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Health Challenge Past Interns: 2009

Social Sciences

Kathryn Bailey, 2010, Anthropology


Internship:
Health Systems and Concerns for Ex-Mineworkers

Organization:
TEBA Development, Johannesburg and Eastern Cape, South Africa. Maeru, Lesotho.

Adviser:
Joao Biehl

"TEBA Development is a non-profit organization that gives back to mineworker communities by providing home-based care (HBC), including psycho-social support and referrals to local clinics, for ex-mineworkers who have had to leave their jobs at the mines due to ill health (mostly HIV/AIDS and TB). My project focused on the HBC program and I observed the home visits and structure of the program in different regions (Lesotho and Eastern Cape). I traveled with the HBC Coordinators of the different regions and the local fieldworkers to the homes of the HBC patients; I interviewed the patients about the effectiveness of the program and their perceptions of illness and the role of biomedicine in their healing and coping processes. One of my goals was to understand the health systems and their limitations, the perspectives and opinions of local people and the challenges they face. In Lesotho I assessed the cost and challenges of changing the HBC structure to be as it is in the Eastern Cape, where TEBA employs their own nurses and care supporters instead of using those in the local clinics. I assessed the effectiveness of the current program, the cost of switching the program structure in Lesotho and challenges that will be faced in the transition. I provided recommendations based on my observations of the differences between the two regions." (See presentation.)


Rebecca Butler, 2010, Ecology and Evolutionary Biology


Internship:
Modeling Antibiotic Resistance

Organization:
Resources for the Future, Washington, DC

Advisers:
Simon Levin and Ramanan Laxminarayan

The spread of antibiotic resistant bacteria has led to bacterial infections that are more difficult and more costly to treat. Understanding the spread of antibiotic resistant bacteria is a necessary precursor to implementing effective measures to control the transmission.  Much of my time at RFF was spent updating a model of steptococcal transmission in day care centers that made use of an extensive database containing data from an intervention project in Sweden.  The model, coded in R, showed the effects of various policies in containing penicillin-resistant pneumococci.  I also developed a model of the transmission of antibiotic resistant bacteria during a flu epidemic, for which I hope to gather empirical data this fall." (See presentation.)


Liz Chen, 2010, Anthropology


Internship:
HIV/AIDS Along the U.S.-Mexico Border

Location:
Pan American Health Organization, El Paso, TX

Adviser:
Joao Biehl

"This summer I worked for the Pan American Health Organization in El Paso, TX. While I was on the US-Mexico Border I worked specifically on projects related to chronic diseases such as childhood obesity and diabetes. I conducted large systematic reviews of obesity legislation in both the US and Mexico and compiled studies that use mass media campaigns to combat the obesity epidemic. In addition to my internship I spent my time outside the office learning from promotoras (community health workers) specifically trained in HIV/AIDS. These promotoras had a lot to say and I learned a lot about health disparities in general along the Border and the importance of culturally-appropriate care. I also had the privilege of working with the Teen Advisory Board of Thomason Hospital on the weekends. These teens opened my eyes to a new  alternative way of disseminating important information relative to public health. They educate their parents and peers and shared with me some of the horrific common misconceptions they hear when discussing topics like HIV/AIDS in their communities. These experiences will serve as the basis for my independent work this upcoming year." (See presentation.)


Daniel Echelman, 2011, Chemistry


Internship:
Health Solutions Through Theater-Based Community Outreach

Organization:
TEARS Group, Kenya

Adviser:
Mahiri Mwita

"With the support of Health Grand Challenge, I traveled to Kenya to work with TEARS Group Kenya.  For a quick word of background about the organization, TEARS is a local NGO based in Nakuru, Kenya that grew out of a youth group that used theater as a means of affecting behavior change as it relates to HIV/AIDS.  My work with the organization was focused on two projects: research into the successes and shortcomings of TEARS’ theater-against HIV/AIDS efforts, the primary objective of the summer, and implementation of a breast cancer awareness pilot project.  With both projects, there were plenty of moments of celebration, and also plenty of moments of frustration.  If I were to leave a recommendation for future students and administrators organizing Grand Challenges projects in the developing world, I would emphasize the importance of good communication with the partner organization before arriving, particularly concerning objectives and expectations, as many of my frustrations came about when I had trouble getting TEARS to move on the program work-plans.  I leave Kenya, though, with a wealth of data and experience with their theatrical efforts, from which we are currently compiling a report for the organization, and with the groundwork for the breast cancer project in place, and would like to extend my sincerest gratitude to Grand Challenges for affording me this opportunity." (See presentation.)


Jasmine Ellis, 2010, Religion


Internship:
Amazon Indigenous Health

Location:
Child Family Health International, Puyo, Ecuador and surrounding communities

Adviser:
Jonathan Gold

"In this internship, I participated in clinical rotations in various clinics and hospitals in Quito and Puyo, Ecuador and their surrounding areas.  I visited and lived with two Amazon indigenous communities, Kichwa and Shuar, and learned their culture and traditions and healing practices.  The purpose for this internship was to conduct my Senior Thesis research comparing Amazon indigenous healing practices with Western medicine, and this internship allowed me to get into contact with the communities that would be essential to conduct such research.  In the clinical rotations, my preceptors were medical doctors who took the time to explain why they made every decision that they made and step that they took.  The indigenous communities were welcoming and willing to travel by foot for a total of ten hours to meet me to take me to their community five hours into the jungle.  Overall it was an amazing experience and I learned so much about some of the many cultures that exist in Ecuador, and most importantly, I learned about myself and to be more comfortable in my own shoes when dealing with difficult and new situations." (See presentation.)


Ukachi Emeruwa, 2010, Economics


Internship:
Reducing the Malaria Burden–One Village at a Time

Organization:
Infanta Malaria Prevention Foundation, Ghana

Adviser:
Kristina Graff

"This summer, I served as an intern for the Infanta Malaria Prevention Foundation. Infanta Malaria is a Non-Governmental Organization dedicated to raising awareness about malaria prevention and treatment by providing education, services, equipment, and medication to the most vulnerable group – pregnant women and children in remote, rural villages. My responsibilities included: data collection; training on malaria prevention; short residencies in villages with Infanta Malaria’s partner organizations; research that assisted in fund raising activities; and attending seminars or other venues that assisted in Infanta Malaria’s efforts to stay abreast of new information."

"Though the internship constituted my first experience in public health, I played an active role in impacting the community. Using some of the resources and contacts that I made, I was able to arrange for an ophthalmology team to visit the village in which I was living, where we provided eye screening and cataract surgeries to the villagers at no cost. The best part of the internship was the flexibility and freedom that allowed me to travel the country and to develop personal projects to help the cause. For the duration of my stay, I worked to design malaria educational materials for children ages 4-7 because early exposure to even the most basic facts about transmission and prevention could significantly increase long-term awareness and knowledge about the disease and preventive measures. By reaching out to the children, I would hopefully be making a contribution that could have a long-term impact for generations to come." (See presentation.)


Mathias Esmann, 2011, Woodrow Wilson School


Internship:
Mosquito Net Distribution in Sierra Leone

Organization:
Unicef, Sierra Leone

Adviser:
Burton Singer

"I distributed 4,000 long lasting insecticide-treated mosquito nets in the Malen chiefdom in Sierra Leone. In a team of eleven college students I walked to a total of 35 village with populations ranging from 26 to 850. In each village we held a town meeting with the town chief and our local partners: Red Cross 'Malaria Keep Up' volunteers, high school and college students from the chiefdom and representatives from the District Health Management Team. The meeting served to introduce our group and to educate the locals people about the importance and correct usage of the nets." 

"Our group then split into 4 teams and we visited each household in each village. We gave nets based on the number of verified sleeping spaces and reinforced the lessons from the town meeting. We put nets up in their homes to demonstrate how it can be hung from the ceiling to cover any part of a room, and how it must be tucked under a mattress/mat. Two weeks before and one week after the distribution, I was based at the UNICEF office in Freetown preparing and following up on the distribution while consulting with their team of experts." 

"The best part of the experience was definitely that we had a big impact on health in the chiefdom, a result we achieved with few resources. Our only major expense was the nets; every one on our team was a volunteer and we used our own resources for food and lodging, which in my case was funding from the Grand Challenges program and the Princeton Class of 1978 Foundation. The Malen chiefdom offered us housing as their contribution to the project. We even decided to walk the 110+ miles to and from the villages instead of renting a vehicle."


Joshua Franklin, 2011, Anthropology


Internship:
Sex Reassignment Surgery in Porto Alegre

Organization:
Grand Challenges Project, Porto Alegre, Brazil

Adviser:
Joao Biehl

"This summer I worked with a center for sex reassignment surgeries provided for free by the Brazilian health system located in a large federal public hospital in southern Brazil. In 2007, a legal action initiated by a group of transsexual patients from this public hospital succeeded in a federal court of
appeals, forcing the Brazilian government to make sex reassignment surgeries available. The rationale, which referred to the universal right to health as well as the right to human dignity and freedom from discrimination based on gender or sexual orientation, raised questions about the meanings of fundamental rights and the way that rights discourses and gender norms shape public healthcare in Brazil."

"During my time in Porto Alegre, I conducted interviews with the lawyer who represented the transsexual patient group and the federal appeals judge who authored the opinion in favor of the group, as well as other legal professionals and scholars working in this area. I also observed the treatment facility, interviewing the medical and psychiatric staff that worked there, and I gathered individual stories from patients participating in the program."

"I am interested in the ways that public healthcare is organized and access to healthcare resources is structured by the politics of gender identity and ideological struggles in the judicial and medical establishments. My research is focused on the unique experiences of transgender individuals, and how those experiences are mediated by institutions of care and the ideological commitments that shape them." (See presentation.)


Irfan Kherani, 2011, Molecular Biology


Internship:
Who Governs the Microbe? Governance of Infectious Disease in South Africa

Organization:
Grand Challenges Project, Eastern Cape, South Africa

Adviser:
Evan Scott Lieberman

(Group internship with Qiong Qiu and Shivani Sud).
"In this study we primarily sought to address three questions regarding infectious diseases including HIV/AIDS, and Tuberculosis in five municipalities in the Eastern Cape of South Africa. How and why do elected and non-elected leaders respond to and prioritize policy problems in different ways? Why do different types of authorities respond to different problems? How and why does this vary across time and space? We utilized several methods of data gathering. A closed ended survey was distributed in 8-12 municipalities with a goal of 200 responses. Semi-structured interviews were conducted with councilors and various types of authorities in 1 metropolitan area and 3 local councils. We spent time in the library doing newspaper research to find reports that highlight the politics of the governance of infectious disease. We also made passive observations, of what we saw in local meetings of councils/committees, other relevant information. While the data from this study has yet to be analyzed, our fieldwork made it apparent that there are many logistical, organizational, cultural and political barriers to effective prevention and medication distribution problems. Even though actors other than the government including churches, businesses, and non-governmental organizations are also playing an active role there remains a large population of citizens who are vulnerable to infectious disease." (See presentation.)
 


Ildil Kore, 2010, Psychology


Internship:
Health Systems and Concerns for Ex-Mineworkers

Organization:
TEBA Development, South Africa and Mozambique


"I interned with Teba Development, an NGO based in Johannesburg that gives focused development services to the mining community of Southern Africa. It offers care and support to ill-health retired mineworkers with conditions such as TB, HIV/AIDS, injuries, etc. through delivery of medical kits, referrals for treatment, voluntary counseling and testing (VCT), family awareness education, and care for orphans. During my time in the Eastern Cape, South Africa, I interviewed the families of ex-mineworkers and collected data regarding overall health, living conditions, and livelihood strategies of the households. In Mozambique, I worked with the Partnership on HIV and Mobility in Southern Africa (PHAMSA), which aims to reduce the HIV incidence and impact of AIDS among migrant and mobile workers and their families. I accompanied community agents (members of community that educate members about safe sexual practices, health, promote education, counseling) on their daily rounds to Teba clients and assisted with community outreach such as drama plays that stimulate discussions and debate." (See presentation.)


Josephine Yolisa Nalule, 2010, Molecular Biology


Internship:
Global Antibiotic Resistance Partnership

Organization:
Resources for the Future, Washington, DC and Kenya Medical Research Institute, Nairobi, Kenya

Adviser:
Ramanan Laxminarayan

"The problem of antimicrobial resistance has received relatively little recognition in many developing countries, at the same time that it has gained immediacy in high-income countries and this is largely because of poor surveillance for resistant microbes. The death toll of resistant bacterial infections may, in fact, be largest in low- and middle-income countries. Two million children under 5 years of age die each year from pneumonia, nearly all in these countries and this mortality is undoubtedly greater because of increasing resistance of the main bacterial causes of pneumonia (Streptococcus pneumoniae and Haemophilus influenza) to common antibiotics, but the limited laboratory capacity and lack of national surveillance that characterize most developing countries has kept this problem hidden."

"However we can contain/delay/slow down the development of this resistance by taking action in the activities where humans contribute to this development. In my internship, I was posted in Kenya by Resources for the Future, DC, to help in the creation of a country profile/situation analysis, in order to set the context for policy solutions and opportunities for dealing with antibiotic resistance. In particular I was working in a Kenya Medical Research Institute (KEMRI) alongside Dr. Sam Kariuki, a molecular microbiologist to collect information on the epidemiology of antibiotic-treatable diseases and levels of antibiotic resistance in Kenya. This information was mainly got from literature and studies done locally. It was found that antibiotic resistance levels to first line treatments were quite high among patients. These results and outcomes were presented at a 2 days conference that sumarized the way that antibiotics (and drugs, generally) flow through the country (including how they are acquired by patients), legal and regulatory requirements for antibiotics (and drugs, generally), and surveillance systems that capture information on aspects of antibiotic use and resistance patterns in the country. I enjoyed my experience in Kenya. I learned a lot about antibiotics and how the problem of resistance is a really big issue. I hope to work in a field such as this after I graduate." (See presentation.)


Joshua Oppenheimer, 2011, Woodrow Wilson School


Internship:
Health and Medicine Program

Organization:
Center for the Study of the Presidency and Congress, Washington, DC

"The projects that I was working on were specific to the Summer of 2009, in which healthcare reform legislation was being crafted on the Capitol. Dr. Blumenthal sought to impact the reform debate as much as she could, so that public health and disease prevention programs would be central to reform, not just changes to health insurance. I conducted background research and wrote a background brief for a Working Group of biomedical research experts who were crafting recommendations for policy makers. I also attended conference at other think tanks and meetings on the Capitol to learn about hot topics in health policy. Dr. Blumenthal also works to shape the internship to your own interests – for me, that meant helping Dr. Blumenthal to write several Op Eds that were published on the Huffington Post. I would strongly encourage future students to intern with Dr. Blumenthal, whether she remains at the Center or whether she takes another position in government."


Qiong Qui, 2012, Molecular Biology


Internship:
Who Governs the Microbe? Governance of Infectious Disease in South Africa

Organization:
Grand Challenges Project, Eastern Cape, South Africa

Adviser:
Evan Scott Lieberman

(Group internship with Irfan Kherani and Shivani Sud).
"In this study we primarily sought to address three questions regarding infectious diseases including HIV/AIDS, and Tuberculosis in five municipalities in the Eastern Cape of South Africa. How and why do elected and non-elected leaders respond to and prioritize policy problems in different ways? Why do different types of authorities respond to different problems? How and why does this vary across time and space? We utilized several methods of data gathering. A closed ended survey was distributed in 8-12 municipalities with a goal of 200 responses. Semi-structured interviews were conducted with councilors and various types of authorities in 1 metropolitan area and 3 local councils. We spent time in the library doing newspaper research to find reports that highlight the politics of the governance of infectious disease. We also made passive observations, of what we saw in local meetings of councils/committees, other relevant information. While the data from this study has yet to be analyzed, our fieldwork made it apparent that there are many logistical, organizational, cultural and political barriers to effective prevention and medication distribution problems. Even though actors other than the government including churches, businesses, and non-governmental organizations are also playing an active role there remains a large population of citizens who are vulnerable to infectious disease." (See presentation.)
 


Olaf Sakkers, 2011, Anthropology


Internship:
Independent Research Project into HIV and the Role of Religion

Organization:
Princeton University, South Africa

Adviser:
Joao Biehl

"Based at a rural hospital in South Africa, my research is focused on understanding the interaction between religion at the hospital and the treatment and recovery of patients who are HIV positive as well as how conceptions of religion affect interpretations of health care and HIV stigma. Patients grapple with disease and suffering, negotiating different descriptions of the world given by traditional African religion and Christianity. Many patients associate the hospital with Christianity and their recovery on ARVs with the work of God. Religion is important to many of the hospital staff too, with nurses and patients gathering each morning to sing hymns and pray. The ARV roll-out at the hospital has been successful, with almost 1000 people on ARVs, yet stigma around HIV persists and the hospital wards remain filled with gaunt patients infected with TB and HIV."


Ashley K. Schoettle, 2010, Woodrow Wilson School


Internship:
Malaria Policy Research–Effect of Bed Nets on Mosquito Transmission

Organization:
Resources for the Future, Washington, DC

Adviser:
Ramanan Laxminarayan

"I spent 8 weeks at Resources for the Future (a non-profit, nonpartisan think-tank dedicated to sustainability, environment, and health) working with the malaria researcher David Smith. I did an independent project evaluating the impact of insecticide-treated bed nets on malaria transmission factors in Sub-Saharan Africa, a topic that is much needed in research and scientific knowledge, yet has not been extensively explored. I am hoping to publish my review paper in the Malaria Journal." (See  presentation.)


Shivani Sud, 2012, Molecular Biology


Internship:
Who Governs the Microbe? Governance of Infectious Disease in South Africa

Location:
Princeton University, Eastern Cape, South Africa

Adviser:
Evan Scott Lieberman

(Group internship with Irfan Kherani and Qiong Qiu).
"In this study we primarily sought to address three questions regarding infectious diseases including HIV/AIDS, and Tuberculosis in five municipalities in the Eastern Cape of South Africa. How and why do elected and non-elected leaders respond to and prioritize policy problems in different ways? Why do different types of authorities respond to different problems? How and why does this vary across time and space? We utilized several methods of data gathering. A closed ended survey was distributed in 8-12 municipalities with a goal of 200 responses. Semi-structured interviews were conducted with councilors and various types of authorities in 1 metropolitan area and 3 local councils. We spent time in the library doing newspaper research to find reports that highlight the politics of the governance of infectious disease. We also made passive observations, of what we saw in local meetings of councils/committees, other relevant information. While the data from this study has yet to be analyzed, our fieldwork made it apparent that there are many logistical, organizational, cultural and political barriers to effective prevention and medication distribution problems. Even though actors other than the government including churches, businesses, and non-governmental organizations are also playing an active role there remains a large population of citizens who are vulnerable to infectious disease. (See presentation.)


Aditi Vasan, 2010, Molecular Biology


Internship:
Multidisciplinary Program on Disease Management – Global Antibiotic Resistance Partnership

Organization:
Resources For The Future, New Delhi, India

Advisers:
Ramanan Laxminarayan and Simon Levin

"Antibiotic resistance is known to be a major public health challenge in developed countries, as increasing rates of antibiotic overuse render these drugs less effective.  It is believed that antibiotic resistance is a major problem in developing countries as well, however, there is very little precise information about the levels of antibiotic resistance and the factors contributing to this resistance in the developing world.  Last summer, I studied levels of antibiotic resistance in New Delhi, India as a summer intern for the Global Antibiotic Resistance Partnership developed by Resources for the Future.  I spent eight weeks at Sir Ganga Ram Hospital, a private tertiary care hospital in central Delhi.  Most of my work involved organizing and managing all of the drug resistance data that hospital had gathered over the past 10 years.  I was able to assist in the research, writing, and editing of a review article examining the problem of antibiotic resistance in India and strategies that are currently being used to reduce levels of resistance.  I also had the opportunity to assist with the organization of an international conference on antibiotic resistance in India, which I attended at the end of the summer.  Through my internship experience, I was able to learn a lot about the practice of medicine in the developing world in general, and the Indian health care system in particular.  I was also able to gain a comprehensive understanding of the cultural and socioeconomic factors contributing to the development and spread of drug resistance in India. " (See presentation.)


Alyse Wheelock, 2011, Anthropology


Internship:
Clinical and Sociocultural Factors that Affect Treatment of Histoplasmosis at a Free Clinic in Guatemala City

Organization:
Clinica Familiar Luis Angel Garcia, Guatemala City, Guatemala

Adviser:
Joao Biehl

"I spent this past summer at Clinica Familiar Luis ingel Garcia, a small HIV/AIDS clinic within a larger public hospital in Guatemala City. The clinic provides free ARVis, regular medical consultation, laboratory tests, and psychological services to people of all ages living with HIV/AIDS. I spent my time at Clinica Familiar in varied ways, trying to familiarize myself with the many services of the clinic and conducting a project on a common opportunistic infection called Histoplasmosis. I observed the medical consultations of the adult doctors and the initial blood tests performed by the clinic psychologists. Outside of the clinic itself, I participated in the required workshops for new patients of the clinic and for individuals who have not been
adherent to their medications. These observations offered a richer context to tmy project on Histoplasmosis, a fungal infection that has a high mortality rate among PLWHAis in Guatemala and in other regions of Central America. My project was based on interviews with individuals who had been diagnosed with the infection, doctors, and social workers at the clinic. In my interviews with clinic patients, I sought to learn more about the backgrounds of the individuals diagnosed with Histoplasmosis, their understandings and perspectives of the disease, and their culturally mediated understandings of the symptoms, diagnoses, and treatment of Histoplasmosis. My project also involved studying patient records and interviewing doctors to learn more about diagnostic and treatment procedures, as well as the infectionis evolution in the clinic since its inception 20 years ago." (See presentation.)
 


Jane Zhao, 2011, Economics


Internship:
Exploring Global Antibiotic Resistance

Organization:
Resources for the Future, Washington, DC

Advisers:
Simon Levin and Ramanan Laxminarayan

My internship at Resources for the Future was centered around antibiotic resistance policy. While I worked in DC, I co-wrote a policy brief about the possibility of using bacteriophages (viruses that kill bacteria) as an alternative to antibiotics and perhaps as a part of the solution to antibiotic resistance.  I learned so much about antibiotic resistance (which poses a very scary threat to the health of our global society) and the multilateral approach to solving this problem. I analyzed the market for phage therapy and FDA hurdles it would have to overcome.  While phage therapy seems to be a viable solution, its regulation and administration is unlike that of any other therapy that is FDA approved.  After completing my 8-week stint at RFF, I travelled to China, where I collected research papers (in Chinese) on antibiotic resistance. I also interviewed a few people in hospitals and universities on the extent of antibiotic resistance in hospitals and rural areas.
 
I learned that antibiotic resistance is not well documented in rural areas, and that its levels are extremely high in the case studies that have been conducted.  Additionally, the levels of antibiotic resistance in Chinese hospitals is often higher than those in the US.  In China, I was able to gain a better understanding of the impact of cultural and social behavior and perceptions of antibiotic resistance.  I learned so much about antibiotic resistance and the policy needed to combat it this summer, and I am thankful Grand Challenges allowed me to take advantage of this wonderful opportunity. (See presentation.)