September 5, 2008

Medical students span globe for Emphasis Program projects

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School of Medicine students David Silvestri, left, and Chris Estopinal take in the scenery in Zambia while working on their Emphasis Program research projects.

Medical students span globe for Emphasis Program projects

VUSM student Matt Kynes tapes a child’s leg at the Cornerstone Children’s Home in Nimule, Sudan.

VUSM student Matt Kynes tapes a child’s leg at the Cornerstone Children’s Home in Nimule, Sudan.

Aaron Dawes, front row, second from left, participates in a ceremony of the Diné people of the Four Corners region.

Aaron Dawes, front row, second from left, participates in a ceremony of the Diné people of the Four Corners region.

School of Medicine students usually complete their Emphasis Program projects in a Vanderbilt lab, but this summer several performed research at various spots around the globe.

“The opportunity to work abroad is a wonderful gift to students and not just because of the exposure to different cultures,” said Denis O'Day, M.D., who directs the Emphasis Program, which gives students the chance to engage in scholarly research during their first two years of medical school.

“I have seen a profound change in the students' perspective on their future role as physicians as they confront the realities of disease in resource-poor societies.”

Here are a few of the students' stories:

• Matt Kynes and his wife, Ansley, traveled to Nimule, Sudan, a town on the border of southern Sudan and Uganda that has seen a rapid and alarming increase in HIV.

Kynes' Emphasis project involved interviewing more than 20 religious leaders about their opinions and attitudes toward HIV/AIDS and the current prevention, counseling and support programs their congregations were offering. The results will assess the status of HIV interventions in Nimule and help religious leaders and HIV organizations create more targeted HIV programs.

Kynes also spent time at the local hospital joining ward rounds, organizing the pharmacy and assisting in the outpatient, major surgery and minor surgery departments.

Finally, he helped his wife care for the physical, emotional and educational needs of 44 local orphans. “My time with the children in Sudan will remain the highlight of my summer and one of the most valuable experiences of my life,” he said.

• Chris Estopinal worked for two months at Macha Mission Hospital, a 208-bed facility in Zambia that provides free HIV care and treatment to more than 3,000 patients, many of whom must travel hours or even days to reach the hospital.

Estopinal evaluated the hospital's home-based HIV care program by comparing outcomes such as death and drug adherence between those patients who live in communities with home-based care and those who do not.

“This data will be useful in determining whether home-based care programs in this rural Zambian setting improve patient health and well being,” Estopinal said.

• David Silvestri also traveled to Zambia, where he partnered with a short-term mobile clinic comprised of Zambian and American medical providers, including Jeff McKinzie, M.D., a Vanderbilt professor of Emergency Medicine.

Silvestri measured HIV prevalence rates detected at the clinic under three types of referral. He also assessed local attitudes and acceptability toward routine HIV testing. The results will help determine the feasibility of scaling up routine HIV testing at local health facilities.

“The vast majority of HIV positive adults in sub-Saharan Africa do not even know they are infected, since even basic HIV testing is frequently inaccessible,” Silvestri said. “The Emphasis program has equipped us to make a significant contribution to the delivery of vital diagnostic and counseling services in an area of tremendous need, while also gathering data that may influence longer-term policy.”

• Aaron Dawes did not leave the United States, but traveled to the Four Corners region of Arizona, New Mexico, Utah and Colorado to work on the Navajo Reservation. There, he spent time at Fort Defiance Indian Hospital, the Navajo Area Office and the Public Health Department at Chinle Comprehensive Health Care Facility. He performed a variety of administrative projects, clinical work and public health assessments.

“I really enjoyed the opportunity to serve a sub-group of the population that is too often overlooked,” Dawes said. “To participate in the lives of a people like the Diné, who exude such vibrancy and pride in the face of abject poverty, was truly inspiring.”