2016 Global Public Health Internship Summary
- Latin America/the Caribbean: The Dominican Republic, Costa Rica, Guatemala, Mexico, and Nicaragua
- South America: Ecuador, Bolivia, and Chile
- Africa: Ethiopia, Ghana, Rwanda, Zambia, Malawi, and Egypt
- Europe: Denmark, Switzerland, and Germany
- The Middle East: Israel, Lebanon, and Jordan
- Asia: Bangladesh, China, Mongolia, Indonesia, Thailand, and The Republic of Georgia
2016 Summer Internship Student Reports
Peter DeJonge (EPID) - Nicaragua
Photo: John (left), another UM SPH intern, and Peter (middle) standing with the lunch staff at the National Laboratory's cafe "El Bosquectio". "We ate here every day and ate everything they had to offer, from grilled cow heart to pork roast and pig's feet."
About the experience: I've been in Managua, Nicaragua for three months working in the National Virology lab. As well as assisting the lab technicians with daily routine respiratory virus detection, I focused on the prevalence of various subtypes of Influenza B virus over the past few flu seasons. Archived naso-oropharyngeal samples within an infant cohort were collected in a local clinic and the surrounding neighborhood. With a list of codes corresponding to infants who tested positive for Influenza B, I spent a lot of time searching through laboratory freezers to assemble the collection of 300+ samples. I am responsible for the RNA extraction as well as the viral analysis via qPCR. Towards the end of my time here, I also assisted with detection of Respiratory Syncytial Virus in samples from the same cohort. It's been rewarding learning new laboratory techniques in a new environment and a foreign language. Each weekend, I've been able to travel throughout the country--learning how to surf, hiking through coffee fields, bartering at crowded markets, and swimming in volcanic lakes. It's been a great summer.
Kelly Walblay (EPID) - Nicaragua
Photo: Kelly Walblay standing in front of the Centro de Salud Socrates Flores (Socrates Flores Health Center) in Managua, Nicaragua, where the Sustainable Sciences Institute is located.
About the experience: This summer I worked for the Sustainable Sciences Institute (SSI) in Managua, Nicaragua. The SSI, in conjunction with the Nicaraguan Ministry of Health, Centro de Salud, National Pediatric Hospital, and the University of California at Berkeley and University of Michigan schools of public health, conducts ongoing cohort studies of infectious diseases in Managua. I focused on pediatric studies regarding dengue fever, chikungunya and Zika virus. I edited protocols and wrote study amendments to expand research to include Zika testing and new Zika studies. I was able to go into the field and oversee data collection as well. My work also included cleaning and linking databases between the sites and tracking Zika cases within the cohort. The experience has been very rewarding and I have learned a lot in terms of both knowledge and skills. I have also had opportunities to travel the beautiful country of Nicaragua and practice my Spanish!
John Kubale (EPID) - Nicaragua
Photo: John Kubale in front of the Centro Nacional de Diagnósticos y Referencia (CNDR) in Managua, Nicaragua where he has spent his internship.
About the experience: John is currently investigating the prevalence of infections and co-infections of respiratory viruses among a cohort of hospitalized infants in Managua, Nicaragua. Working with the Nicaraguan Ministry of Health at the Centro Nacional de Diagnósticos y Referencia (CNDR), John is using multiplex RT-PCR to test cohort samples for 21 respiratory viruses and bacteria. This experience has provided John the opportunity to learn a number of new laboratory techniques and better understand the significant challenge presented by acute respiratory infections in Nicaragua.
Whitney Howell (HBHE)- The Dominican Republic
Photo: Whitney Howell stands in front of Clínica de Familia La Romana (CFLR), the largest non-governmental clinic in the Eastern region of the Dominican Republic, which provides comprehensive primary and HIV-specialized care.
Project: Over the summer, I worked on an evaluation of an antiretroviral therapy (ART) adherence-counseling program. I identified barriers and facilitators to adherence and proposed potential strategies to increase adherence among the most vulnerable populations. My work also involved abstracting and analyzing data from medical records and conducting one-on-one qualitative interviews with current patients in the adherence-counseling program. Finally, I had the opportunity to assist in some of the clinics outreach efforts. I participated in safe sex workshops for female sex workers and observed in-home consultations. Overall, my experience provided me with a better upstanding of clinical settings, allowed me to improve my Spanish language skills, and provided me with an opportunity to immerse myself in Dominican culture.
Wenkang Ma (EPID) - Egypt
Photo: At the Gharbiah Cancer Society (GCS), Dr. Ramadan, a cancer consultant and the supervisor of disease surveillance in GCS, explains the application process for governmental cancer treatment subsidization and shares his thoughts on cancer incidence variation within Gharbiah Governorate to intern Wenkang Ma.
About the experience: To understand the impact of the government-subsidized treatment plan in Egypt on hepatocellular cancer incidence, I worked with the Gharbiah Cancer Society (GCS) in Tanta, Gharbiah, Egypt. As the first of its kind, GCS has been financially supported by Zakat, a special kind of donation in Arabic society, and has built a stable connection with the government through which it assists the implementation of the national-subsidized cancer treatment plan and disease surveillance. I sorted out the cancer case data collected by GCS, retrieved relevant data from other sources (local websites, meeting reports and health professionals) with the help of the staff, and tried to connect these data. It may appear nowadays that cooperation can exist overseas as long as there is Internet or telephone connection, however I do not think it applies to all public health workers: I now understand deeply how the health facilities work, how national subsidized treatment plans are carried out, and most importantly how people regard their health and disease in this country. Such knowledge is indispensable for one who wants to study public health topics in a specific area.
Martha Siegmund (NUTR) - Ethiopia
Photo: Martha Siegmund is checking on a newly developed maize product that is air-drying in the experimental kitchen of the Food Science and Nutrition Research Directorate. Many people in rural Ethiopia rely on a grain-based diet, which does not provide a complete protein. This maize product has been engineered to be higher protein and to include the amino acid lysine, which does not occur naturally in maize, to help ensure adequate nutrition.
About the experience: I spent the summer at the Ethiopian Public Health Institute's Food Science and Nutrition Research Directorate working on the Sustainable Undernutrition Reduction in Ethiopia (SURE) program. The SURE program is a government-supported integrated health and agriculture sector initiative that aims to reduce stunting and malnutrition in children under age 5 by improving complementary feeding and dietary diversity. The SURE program takes a multi-sector approach to improve child-feeding practices through social and behavioral interventions enacted through the health and agriculture sectors. Over the course of my internship, my role has actually involved many different projects. In addition to assisting with analysis of baseline data for the SURE program, I also contributed to a systematic review of community-based nutrition programs, a qualitative study proposal about using research evidence to inform nutrition policies and programs, and an African Union policy report on nutrition indicators in Ethiopia. The most valuable experience was getting a feel for how global health work functions in practice.
Avery Avrakotos and Jessica Youngblood (HBHE) - Ghana
Photo one: Avery Avrakotos discusses participant recruitment strategies with Josephine Kwaw, a staff midwife at Korle Bu Teaching Hospital in Accra, who assisted with recruitment and translation during the course of the study.
Photo two: Jessica Youngblood reviews an interview with Josephine Kwaw, a staff midwife at Korle Bu Teaching Hospital in Accra.
About the experience: In order to explore the structural and cultural factors that affect access to antenatal care among adolescent mothers, SPH students Avery Avrakotos and Jessica Youngblood designed and initiated a qualitative study. Over the course of the past three months, Avery and Jessica navigated the local ethical review system, established a local research team, secured resources, and conducted semi-structured interviews with adolescent mothers and healthcare workers at Korle Bu Teaching Hospital in Accra. With the summer drawing to a close, Avery and Jessica are working to transcribe, code, and analyze all completed interviews using qualitative software. The work has been immensely rewarding and provided Avery and Jessica with experience problem-solving in an international setting, as well as insight into how national policy can impact individual-level patient care.
Melani Kekulawala (HBHE) - Ethiopia
Photo: SPH student Melani Kekulawala (left) with preceptor, Eskinder Kebede (middle), and Center of International and Reproductive Health consultant, Bella Roman (right), discussing baseline assessment results of the family planning clinic at Tikur Anbessa Hospital, Addis Ababa, Ethiopia.
About the experience: Despite a free access to contraceptive methods in Ethiopia, there is still a huge gap in the uptake of contraceptive methods among women of reproductive age. This is partly due to the misconception and misperceptions of this method where patients' and even providers personal and religious beliefs hinder their uptake of the method. Our study sought to determine if a quality of care intervention in the family planning clinics of Tikur Anbessa Hospital and Gandhi Memorial Hospital would increase family planning awareness, demand, and patient satisfaction. With my colleagues, I secured IRB approval, administered pre-intervention facility audits of the resources, services, and staff in both study locations, and conducted pre-intervention patient satisfaction exit interviews. The intervention will be composed of infrastructure improvements, provider training, and heightened advertising of family planning services. I will continue working with my colleges to assess whether such an intervention has an impact on the facility and patient satisfaction. Lastly, I was able to shadow medical interns and residents in the family planning clinics, labor wards, and emergency out-patient clinics, to gain a better understanding of the working conditions and challenges in the tertiary hospitals of Addis Ababa, Ethiopia.
Shelby Eagle (HBHE)- Ethiopia
Photo: UM-SPH interns in Addis Ababa, Ethiopia at Emperor Menelik's Former Palace on Entoto Mountain including Shelby Eagle (second from the left).
About this experience: This summer I was an intern with the Center for International Reproductive Health Training at St. Paul's Hospital Millennium Medical College in Addis Ababa, Ethiopia. The purpose of my internship was to research the cause, cost, and magnitude of infertility among men and women seeking treatment services at health centers in the country. Infertility in Ethiopia is a public health concern because of the social implications of the condition for women – women are often blamed for the inability to conceive despite the commensurate role men play, and may be at increased risk of physical and/or psychological abuse at the hands of their husbands. Additionally, childlessness can be especially detrimental to couples in sub-Saharan Africa because of their reliance on children for economic survival.
Julia Porth (EPID) - Ethiopia
Photo: Julia Porth (fourth from left), her preceptor Yemisrach Abeje (third from right), and Maryn Lewallen (middle) with a group of health extension workers in Worabie, Ethiopia at a data collector training workshop.
About the experience: Although vaccines against 10 childhood illnesses are available for free through the Expanded Programme on Immunization, many children in Ethiopia do not receive the full series of recommended childhood vaccines. To learn why vaccine coverage is so low, I spent the summer working at St. Paul's Hospital Millennium Medical College in Addis Ababa, Ethiopia. I conducted a study that aimed to better understand parental perceptions of vaccine necessity in Addis Ababa. As a part of this project I designed the study protocol and created a survey tool to measure parental perceptions of vaccines. I also visited immunization clinics to understand the context in which vaccines are distributed, spoke with local heath extension workers about their experiences with vaccination and attended a data collector training workshop. Our data is currently being collected and I am very excited to begin analysis this fall! The most valuable part of this experience was having the opportunity to visit the immunization clinics and speak with the health extension workers to learn firsthand about their experiences with vaccination.
Molly Green (HBHE)- Germany
Photo: Molly Green (right) and colleague Felecia (left) enjoying a cake baked by Fouad (back), a refugee from Syria, outside of a refugee housing center in Sophienthal, a small town outside of Bayreuth in southern Germany.
About the experience: This summer, I have been working with Syrian refugees in Bayreuth, Germany, a university town which is in the southern state of Bavaria. Nearly 1300 refugees reside in local refugee housing centers as they await the decisions on their requests for asylum. During the first part of my internship, I met with various stakeholders to assess the healthcare needs of the refugees and determine how to best increase access to healthcare services. I conducted informal interviews and focus groups with refugees in the local housing centers to better understand gaps in services and issues of access. After interviews and meetings with two local NGOs, the branch of city government responsible for refugees, the directors of the refugee housing centers, local healthcare professionals, and university students working on a cultural competence program, I created a poster to be hung in the housing centers. I then worked together with three different refugees from Syria to help translate the materials from English and German into Arabic. I also developed a workshop to be presented at the housing centers to help refugees understand and better access the available healthcare services. In the second part of my internship, I have begun to collect qualitative data relating to ideas of health and healthcare utilization among Syrian refugees awaiting asylum. Throughout the summer, I have been documenting aspects of my experience in my blog.
Grace Christensen (EHS)- Israel
Photo: Grace Christensen (middle) standing with her University of Michigan School of Public Health colleagues, Ding He (Left) and Lynsey Kimmins (right) at the annual conference of Israel public health physicians and schools of public health in Tel Aviv.
About the experience: Collaborating with The University of Michigan, Ben-Gurion University of the Negev, and local NGOs, I have developed a study to put into context Israel's 2013 polio outbreak. The study uses questionnaires as well as GIS mapping to characterize water, sanitation, and hygiene (WASH) access and use among the Bedouin communities in the Negev desert. Many Bedouin communities are unrecognized by the Israeli government and do not have access to water, sanitation, and electricity infrastructures. During my internship I spoke to local NGOs and Bedouin community members about how the problems accessing water and sanitation services impact the health of the community. I developed and piloted a questionnaire to characterize WASH access and use in these communities. The most valuable part of my experience was to see firsthand how political policy and lack of infrastructure directly impact health outcomes of an entire community.
Hannah Selig (EPID) - The Republic of Georgia
Photo: Hannah Selig preparing interviewer materials for the STEPs national survey of non-communicable diseases during her internship in Tbilisi, the Republic of Georgia.
About the experience: For my summer internship I worked at the Non-Communicable Disease Division of the National Center for Disease Control and Public Health in Tbilisi, the Republic of Georgia, under its director, Dr. Nana Mebonia. I've been able to get involved in a lot of their projects and programs relating to disease prevention and surveillance in the country, much of which is still in its early stages. I've worked mainly in helping prepare and implement the STEPs survey, which is a WHO non-communicable disease risk factor survey, and by doing risk factor and survival analysis on the new population cancer registry. I've also had a chance to explore the country, and get to know its people and culture—a wonderful meeting of Asia, Europe, the Middle East and the Caucasus. Without the on-the-ground experience it would be impossible to understand a lot of the data I'm seeing (ie episodic heavy drinking in the context of a post-Soviet state that invented winemaking and toasting) and also humanizing global public health practice (chatting with my marshrutka [minibus] driver and fellow passengers about my work and then being invited to their home for a supra [traditional feast] and to marry their first-born son).
Han Xu (EHS) - China
Photo: Han Xu is doing statistical analysis on SAS for a study on the correlation between ambient air pollution and Chronic Obstructive Pulmonary Disease (COPD) hospital readmission in Chengdu, China.
About the experience: I worked at West China Hospital, Sichuan University in Chengdu, China. During the internship, my main task was using statistical analysis to study the correlation between ambient air pollution and COPD hospital readmission, in order to optimize the configuration of medical and health resources. Because this was a multi-subject project, I got the chance to work with professors and students from the Business School and doctors from the hospital, and to see how public health interacts with business management and epidemiology. Also, I participated in the organization of several international conferences, including one that a delegation from UM-SPH attended. As an intermediary, I was happy that I could help to improve the communication between the two institutions.
Wenlu Yan (HI) - China
Photo: Wenlu Yan at Shanghai Centers for Disease Control and Prevention.
About the experience: Wenlu Yan interned at the Shanghai Centers for Disease Control And Prevention (SCDC) this summer. She participated in two projects held at the Division of Immunizations. In one project, she worked in conjunction with Dr. Abram Wagner at the University of Michigan, conducting a qualitative research project on vaccine decision-making. She visited 9 different immunization clinics across the city and interviewed a diverse group of parents about their attitudes and perceptions about newer vaccines which require payment, like Hib vaccine and influenza vaccine. The research team will conduct data analysis with the data that Wenlu collects to inform the Division of Immunizations of more effective policies and programs. In another project, she spent time learning about the development process of information systems in SCDC including immunization information systems, adverse events databases, and notifiable disease registries. Wenlu has a strong interest in understanding how healthcare industry engages with information technology for different purposes in this increasingly information-intensive world. She is passionate about helping others through well-designed health applications. Wenlu attended trainings given by China CDC about standardization of health information system. She also reached out to the IT team in SCDC and different IT vendors to understand the existing problems in design/development process and provided her insights with them. Through this internship, she gained understanding of the challenges facing the vaccination system in China and the role of health information systems within a developing country.
Sarah Miller (EPID)- Indonesia and Thailand
Photo: Sarah Miller, analyzing data during her visit to the Prince of Songkla University in Hat Yai, Thailand before returning to Jakarta, Indonesia.
About the experience: Sarah spent three months this summer with the Cancer Registry Unity at Dharmais National Cancer Center, the national referral hospital for cancer patients, in Jakarta, Indonesia. Her internship included collaborating with both the Cancer Registry Unit and the Clinical Pathology Unit to create a comprehensive database of patients who have cancers with suspected infectious origin. She learned new statistical software, such as R and Joinpoint, and her analysis of trends will continue throughout the fall term. Sarah also spent time at the Prince of Songkla University in Hat Yai, Thailand conducting age-adjusted incidence and survival analysis as well as projections for nasopharyngeal cancers within the province. In her free time, Sarah got to know the wonderful language and people of Indonesia and explore the vast and varying landscapes of Southeast Asia.
Peiyan Sun (EHS)- China
Photo: Peiyan Sun in front of the Shanghai GM headquarters building on her last day of internship.
About the experience: This internship is Peiyan's first step into the practical industrial hygiene (IH) world. At Shanghai General Motors she completed a campus exposure assessment. From vendor selection and background surveys, to sampling and the final report, this practice let her familiarize herself with the IH work flow in a company. She also helped with the PPE usage investigation in the GM Asia and Pacific area, especially the respirators. With colleagues, she helped workers choose the right type of PPE, and completed the fit test for each respirator used. Through her internship, she met with individuals from different disciplines including consulting, PPE suppliers, and government. She also came to the realization that the IH industry in each country has a different background and culture. To be a global industrial hygienist, one has to have a global view, but also take the regional features (like priority hazard, way of dealing people, local regulation etc. ) into consideration. In these 3 months, Peiyan observed that people are investing effort in different aspects but aiming at the same goal. She believes industrial hygiene work is full of kindness, which will motivate her to go on.
Serena Bidwell (EPID)- Indonesia and Thailand
Photo: Serena Bidwell (third from the left) with the cancer registry staff at Khon Kaen University in Northeast Thailand where she was able to learn about cancer surveillance and work directly with a Thai pediatric oncologist.
About the experience: This summer I was working on a project examining trends in pediatric cancers in Indonesia and Thailand. I spent six weeks at the Dharmais National Cancer Center in Jakarta, Indonesia and worked within the Cancer Registry Unit. Here, I collaborated with registry staff and hospital oncologists to create a comprehensive dataset of all pediatric cancers in Jakarta 1993-2010. I also learned about how the Ministry of Health is working to expand cancer surveillance and create a national cancer registry. I then spent six weeks in Thailand, both at Prince of Songkla University and Khon Kaen University, analyzing pediatric cancer data 1990-2011 and learning about the greatest challenges of diagnosing and treating children with cancer. Furthermore, I was fortunate enough to observe two different cultures and am so thankful for this incredible summer.
Quanshay Henderson (HBHE) - Mongolia
Photo: Co-workers Quanshay Henderson (left) and Nyam-Osor Dugersuren (right) seated in a Ger (traditional Mongolian home) waiting for a survey participant to complete their questionnaire.
About the experience: I spent three months in Mongolia, primarily collecting data in the rural areas of the Gobi desert as well as in the capital city of Ulaanbaatar assessing resiliency and coping methods regarding unethical mining practices. I worked closely with the Mongolian National University of Medical Health Sciences to gain entry into various communities within the country and ensure that the developed surveys were culturally sensitive and appropriately translated.