Downs fellows cover the world

For the first half of his 10-week stay in Eldoret, Kenya, last summer, Timothy Mercer just hung out. “I had to earn some credibility and trust,” said Mercer, a 2008 Downs fellow who was studying street children in the western Kenyan city. His hanging out paid off. “I never felt so privileged to be let into a social group.”

Mercer, a public health student, described his research in an oral presentation at the annual fall symposium of The Committee on International Health—which awards the Downs International Health Student Travel Fellowship. Eighteen students in nursing, medicine, public health and the Physician Associate Program spent the summer conducting research abroad. Two other Downs fellows were planning to travel early this year. The students’ projects explored such topics as nutrition and food security in Uganda, barriers to drug treatment in Cairo, emergency contraception in South Africa, circumcision as a means of preventing HIV/AIDS infection in Peru, and patients’ attitudes toward health care in Indonesia.

In Eldoret, Mercer’s local faculty advisor at Moi University, David Ayuku, M.D., had found that about two-thirds of the city’s estimated 2,000 street children go home at night. Most find it easier to get food and money on the street than at home. But on the street they are at high risk for HIV/AIDS infection and drug addiction. “Just being a street child places you at a greater health disadvantage,” Mercer said.

Rosha Forman, a student in nursing and midwifery, also spent time getting to know her subjects as she studied how Zambian midwives handled the third stage of labor—the period between delivery and expulsion of the placenta. “You want the placenta to come out and you want it to come out quickly—otherwise you are at risk of hemorrhage,” Forman said, adding that postpartum hemorrhaging is a leading cause of maternal death in the developing world. Forman visited four hospitals and seven clinics and interviewed 14 midwives. “I did a lot of sitting and chatting with the midwives,” she said.

Lauren Graber, a medical student, traveled to Kampala, Uganda, at the request of a physician there who was concerned that a local landfill might be the source of high blood lead levels in children. “This is a perfect example of partnered research, answering a question that your host country asks,” said Michele Barry, M.D., HS ’77, professor of medicine and public health and former director of the Yale/Johnson & Johnson Physician Scholars in International Health Program. Graber, working with five Ugandan medical students and a medical student from Mount Sinai Medical Center in New York, tested 165 children and visited 122 homes. High blood lead levels, the students found, were correlated less with proximity to the landfill than with consumption of canned foods and living along busy roads. “We really need to learn more about how kids are being exposed to lead in Kampala,” Graber said.

For more on the Downs fellowship, see "Science and Culture in a Strange Land".