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Day 12 – Welcome to the Ward

Ward where Bilal is working. Photo slightly altered for privacy reasons.

Ward where Bilal is working. Photo slightly altered for privacy reasons.

Bilal Jawed ’17 – Welcome to Ward 4C in Mulago Hospital, the last stop for many HIV patients and my second home for this summer. Understandably, one of the most common questions I get asked by senior members of the team is: “[H]ow are you getting used to the ward?”

It is very difficult for me to capture the atmosphere of the Ward: the sights, the sounds, and the smells. You can practically feel the sickness in the air and touch it. Perhaps it is best to begin with the familiar.
Imagine your last hospital stay, and if you are fortunate enough to never have been admitted into a hospital, think back to visiting a friend or loved one. Maybe you are dropping by to sign a cast, welcome a little one into the family, or give your well wishes after a successful surgery. You probably have a room to yourself, a nurse that visits every hour or so, clean bedding, and food to ensure the best chance at recovery. When you go to bed, you feel comforted by the fact that the best doctors armed with nearly unlimited medications and technology will be present if anything were to go wrong.
Now, welcome to 4C. First remove your individual room and replace it with a large, open-aired room, packed to the brim with hospital beds. Inches to your left, right, and at your feet, are beds of literally the sickest people in the world. People battling HIV along with tuberculosis, meningitis, malaria, hepatitis, rabies, or most often, a combination of several infectious diseases. When you go to bed at night, you can hear your neighbor convulsing from a seizure, or someone across the room moaning from pain. In the morning, you can smell people who urinated or defecated on themselves, or hear the cries of a family mourning someone who did not make it though the night. You depend on your family to visit you, clean your sheets and feed you, because the hospital does not have the proper resources or staff to provide them for you. At the same time, you are fighting your own battle. Not a broken arm or the flu, but diseases that require the best care in the world — but sadly, you do not have the best care in the world because you belong to Ward 4C.
Now that we’ve seen a glimpse of the patient’s perspective, I’d like to quickly and briefly shift to the doctor’s challenges (a topic to be revisited in a future blog). From Day 1 when the patient is admitted, it is a race to get him or her discharged. Especially because we deal with HIV patients with already weakened immune systems, hospital acquired infections (HAIs) are a real danger. This took me a long time to grasp—the ward, where people go to heal, can actually be a source of illness because of the high concentration of already very sick people. Moreover, with limited availability of drugs and equipment like ventilators and MRI machines, it is like fighting a goliath blindfolded. The challenge ahead is already so monstrous, but handicaps we face make it just that much harder. In fighting the “Goliaths”, there is definitely a danger to the “Davids”—stress, emotional struggles, or even worse. While many of the doctors and nurses that I have spoken to won’t admit it, there is certainly a health risk of just working in Ward 4C. TB is in the air, and HIV+ infected needles are everywhere. I myself have handled HIV+ needles and cerebrospinal fluid containing HIV (of course, having received the proper training and precautions). While these are trained professionals and historical occupational exposure is relatively low, it is always frightening knowing that you are a single accident away from needing post-exposure prophylaxis.
The week before my flight to Uganda, I was hit with the news that my father had a heart attack. Instead of taking my Chemistry final, I was spending nights in the hospital back in Indianapolis with my father awaiting and following his open-heart surgery. While we were all nervous, I knew in the back of my head that everything would be fine because at the end of the day, I trusted the quality of care. Fast forward only a week and half and I can’t say the same for the patients battling HIV/meningitis. I’m glad to be witnessing these harsh realities firsthand. For both the patients and the doctors, it truly is a war out here, but I am glad to be apart of it in anyway I can.
More to come about working on a clinical drug trial in Kampala!

Day 1 – A Brave New World

bilalblogBilal Jawed ’17 – It didn’t hit me when I first got the news in the spring. It didn’t hit me the weeks leading up to the flight. It didn’t even hit me when I stepped onto Ugandan soil for the first time and rode to my apartment in the late hours of the night after a long two-day journey. But this morning, precisely at sunrise, that’s when it hit me. That is when I realized I would be spending my entire summer in Kampala, Uganda. I awoke to a certain cocktail of sounds that affirmed that I was 7700 miles from Crawfordsville. The Adhan, the Muslim call to prayer at sunrise could be heard from a nearby mosque, monkeys howling from treetops, a baby crying in the next door complex, and the fan blowing against the mosquito netting covering my bed that protects from Malaria.

It was certainly daunting and awe inspiring at the same time. will certainly be challenges in adjusting to life in Kampala, both big and small. Its always tough knowing your family and friends are just going to bed as you are waking up or knowing fast internet speeds are a luxury of the past (I definitely will never complain to the Wabash IT department ever again). The package includes no air conditioning, lots of traffic, and frequent power outages, and a myriad of other adjustments, but anything can be seen as an adventure in an appropriate light. The ground is red, the people are very friendly, and I am ready to get to work. More to come about working day to day with HIV patients in Mulago Hospital!


Looking Beyond Belize’s Beaches

Luke Wren ’14 – This week has been full of experiments. My research associate Sanjeev and I have conducted five separate experiments this past week and now only have a few mortality assessments this week. Although I won’t bore anyone with raw data…we have looked at how insecticide-treated bednets affect the triatomine bug (the vector for the parasite that causes Chagas disease) versus a non-treated bednet, and we have done the same with insecticide paint and IRS (indoor residual spraying). We had workers of the vector control department of the Ministry of Health (MOH) come and spray small pieces of wood and cement block, since these are commonly used housing materials that are usually sprayed with IRS here in Belize.
One of the most important things I have learned from my time in the lab at Wabash until now is reducing variables, or at least controlling the ones you can. For example,  setting up the IRS experiment having the MOH personnel mix the chemical, and spray it using their own sprayer and technique, reduces/controls for variables like operator application (vs. if I were to mix the chemical and spray it myself). Having simple things like this makes for higher quality data.
My stay here so far has involved much more than being bent over a lab bench. I have seen most of Orange Walk, been fishing, and cooked a variety of meals. It gets dark here very early and very quickly, so outside nighttime plans must be accompanied with headlamps and flashlights.
Although this is a fairly quick and concise update, I wanted to share my thoughts on Belizean towns — specifically Orange Walk. I think my favorite part of a small Central American town such as this is all the small shops, restaurants, and market places. I think as an American I have always cherished the convenience of a supermarket like Wal-Mart or Target, but I think we have turned grocery shopping into a timed event rather then a community engaging experience. This isn’t to say we have to have a kum ba ya moment every time we are picking up potatoes, but we should slow down and try to embrace a social gathering place such as a market. Shops here can vary from the size of a room to a two-story building with many aisles. Nearly all stores here have an openness about them — many of them without doors per se — that you can walk into.  I will miss the smallness of the streets here, but I hope I can keep a different mindset when I am shopping in the states.

Jawed ’17 Doing Research in Uganda

Bilal Jawed ’17 – This summer I will serve as a research assistant in Kampala, Uganda from mid-May to mid-August. I will assist in a clinical drug trial for treatment of Cryptococcal Meningitis in patients with HIV. I would like to extend a deep thank you to Dr. David Boulware and the entire team in Uganda for making this opportunity possible.
I sit here in the Indianapolis International Airport, gate A6, en route to Detroit. Everything seems so much larger in the moments before takeoff: the length of the trip (almost three months), the work to be done (HIV research), my suitcase (barely under the 50 lbs. limit), and even the trip. From Detroit I will fly overnight to Amsterdam, followed a quick stop in Rwanda, and finally after almost a 48 hours later, I hope to arrive in Entebbe. That doesn’t include layovers, baggage claims, customs, security, and jet lag. My absolute final destination will be Joseph, my transportation from Entebbe to Kampala where I will be living. Please be there Joseph, please.
Over the past few weeks, I have been hearing many of variations of the phrase “life changing”. Some examples include “find your calling”, “confirmation”, “changed man”, and my favorite, “come back with a moustache”. Personally, this has been the most daunting part of my experience thus far. Not the preparations, not the long journey ahead, not living in a foreign country for a summer, and not even the tsetse flies (thanks for the heads up Dr. Ingram); but the idea of being changed. As I board this flight to Detroit, I will certainly have great expectations but also cautious ones. I will try my best not to expect to be changed but instead I hope to keep an open and active mind, learn, and just hold on for the ride.

Hauser ’15 Working Science Skills in Alaska

Wes Hauser ’15 – Before this summer, I never imagined I would travel to a small town in south-central Alaska to hone my abilities as a scientist. However, here I sit in Homer, Alaska delivering an update describing just that. This summer I’m working on a series of projects with Smithsonian scientist and Wabash Alum Dr. Dennis Whigham, who I worked with last summer at the Smithsonian Environmental Research Center (SERC) in Edgewater, Maryland. While my work from last summer was largely laboratory-based (and can be found here), the nature of my research this summer is strikingly different.
 
Wes Hauser working in Alaska fields.

Wes Hauser working in Alaska fields.

My attention is primarily focused on two research projects in Homer. The first explores the impact of landscape features on the nutrient cycling of two headwater streams. This involves collecting leaf litter and soil core samples from fertilized and unfertilized portions of the stream in an attempt to profile how Nitrogen moves through these systems. Previous work has shown that inorganic nitrogen is crucial to the vitality of juvenile fish communities in these streams; therefore, several management implications will emerge based upon how the surrounding wetlands source and store this valuable nutrient.

 
The second project I’m undertaking centers around a commonly occurring Alaskan bog orchid, Platanthera dilatata. Relatively little information marks the species’ population structure and reproductive biology, so I’ve been collecting those measurements from three distinct populations near Homer. I’ve also set up several pollination experiments and exclosures to determine the nature of how the species reproduces. Information from this project will be used to update the North American Orchid Conservation Center (NAOCC), an online orchid information database governed by SERC.
 
While I’ve devoted much of my time to these two projects, I’ve also had several enriching experiences outside of my research pursuits. Taking time to enjoy the stunning natural environments of Alaska has been high on my list, and tide-pooling, trips to the beach, and hikes in the woods have all made my time here phenomenal. I’ve also had the chance to explore several museums in Homer that have outlined the community’s rich history (particularly through its ties to commercial fishing).
 
Needless to say, this internship experience has broadened my horizons both as a scientist and as a young naturalist. I’m grateful to the Wabash College Biology Department and the SERC Plant Ecology Lab for funding for this opportunity. I’m also thankful for my research mentor, Dennis Whigham.

Coutchie ’15 Connects with Summer Immersion

Fritz Coutchie ’15 – When I first met my sixteen co-workers and our boss, Mr. Roland Morin, I was unsure if I would find my summer internship fulfilling. The LABB internship program is meant to round out a Wabash liberal arts education with practical business experience and knowledge, while simultaneously bringing value to the College.

Our boss, Morin is a 1991 graduate of the College and understands how to work with Wabash students. Initially, Mr. Morin was stern and often reminded us that we can be fired. Since, he has revealed a warmer side and taken a genuine interest in our lives.

Coutchie

Coutchie

Our first week was filled with discussions of leadership and finance; we read cases, articles and listened to guest speakers. While all of those opportunities were great for learning the practical applications of the theories we studied in our readings and class discussions, the most fulfilling experience I had was taking the StrengthsQuest StrengthsFinder inventory. StrengthsQuest is a program run through Gallup, which provides insight into how to optimize a person’s top five “talent themes.”

Talents are innate; however, too frequently individuals allow their talents to remain dormant. StrengthsQuest helps an individual identify his/her natural strengths and provides suggestions on how the talents can be developed in the future. Dr. James Jefferies, Assistant Director of Career Services, ran a group seminar to supplement the suggestions StrengthsQuest provided. Each of the “talent themes” relate to how one thinks or works with other people. Dr. Jefferies demonstrated how understanding the “talent themes” of others could aid in teamwork.

My top five strengths were Ideation, Learner, Strategic, Woo, and Command. In plain English this means that I naturally make connections between ideas well, I desire the accumulation of knowledge, I tend to think in patterns, I enjoy meeting new people and I readily make decisions and influence others.  None of my strengths lend themselves to building deep connections with others or with execution of tasks. I would do well to work with individuals who possess the “talent themes” I lack.

Throughout our internship we will be expected to work in teams and create business proposals. I anticipate knowing each other’s “talent themes” will be instrumental in constructing and working within these teams during the internship. Once the summer is over, the idea of “talent themes” will provide a future framework of thought when dealing with others and seeking out those who thrive in ways that I do not.

Now I look forward to the rest of the LABB program. It is evident that this internship is intended to increase the self-awareness of those participating. As we learned on our first day, a good leader has a high degree of self-awareness and a good businessperson is generally a good leader.

 


Health Program Provided Career Direction

Health Care Immersion Program (HCIP) 2014

Earlier this spring (May 11-15) eight Wabash men participated in the 2nd annual Health Care Immersion Program in Indianapolis.  Students learned through a series of presentations by Wabash alumni who are currently working in health care and related fields – a crucial, complicated, and extremely varied sector of our economy.  Dr. Frank Howland also lead the group through vigorous coursework throughout the week.  The HCIP was created from the success of other past immersion programs and under the umbrella of a current Lilly Endowment, Inc. grant.

The following students were selected to participate based on the strength of their applications and interviews:  Tiger Zuo, Ethan Farmer, Bilal Jawed, Thanh Tran, Ryan Gross, Tu Nguyen, Mazin Hakim, and Ian Artis.  On the final day of the program, students gave 3 group presentations covering varied aspects and perspectives of the topics covered over the course of the week.

Group550

Tiger Zuo ‘16 – After taking the Health Economics class with Dr. Howland last semester, I had decided to give the Healthcare Immersion Program a try. Fortunately, I got admitted into the program and I got a more immersive experience in healthcare in terms of the knowledge which I acquired from Dr. Howland’s lecture. The visit to St. Vincent hospital helped me to build a more comprehensive approach on how hospitals generate revenue in terms of cost shifting and multiple-sites budgeting, The different visits with physicians helped us to bring different perspectives together to think more critically. More importantly, the visit to the IU Innovation center helped me to sort out the initial process on how to bring ideas and pitches into a solid plan of action. I highly suggest that students who are interested in Healthcare apply for this program. Last but not least, Dr. Howland’s Health Economics (ECON 235) class is a must-take for individuals who wish to pursue a career in healthcare.

Thanh Tran ‘17 – Throughout the Health Care Immersion Program, I learned a lot about the multiple facets of the health care industry in the USA, along with important influential factors including public policy, entrepreneurship, and economy. Especially the speakers in the program, who are experts in health care services, brought up the very insightful perspectives. We truly had interesting and in-depth conversation about health care throughout the talks. Furthermore, the program has essentially enhanced my personal viewpoint about the health care industry in the USA.

On the first day of the program, Dr. Stephen Jay from Fairbanks School of Public Health IUPUI talked about public health and health the care system in America. I found it very important as humans nowadays are still facing imperative global health issues such as infectious diseases, water and air pollution, global warming and health care access. Dr. Stephen Jay moved on to the second half of his talk about the limitations of the current health care systems. One of them is the insurance coverage for Medicare/Medicaid. For example, doctors and pharmacists are less likely to treat Medicaid patients because they wouldn’t get reimbursed adequately afterward.

One of the most remarkable points of the program is the trip to St. Vincent Hospital and IU Research center. Dr. Joe Trebly gave us a tour around the Research and Technology Center. This center is special in that it hosts many start-up medical and research firms. Dr. Trebly talked about the development and financial support of entrepreneurial avenues in science and medicine. In addition, Dr. Trebly gave us good advices on prospective careers and how to pursue what we are truly passionate about.

At the end of the trip, our group made a presentation about Health in Montgomery County and Indiana. Throughout the research, our group got to know more deeply about the specific health issues in Montgomery County and Indiana by applying what we had learned so far through the trip. Our group presentation has received positive feedback from professors at Wabash College.

Health1PREPMazin Hakim ‘17 – Health Care Immersion Program 2014. What can I really say? Countless times the thought crossed my mind how much my good friend (a pre-med student at Purdue) would love to take part in such an eye opening experience into the universe of healthcare that this program was. It is certainly a privilege of Wabash students to be able to participate and learn from such high standing Wabash alumni.

I feel that a brief introduction of myself and why I wanted to participate in the Healthcare Immersion Program would serve well.  First off, my name is Mazin Hakim (class of 2017) and I am a Chemistry major with a Math and Spanish double minor. As a part of the Wabash 3/2 dual-degree engineering program, I plan on studying chemistry, math, and Spanish at Wabash for three years and following that with two years of concentrated biomedical engineering studies at Purdue. Although the Wabash-Purdue biomedical engineering program is not quite set up yet, I am confident that I will be able to reach out to Purdue and demonstrate to them why I would like to go there to study biomedical engineering.

Along with my passion in science and engineering, I have held an interest in healthcare since studying anatomy and physiology in my sophomore year of high school. This is the reason why I found interest in and decided to take part in this immersion program. Mostly, I wanted to be able to figure out where biomedical engineering fell in the array of healthcare in the United States. Coming out of the program, I have found that, in some sense, it applies almost wherever I can imagine. Learning from Dr. Joe Trebley, head of startup companies at IURTC, I found that medical device startup companies are intertwined in healthcare policy, regulations, and patent laws. From Dr. Kolisek, president and orthopedic surgeon at OrthoIndy, biomedical engineering is directly applicable to the development of the prosthetic knees and hips they implement on a daily basis.

These are just examples among many. Knowing pretty much nothing about health care upon starting my four day journey, I also learned implications of the Patient Protection and Affordable Care Act (Obamacare), and applied that to many opinions of where in the world health care is moving. The conclusion to take away from what I have seen throughout this program is that in modern, fast-paced American society, there exists virtually infinite sides to the broad field of healthcare.

As jam-packed as this week was with information and learning, it is almost hard to differentiate which speakers told me what. Overall, this was a great experience for me to learn about healthcare in our nation, bond with some Wabash brothers, and meet some pretty amazing alumni. But of course, none of this would have been possible without the support of the Lilly Endowment, which paid for our hotel and meals, and the organizers of the program. For this, I am truly grateful.

 Bilal Jawed ‘17 – The 2014 Wabash College Health Immersion Program made me feel stupid. As absurd and ridiculous as the previous statement may appear to be, I mean it in the most beautiful way. The program revealed to me a complicated and intricate world of health care, science, intellectual property, and everything in between. It was only until we saw these complexities up close from different perspectives that we truly understood how much more there is to health care. These extremely different perspectives are where the value of the Immersion Program lies. Experiencing Dr. Stephen Jay from the IU School of Public Health speak on a global perspective of health and then, within hours, witnessing Dr. John Roberts speak about these same topics right at home was truly amazing. The diversity of the immersion, such as Dr. Frank Kolisek’s discussion on million dollar orthopedic robots and their relationship with insurance companies coupled with Dr. John Sturman’s ethical discussion on opioid treatment of chronic pain truly blew me away. These are just a few of the examples of the amazing and diverse perspectives that were jam-packed in less than a week of immersion. As I absorb and “immerse” myself in these new perspectives, I am proud to say that I am now forming my own. Although the Health Immersion Program did make me “feel stupid”, it could not have been a better humbling experience, reminding me of how much more I have to learn and achieve.

I would like to give deep thanks to all the esteemed speakers who took time out of their extremely busy days, Dr. Howland, Betsy Knott, and Cassie Hagan for organizing and guiding us through this whirlwind, and Lilly Endowment, Inc. for making this opportunity possible.

 Tu Nguyen ‘17 – The Health Care Immersion Program was a wonderful opportunity for us to improve our understanding about the health care system and its existing problems. During the trip, we had the chance to talk with 7 speakers, who were very knowledgeable and enthusiastic. They provided us with multiple angles and opinions about the health care system in America. For instance, on our first day of the trip, Dr. Stephen Jay ’63, Professor of Medicine and Public Health at IU, talked about the general ideas, cost and benefit of the Affordable Care Act (Obama Care). In the evening of the same day, Dr. Joe Trebley ’01, Head of Startup Support and Promotion of IU Research and Technology Corporation, provided us with the economic and innovation perspective of the health care system. For that reason, the program has helped us to have a diverse view of medical-related careers, which betters our orientation of our career choice. I think this is an awesome opportunity for students, and not only those interested in the pre-med program, but students who are interested in other programs as well. I really wish that the program was longer so that we could have had more time to spend on deepening our understanding and thought about the health care system. Last but not least, thank you to the Eli Lilly Endowment, Dr. Frank Howland, and Mrs. Cassie Hagan, who had supported this program.

Dr. Frank Kolisek '82 talks health care with the students.

Dr. Frank Kolisek ’82 talks health care with the students.

Ethan Farmer ‘16 – Going into this immersion program, I thought I had my time after Wabash figured out. Due to my interest in health care, I am planning on going to medical school once I am done here at Wabash. One reason why this program looked so inciting to me is because of the diversity I thought I was going to experience. What I found out is that I had no idea how vast health care is and all of the different jobs that make up this vital part of our country. This diversity is something I quickly found out to be just as important as the specific field I am intending on pursuing, making it imperative that I learn more about it.

The Health Care Immersion Program allowed for this because we saw multiple alumni all over the health care spectrum. This included doctors like Dr. Jay, professor of Medicine & Public Health, and Dr. Emkes, Medical Director/Managed Care Services at St. Vincent, all the way to medical company startup entrepreneur Dr. Trebley. Some of the talks we participated in were very specific and discussed an issue pertaining to what they do, while other talks covered a broader range of health care including the ACA, how it affects doctors, and what it means for job searchers coming into the health care system. Being able to learn the various aspects of the health system through these alumni, has given me a new outlook on the health field and the vast opportunities it provides. Experiencing this immersion program has also made me excited to take up the challenges that the incoming medical students will have to address as we transition into the real world.

I would like to thank Betsy Knott, Cassie Hagan, and Dr. Frank Howland for their time, effort, and leadership as we continued through this program. I would also like to thank the Eli Lilly Endowment, Inc. for providing us with the ability to experience this opportunity.

Ryan Gross ‘17 – My experience during the 2014 Health Care Immersion Trip can be summarized as eye opening. I learned that the health system of America is extremely complex with a future of many uncertainties. The numerous Alumni that spoken to our small group of eight had a variety of perspectives towards the future of the health care system here in America. Hearing from health care professionals that hold different perspectives helped me polish my own views on this country’s health care system. As it turns out, the health care specific immersion trip turned into an opportunity to learn the culture of my fellow Wabash men as well. Our group had a variety of different cultures/ethnicities, which was another great learning experience in itself. Overall, I learned a lot of details about the health care system of America but also, I learned that a Wabash man is one who is hungry to acquire their goals regardless whether they’re a current student or an Alumni or even what country they originate from. I’d like to thank the Lilly Endowment, Dr. Frank Howland, Betsy Knott and Cassie Hagan for allowing me this valuable opportunity, one which I hope grows to inform more Wabash men about the future of this country’s health care system.