Leslie Claracay, DMS 2010
This summer for my DIHG Fellowship, I worked on Olango Island, Philippines. I focused on dengue fever prevention education since the island had recently suffered from several cases brought in from mainland Cebu, where dengue is endemic. On Olango Island, I worked with the nurse in charge of the island's main health center. My job was to create an updated, follow-up dengue fever prevention class to complement booklets of information distributed when the cases really hit. As prep before my trip, I created flyers and posters as visual aids for the project. The previous dengue campaign included booklets of info about dengue, so I condensed the most important information into a one-page flyer. I included a drawing of a house with the various possible breeding places labeled so that it would be simpler and faster to understand, especially since most of my audiences were barely more than elementary school educated. I also created posters in the audience's dialect so that they could more easily follow along with my lectures. As for the audiences, I would travel all around the island to its different streets and areas to gather groups of people. Most of them would be mothers who stayed at home to take care of the house while their children went to "school," which was sometimes just a small, grey, one-room shack surrounded by trash and dead plants. My "classrooms" were anywhere from big trees to chapels, and I would offer incentives, such as ice candy or pan de sal, to draw larger groups of people. I also took advantage of immunization clinics to teach dengue education to parents who had to wait in line for over an hour.
Isaac Howley, DMS 2010
I traveled to Accra, Ghana for seven weeks in the summer of 2007 to do a case series about the social and medical effects of highly active antiretroviral therapy (HAART), which is administered in Ghana by a national subsidized program. My advisors for this were Dr. Awewura Kwara from Brown University, Dr. Margaret Lartey from the University of Ghana Medical School, and Dr. Elizabeth Talbot from Dartmouth; all three doctors do infectious disease. As far as I can tell, in 3 years of existence, nobody had yet assessed the effectiveness of this national program. I was based out of the Fevers Unit at Korle Bu Teaching Hospital, the most prestigious teaching hospital in Ghana and the only public hospital in Accra (pop. ~1.5 million). I interviewed 270 patients about their employment history and perception of stigma before and after getting sick with AIDS and starting HAART. I also reviewed the records of these patients, recording information about demographics, CD4 counts, weight, and opportunistic infections in the first year of treatment. I have not yet analyzed these data, but they seem to indicate that a) CD4 counts increased over the first year of treatment by amounts similar to other HAART programs in West Africa and in developed countries, and b) there a pressing need exists for specific social and financial services to assist patients whose employment has been impaired by AIDS.
Shailvi Gupta, Rajesh Ramanathan, Rajendra Aldis, DMS 2010
For our summer project we traveled to Pune, India where we conducted an evaluation of an online course run by the Johns Hopkins School for Public Health. The course was designed to provide physicians in Pune with up-to-date information about standards of care for pediatric HIV/AIDS patients. Our goal was to learn whether the course met the needs of doctors in Pune, and to gain a broader understanding of the HIV/AIDS crisis in India. We conducted focus groups, personal interviews, and completed a chart review. The doctors who took the course practiced in a variety of settings, from small private clinics to large government hospitals, so we had the opportunity to learn how care is delivered in these different settings.