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Downs fellows report on summer research

Yale Medicine Magazine, 2007 - Spring


HIV/AIDS, trauma of war and genocide are among the topics of last year’s presentations.

For Christopher P. McManus, a student at the School of Public Health and the School of Forestry & Environmental Studies, doing research in South Africa’s Kwazulu-Natal province meant learning anew what is meant by family. “I didn’t even know what a household was,” said McManus, noting that polygamy leads to a different definition.

McManus described his research in October at the annual fall symposium of the Committee on International Health. Every year students in nursing, medicine, public health and the Physician Associate Program report on research done the summer before. In 2006 a dozen students undertook research projects in Africa, South America and Jamaica. McManus, one of three students to make an oral presentation, studied the impact of HIV/AIDS on rural households.

“There are a whole bunch of people in these households and everyone does a whole lot of stuff,” he said. “If you remove one member of a household it is very difficult for that household to maintain security.” AIDS, he said, tends to affect the most productive family members, and their absence can lead to a food shortage. He found that 42 percent of the households surveyed made up the difference with wild food, such as birds, hare or antelope. Coping strategies included watering down porridge or using pumpkin to stretch it, borrowing food and skipping meals.

Eloise D. Austin, a second-year medical student, described the mental health effects of the Rwandan genocide of 1994 on children. She interviewed 40 orphans and found that their problems included grief, loneliness and frequent memories of traumatic events. According to past studies, “most children had seen the death of a close family member, had witnessed massacres, had been forced to hide, had seen dead bodies or body parts,” she said. Her open-ended interviews suggested that the mental health burden from these traumatic events was still considerable.

Amy L. Glick, a nursing student, examined perceptions of care by patients and providers at a new HIV/AIDS clinic in Togo, in western Africa. In that region she found stigma to be pervasive. Some patients said that people in certain villages or tribes believed that AIDS was caused by sorcery, or that discussing sex education and prevention with young adults would cause promiscuity. And in some hospitals, patients with AIDS described poor care, neglect and insults from staff. The AED-Lidaw Health Clinic, where the research was conducted, is working to combat these negative experiences and provide a positive experience for patients with HIV/AIDS.

Other research topics included sand fly-vectored diseases in Peru, attitudes toward female condom use in Botswana and the willingness of medical and nursing students to treat HIV-positive patients in Sierra Leone.