Neudy Rojop, 29, stands on a bumpy, cobbled lane in Guatemala in the small rural village of San Rafael Pacayá. It leads to the home where she grew up and where she still lives today.

"Just in this lane," she recalls through an interpreter, "my mom used to walk me and my brother and my sister to school every morning."

Many of her relatives live nearby — uncles, aunts and a younger cousin named Carlos, or Carlitos if you're family. When Rojop was about 10, she says she remembers an urgent knock at their door one night. It was about Carlos.

"My aunt came to my house asking for medicine because he was so sick," Rojop recalls. They grabbed whatever they had — medicinal syrups, herbal teas — and raced out of the house. "I remember the moment when I saw him," she says. "He was lying on the bed. He was with this fever and his skin was red."

Carlos was struggling to breathe and his family couldn't afford the transportation to get him to a private doctor. Without any local clinics, Rojop's family couldn't even figure out what was making him sick. "We were just waiting for him to recover," she says.

After several days, he got better. Looking back, Rojop figures he had the flu or some kind of pneumonia. But it wasn't just Carlos. She says that growing up, she noticed how frequently many of those around her were getting sick, especially her little siblings and cousins. She says that as a teenager, she started to realize more-urban communities in Guatemala had better access to health care.

"I didn't think it was fair," Rojop says, "because I didn't know how to help my family members who were sick to get better."

It all crystallized within Rojop into a singular decision. "I thought, 'I need to become a nurse so I could change my community for good.' "

In San Rafael Pacayá, Rojop's options were limited. There was nowhere nearby to study or practice nursing at a more advanced level. Her schooling took her increasingly far away, but she continued to live at home. "I didn't imagine myself moving out from this community," she explains.

Ambitions for a clinic and more

It turns out, about half an hour's drive away, the lack of medical care in rural parts of Guatemala was bothering someone else as well. During the years when Rojop was studying nursing, Dr. Edwin Asturias was returning to his hometown for a visit to think about how to bring more care to the community. He recalls a day he was standing on the roof of a school in Chiquirines, in the far western part of the country just a few miles from the Pacific Ocean.

Asturias, an infectious disease pediatrician with the University of Colorado, had grown up pretty close to that spot and, like Rojop, he witnessed how poverty, malnutrition and a lack of medical care created repeated cycles of disease battering his community.

From the rooftop, he gazed at the dirt field next door, where only a single almond tree stood. And he thought, "This could be way more than a parking lot. This is going to be where we're going to build the clinic that could provide service to the population," he recalls.

Asturias' vision swelled beyond a clinic. He wanted to train people and build space to do research "to better monitor these illnesses," he says, "and try to provide early interventions rather than late interventions, or try out new therapies or new ways to prevent some of these illnesses."

The people here "may have the common viruses," he explains. "Those that are knowns. But also there may be an emerging virus that we don't know about."

In other words, he wanted to do surveillance to keep emerging infections from ever posing a threat in the first place.

The idea was pretty audacious. High-level research usually happens in the big cities. But Asturias was undeterred. He remembers looking out at that lot and seeing that almond tree: "And I said, 'That tree needs to remain there, because it's going to be the shade that will provide that comfort for the people that are working there.' "

Over the next few years, Asturias gained support from the University of Colorado, Children's Hospital Colorado and a local banana and palm oil company. He and a small team brought his vision to life.

The almond tree still stands. Today, it's surrounded by five large, low buildings. They comprise La Fundación para la Salud Integral de los Guatemaltecos, or FunSalud for short. It's part health clinic, part grade-A laboratory. The clinic is usually busy with a staff of six seeing about 300 patients per month.

Think globally, act locally

Inside, Dr. Dan Olson, a pediatric infectious disease doctor at the University of Colorado and a research director here, is like a kid showing off his toys. He points out DNA sequencers, ultra-cold freezers and the air conditioning necessary to keep all the equipment from overheating. And he explains it's all powered with consistent electricity from solar power — blackouts and brownouts can be harmful to laboratory equipment.

"Our site is, I think, in a good spot to pick up some emerging pathogens from this region before we're in a pandemic," says Olson. Think back to COVID, he says. "Hospitals were already filling up with this unknown pneumonia by the time we even had a clue of what was going on. But it already spread beyond China's borders before we even had a name for it."

Instead, FunSalud is doing what's called active surveillance — with studies aimed at going out into the community to look for emerging diseases with pandemic potential. "[It] gives you a better chance to develop interventions, whether it's diagnostic tests, whether it's vaccines, or even some clear public health measures we think will limit the risk," Olson says.

To do this work, you need a sophisticated lab. Olson says FunSalud is on par with something you'd find in the United States.

But in the early days, a question loomed. Who would want to work here doing research in the tropical heat surrounded by mosquitoes? Who would trade in Guatemala City or the Centers for Disease Control and Prevention in Atlanta?

"We struggled with this," says Olson. "Initially, we had thought about bringing in a grad student from the U.S. But then they go get their job somewhere else and they're never back again."

So Olson and his team started looking locally — around the time that Neudy Rojop showed up. And she is emblematic of the way the research center operates.

"We hired her right out of nursing school," explains Olson. "She had zero clinical experience and she had zero research experience." She started as a nurse with their first research project on dengue. Olson says something became clear immediately. "She was a superstar," he recalls. "You'd give her an idea and then she would run with it a mile." So FunSalud mentored her to become a study coordinator.

Every morning, Rojop walks down that lane in San Rafael Pacayá before boarding a yellow school bus that picks up much of FunSalud's workforce. When the bus arrives, a couple of dozen people file out, including researchers, technicians, the accountant and the cook.

Rojop has worked at FunSalud for almost a decade, and she's moved up the ranks. She's come to really love research, and now she's a research coordinator.

Rojop starts her days inside the building called Research One, at a morning meeting with the other team leads, making decisions, solving problems and setting priorities.

The place is a flurry of activity. In the main area of the building, the several dozen junior researchers who power this place divide up by research project. One team is conducting disease surveillance among farmworkers. Another huddles to assess whether mosquitoes can operate like a swarm of flying phlebotomists to collect the blood of people and animals across dozens of nearby households — blood that can be scanned for pathogens.

One by one, the research teams finish their discussions and begin their work. Rojop steps outside. "Now we're heading to Chiquirines," she says as she gets behind the wheel of a tuk-tuk. Rojop leads one of the research projects monitoring people in the community for disease — both known illnesses and possibly ones not seen before. She fires up the three-wheeled vehicle and drives off to the home of one of the families involved in the study.

Dr. Mirella Barrientos helped lead the search that brought many of Rojop's colleagues to FunSalud. She's the other research director here, and she says there was tons of talent in FunSalud's backyard. "We want people of here," she explains, "that can work for their community, their families, their children."

When Barrientos hires researchers and nurses, she looks for one thing above all: "This curiosity for research, curiosity for growing in their learning." So they can excel at one job and possibly grow into others.

For instance, several years ago, a lab tech broke her arm and the lab needed someone who could draw blood samples from people and animals. The lab director remembered someone named José Anaya, who transported equipment. They brought him into the lab, taught him the ropes and he loved it.

Anaya says that temporary gig at FunSalud changed his life. There just aren't a lot of job options around here. Now he's had a chance to work as a lab tech, and he's hoping to be invited back next month to assist with a new research study.

Barrientos and Asturias say they've seen people grow into new and bigger roles over and over again.

"We're trying to show them that you don't need to go to the United States to do your graduate degree," Asturias says. "That you can do it here, practice your craft here, and do better for your own people."

At the end of the day, the yellow bus returns to FunSalud to do its morning route in reverse. Rojop climbs aboard to ride the half-hour back home. By day, she sees a lot of disease, and that memory of little Carlos falling ill all those years ago often resurfaces.

"The difference is before I was so young that I couldn't do something for him," she says. "But now I can help because I know how."

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Controlling the coronavirus involves some of the wealthiest and most powerful institutions in the world, and yet the COVID pandemic has claimed the lives of nearly 7 million people. So what needs to change to keep it from happening again? One idea is to find a better way to keep eyes focused on the ground, a way to see infectious diseases and emerging viruses at the super local level. NPR's Ari Daniel went to a small research outpost in rural Guatemala and found a place where this idea is very much alive. He was there for our series, Hidden Viruses: How Pandemics Really Begin.

ARI DANIEL, BYLINE: I ask Edwin Asturias to take me to the place where it all started, so he leads me across a grassy field to a local school. We're in western Guatemala, not far from the Pacific Ocean. About a decade ago...

EDWIN ASTURIAS: We were standing up here overlooking the parking lot and saying, this is going to be where, you know, we're going to build a clinic.

DANIEL: But a clinic was just the first part of his plan. Asturias is an infectious disease pediatrician at the University of Colorado. He grew up nearby, and he tells me he witnessed firsthand how poverty, malnutrition and a lack of medical care combine to create cycles of disease.

ASTURIAS: You know, those interactions affect the way that you develop, you know, your brain and, you know, being successful in school or not. And to top it off, now their parents who have survived those illnesses when they were young are suffering now huge amount of chronic illnesses.

DANIEL: Asturias says all this keeps communities like his from thriving, so his vision swelled - to not just treat illness but to study and prevent it. He wanted a center for research.

ASTURIAS: Where we can better monitor these illnesses and try to provide early interventions, to sort of try out new therapies or new ways to prevent some of these illnesses.

DANIEL: The idea was pretty audacious. High-level research - that usually happens in the big cities. And besides, who would want to work here? Who'd trade in Guatemala City for mosquitoes and tropical heat?

DAN OLSON: You know, we struggled with this.

DANIEL: Dan Olson is a research director here.

OLSON: You know, initially, we had thought about bringing in a grad student from the U.S., but then they go get their job somewhere else and they're never back again.

DANIEL: Still, over the next few years, the health clinic was built, and the laboratory, with support from the University of Colorado, Children's Hospital Colorado and a local banana and palm oil company.

OLSON: So we're now walking in to the processing lab where we receive...

DANIEL: I step into the result of all that work. It's called FunSalud.

OLSON: So this lab, the new design, happened in the last year.

DANIEL: Olson's like a kid showing off his toys - DNA sequencers, ultra-cold freezers. This lab, he says, is on par with something you'd find in the U.S., which they need to take on one of their more ambitious goals - watching out for viruses that have pandemic potential.

OLSON: If anything COVID and Zika and H1N1 have taught us, it's that you can't stick your head in the sand and hope that the next pandemic isn't going to arrive.

DANIEL: So FunSalud is doing what's called active surveillance. They're running studies here to try and detect emerging diseases early.

OLSON: Gives you a better chance to develop interventions, whether it's diagnostic tests, whether it's vaccines...

DANIEL: But who would run the research efforts? Olson and his team still wanted to find people nearby. Now, they did manage to hire nurses who lived locally. One of them was a young woman named Neudy Rojop.

OLSON: So, Neudy - you know, we hired her right out of nursing school. She had zero clinical experience and she had zero research experience. And she was a superstar.

NEUDY ROJOP: (Through interpreter) I'm very lucky to have- since I live down the road near my community.

DANIEL: Today, Rojop's 29, and she embodies the passionate drive this place has come to depend on - local young people who notice something in their own community they want to change. Growing up, Rojop says a lot of her young relatives got really sick. When she was about 10, she remembers an urgent knock at their door one night. It was about her little cousin Carlos, or Carlitos if you're family.

ROJOP: (Through interpreter) My aunt came to my house asking for medicine, if we had, because he was so sick.

DANIEL: They grabbed whatever they had - syrups, teas - and raced out of the house.

ROJOP: (Through interpreter) I remember the moment when I saw him. He was laying on the bed and his skin was, like, red because he was with this fever.

DANIEL: His family couldn't afford a private doctor. Carlos was struggling to breathe.

ROJOP: (Through interpreter) He looked kind of, like, sad.

DANIEL: Rojop was afraid. She feared the worst.

ROJOP: (Through interpreter) I didn't think it was fair because I didn't know how to help.

DANIEL: Fortunately, Carlos survived. But the whole episode made a deep impression on her.

ROJOP: (Through interpreter) I thought, I need to become a nurse so I can change my community for good.

DANIEL: Rojop's options were limited. She didn't want to leave her home or family. But then, when she was working on her nursing degree, a friend said, hey, there's this new clinic opening up just down the road.

It's 8 a.m. A yellow school bus pulls up beside FunSalud. A couple dozen people file out, including Neudy Rojop. She's worked here now for almost a decade.

ROJOP: (Through interpreter) It is a relief and such a satisfaction for me to contribute something for my community.

DANIEL: Rojop showed up thinking she was going to be a nurse, but something happened.

OLSON: You'd give her an idea, and then she would run with it a mile.

DANIEL: The research just clicked for Rojop, says Dan Olson. At first, they asked her to work on a study looking at using cellphones to track the spread of dengue. She thrived. So she kept getting promoted.

ROJOP: (Through interpreter) I want to keep learning, to get more help for even more people.

DANIEL: Today, Rojop's a research coordinator with two master's degrees under her belt. She starts her days with the other team leads. Then all the researchers and nurses divide up by project. One team's tracking illnesses surfacing among farm workers. Another huddles to assess their mosquito and infectious disease study. Edwin Asturias watches this hive of activity. He smiles.

ASTURIAS: We're trying to show them that you don't need to be - go to the United States to sort of do your graduate degree in epidemiology, for example, that you can do it here, practice your craft here and do better for your own people.

ROJOP: (Speaking Spanish).

DANIEL: One by one, the research teams begin their work for the day. Neudy Rojop gets behind the wheel of a tuk-tuk and drives off to the home of one of the families involved in a research study she's in charge of. Over the years, as Asturias has watched FunSalud fill with folks like Rojop, local talented young people just waiting to be found, it's been a powerful lesson.

ASTURIAS: A lesson that also has transformed my way of looking at global health forever, in the sense that we need to make sure that these people can take on from us when we are not here anymore. Truly, who is going to transform their local communities and their lives is going to be themselves.

DANIEL: And in the process, many of them undergo their own personal transformation. They become someone they never imagined - a scientist.

Ari Daniel, NPR News. Transcript provided by NPR, Copyright NPR.

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