Summer Sends Public Health Students on Global MissionsPosted Nov. 13, 2013
Five students traveled to rural Western Kenyan to serve in the Mama Pilista Bonyo Memorial Medical Centre for five weeks. Two students journeyed to Belize to work with children and investigate water sanitation issues there. A doctoral student with a passion for reducing transmission of malaria spent the summer in a National Institutes of Health lab researching mosquito flight capacity in sub-Saharan Africa. All returned with an even stronger commitment to global public health.
MPH student Bill Wallace was the force behind the Kent State contingent making Kenya its destination this summer to work full-time at the medical clinic. Wallace had been there previously on a trip sponsored by Bonyo’s Kenya Mission (BKM), an organization founded by Bonyo Bonyo, D.O., an Akron physician native to Masara. BKM is dedicated to improving health care and education in the rural Nyando District of Kenya, and the Kent State students were pioneers in starting longer-term mission trips for the organization. Passionate about returning to Kenya, Wallace was a persuasive recruiter.
“I was new to the MPH program in the spring and went out to dinner with some of my classmates,” recalls Samantha Pecnik, who is studying environmental health science. “Bill Wallace was there, I had no idea who he was, and he just asked me to go to Africa for five weeks. I was at a point in life where I said, ‘Why not,’ and jumped on the bandwagon and started fundraising,” she says. Pecnik’s involvement at the clinic centered around its lab, where she used her chemistry background to assist with tests for malaria, parasites, TB and typhoid. “Malaria is like the common cold over there, and the majority of patients presented with malaria symptoms,” she says. “I never knew the full impact of malaria on Africa.” Pecnik also worked in the dental clinic, examining teeth, administering nerve blocks and pulling teeth. “Having our presence there changed their lives in the smallest and biggest ways,” she observes, especially recalling how the village children “lit up like Christmas” when Pecnik and her fellow students distributed t-shirts brought from home.
Olivia Hartman chiefly worked in the clinic pharmacy. “I learned enough of the local dialect, Luo, to communicate with the patients about how and when to take their medications. They got a kick out of my pronunciation, and it was great to see most everyone leave with a grin on their face,” she says. “The experience reinforced the importance of patient-provider interaction – genuinely caring and taking the time to ensure you understand patients and that they understand what they need to do to improve their health,” she observes. Malaria was also on Olivia’s mind in Kenya, especially given her summer 2012 experience working in mosquito control for Summit County Public Health. “In the United States, we spend so much money on barrels of pesticide, and in Kenya, they have next to nothing. Kenyans are suffering very much from mosquito-borne illness,” she observes. “The mosquito-control program there provides bed nets for children under age four and pregnant women, while we have trucks, pesticides, disease monitoring surveillance and a full team to tackle this problem in the Unites States. We're hoping to raise enough money this year to bring a bunch of bed nets with us when we go back,” says the health policy and management MPH student.
She’s not the only Kenya traveler who was affected by the disparity between Kenya and the United States. “Kenya is one of the countries with the least amount of things and stuff, but the people are just as happy or happier than any American with a ton of money,” says Patrick Gorby, health policy and management MPH student. “One of the most viable things I took away is a great deal of gratefulness,” he says. Gorby describes a typical day at the clinic as “working there all day from early morning till around 5:00 p.m., performing triage, caring for cuts and infected wounds, putting in stitches, administering vaccines and setting IVs, operating the pharmacy – doing whatever needed to be done and getting as much done as we could,” he recalls. Gorby also assisted with the delivery of a baby, who was given his same name, Patrick James, “which was very cool,” he recalls.
Working in pediatrics and obstetrics at the clinic had profound impact on Laura Bevington, as she found her “purpose in life” there. “I never thought I wanted to do anything clinical,” Bevington recalls, but now she plans a career in international midwifery; she will pursue accelerated nursing training after completing her health policy and management MPH program. Bevington’s favorite day was Thursday. “That was baby day, when we would have perhaps 20 babies from the community come for free vaccines, which I was trained to administer. It was really fun,” she recalls. “Women in labor walk miles to the clinic, crawl up on a table, deliver a baby, wrap it up and, within 30 minutes, clean themselves off in a bucket of water and walk home, with no assistance, no male accompanying them and no pain medication,” Bevington marvels. Kenya was Bevington’s third global education experience, after an undergraduate trip to Southeast Asia and a summer internship at the German Embassy in Leipzig. After most of the students went home, she and Hartman stayed for another 10 days to clean up and reorganize medical supplies at the clinic. “Visitors are asked to check two bags, one filled with just medical supplies to leave over there,” she says.
Team leader Wallace was not only a force in recruiting his fellow Kent State travelers – he was a force in saving the life of a patient seeking help for a wound on her foot. “At the end of the first week, a woman, Eunice, arrived on a motorbike, in much pain and with a softball-size wound on her left foot that started with a thorn,” Wallace recalls. “While cleaning and rebandaging the wound and giving her antibiotics, we learned that she had diabetes,” he says. “A couple of days later, it had gotten a lot worse, with swelling up to her ankle, and if it moved to the bone, she would be lucky to survive.” The patient was urged to go to the city hospital 30 kilometers away for IV antibiotics, but she did not. “When leaving the clinic one day, we decided to stop by her house, and to our surprise, the wound actually looked better. A neighbor with some minimal medical training was cleaning and rebandaging it,” Wallace says. So for the rest of trip, “I went twice a week to see Eunice in her mud house, and we managed to get her on diabetic meds by mouth to help get better blood flow to her foot,” he says. “New tissue was growing, but I was worried what would happen after we left.” Wallace’s last stop before leaving for the airport was to care for Eunice, and he subsequently received an email from the clinic administrator that she was seen walking in the market. “I was happier as I could have been all day,” he says.
It wasn’t all work and no play for the students, who took a safari near the end of their time in Kenya. Gorby had his face licked by a giraffe, and Bevington, wanting a photo close-up, ended up dangling from the safari van just feet away from a lion before being cautioned to pull back by the driver.
MPH students Eric Hutzell and Ashley Hendricks traveled to rural Belize, as part of a four-person team from Lutheran Campus Ministries, to lead a vacation Bible school and investigate water sanitation issues in the Cayo District. Hutzell and Hendricks taught the Bible school students how to make soap and wash their hands and brought along a microscope to help educate about sanitation. “It was the first time there was anything like that in their village,” explains Hendricks, an environmental health sciences MPH student. “The children were were timid at first, but later even their parents came and were interested in making soap,” she says.
Hendricks and Hutzell spent most of their free time along the Mopan River, making maps and shooting video with a point-of-view camera loaned by Andrew Curtis, Ph.D., associate professor of geography. Curtis is director of the Geographic Information Systems (GIS) | Health and Hazards Lab and is former director of the World Health Organization’s Collaborating Center for Remote Sensing and GIS for Public Health.
“Walking along the river between San Jose Succotz and Calla Creek, we recorded chemicals that were being dumped directly into the river, trash problems and agricultural drainage,” explains Hutzell, a health policy and management MPH student. “Residents have a tradition of using the river for bathing and for washing their clothes and their goats, which provide milk and food,” adds Hendricks. The river is also used for tourist recreation, according to Hendricks.
Returning home, Hutzell is now collaborating with Curtis and fellow students to use the mapping data in analysis of water hazards in rural Belize, the urban slums of Kenya and suburban Zambia. “There are so many chemicals, viruses such as Hepatitis A and E and trash in the water, so we’re really hoping to raise awareness about the hazards in the Mopan River,” he says.
While spending her summer in a Washington, D.C., lab, doctoral student Amy Krystosik’s mind was five thousand miles away, in the sub-Saharan country of Mali, as she studied the capacity of mosquito flight there.
At the Laboratory of Malaria and Vector Research of the National Institute of Allergy and Infectious Diseases, Krystosik’s chief project was development of a novel assay to measure flight capacity of the African malaria mosquito, Anopheles gambiae s.l. Krystosik’s initial exposure to medical entomology came during an undergraduate trip to Ecuador to study Chagas Disease. This led to a master’s degree in International Health and Development from Tulane University, and the Peace Corps and HIV/AIDS work followed. With plans for a career in Latin American medical entomology and epidemiology, Krystosik wanted a lab-based experience this summer to gain skills for her doctoral research and future career.
“One hypothesis to explain the repopulation of anophelines after the dry season is migration,” says Krystosik. “To investigate this hypothesis, we developed an activity meter to measure flight by sound, accounting for environmental conditions,” she explains. “We found that intensity of sound can predict flight density at a frequency of 400-800 hertz (cycles per second) at temperatures greater than 63 degrees Celsius in the colony,” she says.
In other work at the lab, Krystosik assisted Diana Huestis, Ph.D., on her investigation into aestivation, or dry-season hibernation, of African malaria mosquitoes. “They shouldn’t be able to survive for the five- to seven-month dry season, but when the wet season comes around, the population reemerges,” Krystosik says. Using new mosquito colonies from the Malian field site, the staff simulated actual seasonal shifts in photoperiod using light boxes.
A highlight of the summer lab experience for Krystosik was having the opportunity for frequent discussions with Tovi Lehmann, facility chief, who held an open-door coffee every day from 5:00-6:00 p.m. “Some of the best malaria researchers in the world are all there in one place, and I’ve developed invaluable relationships from this experience,” she observes.
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“If you have the opportunity to do global public health field work or an internship, do all you can to make it happen,” advises Gorby. “It broadens your perspective of public health and is very viable for what you’ll be doing later in life, whether you stay in America or not. You’re learning information you can’t gain any other way,” he says.
“I will never look at my life and home the same way again. This trip turned my world upside down,” declares Bevington. “You will want to do a lot more than you did before, despite how much of a humanitarian you were before going,” she says.
Wallace agrees. “You are making a sacrifice to go on a trip like ours to Kenya, and it’s absolutely worth the sacrifice,” he says. “But the sacrifice is not the tough part. It’s the immensity of the need for help. There is no end point, the work is never finished, there are not enough hours or funds,” he says. “You’ve done good work, but there is always more that you could have done,” he concludes. A similar mission trip to Kenya is being planned for summer 2014. Wallace is raising sponsorship funds and can be reached at email@example.com.