Studying populations that were hard to reach even before the pandemic

By James Feng, MS Candidate in Global Health Sciences

Global health was not a field I thought I would end up in. I have always been interested in medicine, and as an undergraduate, I thought clinical experience and laboratory research were the keys to success. However, I soon came to realize that I was not seeing the whole picture. In the clinic, I saw how social factors affected the level of care patients could receive. Unable to adequately address these issues in the clinic, I found my way to the Master of Science in Global Health Program at IGHS.

For my capstone project, I am working with Dr. Adam Bennett to characterize risk factors for malaria infection in Laos. The prevalence of malaria in Southeast Asia has been drastically reduced, allowing many countries to push towards complete elimination. The remaining at-risk populations are hard to reach because they tend to live in rural, forested areas and are highly mobile. We want to find ways to effectively and efficiently deliver malaria prevention and care to those at the highest risk of infection.

My capstone is looking at the effect of forest travel on treatment-seeking behavior and malaria infection. Time spent in or near forested areas increases the chance of being bitten by the mosquito vector, the Anopheles. Many people need to be in forests for work, eliminating the possibility of simply stopping this behavior. Instead, we hope to gain more information about their behavior, such as identifying reasons for going into forests, modes of transportation, and time spent in the forest. Access to healthcare is an important factor in the health outcome of malaria and can be contextualized by considering the treatment-seeking behavior of individuals. If someone is not seeking treatment for fever, a common symptom of malaria, it is important to know the reason. Since many at-risk individuals travel frequently, it can be difficult for them to have reliable access to healthcare to receive the proper treatment when they need it.

The original plan was for me to use survey data being collected this spring by other members of the research team. I was not going to actively collect data, but Dr. Bennett wanted me to get firsthand experience in global health research to provide better context of the project and our goals. I was scheduled to travel to Laos to support the researchers on the ground. The COVID-19 pandemic required me to cancel my travel plans and change the data set as data collection could not continue. Fortunately, I will still be able to address my core research question as I switched to an existing data set that used a similar survey.

Coming from a molecular biology background, I learned to approach disease from a strictly biological perspective. The health outcome would be based on the individual’s health, working on the assumption that any and all treatments are available. However, the master’s program has taught me how social determinants such as structural racism, the healthcare system, and health policy also significantly affect health outcomes. COVID-19 has exposed many inequities in the U.S. and has really driven home the notion that global health is also local.

Not only has the COVID-19 pandemic further validated my decision to pursue global health, but it has also made me realize the importance of the relationships I have built in the program. I miss the supportive and stimulating environment that my professors, course assistants, and classmates created. They are among the kindest and most inspiring people I have met, and I look forward to seeing what the future holds for us all! Despite the remainder of our year being remote, I am excited to see everyone virtually in July to finish the journey we started together.