Chambers’ Global Fellows have summer 2017 travel plans set. Fellows are coordinating IRB applications for their sponsoring and their sending institutions and considering details related to fellowship success. Lists are prepared: field equipment collected, data collection instruments and analysis of data are ready, along with yellow cards, Visa’s, MOU’s and malaria prophylaxes. Four to six-week intensive summer fellowship in global population health care settings brings to each fellow, the promise of professional and personal growth. This experience provides an opportunity to co-create research capacity internationally with diverse population health-partners in country and across the Nebraska University System.
The Suzanne and Ward Chambers’ Global Health Fellowship will fund four impressive fellowship candidates during the summer of 2017. These College of Public Health students, across specialties, have the honor of representing the University of Nebraska Medical Center’s CoPH and of creating a public health research project. They will coordinate with in-country academic, clinical service and research-partners projects that address global population health issues that influence international communities.
Compassion is the keen awareness of the interdependence of all things – Thomas Merton
Nada Alnaji, MD, MPH, a Ph.D. student in the College of Public Health, is one of four students chosen to receive the Suzanne and Ward Chambers Global Health Fellowship for summer 2017. Nada will collaborate with Relief International-Jordan (RI-J), working with refugees and displaced persons in Amman, Jordan. Her research involves studying Syrian refugee women and children and the effects of child marriage and pregnancy-related complications on health. She will serve on the RI-J team, collecting her data while also providing technical assistance for training field workers to collect data, monitor data quality and suggest necessary actions to improve data quality. The study design, developed to meet the Relief International program needs, will serve Syrian refugees. Dr. Alnaji is qualified for this experience, as a Saudi Arabian fluent in Arabic and accustomed to both the culture and the challenges of work in the Middle East.
Nada is pursuing a career in international public health. Applying what she has learned in Jordan and interacting with the staff at Relief International will open doors and enhance her career opportunities upon graduation. Her goal is to pursue a humanitarian public health position in the Middle East and to continue with full scope work after graduation, as an MD/MPH/Ph.D. Dr. Alnaji’s faculty advisor is Dr. Shinobu Watanabe-Galloway who will be Skyping regularly with Nada during her 6-week stay in Jordan. Watanabe-Galloway will be mentoring, advising and supporting Nada, a role familiar for this faculty member who is the Research Director for Behavioral Health Education Center of Nebraska (BHECN) and is an Associate Professor and Vice Chair in Department of Epidemiology at the CoPH.
Moses New-Aaron will be working with researchers in Dodoma Tanzania at the Regional Referral Hospital’s Care and Treatment Center with women who are living with HIV. His research will combine both qualitative and quantitative analysis of cervical cancer screening. Cervical cancer is the leading cause of cancer deaths in Tanzanian women. Advising Moses is Jane Meza, PhD. Interim Associate Vice Chancellor for Global and Student Support and Senior Associate Dean and Chair of Statistics at the College of Public Health.
More than eighty percent of cervical cancer deaths are preventable by access to cancer screening and treatment; Tanzania has one of the highest cervical cancer burdens in East Africa. Tanzania has an incidence rate of 50.9 cases for 100,000 women with 37.5 per 100,000 of these women dying from their disease. Mr. New-Aaron will work with an academic and clinical research team, dedicated to identifying cervical dysplasia and treating positive lesions to prevent cervical cancer. The team has a population-health goal of determining current cervical cancer screening practices in HIV-positive clients, barriers to screening/treatment and perceptions of both patients and health care workers to the prevention of invasive cervical cancer.
Vaccinating youth against the human papillomavirus (HPV) has not been available in the Dodoma Region. Women most at risk for invasive cervical cancer are those who are immune-suppressed (such as HIV-positive patients) and those with the HPV virus. Moses is accustomed to combining clinical services and research, as an experienced Clinical Laboratory Scientist and as a Biostatistics, graduate student. His interest in infectious diseases, which are endemic to a population, will provide background for this career path that targets vulnerable populations and cross-cultural work, including communities in the United States. In Tanzania, New-Aaron will encounter the single visit approach (SVA) with acetic acid (vinegar; VIA) screening for cervical cancer with cryotherapy treatment delivered on the same day when a woman tests positive for a treatable dysplastic lesion. He has a unique opportunity to work within the academic, University of Dodoma and the Dodoma Regional Referral Hospital system, which includes ministries of both education and health.
Sachi Verma was motivated to apply for the fellowship “to experience another nation’s healthcare system and to consider ways that systems and exemplary leadership might be applied to other global healthcare environments.” Ms. Verma has a global perspective, having experienced divergent global policies and programs that address health disparity, life-saving and access to care. Sachi has created a strong proposal working with a newly launched emergency transport service using trained motorcycle drivers to respond to emergencies and provide transport to health services. She is collaborating in northern Tanzania with a physician, Marko Hingi, who has global health knowledge and leadership. Dr. Marko Hingi is affiliated with the Catholic University Health and Allied Sciences (CUHAS) is the Executive Director and Co-Founder of Tanzania Rural Health Movement (TRHM), a registered non-profit community-based organization in Mwanza City. A co-created research project will be a quality improvement, and collaborative evaluation work with Hingi and Trek Medics International, a New York-based non-profit. Trek system is devoted to piloting emergency response fieldwork and research to come up with an effective emergency system for limited resources settings with SMS linkages. Hingi and TRHM began one year ago the SMS-based emergency system for trauma care, stabilization, and transport to health services. Through Ms. Verma’s work, Hingi and team will evaluate the effectiveness of the TREK program, the efficiency and community acceptance/buy-in and ultimately that impact of the project on reducing trauma morbidity and mortality. In her proposal, Sachi reported that in Tanzania, trauma remains a major public health issue and is a cause of morbidity and mortality, particularly among healthy, productive young male population. Injury is a common explanation behind admission to Bugando Medical Center and is related with high morbidity and mortality, along with consuming a significant amount of medical services budget.
Sachi is a Public Health Administration student, whose career goals include becoming a global health policy and administrative leadership roles in international settings. She expresses a keen desire to broaden her knowledge and exposure to solutions across global south settings that can inform decisions in other low-resources settings. “I also know that this experience will educate me on ways to create effective programs and solutions in under-resourced health systems. The experience may also be able to inform me of solutions to global North Country dilemmas concerning access to care and ways to decrease health costs.”
Advising Ms. Verma will be Fernando A. Wilson, PhD, Associate Professor and Acting Director of Center for Health Policy, Graduate Program Director in the Department of Health Services Research and Administration. Dr. Wilson will give research and data management support to Sachi during her six weeks in Tanzania and upon return with data analysis and publication of those results. It is truly a partnership approach, with progress made into cooperative learning, teaching and researching opportunities for UNMC students and global population health experts.
Xiaoting Sun will be working using a longitudinal national health insurance research database in Taiwan. Sun is completing her third year of PhD work in Health Services Research, Administration, and Policy. Professor Li-WU Chen, PhD., Director of the Center for Health Policy Analysis and Rural Health Research and Co-Director of Nebraska Public Health Practice-Based Research Network mentors Xiaoting Sun. For six years, there has been a collaborative working relationship between the National Taiwan University’s (NTU) CoPH and Dr. Chen. This productive and sustainable partnership is a platform from which Sun can also consider Nebraskan challenges related continuity of care (COC) in primary preventive and secondary preventive health care. Dr. Li-Wu Chen, who graduated from NTU’s COPH, and has a collaborative relationship with Taiwanese researchers on topics related to preventable hospitalizations and readmissions. The collaborative work, especially examining rural/urban disparities in both countries, builds strong continuing relationships that benefit UNMC graduate students and our Nebraska System. Taiwan’s National Health Insurance Claim Database (NHICD) contains population-based and comprehensive expenditure information. This national database inputs care from the universally covered national health insurance and enables researchers to conduct valid longitudinal studies to examine critical health policy issues
Ms. Sun’s fellowship specifically explores the effect of continuity of care (COC) on preventive services utilization and hospital readmission. The data will be collected from the Taiwanese National Health Insurance Research Database (NHIRD) positions the investigator with opportunities for research and experience that contributes to her doctoral studies and her future career possibilities.
Sun describes in her fellowship proposal critical points that make this an ideal Chambers’ Fellowship topic. She describes the expected demise of the Affordable Care Act (ACA) that expanded insurance coverage and promoted innovative healthcare delivery model to improve COC. Her emphasis, in Taiwan, that informs the United States is associated with how policy emphasizes COC and can inform health care utilization rates, hospital readmission and eventually population health outcomes. The NHIRD study will explore Taiwan’s universal health insurance system, and create from the data analysis, recommendations for best practices.
The College of Public Health congratulates the Suzanne and Ward Chambers’ Global Fellowship scholars and is appreciative of the funding and support offered to our global health education from the Chamber’s family.