Deutsch-Feldman, Molly

Zambia

Malaria Transmission and the Impact of Control Efforts in Southern Africa (Macha)

The student will assist with an initiative to accelerate malaria control in Southern Africa through an NIH-funded International Center of Excellence for Malaria Research. Our goal is to make substantial contributions to regional malaria control in Zambia and Zimbabwe through state-of-the-art research on malaria epidemiology, vector biology and the genetics of the malaria parasite in three different epidemiological settings, representing regions of effective malaria control (Choma District, Zambia), ineffective malaria control (Nchelenge District, Zambia) and resurgent malaria (Mutasa District, Zimbabwe). .

I spent my placement in Macha, Zambia, working at the Macha Research Trust (MRT). My mentor for the project was Professor Bill Moss. I conducted research on malaria, both in a lab setting and by going out into the field to conduct rapid diagnostic tests. My work focused on analyzing antibody responses to the malaria parasite within a longitudinal cohort. Overall, I had a very positive experience and am more committed than ever to working in global health. 

Before going to Macha I had limited experience working in developing countries, and almost no experience living and working in a rural environment. I gained a great appreciation for just how difficult it can be to conduct research in these settings, but also how important it is. As critical as classroom learning is, and as much as I enjoyed the courses at Hopkins, this summer reinforced the importance seeing first hand the people and the area that you are studying. One aspect of the research that I most appreciated was how well the research is integrated into the Zambian community. Not only is the research site in Zambia, but the lab is staffed by and run by Zambian scientists, and a Zambian field team conducts all community based field work. Though it may seem obvious to have this type of set up – it is often easy to fall into a trap of conducting research removed from the actual population you are trying to serve. This summer showed me again the importance of incorporating research into low-resource environments, and logistically that it is possible.

One of the greatest challenge we had this summer was lack of resources available to the lab and field team. It is just too expensive and difficult to get laboratory materials out to such a rural site on a regular basis. The lab has to be extremely careful not to waste any equipment or materials since they are so limited in when they are able to restock. Lack of electricity or internet at times also made the work more challenging, but overall helped me to appreciate how readily available such resources are in Baltimore and how often I blindly take advantage of them.

I would say that the most exciting part of my summer experience was being able to go out with the MRT field team and collect blood samples. The team conducts surveillance within the Macha region in order to detect as many cases of malaria as possible. Being able to interact one on one with the people who lived in Macha, and seeing how the field team was able to so quickly and efficiently test people, was certainly a new and exciting experience. Field collection definitely has its challenges – some days we had long drives in order to find the households we were testing, and often people were not home or unavailable for testing. I certainly appreciate the great amount of work that must go into data collection and just how difficult it can be to even get information. It is another aspect of research that I took for granted before going to Macha.

I spent a lot of time thinking about the conflict between basic and immediate health needs versus research that aims to have much larger, though more distant effects. As important as investing in broad research projects is, it is difficult to see the every day needs of the local clinics and hospitals without thinking that maybe the money could be used for more immediate uses. I hope to pursue work that incorporates these two elements – and in some ways the work at Macha does try to incorporate both, which was exciting to see (in addition to testing people for malaria, the field team also immediately provides treatment to anyone testing positive). Though I am still unsure about how to balance these two elements, my experience this summer certainly gave me new perspectives on such issues and reinforced my desire to continue working in international health.

Girls going to collect water in Macha:

Kids Club: an event fun by the Macha Research Trust for local kisd living with HIV. The day had fun activities like skits and singing but also focused on teaching kids important information about HIV:

Harry, the field team manager, testing a local woman and her baby for malaria:

The entrance to the Macha Mission Hospital:

The field team set up. We conducted rapid diagnostic tests for malaria, collected blood samples to bring back to the lab and provided treatment for anyone who tested positive for malaria. The testing was done right outside villagers' home:

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