After a long day of learning about and experiencing Belize’s culture, the ’20s and ’18s, along with Mrs. Goodson, Mr. Runzo, a few GPSA leaders, and a couple local children, competed in a friendly game of soccer. Many laughs and falls later, we walked to our separate home stays to shower and prepare for dinner. In the evening, our host mom prepared delicious johnnycakes, which we ate with peanut butter, jelly, cheese, or beans. After we finished eating, we headed to our room to play with our host family’s three-year-old son, Leo. His high energy level brought smiles to our faces, and we spent time laughing along to his antics. Later, we headed to the local restaurant, where we shared a plate of watermelon as we watched the NBA finals. A few of us also drifted to different tables to play a couple rounds of the card game, Hearts. A couple of nodding heads later, we all admitted that we were tired and headed off to our separate home stays to sleep.     – Julia Duarte, GHF ’20

Written by Courtney Kilduff (GHF ’20) to account for June 10-11, 2017:

After two flights and a long bus ride, the Global Health Fellows (’18s and ’20s) arrived in San Ignacio, Belize! We took a relaxing afternoon to settle in and get to know our host families. The following day (Sunday, June 11) started off with a meeting with Global Public Service Academies (GPSA) volunteers; we listened to presentations about hand-washing and patient care, were informed of the week to come, and even learned some more Spanish. Some things we learned included the 7 steps of patient care: preparing the station, greeting the patient, introducing yourself and your program, making sure the patient is in a relaxed position, explaining what you hope to do, following the protocol, and gaining consent before anything else. We role played interacting properly with patients. After eating lunch with our separate host families again (we eat all our meals in our homes), we took a bus to see the Mayan ruins at Xunantunich.

Written by Claire Cunningham, GHF ’18, to recount afternoon of June 11, 2017:

After lunch with our host families we all met up to go to the Mayan ruins. After about an hour long bus ride with our bus driver and tour guide, José, we got on a ferry to get to the ruins. To get to the ruins we walked up a big hill and saw howler monkeys on the way. José told us many interesting stories about the Mayans including the fact that the did not call themselves the Maya. When Columbus arrived in Central America he asked the people what they called themselves. They replied “maya” which means “I do not understand.” Therefore, Columbus wrote about the people who call themselves the Maya. We saw several different ancient buildings. The largest of which was the Castillo. The Castillo is a staggering 40 meters tall. It was hard to imagine how the Mayans were able to build such grand structures without modern tools. The view from the top was breathtaking. We had lots of fun exploring the ruins and the animals that now inhabit them such as monkeys, tarantulas, and iguanas. Visiting the ruins really gave us insight to the culture of the ancestors of many people in Belize. Afterwards we visited a market right outside of the ruins to buy souvenirs. We all returned to our host houses for dinner and went to the store afterwards to buy ice cream — which is without a doubt the best way to end a great day in the sun. 

The Global Health Fellows in the 2018 and 2019 cohorts recently read and discussed an interesting case from the Center for Global Development on treating cataracts in India.  Following the case, the 2019 cohort traveled to Virginia Eye Consultants.  

Below is a reflection from Andrew Thetford, GHF ’19.

This past Tuesday, the 22nd of March, the 2019 Global Health Fellows had the privilege of watching two cataract surgeries and touring the facility that offers these services.  Our day at the Virginia Eye Consultants Center began with a tour of their amazing building, one of the nicest and most comfortable medical centers I had ever been to.  We viewed the many offices that are located in the building, including a newly renovated area that greatly increased the working space.  We were also shown to two different machines for diagnosing cataracts and other issues in the eye.  One was the Fundus Photo Camera, and the other was called an OCT machine.  Each device took detailed pictures of the back of the eye using high resolution photos, and these pictures could then be studied to examine the severity of a cataract or other problems.  

After our tour, we watched our first surgery. The first patient was a woman around 75 years old, and she was having surgery done on a cataract in her left eye.  This being my first time observing a surgery, I wasn’t exactly sure what to expect, but I was very amazed at what I saw.  The patient is awake the whole time, and is just given a pill to make them feel “as if they have had a couple of drinks,” as our guide explained.  They have to focus on a light directly above them during the entire surgery, which lasts 7-10 minutes, and they feel absolutely nothing during the procedure.  The surgeon began by lubricating the eyeball with fluid, then making two small incisions around and above the iris, the colored part of the eye.  After making these cuts, he sliced off the thin membrane that sits right above the lens of the eye, which itself sits right below the iris and can be seen through the pupil, the dark opening in the center of the iris.  He then removed this membrane with a very small pair of tweezer-like tools.  Now, the cataract was visible.  And like I said, I’m no cataract expert at all, but even I could tell that this was one old cataract.  It was very thick and dark, and really reminded me of the inside of a jelly bean in appearance and texture.  The doctor poked around for a little bit, then inserted a vacuum-like tool into the slits and began to extract the cataract.  Because of the thickness of the cataract, it took a while.  The cataract fell apart in chunks and was quickly sucked up by the tube.  After finishing, the doctor inserted the new lens into the opening.  The lens was rolled up like a contact, and sprung apart once inserted into the eye.  The new lens immediately improves vision, allowing the patient to perceive colors and details that they had not been able to in a long time.  

Our second patient was a little different.  A few years younger than the previous patient, this woman had had a laser procedure done on the cataract before actually having it removed.  This means that a precision laser device softened and cut up the cataract to make it easier to extract.  This combined with a younger and softer cataract made for a swifter and easier procedure.  

After finishing up with both patients, we finished our visit with a tour of the Pre- and Post-Op area.  This room was filled with curtained-off sections for wheelchairs and hospital beds.  One of the patients we had watched, who had just finished up with surgery no more than 15 minutes before, was already up and ready to leave.  We were also shown the laser machine that performed the preliminary procedure on the second patient.  It filled an entire room, and had several dials and buttons that made no sense to my cohort.  The operator of the machine, however, obviously possessed a wealth of knowledge and experience for how to operate the device, and gave us a very detailed overview of how it worked.

Our trip to the Virginia Eye Consultants was a great experience.  The 18’s and 19’s just recently finished a case study discussing cataracts in India, so this was an awesome way to experience it firsthand.  Additionally, several of us are interesting in further researching optical health in developing countries, so having learned about and witnessing cataract surgeries is not a bad thing to have under our belts.

The Global Health Fellows traveled to Charlottesville, Virginia on February 10th and 11th for a wonderful opportunity visiting UVA’s Center for Global Health, a panel at Darden School’s “Pay for Success” conference, and spent some time reflecting on the year and goal setting for the spring semester.  

Below are reflections from our Fellows from the weekend:

Friday Morning – By Kara Kaufman (GHF ’19)

We began our trip with a departure at 7:30 from Norfolk Academy. ​I, of course, grabbed two Hardees biscuits for the trip, and many of us slept through the entire bus ride. About half way there, Mrs. Goodson handed out the case study on Migrants in South Africa, and we congregated in our groups to devise a rough outline of our plan to solve one of the many issues mentioned within the case. We soon arrived at UVA’s Center for Global Health, which is a really nice work space and a new sight for the 20’s. April Ballard, one of the main directors of the center, gave us a warm welcome, and we received some advice from Colleen Laurence (UVA Case Competition Founder) via Skype about how we should go about tackling the case. Groups assembled once again and progressed their plans until lunchtime.

During lunch, we listened to Ashwinraj Karthikeyan talk about his project, Pheonix Aid, which designs and provids wound dressings for diabetic foot ulcers all over the world. Next, Ashwanth Samuel and Eliza Campbell touched on their research and work through public health. Samuel gave us his story and insight into the system of mobile banking in third world countries, and Campbell shared her experience in developing a more effective diagnosis for child depression in Malawi.

Then, a group of students and professors came to guide us through our cases, and really provided useful opinions and views that, for my group, completely changed and shaped our ideas. I felt much more confident in our program of a mobile clinic reaching outside of the insufficient government community clinics to reach all migrants within a neighborhood, tackling inequality within the heath care of South Africa. Finally, each group then presented their ideas informally, and it was time to leave.

Friday Evening – by Laura Read (GHF ’20)

Saturday Morning – by Ells Boone (GHF ’20)

The Global Health Fellows woke up on Saturday morning at Rodes Farm ready to go for our last day of the retreat. We awoke around 8 AM and enjoyed a breakfast consisting of bagels and bananas. After breakfast, we turned our attention towards improving our needs assessment that we will take to Belize this June. The needs assessment focuses on various questions from 7 main categories: Smoke inhalation problem due to inside cooking, Water/Sanitation, Hunger/Nutrition, Illness, Maternal and Child Health, Education, and Energy Poverty. Once we finished our work on the needs assessment, the fellows loaded up the bus and took off back to NA. On the ride back, we stopped at the Market at Bellair for sandwiches and continued on our way. We got home in time for Snowball (Upper School dance) and called the retreat a success.  

Dr. Janice Newsome, mother of Olivia Newsome (GHF ‘18) and doctor at Emory University in Atlanta, Georgia, came to talk to the Global Health Fellows in mid November about her journey into the medical field. Now an Interventional Radiologist at Emory, the path Dr. Newsome took towards her current career is unlike many we have previously heard. She was born in a poor community in Jamaica and was raised by a group of nuns from her community. At age 14, she moved to New York City and entered into a public school system extremely different from the one she had left. In Jamaica she was deemed “smart”, therefore she had focused on math and science classes and it was assumed that she would go into a similar career. Once in New York, she applied to the gifted program at school, not knowing if she was considered gifted or not, and was accepted into the more advanced public school system. After high school, she went through the 6 year undergraduate and medical school program at Icahn School of Medicine at Mount Sinai. She then continues with residency at VCU and a fellowship at Jackson Memorial Hospital. She worked at a few different hospitals before landing at Emory University as a doctor and a teacher.

Interventional Radiology is a recently added specialty, as is usually had fallen as a subspecialty of Radiology. These radiologists perform diagnostic procedures, treat obstructions and bleeding, perform procedures to avoid surgery and treat cancers, just to name a few. Dr. Newsome not only performs procedures, but also is constantly thinking of innovative ways to advance her field. She has five ongoing project designs for devices that will improve the effectiveness and efficiency of procedures. One of those projects is a bio convertible filter for patients whose blood will not clot properly. Typically the patient would have the filter inserted and then removed at a later date through another procedure. Dr. Newsome’s design would eliminate this second procedure, as the device would dissolve on its own. She works with a team of engineers to put her ideas into action and is preparing to present some of her new innovations at the Georgia Tech Capstone Design Expo this December. As well as working at the hospital, Dr. Newsome leads and mentors a group of Interventional Radiology fellows. Ever since she was a little girl in Jamaica, she gravitated toward teaching people anything and everything, and that passion still has not gone away. She believes that being able to share your knowledge and experience with others is a valuable skill and finds this part of her job to be extremely fulfilling.
Throughout her talk, Dr. Newsome reminded us to follow through with our passions, even if obstacles may stand in the way and to take advantage of all opportunities. She dedicated herself to what she loves and it has lead her to be a innovative and progressive leader in her field. Dr. Newsome remains grateful for the opportunities she was given on her own path to Emory and ended her presentation to us with the reminder: “To whom much is given, much is required.”

The first day of the 2020’s community service began on Wednesday afternoon at Lifenet Health. As we arrived, we were warmly greeted by Morgan Burgess, the Lifenet Health Foundation Development Coordinator. After we put on our visitor’s badges, we were escorted to a conference room where we were asked to complete a quiz on organ and tissue donations. The quiz was comprised of 15 questions on the most common myths and misconceptions of organ and tissue donations. Each question contained a statement that the test taker had to identify as either fact or fiction. After everyone had completed the test, Mrs. Burgess reviewed each question and gave us the opportunity to take notes and ask questions. Following a detailed discussion about the quiz, Mrs. Burgess introduced us to the 2016 Norfolk Academy Global Health Fellows and Lifenet Health Project. The goal of the project is to create a slogan to promote awareness of organ and tissue donation on a personal and emotional level. We then said our goodbyes and headed back to the Norfolk Academy campus. During the first week of community service the class of 2020 learned two important things. One being the importance of fully understanding a topic before making a strong decision and the other being the value of spreading a positive message in the community to benefit others. I  really enjoyed my first week and I cannot wait to see what week #2 has to offer!

On October 5, 2016, the 20’s cohort of the Global Health Fellows attended the second community service meeting and third overall visit to LifeNet Health, the regional Organ Procurement Organization (OPO). Our overall project is to create a slogan that can spread awareness for organ and tissue donation. During this meeting, we listened to Mrs. Donna Bishop’s story of her life changing experience as a receiver of a vertigraft donation. Later, we discussed language sensitivity. Mrs. Donna Bishop, a receiver of a vertigraft, had been in pain for a year as a result of a vertebrae injury. She had surgery done in which a donated graft would be placed and infused into her spinal column along the C2-C3 vertebrae, which would alleviate the pain. Mrs. Bishop recalled the great relief she had the next morning and her gratitude to the organ and tissue donation program. Her story demonstrates the incredible impact that the donation had on her life. Also, we learned about the importance of language sensitivity in organ and tissue donation. Families who have lost loved ones must be treated with the utmost respect by all organ and tissue donation organizations if the deceased is an organ and tissue donor. That is why these organizations, including LifeNet Health, must be as respectful as possible. As they strive to treat families with respect, they are constantly changing their language to make it more caring and suitable. An example of this is the change from saying “life support” to the more accurate “mechanical support” because saying “life support” gave a false hope to the family that their loved one is still alive while in actuality, the patient may be virtually deceased. Through this, we learned of the intricate system of the organ and tissue donation program and how much the families of the patients matter.

Submitted by Ingrid Benkovitz (Class of 2019)

Jon Todd (NA ’99) moderates a panel of UNC graduate students

After an early rise on Friday, we embarked to the University of North Carolina, bright-eyed and bushy-tailed. Jonathan Todd, from the Gillings School of Public Health (and an NA alumus!), put together an incredible morning of intellectual, thought-provoking speakers in the field of Epidemiology.  

We first heard from Anna Bauer about her research on Preeclampsia, a fairly common pregnancy complication. The presentation was filled with data that was very helpful in understanding her talk. Next, Christine Gray spoke to us about her research on trauma and abuse among orphans and how the statistics may differ depending on if the children are raised in an institution or a family setting. This conclusive study was able to give us a greater knowledge of the procedure of collecting data in an ethical way and comprehending what it means. Alex Breskin then showed us his research on the Hepatitis C Virus, a virus that was considered non-curable until recently. He was able to emphasize and open our eyes up to the extremity of a somewhat overlooked disease. Jonathan Todd, our last speaker, explained his research about how different doses of statins affect incidence of cardiovascular disease. His presentation was beyond impressive; Norfolk Academy should be proud!!

NA GHF pose with our UNC panel at the Gillings School of Public Health

While all the speakers specialized in different topics, they all had one thing in common: a truly inspiring passion for what they do. Following these presentations, we were lucky enough to have a panel of more students and workers in the field of Epidemiology. With such an intriguing field, the number of questions we had seemed unending, but sadly, the morning did have to come to an end.

In the afternoon, Fellows traveled to the UNC Challenge Course to grow as a team and to push their physical limits!  The following reflection of the challenge course is from Andrew Thetford (Class of 2017).

After our morning session at UNC and a working lunch on Franklin Street to finish discussion of our case study, the GHFs headed to the University of North Carolina’s challenge course.  This was much different than a lot of us expected.  I assumed we would be on something like the Adventure Park at our local aquarium, but it was much different.  Most of our time was spent on the “Low Ropes Course”, which consisted mainly of team building exercises.  We started off with an icebreaker game, then transitioned quickly to a version of the game “Concentration”.  Each set of cards in the game had an important characteristic necessary to working well as a team.  Appreciating diversity, equality, hard work, and others were all flipped over after several tries by each fellow.

Gabi Diskin (Class of ’18) explains key components of working as a team

 After completing the first game, we were challenged to pick three of the many traits to become our focus for the day.  Following much deliberating, we decided on focus, positive attitude, and teamwork because they seemed to cover most of the other traits as well.  

Justine Kaskel (Class of ’17) slows the “water” as it flows downhill

Then, we moved on to a more physical and mentally grueling obstacle.  We had to use cut PVC pipes to move a golf ball down a hill and into a tiny bucket.  This required us to wait for the golf ball to move past our PVC pipe, then quickly transition to the back of the line.  It went on like that for a few rotations, with the first person in line continually moving down the hill and towards the back of the line.  However, it wasn’t as easy as it sounds.  If the ball dropped, we had to walk back up the hill to the starting line and repeat, and we dropped the ball A LOT!  It took 45 minutes of a lot of leadership from the ‘17s and others and a bit of yelling from everyone to finally get the ball into the bucket that was no more than 20 yards away.  

After each activity, we would sit down and talk about what we did and how we could have done better with each other.  We also tried to relate everything back to the three traits we chose at the beginning: focus, positive attitude, and teamwork.  Next, we were instructed to pick our favorite quadrilateral (the group consensus was a trapezoid) and we moved into the shade.  We formed a big circle, donned blindfolds, and were told to take the pile of rope in the center of the circle and form a trapezoid with it, all while wearing blindfolds.  This also took a lot of leadership and talking over one another to succeed, but we made it happen rather quickly.  

Ryan Fulmer  (’17) helps Ray Fitzgerald (’19) cross the spider web

After another discussion, we walked into the woods a bit towards “The Spider Web”.  This was a bunch of strings strung randomly across a big wooden frame built to resemble a huge spider web with large, different sized holes in it.  Our challenge was to get everyone from one side of the spider web to the other, without touching the web.  This required us to carefully carry people through each hole.  However, there was a catch.  We could only use each hole twice, so we had to strategize who to put in each hole based on weight and size.  This challenge required a lot of brawn as well as brains, so it took a lot of teamwork to lift one fellow up, pass him or her slowly through a hole several feet across, and transport them into the waiting arms of GHFs on the other side, all without touching the strings.  Oh, and there was a time limit!  The time limit really compressed the amount of time strategizing.  We ended up having to put some of the biggest fellows, like Graham Barbour ‘17, into one of the smallest and most awkward holes.  After this challenge, we talked about what we did well and what we could’ve done better for a little bit, then we walked down to the zipline.

Climbing to the top!

The zipline is the largest in the Southeast, and sat atop a wooden platform 100+ feet off the ground, connected only by a huge net.  In order to go on the zipline, one had to climb all the way up the net before strapping in and jumping.  After everyone had ridden the zipline, we finished our day with one last reflective activity where everyone picked card with a picture on it, then described how the picture represented some aspect of our day.  While there were the deep, classic people like James Hood ‘19 who said his picture of a road and a far off house represented the challenges we had to face to succeed, there were around seven blunter people who picked pictures of the sun because it was very hot and very muggy outside.

Although it was hot, sweaty, and difficult, I think we as a program finished with a lot of takeaways.  We had picked three core values that are necessary to accomplishing our goals, we had completed every challenge, and we had admitted to our faults and come up with alternative, better ideas after doing so.  We had grown together as a team, and everyone gained valuable experience as both leaders and followers, not to mention the workout everyone got from carrying each other around in the heat.  The Challenge Course was a lot of fun and a great addition to our time at Duke and UNC.

Submitted by Lawson Montgomery ’18

After a great lunch with Dr. Robert Malkin of Duke’s Global Health Institute, we ventured to the Duke Clinical Research Institute and began on a discussion about research ethics from Dr. Ross McKinney. This was very interesting as it gave us the history of ethical issues in clinical research and a deeper understanding on how to conduct a true clinical study. Next, we listened to Dr. Danny Benjamin and his clinical research on different dosages and how they correspond to developmental ages of infants and children. After these two speakers, we had a panel that was composed of Erin Wolfe, Caitlin Grennan, Julia Giner, and Tiffany Bell. All were involved with Duke and all shared their personal paths to Clinical Research and Duke. We then asked questions about a variety of topics which included sickle cell disease and microbiology to mention a few. This panel helped show us that there are a multitude of paths that can be taken in the medical and clinical fields. We want to thank our speakers and panelists for the time they took out of their days. We would also like to thank Dr. Vivian Chu, moderator of panel and specialist in infectious disease, and Amanda McMillan. They were the women responsible for this awesome afternoon of speakers and panelists.

Submitted by Julia Duarte, GHF ’20

Seniors Ryan and Justin (’17) lead a discussion on “Diligence”

On a Tuesday afternoon, after the Class of 2020 Fellows were introduced to basic Global Health terms and to their new senior mentors at the Chesapeake Bay Foundation’s Brock Environmental Center, we split up into different groups to discuss our summer reading book, Better, a surgeon’s notes on performance. Author Atul Gawande focused on three main themes: Diligence, Doing Right, and Ingenuity. By telling short stories that enlighten readers about health in a community and on a global scale, Gawande’s writing style intrigued and captivated all of the fellows. Some of the topics discussed included the importance of washing hands, the steps to eradicating polio, the complications of human birth, and many more. The seniors led the new fellows through a discussion about each of book’s themes, asking frequent thought-provoking discussion questions. Some of the questions being discussed included “Do you support or oppose the involvement of physicians in death penalty executions?” and “Do you feel that doctors should always follow the rule book or step away from it when coming across a problem they have never dealt with before?”. These two questions and many more helped steer discussions between the ‘17s and the ‘20s fellows. After reviewing and discussing each theme with different seniors, I came to the conclusion that Gawande had a deeper message behind his book. Not only do these series of stories teach us about medicine; but they also explain how to deal with failure and grow from it. That will determine your character, even if you are not a doctor. Every fellow should keep this lesson in mind as they begin a new year with new challenges.