is a perception that this is only an issue in developing countries, but even in Peru, an upper-middle income country, this can happen and is a real problem.

Libby: We’re actually evolving the Bass Connections course into a broader project that encompasses the technologies that are a part of WISH. This project will focus more on the intervention model as a whole, the entire screening model and how we want to shift that into a healthcare system. With the pandemic, there are a lot more considerations now. Not just in how we deliver care, but in how we select a care model.

Andrea: Essential services including elective procedures, primary care, and issues related to reproductive health are being postponed and delayed. I think next year’s course will focus on how we can continue to provide care under recovery conditions.

I do think the WISH model is positioned well to be able to adapt; it is based on community health principles combined with tech-enabled technology, including self-testing technology. I think that this is going to be a wave of the future: identifying essential services that can be provided either at the community level or at home, and I think that the WISH model is one model that can do that well. With COVID-19 I think we will have to reconsider barriers, such as cost and policy, and adapt the model to the current situation.

To learn more about the WISH Model head to:https://wishrevolution.org/

Innovate with passion, deliver with compassion. www.DukeGWHT.org