MCW and Notre Dame join forces for global health student research program

Visiting rural thatched-roof homes, exploring pitch-dark caves to find disease-carrying insects and presenting research findings to a foreign Ministry of Health was all in a month's work for three second-year medical students from the Medical College of Wisconsin (MCW) this past summer.

Liya Assefa, Olivia Davies and Josh Thiel traveled to Belize as part of the Dr. Elaine Kohler Summer Academy of Global Health Research, an initiative with the MCW Office of Global Health and long-term supporters the John M. Kohler Family Foundation. The award supports rising M2s as they participate in 10-week hands-on global health summer research projects.

This year, nine students conducted research in four different countries as part of the program, which has provided 45 MCW students with opportunities to conduct research projects in 14 countries since 2011. Partnerships and collaboration are key to the program’s success; students work with both MCW faculty and faculty in their host country to address global health issues. This year, a new collaboration with the University of Notre Dame opened the way to mutually beneficial research for the three Kohler Scholars studying in Belize.

MCW second-year Josh Thiel in Belize during summer 2017 research trip
MCW second-year medical student Josh Thiel speaks with children about vector-borne diseases during his summer 2017 trip to Belize as part of the Dr. Elaine Kohler Summer Academy of Global Health Research.

"Over the last three years, we have been strengthening ties with Notre Dame's Eck Institute for Global Health, a premier institution for global health education," says Stephen Hargarten, MD, MPH, MCW associate dean for global health. "Though Notre Dame does not have a medical school, their institutional support behind global health is tremendous. Our relationship gives both institutions new opportunities to enhance research in areas where we both already have involvement."

A strong research connection between MCW and University of Notre Dame already existed in their shared interest in Belize. MCW has a long-standing physician and nursing capacity building project in the country through the MCW department of emergency medicine. Notre Dame also conducts research in Belize in partnerships with the Belize Ministry of Health and the Belize Vector and Ecology Center in Orange Walk Town. Under the leadership of John Grieco, PhD, Notre Dame research associate professor in the department of biological sciences, their work is focused on strengthening the country's ability to respond to Zika and other arboviruses through surveillance studies, health-care professional training and public health awareness education.

Belize Vector and Ecology Center (BVEC)In a new collaboration between MCW and Notre Dame, Dr. Grieco hosted the three Kohler Scholars during their summer 2017 research experience.

"We each had a different research focus, but we all relied on and worked closely with Belizean nationals, Dr. Grieco and the team at the Belize Vector and Ecology Center," Davies says.

The students each worked with Belizean nationals in the field and the lab to collect data around the tropical diseases Zika, Chagas' disease and dengue virus. The students chose their topics based on their interests and guidance from local experts and Dr. Grieco. Thiel's research focused on dengue-carrying mosquitos' habitat preferences as well as larvae resistance to larvicide, while Assefa's and Olivia's research focused on human knowledge, attitudes and practices toward Chagas’ disease and Zika. The students gained exposure to research methods and practices as well as a broad introduction to Belizean culture.

Davies' research took her to northern and southern Belize to study Chagas' virus perceptions and understandings of people in the two regions.

Collecting samples in Belize"One of the more unique experiences I had was hunting in a dark cave to collect disease-carrying insects. The cave was a popular spot for the colony I was studying," she says.

Davies' work led her to making house visits to conduct surveys with Belizeans in various regions to assess their understandings and practices toward Chagas' disease.

"Local people there were so friendly; they were often offering me a spot at their table and cutting up watermelon for me before I had even explained why I was there," she says.

Thiel says he spent much of his time in the lab in Orange Walk Town, Belize, testing water samples for larvae that had been collected from car bumpers, children's push cars and cisterns.

Near the end of their research period, the three students had an opportunity to present their work to the leadership of the Belize Ministry of Health.

"It was really incredible and certainly nerve-wracking to be presenting our findings to the Ministry of Health," Assefa says. "We actually got to share preliminary findings and saw it sparking conversation among the Ministry leaders. We saw that the research we were doing could actually make a difference."

All three students agree that working closely with the local Belizean experts, Vector Control team, Belize Vector Ecology Center and Notre Dame was critical to creating actionable research. They also say their time in Belize will have long-lasting effects on their own futures as physicians.

Analyzing samples in Belize "This experience has certainly solidified that global health will be part of the career I pursue," Thiel reflects. He adds that his research has made him think differently about local perceptions and health care in Milwaukee. "Infectious, vector-borne diseases are able to travel. My research has made me wonder what kinds of survey responses I would see in Milwaukee for these same diseases."

Davies agrees that the summer experience has made her think differently about both local and global health.

"I have always felt a strong desire to explore and understand different cultures, which is part of why I became interested in the Kohler opportunity initially," she says. Davies volunteers at a local free clinic and says the summer abroad has shown her the parallels in disparities in different countries. "People have the same issues everywhere. It's astounding how much you can look at our local community and see comparisons and see people hitting barriers when they are trying to access care." She hopes to become the kind of doctor who can help both local and global patients.

For the Kohler Family Foundation, these kinds of realizations are exactly the purpose behind the program, which honors the memory of Dr. Elaine Kohler, MCW alumna and former associate professor of pediatrics. The program pays tribute to her life's local and global health work and her selfless commitment to serving communities. Members of the Kohler Family Foundation board are deeply involved in the students' summer experiences and meet with them both before and after their research experience.

"We had the opportunity to present our poster presentations to the Kohler family, which was really special," Assefa says. "They encouraged us in becoming global physicians, and they understand global research comes with a set of unique challenges. I felt very supported by them."

The support from the Kohler Family Foundation even has opened new possibilities for Assefa and Davies, who were recently accepted to present their collaborative research at the 66th annual meeting of the American Society of Tropical Medicine and Hygiene in Baltimore this November.

"In addition to benefitting local communities and institutions, we have seen the Kohler summer program yield significant benefits for the students who participate," says Tifany Frazer, MPH, program manager of the MCW Office of Global Health. "Experiencing a community, culture and health-care system unlike their own broadens their perspective of health-care delivery. Fifty percent of Kohler Scholars have gone on to work in primary care. Without the Kohler family's generous support, this research program would not be possible."

"Partnerships like the ones between MCW, the University of Notre Dame and the Kohler Family Foundation exemplify a 'best practice' in academia,” says Joseph D. Kerschner, MD, Dean of the School of Medicine, Provost and Executive Vice President at MCW. “These collaborations allow progress that neither institution could attain on its own and have a lasting impact on not only our medical students and the MCW Family, but the global family at large."

A village in Belize

Collecting data in Belize

Insect samples in Belize

Discussing insect-borne illnesses with families in Belize

Community health worker office in Belize

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