Category: Competency Discussion

Trainees sharing dinner in Uganda

Joys and Challenges

Most of the topics for the bi-weekly conference calls the NPGH Fogarty Fellows participate in are research-related (such as “Tropical Disease and Neurology,”) but the theme for November’s talk was simply “Challenges and Joys.” As Joe Kolars, one of the Principle Investigators from the University of Michigan who led the call put it, this offered a “much-needed chance to take the nose off the grindstone, step back, and reflect on what’s working and what’s not.” Three to four months into their fellowship, most trainees were ready to do just that.

The most common challenge encountered by fellows was frustration over slow-moving research projects. Eleven months is the blink of an eye for bureaucracies and many trainees agreed they had had to modify their plans once they had a better understanding of local procedures and conditions in their study sites. Michael Mahero, a veterinarian working in Uganda, said meeting with some district officials really helped him understand how to help his work move through the approval process and find some “low-hanging fruit” to pick while waiting for everything to come together.

Despite the challenges that come with working in global health, the trainees were excited to share the joys of their fellowship, both personal and professional. Valerie Cortez came back from a month of field work in the Amazon awed by the diversity of butterflies and the beauty of the jungle. Anya Romanoff, who spent the first few months of her fellowship conducting a country-wide survey of breast cancer prevention practices, was happy to have found a warm reception and a permanent study site in Trujillo, Peru. The Thailand team and Uganda fellows felt refreshed from having shared dinners and each other’s company.

Joe Kolars reminded the trainees that dinners with each other or conversations with their mentors to bounce ideas around is one of the best ways to come up with solutions to problems. He remembered from his own early career not wanting to ask his mentors for logistical advice, feeling that it would be a sign of failure. Science is about much more than reagents though, and sometimes success requires good relationships and an understanding of how things work; which can be especially challenging in a foreign culture. Nevertheless, there are plenty of resources and people through the Fogarty network who are happy to help, and who have probably made it through similar struggles. The call ended with warm wishes for the holiday season, which for trainees living south of the equator, will certainly be warm!

by: Nikki Eller

By James Newton [CC-BY-4.0 (], via Wikimedia Commons

Defining Global Health

Dr. Zunt begins our 6 AM meeting with a long draw of Seattle’s famous coffee. It is 1 PM in Ghana, 9 PM in China, and 3AM in Hawai’i where one dedicated Scholar is phoning from, unwilling to miss the chance to discuss the Fogarty Fellows’ first assignment with his colleagues: just what is global health?

Incredibly, this conversation is taking place between 21 people—most of whom hold at least one doctorate—scattered across eight countries, all struggling to define what they have dedicated 11 months, if not their entire lives to working on. Zunt, a neurologist at the University of Washington and the mentor leading the discussion, thinks of today’s topic as a part of crafting the perfect elevator speech: what do you tell grandma when she asks, “what do you do?” From their responses, you can tell the trainees have taken the question seriously.

The discussion begins with how global health differs from international health—which, as Eleanore Chuang notes, “European colonial powers established… in response to their countrymen returning from the ‘tropics’ with unusual diseases.” Clearly, the trainees are all proud to be working in a field that emphasizes a collaborative and multidisciplinary approach to medicine, rather than the traditional vertical transmission of ideas and vaccines from colonial doctors to impoverished patients. Ruth Namazzi, a Ugandan pediatrician, concludes that international health “stresses more the differences between countries than their commonalities.”

This newest group of trainees agree that “[g]lobal health focuses on equality, not only health equity – health as a universal human right, but also equity in multilateral collaboration – both developed and developing countries sharing comparable responsibilities and opportunities” (Jing Gu). George Ayodo, a Kenyan Fellow focusing on malaria research makes a valid point that “[t]he training of scientists in low or middle income countries is a key to equity given that they are expected to play a key role in overcoming challenges of health practices.” One of the many aims of global health is to build health infrastructure and capacity in low and middle income countries, in order to curtail dependency on aid as well as acknowledge that “each country will have distinct obstacles to researching and/or implementing solutions [for global health challenges]” (Melanie Gasper). Even though health problems are universal, the contributing factors are not necessarily so.

Although the persons gathered for our virtual meeting share a passion for global health, their reasons for entering the field are as varied as they are. Fan Lee explains that she was drawn by the way it “examines the whole system, not just how a particular disease affects a specific individual, but how culture, stigma, education, economy, environment, infrastructure and many other societal and social constructs intertwine like spaghetti to influence health.” Whatever global health means to them, the trainees are ready to work for it, and obviously excited to be able to share their thoughts and experiences with other Fellows and mentors. Marilyn Kioko succinctly states “global health is an ideal.” And it is one these trainees are committed to.

by Nikki Eller

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