Hi everyone, thanks for taking a look at my first blog entry. I’ve never had a blog before, but I have realized that there will be so many experiences to share during this next year. But I still love writing and receiving personalized emails, so no worries, I’ll keep sending those too.
I have returned to Gaborone, Botswana for a year of clinical research. I decided to take a year off between my 3rd and 4th year of medical school, so I could reexplore Botswana and participate in exciting research. I spent a few months in Botswana in 2005 working at the Botswana-Harvard AIDS Institute Partnership, and helped start an important study, the Mma Bana Study, on the prevention of mother-to-child transmission of HIV through breastfeeding. Now I’m back, and even have funding through the Doris Duke International Clinical Research Fellowship, a pilot fellowship that offers international research opportunities for medical students. I feel so grateful to have received the fellowship, as the summer events have proved useful and the mentors (particularly my mentor, Dr. Roger Shapiro) have been incredible.
Roger and I designed a study to determine whether there is an association between HIV infection, antiretroviral therapy, and adverse pregnancy outcomes, including stillbirths, premature delivery, and early neonatal mortality. Research studies have shown that HIV infection is associated with poor outcomes; however, it is unclear whether antiretroviral therapy is further associated with these outcomes. This becomes an important issue, as more HIV-infected women are gaining access to antiretroviral therapy during pregnancy, both for their own health and for the prevention of mother-to-child transmission of HIV. Thus, Roger and I plan to create a large database that documents every birth that occurs at Princess Marina Hospital in Gaborone, Botswana; the Gaborone City Council Maternity Wards in Gaborone, Botswana; and the Scottish Livingstone Hospital in Molepolole, Botswana. We will then determine which risk factors are associated with adverse pregnancy outcomes. We submitted IRB applications over the summer to the Botswana Ministry of Health, Harvard Medical School, and Harvard School of Public Health, and are hoping to have final approval in the next week.
Roger and I designed a study to determine whether there is an association between HIV infection, antiretroviral therapy, and adverse pregnancy outcomes, including stillbirths, premature delivery, and early neonatal mortality. Research studies have shown that HIV infection is associated with poor outcomes; however, it is unclear whether antiretroviral therapy is further associated with these outcomes. This becomes an important issue, as more HIV-infected women are gaining access to antiretroviral therapy during pregnancy, both for their own health and for the prevention of mother-to-child transmission of HIV. Thus, Roger and I plan to create a large database that documents every birth that occurs at Princess Marina Hospital in Gaborone, Botswana; the Gaborone City Council Maternity Wards in Gaborone, Botswana; and the Scottish Livingstone Hospital in Molepolole, Botswana. We will then determine which risk factors are associated with adverse pregnancy outcomes. We submitted IRB applications over the summer to the Botswana Ministry of Health, Harvard Medical School, and Harvard School of Public Health, and are hoping to have final approval in the next week.
Last week was very exciting, as Roger and I introduced the study to the physicians and nurses that run the maternity ward at Princess Marina Hospital. The physicians and nurses gave valuable input, including broadening the term loss of pregnancy and including all pregnant women who deliver after 16 weeks. Respect for the hierarchy is very important; even among the nurses, there are deputy nurses who run the wards and department nurses who oversee the work of the deputy nurses. The success of my work will largely depend on the cooperation of the nurses and physicians in these wards.
My housing is temporary at the moment. I am staying in a house close to to Princess Marina Hospital. There are 4 other expats living here, 3 of whom work at Botswana-Harvard as well. There’s Rebeca, an ID physician; Rim, a UCSD med student; Lindsey, who just graduated from Princeton and is about to start Mt Sinai med school; and Sarah, who works at the UN. Lindsey cracks me up the most! She just purchased a car and has learned to drive manual on the left side of the road.
I have 2 friends here in Gaborone from my stay here 2 years ago - Clearance, a lovely Motswana who I met at Botswana-Harvard, and Fajad, a nice guy who I met through a Harvard grad. They were both excited to see me again, which was so nice. Clearance is a very loyal friend - I decided to run a 10K race a week after I arrived, and she was there to cheer me on! It was really difficult, I think because the altitude is higher and the air is so dry. Also the race started at 2:30 pm in the afternoon, and the sun was most unforgiving. It was fun, and I am excited to start training for a half marathon at the end of October.
The same day as the 10K, I organized a braii for Clearance, since she turned 26 the day after I arrived! A braii is a barbecue, and staple foods include meat (on the bone), pop (maize meal), and chakalaka (relish and vegetables). Clearance’s friends and a group of friends my roommate and I met the week before came to the braii. The braii was a success! We stayed up all night and enjoyed the sun rise the next day.
One thing I forgot to mention was that during the 10K run, there were a lot of young girls who ran either barefoot or with socks only. Clearance mentioned that not everyone could afford running shoes, and that if they were going to run without shoes, she thought it was better to run barefoot rather than with socks. The pavement was extremely hot that day, and I cannot imagine how difficult it was to run without shoes.
That’s it for now! Thanks for reading!
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