Written by Sithembile Chithenga, MBBS, Master of Public Health Candidate, Washington University in St. Louis and participant in the 2019 Institute for Public Health Summer Research Program – Public & Global Health Track
I started the summer program with an intent to be part of something meaningful and to apply the public health methods that I learned throughout the school year.
During the summer I worked with DOLF project at the Division of Infectious Diseases. I researched a neglected tropical disease (NTD) called onchocerciasis that is transmitted by black flies and causes blindness as well as various skin conditions among the world’s vulnerable populations. Although onchocerciasis affects approximately 20 million people, it hasn’t always been a priority in health systems until it was specifically identified – along with 19 other diseases – by the World Health Organization and its partners as relatively neglected conditions for which the global community needed to mobilize resources.
As a part of my research, I analyzed data from a clinical trial in Ghana. The trial is one of several projects directed toward controlling the transmission of NTDs and eventually eliminating them. NTDs like onchocerciasis add vulnerability and can be severely debilitating in affected communities, so it was an inspiring to work alongside researchers driven to prevent this. Support from my mentor, Dr. Gary Weil, and his team members enabled me to progressively master their tools sets, from the meticulous design data collection systems to the analysis and later the interpretation of the findings. Our work would also inform another study looking at drug combinations that could potentially accelerate the control and elimination of onchocerciasis. Unfortunately, not all the summer’s lessons were positive.
In my native language Chichewa, we have a proverb: When the elephants fight, it’s the grass that suffers. This means that vulnerable individuals often bear the consequences of issues regardless of their relation to those issues. Over the summer it became increasingly apparent that success of NTD programs in many parts of the world were somewhat contingent on politics.
Firstly, political willpower was required to implement and sustain NTD programs, many of which must run for several years, spanning across different political administrations. Secondly, political destabilization directly threatened NTD control and elimination efforts, as health professionals were unable to carry out their work in unsafe conditions and in some instances, infrastructure required for healthcare service delivery was destroyed. So already, vulnerable populations not only had to bear the direct consequences of conflict, they also had to endure hardships from loss of access to health services.
I find myself happy for all the growth opportunities that led me to accomplish my goals and inspired by the unexpected lessons.
It’s not a new concept: instability disrupts public health and other essential services, but that doesn’t mitigate the impact of it. There are no simple solutions to these problems however, this has further motivated me to continue working with vulnerable communities and help develop solutions for healthcare delivery in fragile areas.
As a first step towards this, I’m very grateful to have spent the summer surrounded by inspiring faculty addressing health inequalities around the world and peers who are motivated to change public health.