Saturday, May 26, 2012

Alumni Profile: Sarah Williams, UVP Fundraising Chair

Sarah Williams is a Research Associate at the Center for Strategic and International Studies in Washington DC. She interned with UVP as a Healthy Villages Team Leader in 2009. She has a Masters in Global Policy Studies from UT Austin. She now serves on UVP's executive board as the Fundraising Chair. 

Uganda Village Project (UVP): Tell us a little about yourself -- what are you working on these days?

Sarah Williams (SW): I have a masters degree from the Lyndon B. Johnson School of Public Affairs in Austin, Texas. I now work at the Center for Strategic and International Studies in DC, a think tank that focuses on strategic security issues. I'm working primarily on nuclear energy and energy security issues. While I've certainly transitioned away from international development in many ways, I consider my experience with UVP to have been helpful in informing the way I think about national and strategic security issues. The issues we will face in the 21st century in my field are changing, and will increasingly be connected to concerns like human security, infrastructure, and health.

UVP: What was your experience with Uganda Village Project like?

SW: I was a team leader in Walukuba in the summer of 2009. We were beginning the Healthy Villages Program, and I led a team of four volunteers in an effort to build a well, install basic health infrastructure and provide basic health literacy in one of the district's poorest villages.

UVP: What was your biggest challenge working in Iganga? How did you deal with it?

SW: Our challenge was community engagement--from the beginning to the end, we had difficulty gaining the support of the local leaders. Engaging local leaders on a trial and error basis was the best we could do--and listening intently to what they were and were not telling us. Listening more than we spoke helped us better understand the situation in the community, identify who could help us complete tasks, and brought us a great deal of respect.

UVP: What is your favorite memory about your time in Uganda?’

SW: On our very last night in the village, all of the children in the community came to our house and we sang and danced around our large fire pit with the kids singing and drumming. Slowly, the women and men--their parents and grandparents--joined us and it became a raucous send-off that went well into the night. It's a memory I'll have forever.

UVP: What advice do you have for future interns/volunteers?

SW: Have fun, work hard, and manage your expectations. You are not going to change the world in one summer, but you can learn a lot and contribute to important work.

UVP: How has UVP shaped your career today and what you aspire to do in the future?

SW: In an abstract way, my experience with UVP has helped me manage expectations in my current career. Being able to take a step back, breathe, and recognize that all the issues you are trying to deal with and "fix" can't be straightened out at once goes miles to making a career, or a day-to-day task more manageable and enjoyable. Working hard while understanding that all of the work in the world can't necessarily solve a given problem is hugely important, in my opinion.

Sunday, May 20, 2012

Deceptively simple science aims to save premature babies

By Kathleen Bongiovanni, MIPH, MS; Photographs by Seattle Children's Hospital

Kathleen Bongiovanni serves as a Member at Large with UVP. She works as a Program Manager in the Center for Developmental Therapeutics at the Seattle Children’s Research Institute. She holds a Masters in Genetics and a Masters in International Public Health. Kathleen recently won the Gates Challenge Explorations award funded by the Bill and Melinda Gates Foundation. 

Sometimes even a simple idea can make a difference in people’s lives.  In my case, I hope that the creative adaptation of a simple science concept will one day save the lives of premature infants in the developing world.

As a program manager in the Center for Developmental Therapeutics, I support researchers working in the realm of preterm birth and neonatal health.  So far, the main focus of that work has been on treatment options for premature infants, including the development of the Seattle Children’s Positive Airway Pressure ( Sea-PAP) device, an easy to use respiratory support device for preemies.

The aim of my new research project is to investigate new ways of easily and inexpensively diagnosing lung immaturity in premature infants.  Premature birth is a leading cause of neonatal death in the U.S., but not many people realize that it is also a huge issue in developing countries.  New research has shown that 15 million premature babies are born each year, and helping preterm infants everywhere lead long, healthy lives is an important goal of my research.

In developing countries, especially in Uganda—which is where part of my research will take place—many mothers choose to give birth at home, and fewer than fifty percent of births occur with the assistance of a trained health care worker.  Premature infants are born with immature lungs that often lack the ability to make enough surfactant, a surface tension lowering fluid that opens up airways and makes it easier for us to breathe.  Without surfactant, a baby’s lungs are prone to collapse and the baby as risk for developing respiratory distress syndrome.  If problems go undetected and are not treated quickly, this syndrome can lead to death or lifelong disability.

Mothers in resource-limited countries may not be aware that their infant is born prematurely and may not recognize the danger signs of lungs immaturity, placing these infants at risk for developing respiratory distress syndrome.  About 50 percent of deaths that occur within the first 30 days of life are due to delays in problem recognition and care-seeking.  If a mother or trained health care worker is unable to recognize the danger signs of respiratory distress syndrome, the mother or family won’t know to take the infant to a health care facility.  The resulting delay in care, sometimes up to 3 days, can have a devastating impact on the health outcome of the infant.   

Tests for lung immaturity are available in the U.S. and other developed countries, but these tests are complex and expensive, and require invasive amniocentesis or gastric aspiration.  Alternative lung immaturity tests that are appropriate for use in developing countries do not yet exist. 

My research project revamps an old test that was originally developed in the 1970s.  I characterize it as being “deceptively simple,” and thanks to the newer, fancier tests, many people have overlooked it.  The test is called the foam stability test, or shake test.  It works by mixing amniotic fluid with ethanol and shaking the mixture by hand in a vial, then letting it sit for 10 minutes.  You then look at how many bubbles are in the vial.  Lots of bubbles means that the amniotic fluid contains enough surfactant to support an infant’s breathing- no respiratory distress syndrome.
Amniocentesis is not readily available in developing countries, and would be too expensive to implement.  My idea is that the foam stability test should work by taking and saving the oral fluid that is routinely suctioned out of an infant’s mouth right after s/he is born.  This fluid is similar to what you would collect through amniocentesis, and should perform well with the foam stability test.  Oral fluid can be collected noninvasively, and ethanol is not expensive.  The test is simple and can be conducted by someone with minimal training, making it perfect for use in developing countries. 

Right now, I am working with clinical colleagues at Texas Children’s Hospital to plan clinical studies that are necessary to assess the efficacy of this diagnosis technique. I am also traveling to Uganda in June, and will work with my collaborators there to hold focus groups and interviews with women and clinicians in rural settings. Our goal is to gain a better understanding of their feelings on suctioning and testing infant oral fluid, and how amenable they would be to the lung immaturity diagnostic test.

In addition to my work at the Seattle Children’s Research Institute, I am also a member of the board of directors for the Uganda Village Project. One of the reasons that I am conducting part of my research in Uganda is that the rate of preterm birth and infant mortality there is very high, and I believe that simple interventions can make a big difference. Uganda Village Project has a Safe Motherhood Program that provides education and improves access to appropriate medical interventions to people in rural areas, who would not otherwise be able to access these life saving services. As a board member I have the privilege of helping to shape UVP’s strategy and programs, and actually met one of my research collaborators, Dr. Peter Waiswa, through our mutual work with UVP. While in Uganda for my research project I also plan to visit the UVP offices in Iganga, and finally meet some of the people I see at our monthly teleconferences!

My research project  is possible because I won a Grand Challenges Explorations award, a rapid grant making initiative funded by the Bill & Melinda Gates Foundation.  Grand Challenges Explorations (GCE) provides funding to individuals worldwide so that they can explore ideas that break the mold in how we solve persistent global health and development challenges.  

Read more about Kathleen's work here:
Learn more about UVP's Safe Motherhood Program here:

Monday, May 14, 2012

Alumni Profile: Crystal Shen, MD Candidate, Mayo Medical School and Former UVP Intern

Crystal Shen is a medical student at the Mayo Medical School and is a Fogarty International Clinical Research Scholar with the National Institutes of Health in Nanjing, China. She interned with UVP in 2009. 

Uganda Village Project (UVP): What are you doing today, and what do you aspire to do?

Crystal Shen (CS): I am currently wrapping up a year in Nanjing, China as a NIH Fogarty International Clinical Research Scholar. I have been working on STD/HIV research in high risk populations, including female sex workers, through a collaboration between UNC and the China CDC’s National Center for STD Control.  I am also a medical student at Mayo Medical School in Rochester, MN. I finished my first three years of medical school before heading to China and have one year left. Prior to my medical school days, I attended the University of Michigan, where I studied biomedical engineering, and then I worked on the HPV vaccine as an engineer in Merck’s Global Vaccine Technology & Engineering organization.

I will be heading to the Johns Hopkins Bloomberg School of Public Health next year to pursue my Master in Public Health degree as a Sommer Scholar. Afterwards, I will head back to Mayo to finish medical school and then see where residency takes me. 

UVP: Tell me about your experience with Uganda Village Project.

CS: I worked as a UVP Healthy Village intern during the summer of 2009, where I was privileged to be a part of the Bugabula B village community.  My team’s efforts focused primarily on community health work. We presented health education outreaches, developed a mosquito net & water treatment supply chain, coordinated the construction of a shallow well, planned HIV testing days with the local government health center, facilitated development of a HIV/AIDs education club at a nearby school, and developed a Village Health Team, among other things.  A key goal was to be as much a part of the village community while we were there. Building trust with village members was important for creating a foundation for future health interventions within that community.  Our day to day schedule varied, but often consisted of spending the morning on various chores (including getting water from the borehole, handwashing our laundry, etc) and then working on outreaches or other goals in the afternoon and evening.  

UVP: What was your biggest challenge working in Iganga? How did you deal with it?

CS: Upon arrival in the village, there were various challenging aspects we had to adapt to. We quickly adapted to such environmental changes as living with no electricity or running water. What we found more challenging was modifying our expectations and approaches to “getting things done.” My team members and I were idealistic and eager to accomplish much during our months in the village. Forging forth enthusiastically, we worked hard to prepare for our first educational outreach. To our dismay, only a few people showed up at the time we planned to start. Concerned about the poor turnout, we began going around from home to home with a local village leader to mobilize people to attend the outreach. 

Although it took a couple of hours, we eventually had a sizeable crowd gathered to hear our health presentation. As the summer progressed, we learned to focus less on adhering to schedules and more on slowly building relationships in the community. Rather than being distractions from our work, our morning conversations with the village women while pumping water at the borehole and the hours we spent playing with children in the yard helped us learn and become more integrated into the local culture and community. We were also extremely fortunate that the leaders in the village were motivated to do all they could to help the community, and were therefore willing to aid us in our efforts. These relationships were essential to our progress in various endeavors. These leaders also became part of the Healthy Villages Team that continued, even after our departure, to promote beneficial health practices through working year-round with UVP staff.

UVP: What is your favorite memory about your time in Uganda?

CS: Peaceful evenings in the village spent playing with kids in the yard were definitely the highlight of my summer. I remember lots of fun times when the kids would draw pictures of common things to teach us words in Lusoga, or when we demonstrated our repertoire of animal sounds to learn the Lusoga names of various animals.  Also, the baby goats and magenta-dyed chickens living near our house were quite memorable as well!

I was fortunate to have the opportunity to return to Uganda a year later in 2010 when I spent a few months in Kampala working on pediatric cerebral malaria research at Mulago Hospital. I met up with UVP staff & alumni (including one memorably festive get-together in Mabira Forest) and also re-visited Bugabula. It was interesting seeing how much had changed over a year as well as what had stayed the same. Some of the children had grown quite a lot and our former house had been repainted in bright colors, but the many familiar aspects of the village still made it seem a bit like home.

UVP: What advice do you have for future interns/volunteers?

CS: Be open and adaptable. Every village is different and it is useful to find out what they need and tailor your efforts accordingly. There will always be surprises, but sometimes that turns out to be for the better. Most of all, enjoy this opportunity to “be on the ground” working with people. It comes with multiple associated hassles, but also can have many wonderful moments.

UVP: How has UVP shaped your career today and what you aspire to do in the future? 

CS: The positive experiences I had working with UVP  helped strengthen and confirm my interest in future work in developing countries, despite the challenges Having the opportunity to work on the ground and live within the community was immensely valuable. 

In the future, I envision working in academic medicine as a pediatric infectious disease specialist combining clinical care, research, and health systems improvement centered around infectious disease issues, particularly in developing country settings.

UVP:  Tell us about a time you used something you learned/experienced at UVP in your more recent jobs/volunteer experiences.

CS: Living in rural Uganda was particularly useful for further developing my ability to adapt to change, to be resourceful, to be patient, and to stay calm in the face of unexpected challenges. Another key lesson from my UVP summer was realizing that investing in people can ultimately be more worthwhile than solely focusing on meeting objectives. These lessons have proved valuable in other areas of my life, including during my third year medical school rotations.  Sometimes it can be easy to get caught up in all of the things that need to be done, but it’s important to focus on the people at the center of it all whether they’re village members in Uganda or patients in the hospital.