At Emory University

Dr. Emily S. Pingel

I never imagined that I would fall in love with São Paulo. Having grown up in Appalachia, big city life felt intimidating. But from the moment that I set foot in the Bom Retiro health post, I knew a journey of sorts had begun. 

With the support of a Fulbright Research Award, a Boren Fellowship, and the Bom Retiro community health team, I conducted an ethnographic study of how patient care unfolds across sociocultural and linguistic difference. I explore how health professionals – including community health workers, doctors and nurses – construct racialized understandings of local residents that in turn affect the approach to patient care. I also investigate how digital technologies, such as WhatsApp, shape and are shaped by women’s emotional desires in the context of everyday life in Bom Retiro. 

My research employs participant observation – both within the clinic and out in the neighborhood – alongside in-depth semi-structured interviews with patients and providers. In 2021, I successfully defended my dissertation, entitled “Primary Care and the Reproduction of Health Inequity in a Central São Paulo Neighborhood.”  The next stage of my career will begin in June 2021, as a Presidential Management Fellow in the Division of HIV/AIDS Prevention at the Centers for Disease Control and Prevention. 

To learn more about my work, please visit my academic homepage.

Alexandra Llovet

I am an MD/PhD student at Emory University pursuing a PhD in Epidemiology. My research focuses on mixed-methods analysis of social determinants of health among immigrant populations in Brazil and the United States. As a daughter of immigrants and fluent Spanish and Portuguese speaker, I am uniquely positioned to conduct this research.

I have been a part of the Lesser Research Collective since 2017. In my undergraduate thesis, I analyzed the diverse origins of the stigma of leprosy and suggested that the cultural phenomena surrounding leprosy has a longstanding impact on patients’ quality of life. I simultaneously conducted an Epidemiology project on delays in leprosy diagnosis in Minas Gerais. I presented this work at the International Leprosy Congress in Manila. In 2019, I obtained my Bachelor’s in Biology and Spanish/Portuguese with Highest Honors on my thesis. I was a Fulbright Research and Study grantee in 2020 for a project on the multigenerational effects of compulsory isolation of leprosy patients. This project was, unfortunately, upended by the COVID pandemic. During this time, I worked with Dr. Pingel and Dr. Lesser to write about the primary-care in Brazil during the pandemic.

My undergraduate experience with Lesser’s interdisciplinary team informed my vision for healthcare as a provider and researcher. I began my medical training at Emory in 2020. I applied lessons from my research throughout my initial three years of clinical training. In clinics and hospitals, I noticed significant disparities and barriers to care for Spanish-speaking patients. This drove me to research immigrant healthcare and create actionable items that mitigate disparities. In my PhD phase, I am pursuing research in Brazil and the United States to improve health among immigrant populations. I conduct semi-structured interviews on barriers and supports available to Spanish-speaking immigrants living in Brazil and the United States.

Please see other research projects I am working on here: 

“The Present and Future of Adult Day Services for Hispanics with Dementia: Understanding the Workforce Needs and Utilization of Adult Day Services”

Maria Jose Velez

Maria Jose Velez is pursuing a PhD in Hispanic Studies at Emory University, US, where she also earned her Master’s in Hispanic Studies. She has conducted international research in Kenya, Brazil, and Argentina, focusing on medical anthropology and reproductive health. In Kenya, she worked with CHAMPS (Child Health and Mortality Prevention Surveillance) and other NGOs, gaining field experience in global health initiatives.

Her work explores the intersection of reproductive health, biomedical and societal discourses, and migrant women’s agency in Latin America, particularly among Bolivian and Qom women in São Paulo and Buenos Aires. Her ongoing doctoral dissertation, “The Negotiation of Reproductive Discourses: Migrant Women and Family Planning in São Paulo and Buenos Aires,” examines how migrant women navigate reproductive health decisions within complex biomedical and social frameworks.

Maria’s research has been supported by grants from the Emory Global Health Institute and The Institute for Humane Studies.

Paula Manfredini

I am a History PhD student at Emory University, researching health in Brazil and its impact on women in urban areas. I focus on motherhood, examining how medical knowledge and interventions influence pregnant women’s lives. I explore how medical theories, practices, and interventions shape societal understandings of health and illness, often reinforcing social hierarchies and impacting access to care. My current work connects gender, health, and nutrition, studying how medical ideas shaped the diets of working women in São Paulo in the 1920s.

My interest in health-related topics started long before my time at Emory. I hold a Teaching Degree in History and a Master’s in Human Rights from Pontifícia Universidade Católica do Paraná (Brazil), where I researched public health in 20th-century Rio de Janeiro. My work there analyzed how top-down policies impacted underserved communities and studied connections between health laws and social inequality. While at Emory, I completed a research project analyzing the diaries of Rockefeller Foundation physicians working in Latin America during the 1940s.

As a member of the Lesser Research Collective, I aspire to provide historical perspectives on Brazil’s current health challenges. Understanding the roots of health inequalities is the first step to supporting effective, inclusive projects that improve access to care for immigrants in São Paulo. As a native Portuguese speaker fluent in English and Spanish, I aim to engage with multilingual materials to understand better how immigrants navigate the Brazilian health system.

Coco Sandoval

I am a Psychology, Spanish, and Portuguese major at Emory University, focusing on cross-cultural mental health and neurodevelopmental disorders. My research explores the impact of language barriers on mental health care access among Spanish-speaking immigrant communities. I examine how linguistic and cultural differences create obstacles to mental health services and the implications of these barriers on the well-being of marginalized populations. My work aims to identify ways to improve mental health care delivery and reduce disparities in care for these communities.

My fieldwork in Bom Retiro, Brazil as part of the Lesser Research Collective engages directly with the community as I work alongside healthcare providers to analyze the practical challenges faced by Spanish-speaking immigrants in accessing mental health services. By collaborating with local practitioners to bridge language and cultural gaps, my research helps individuals to receive the care they need. My field experience will become part of my honors thesis and allow me to make a tangible difference to residents in Bom Retiro.

My interest in mental health and neurodevelopmental disorders began well before my time at Emory. I am passionate about understanding how social, cultural, and environmental factors contribute to mental health outcomes. Through my research at Emory’s Learning, Understanding, Memory, & Neurodevelopment Laboratory, I study the neurodevelopmental processes and learning mechanisms in diverse and underserved populations. In addition to my academic work, I am a trained respite worker, providing direct support to children with Autism Spectrum Disorder (ASD). This hands-on experience has deepened my understanding of neurodevelopmental disorders and the challenges families face when accessing appropriate care and resources.

I am fluent in English and Spanish and working towards fluency in Portuguese, and I use my language skills and cultural understanding to bridge gaps in mental health care. As I continue my research and clinical training, my goal is to improve access to care for underserved immigrant populations through both research and direct community engagement.

Surbhi Shrivastava

I am a doctoral candidate in Sociology at Emory University, US. My research and teaching interests include the sociology of sex and gender, medical sociology, and health consequences of violence. My doctoral dissertation, “The Making of Stratified Cesareans: Patterns and Processes of Surgical Births in India and Brazil,” is a mixed-methods cross-national examination of how social stratification in structures, cultures, and identity affects cesarean birth outcomes and experiences among women. 

As part of the Lesser Research Collective, I have conducted fieldwork in São Paulo, Brazil, over two visits (2022 and 2024) through group funding from the Emory Global Health Scholars program. My preliminary visit allowed me to understand the context of public healthcare delivery for birth through Sistema Único de Saúde (SUS). My second visit allowed me to collect pilot data for my postdoctoral project on South Asian immigrant women’s health experiences in Brazil.

Before Emory, I received a Bachelor of Dental Surgery (Manipal Academy of Higher Education) and a Master of Public Health (Tata Institute of Social Sciences) from India. I also have professional experience working with non-profit research organizations in Delhi and Mumbai. Details of my published work are available here.

Dr. Sara Kauko

I joined Dr. Lesser’s research team in Sao Paulo as a research assistant and photographer in June 2016. I had never set my foot in the city before and spoke Portuguese on the level of a six-year old. Nevertheless, as an anthropologist and Latin Americanist, I found it fascinating to be able to participate in the Bom Retiro research project.

I accompanied the task team from Bom Retiro’s health center a few times a week as they attended to patients in their homes. Wearing my anthropologist’s hat, I was drawn to learning more about the patients’ backgrounds and present lives. Wearing my photographer’s hat, I documented these patient rounds and at the same time, the life in the neighborhood.

As a Spanish speaker, I learned Portuguese rather easily. My camera often mediated my interactions with people, which helped me to learn more. The time I spent in Bom Retiro eventually turned into an archive of hundreds of images and a photographic exhibition on one of the health center’s walls.

I wrote my doctoral dissertation on the relationship between socioeconomic mobility, race, and entrepreneurialism in northern Argentina, and graduated in the spring 2020. The difference between the vertical megalopolis of Sao Paulo and the flat provincial city in Argentina where I conduct research is colossal. Yet in both places, the human experience of ethno-racial exclusion and aspirations for upward mobility can be remarkably similar. Those similarities intrigue me. I hope to go back to Argentina’s Portuguese-speaking neighbor someday to explore them further.

Daniella Gonzalez

I had the pleasure of working in Team Lesser in the Bom Retiro neighborhood last summer. While in the Bom Retiro neighborhood, I joined physicians and nurses during medical appointments with pregnant patients (prenatal care) and women who had recently given birth. The physicians and nurses described their prenatal cases as either “planned” or “unplanned” on daily activity logs and the women’s medical files.

This led me to my research question, how do patients and healthcare providers of the clinic (physicians, nurses, and community agents) conceptualize family planning? In other words, what makes a pregnancy “planned” or “unplanned” for patients and providers? I spoke with women during their medical appointments to understand how they describe their own pregnancies and their definitions of a planned pregnancy. I then spoke to community agents, physicians, and nurses to ask about their own conceptualizations and whether they perceived differences in cases with women that stated planning their pregnancies and women that did not plan. 

This information, along with demographic information found in women’s medical files, demonstrated that patients and providers did indeed conceptualize family planning in different ways. This gap between patient and provider must be closed to improve family planning services within the clinic. To do so, providers must acknowledge these conceptual differences and engage their patients in more conversations on family planning and contraception use. 

I wrote about this in my thesis.

Doris Cikopana

My honors thesis explores the topic of accessibility to health services in Brazil. The thesis is a case study of the UBS Bom Retiro, a health post/clinic in the neighborhood of Bom Retiro located in São Paulo, Brazil. The neighborhood is home to multiple immigrant groups such as the Bolivians, Koreans and Paraguayans.

This thesis aims to better understand how accessibility barriers work in this neighborhood and what initiatives has the staff taken to reduce these barriers. Another aim of this thesis is to analyze the level of access to health services by patients who do not speak Portuguese as a first language. Lastly, this thesis contains possible health policy suggestions that could provide solutions to accessibility barriers in UBSs that are located in neighborhoods with a similar demographic profile as Bom Retiro.

My research was supported by the Fox Center Undergraduate Humanities Honors Fellows Program.

Sabrina Jin

I learned the importance of remaining open to surprises in career development as I watched myself evolve from an entomology enthusiast into an aspiring medical anthropologist. Even so, traveling to Brazil for my research was the last thing on my radar.

I am working towards a B.S. in Biology and a B.S. in Anthropology and Human Biology with a concentration in Cultural Anthropology in the Emory College of Arts and Sciences. I participated in the Oxford Research Scholars program in 2019 with Dr. Emily McLean to investigate gene-environment interaction in Drosophila melanogaster before deciding to shift into the social sciences. Currently I work with Dr. John Pothen in the Emory Department of Sociology to study suburban gentrification in a small neighborhood in Atlanta. I am a staff writer for the Emory Undergraduate Medical Review, a third-year legislator on College Council, and a recipient of the 2021 Halle Global Fellow Award for international research.

I will conduct an ethnographic study on the Asian Brazilian populations of Bom Retiro and Liberdade, São Paulo, as a part of the Lesser Research Collective. My research investigates anti-Asian racism during the COVID-19 pandemic and explores the relation between racism, mental health seeking behaviors, and activism within an Asian diasporic context. During 2021 I will implement surveys and interviews in São Paulo and San Francisco for comparative analysis. I will also employ a mixed-methods approach involving web scraping on social media platforms to survey changes in the frequency of hateful language towards people of Asian descent. My fieldwork will contribute to my senior honors thesis, tentatively titled “The Effect of Racialized COVID-19 Discourse on the Health of Chinese Immigrants and Brazilians of Asian Descent,” and my goal of completing an MD-PhD in medical anthropology.

Savannah Miller

As a public health practitioner and scientist by training, I did not think taking language courses would lead me towards my master’s thesis topic. Yet for the two years I was at Emory for my Master’s of Public Health I worked with the Lesser Research Collective while taking Portuguese courses “for fun.” This led me to defending my thesis entitled “A Qualitative Assessment of Water, Sanitation, and Hygiene in an Urban Working-Class Neighborhood of São Paulo, Brazil.” 

I graduated from the University of North Carolina Wilmington in May 2020 with a B.S. in Biology, a B.S. in Public Health, and a minor in Spanish. As a National Oceanic and Atmospheric Administration Hollings Scholar, I conducted research with the Sitka Tribe of Alaska on subsistence food safety and paralytic shellfish toxins. I recently graduated in May 2022 from the Global Environmental Health MPH program at the Rollins School of Public Health at Emory University. 

As a previous member of the Lesser Research Collective, my research focus was on accessible and equitable water, sanitation, and hygiene (WASH) and the challenges rapid urbanization poses to the provision of adequate WASH services. This is especially noticeable in the highly urbanized Brazilian state of São Paulo, where 96.56% of the state’s total population of over 44 million lives in urban areas. WASH-related diseases, including malaria, dengue, Zika, cholera, tuberculosis, and other diarrheal illnesses, have been a persistent problem in Brazil. The goal of this study was to use qualitative research methods, especially thematic analysis of community ethnography field notes, to illustrate the reality of daily-life for those living in an urban-working class neighborhood of São Paulo city. By analyzing historical and contemporary WASH policies in Brazil, this research provides better understandings of inconsistencies between public policy and the reality of daily life in the context of WASH. The study had two primary questions 1) “How has the prioritization of sanitation by policymakers, both historical and contemporary, shaped the health of the urban working-class in Brazil?” 2) “How do living and working conditions among the urban working class relate to the creation and/or implementation of water, sanitation, and hygiene (WASH) services?” Findings from this study suggest that local authorities should employ a bottom-up, equity-centered lens emphasizing distributive justice when creating and implementing WASH-related public policies to ensure inequities are not overlooked.I now work for an international pharmaceutical company in their Vaccines Division, assisting pediatric and primary care offices across Georgia to better improve their vaccination rates and patient population health. I continue to stay in contact with my fellow Lesser Research Collective colleagues and hope to one day visit Brazil!