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Worldwide Experiences

 

Worldwide Experiences

 


The Center for Global Health Equity’s research efforts currently straddle four continents, with partners in Rwanda, Tanzania, Kenya, Uganda, Brazil, Cambodia, India, Bangladesh, Costa Rica, Ecuador, and Southwest Virginia. Recently named director of the center, Dr. Scott Heysell, the Thomas H. Hunter Associate Professor of International Medicine, is deeply involved in these partnerships and is building on the center’s foundational work to reduce health disparities around the world.

Dr. Heysell is an experienced researcher with an extensive background in the study of infectious diseases. He is also, naturally, a world traveler. We caught up with him between his recent trip to South Africa and his next trip to Moshi, the capital of the Kilimanjaro region of Tanzania.

 

Trusted Relationships, Mutual Gain

Dr. Heysell visited the University of Venda (UNIVEN), in South Africa, where UVA’s relationship began with a training program that helped community health providers and researchers further their work serving the local farming community of Limpopo, an area challenged by numerous health conditions, including undernutrition, sanitation, malaria, tuberculosis, and HIV. Now, after two decades and support from multiple training grants funded by the Fogarty International Center at the National Institutes of Health, the center’s partnership with UNIVEN has continued to develop, providing opportunities to collaborate for undergraduate and graduate students, medical students, and also postdoctoral fellows and faculty researchers.

“These learning programs are mutually beneficial,” explained Dr. Heysell. UNIVEN researchers and staff are deeply immersed in the community, committed to improving health conditions and treating the people of Limpopo for diseases that are of local concern. Approaches based on such local responsiveness provide valuable opportunities for UVA researchers, who in turn share research practices and solutions.

UVA is committed to each of its undergraduate students having an opportunity for at least one international experience before graduation, and the center’s extraordinary programs are a vitally important part of achieving that mission.

— Stephen D. Mull, vice provost for global affairs

In its 40th year, UNIVEN is still relatively new, but not new to UVA faculty who have been involved in multiple programs to train South Africans. The center is building on its relationship with UNIVEN, a trusted partner, to study many high-priority topics such as antimicrobial resistance, an issue of global relevance. UNIVEN recently launched an antimicrobial research center that’s led by Pascal Bessong, one of the earliest participants in the UVA-UNIVEN training program and who did his postdoctoral training at UVA. He is now a professor at UNIVEN.

The overlap of research content is multidisciplinary, which makes it particularly interesting to faculty and students in areas of medicine, data science, and bioinformatics. “Programs like these are aligning with UVA’s goal to increase global experiences for undergraduates, primarily, but are also offering cross-disciplinary opportunities for all UVA students and connecting faculty researchers with global partners,” said Dr. Heysell.

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Road in Mapate

UVA’s Center for Global Health Equity is strengthening ties to partners and communities in South Africa and across the globe.

Creating More Global Connections

Dr. Heysell also spent time on his trip at the University of the Free State (UFS) in Bloemfontein, South Africa, a university interested in expanding its postdoctoral- and graduate-level research as well as its faculty’s research portfolio. The Center for Global Health Equity, part of a tripartite relationship between UFS, UNIVEN, and UVA, is helping UFS and UNIVEN staff who seek doctoral degrees.

“This is a unique opportunity for us to provide mentoring and training to the students, some who have traveled here to UVA, and it’s been successful,” said Dr. Heysell. “Many of those Ph.D. students are now sitting for their final doctoral evaluations or have graduated.”

UVA provided the connection between UNIVEN, a historically disadvantaged university, and UFS, a historically privileged institution; and now the hope is that the faculty of both universities develop their relationship and programs that UVA students can engage in.

“We don’t expect every student who has a global experience or even any medical student who practices clinically outside the U.S. during med school to then become a global health physician or researcher,” said Dr. Heysell. “But what we’ve found is that those who have these types of experiences may be more likely to work in health disparities in their own context. If we can facilitate that, we will also have healthier communities here in the U.S. as a consequence.”

 

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Tugela Ferry

Dr. Heysell (back row, center) and Dr. Thomas (front row, center) with members of the Tugela Ferry clinic.

A Family’s International Experience

How did Dr. Heysell get involved in addressing global health equity? That’s an interesting story worth knowing about.

Dr. HeyselI works in partnership with his wife, Dr. Tania Thomas, associate professor in infectious diseases and international health at UVA. They met in medical school at Oregon Health Sciences University (where both earned M.D.s and M.P.H.s) and completed residencies at Yale University. While Dr. Heysell traveled to India during medical school and Vietnam during a global residency exchange program, it was during a second residency program in rural South Africa where Drs. Heysell and Thomas worked together and first envisioned a career in global health and academic medicine.

Their experience in South Africa—and their mentor, Dr. Gerald Friedland, one of the first HIV doctors in New York City—influenced their decision to pursue careers as physician-scientists working among communities of people living with HIV and working to end conditions such as tuberculosis. After residency, the couple received funding to live in the impoverished town of Tugela Ferry, South Africa, for a year before moving to Charlottesville. They took their six-week-old daughter with them.

Tugela Ferry is in the traditional Zulu homeland region, and in 2007-2008, when Dr. Heysell and his family were living there, had been particularly hard-hit by the HIV epidemic, and like much of the continent, had to fight to receive antiretroviral medications to treat HIV/AIDS. At the time, many patients were still dying of HIV/AIDS and people with weakened immune systems were much more susceptible to other infections like tuberculosis. The highly prevalent HIV infection converged with an epidemic of tuberculosis in a form called “extensively drug resistant tuberculosis,” or XDR-TB. Drs. Heysell and Thomas wore N95 masks to care for patients with XDR-TB, a condition that was often untreatable and carried a huge stigma in the community. Infected family members could be outcast and sent to die outside the home.

“Despite how dreadful and how seemingly hopeless it was in that environment, there was tremendous progress and a lot being done to combat the HIV and tuberculosis convergence in partnerships with local community leaders and stakeholders, physicians and nurses, front-line health care workers as they’re sometimes described, and academics—people working in South African and American universities,” said Dr. Heysell. With this combined effort, the HIV and tuberculosis problem in the region significantly improved, along with ushering in new forms of community-based health care models.

 

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Dr. Heysell's Daughter

Official I.D. badges for Dr. Heysell and his daughter.

Hardly the typical backdrop for raising an infant—and yet the community was welcoming and helpful to the family. “Our daughter was raised by a village,” said Dr. Heysell. “She had so many people who cared for her, all of our friends and nurses, everyone living in this little hospital, where you could come and go. Well, it sounds like something you might not want to sign up for!”

Both parents were equally engaged in their work and in raising their child in Tugela Ferry. By the time their daughter was seven or eight months old, she was learning to make the basic clicking sounds of the Zulu language, prior to saying her first words. She was surrounded with the usual children’s books, but also had special pets around her—goats. “Those were her dogs, she called the goats dogs,” Dr. Heysell explained.

The couple now have two children who often travel with them, such as once a year to Tanzania, where the center has developed a long-standing partnership and where Dr. Heysell travels frequently. In fact, he would be leaving in a week for the Kilimanjaro region of Tanzania, where a training program is in place and a grant writing workshop is held. UVA students pair with the Tanzanian postdocs and work virtually on research projects. His daughter and son are used to the traveling. “They have embraced it and have accepted that this is what mom and dad do.”

 

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Dr. Heysell and Dr. Idu Meadows

Dr. Heysell with infectious diseases postdoctoral fellow Dr. Idu Meadows.

A Shared and Global Mission

Involving students in global health research is central to the center’s mission and plays a large role in UVA’s efforts to provide global experiences for students.

The center’s opportunities include faculty-student mentoring in the context of the CGHE University Scholar Award, which supports students representing diverse disciplines; the Global Health Case Competition—an annual event that engages UVA students, faculty, and global partners in real-world problem solving—and a robust array of global health programming involving distinguished speakers, collaborative events, and engagement opportunities throughout the year.

The CGHE University Scholars Awards and Scholars in Medicine Awards, made possible with private support, offer students financial resources to pursue global research. Awards in 2022-23 funded 65 students whose research covered a range of disciplines across many parts of the globe, for example:

  • “Formative development of a personalized mobile health intervention to support people with tuberculosis in Moshi, Tanzania,” conducted by Carolin Fabian (McIntire '23) and Liza Khusishvili (McIntire '23), who were mentored by Dr. Jackie Hodges in the Division of Infectious Diseases and International Health.
  • “Improving agricultural sustainability and community resilience in the context of water scarcity and climate change across central Chile,” led by engineering doctoral student Benjamin Goffin, working with Diya D. Gupta (Col '26), both mentored by Venkataraman Lakshmi, John L. Newcomb Professor of Engineering.
  • “Pepea in schools: Understanding the special education landscape for students with autism in Kenya,” a project that engaged Halyee Ressa (Col '25) who worked on-site in Kenya with Virginia Girling (Col '26), who joined virtually from Charlottesville. Both were mentored by education professor Mandy Rispoli.
We could not provide students with this kind of life-changing experience without the generous philanthropic support that the center’s donors have provided over the years.

— Stephen D. Mull, vice provost for global affairs

Several student participants shared their thoughts on the rewards of their global health research experience:

  • “Research is such an exciting and novel form of exploration into science. Practicing it in a global context has allowed me to expand into explorations of people and communities and put the science into context. I have discovered how challenging and applicable my work is when it is taken outside of the laboratory setting.” —Karin Brett (Engr ’24)
  • “This summer changed my life and solidified global and public health as my future.” —Owen R. Selden (Col ’25)
  • “Being able to travel to Rwanda to conduct global health research has helped me grow into a person I didn’t expect. Not only was I able to learn more about the ins and outs of research, but I was able to fully immerse myself in a culture that embraced me with open arms and opened new perspectives on what it means to be empathetic, open minded, kind, and curious. This experience has been invaluable to me both as a person passionate about global health, but also as someone who is willing to learn and explore the unknown, which for me has been Rwanda as a country and culture.” —Dazhanae Houston (Col ’24)
  • “As a CGHE and Sister Bridget Haase Scholar, I traveled to Eldoret, Kenya, to research the opportunities available to children with autism and the impressions people have about autism in this area. Meeting with local doctors, teachers, and caregivers, I learned about the misperceptions many people in Kenya have about children with autism. But more important, I learned about the joy these children bring to their communities and the strong desire their loved ones have to provide greater opportunities for their development, a goal our research study aims to help achieve in the future.” —Haylee Ressa (Col ’25)

Given the positive results and valuable experiences for students, UVA seeks to increase awards and opportunities.

“Historically, the center has provided that balance, allowing students to have a substantive, engaged, on-site experience working toward a health outcome that students feel like they’ve been a part of advancing,” said Dr. Heysell. “We’d like to grow and offer this pinnacle UVA experience for as many students as possible.”

To learn more about how to support the Center for Global Health Equity, contact Carrie Jordan, director of development, at cad4mn@virginia.edu or 434-414-4727.

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