• agaro_ethiopia

    Agaro, Ethiopia, located in the Jimma Zone of the Oromia Region

  • debramarkos_monamuse

    Debre Markos, Ethiopia

  • boliviasmart

    La Paz, Bolivia

  • boliviasp2013

    Students at Machu Picchu after completing their field studies in Bolivia

  • cambodia17

    Health Center in Phnom Penh, Cambodia

  • 5 MPH Students On A Cambodia Field Study

    Phnom Penh, Cambodia


Summary of Global Health Field Studies

Over the last two years, 89 public health, joint degree and dual degree students have traveled abroad to conduct their public health field studies. Students traveled to Bolivia, Ethiopia and Cambodia and worked with universities, hospitals, clinics, and community organizations. They studied topics ranging from child malnutrition and neonatal care to health literacy, medication inventory management and research ethics. Below, we highlight several projects:

  • Zachary Hathaway, MSPAS/MPH (Class of 2013) conducted a study to assess the knowledge and perceptions of research ethics among medicine and public health students in Bolivia. He designed a cross sectional study enrolling over 200 medical and public health students. Self-administered surveys were collected from students at three participating universities. Descriptive statistics from 20 questions will be used to determine students' knowledge, attitudes, perceptions and experiences related to health research ethics. The findings of this study will be used to inform the development of a Research Ethics Program in Bolivia in partnership with Touro University, California under the leadership of professor Sarah Sullivan. (Spring 2013)

  • Kimberly Dauz, MPH (Class of 2013) conducted a project that aimed to identify simple, low-cost strategies for improving neonatal health in Cambodia. Kim partnered with the Reproductive and Child Health Association (RACHA) for her project. She used participant observation methods and observed antenatal care, delivery and postpartum visits. She also held discussions with Maternal and Child Health (MCH) officers, midwives, new mothers and physicians throughout the province to inform her recommendations. A literature review of recently peer-reviewed research was conducted in order to complement her field observations. Kim, who presented her recommendations to RACHA’s program directors, recommended use of the WHO Safe Childbirth Checklist for standardizing practices, umbilical cord cleansing with the antiseptic Chlorhexdine to reduce infection and the development of a mobile health program for improving adherence to antenatal and postnatal care visits. (Fall 2012)

  • Katrina Chapman, DO, MPH (Class of 2011) worked with local researcher at the University of Debre Markos to examine childhood nutritional status its association with age and gender in that region of Ethiopia. Child malnutrition contributes significantly to child mortality. Over the past decade, there has been a steady decline in the prevalence of child malnutrition in developing countries.  However, this decline has not been observed in sub-Saharan Africa. She conducted a cross-sectional study of 239 children, 0 to 5 years of age, who were seen as outpatients in the Debra Markos hospital and the Debre Markos health center. She found that 50.5% of the children had stunted growth, 17.4% were underweight, and 8.4% were wasted. In addition, there was a higher prevalence of stunting in the youngest age group (0-5 months) and this association between age and stunting was statistically significant. There was also a statistically significant association between male gender and stunting. The study results indicate the importance of targeting infants aged 0-5 months for nutrition interventions in Ethiopia.  Results also suggest that the assumption of female gender discrimination with regards to nutrition might not be applicable to Debre Markos. (Fall 2010)
  • MPH Alumni, Rebecca Astrachan, Meghan Labine, Laura Marshall, Sarah New, and Ruchi Patel (Class of 2012) completed their Global Health field studies by piloting the Cambodia Public Health field study site, a partnership between the Public Health Program in the College of Education and Health Sciences at Touro University of California and the Reproductive and Child Health Alliance (RACHA).  RACHA is a local non-governmental organization (NGO) in the capital, Phnom Penh. The students participated as field interns under the primary supervision of Chuon Satharidh at RACHA for ten weeks.  As part of RACHA’s Capacity Building team, a principal component of the field study project was to conduct field observations of annual quality improvement (QI) assessments, as related to reproductive, maternal and child health within Cambodian community-based health centers. These field observations involved intensive site visits to the health centers, provincial referral hospitals, patient homes, and community-based distributions (CBDs) of birth spacing materials within six of the twenty-three provinces. Based on these evaluations and resources provided, a Health Center Hygiene for All manual was composed for community-based health centers to use as a hygiene standards guide (Astrachan, Labine, Marshall, New, Patel, 2011). (Fall 2011)
  • DO/MPH Candidate 2014, OMS II,  Pamela Schwendy completed a preliminary Research in Debre Markos, Ethiopia. In a small city about four hours north of the capital, Addis Ababa, Schwendy worked in the small community hospital where she performed research to determine the prevalence of anemia among pregnant women who attend the hospital for prenatal care and/or delivery. Understanding the scope of this life-threatening disorder will enable the local physicians and future Touro students to align resources and promote prevention, routine screening, health education programs and further research. (Summer 2011)
  • Peng Li, MPH (Class of 2012) investigated prevalence of HIV among pregnant women in Debre Markos Hospital. Li worked on a retrospective cross-sectional study at Debre Markos Hospital’s Antenatal Care Clinic with the purpose of providing better understanding of the magnitude of HIV in the community and to better assess priorities to serve, promote health, and prevent HIV among pregnant women in Debre Markos. The results of this study suggested that during pregnancy, efforts should be geared toward early detection and prevention of HIV prior to delivery. (Summer 2011)

  • Vitaley Kovalev and Michael Wells (MSPAS/MPH Class of 2012) conducted a Community Based Cross-Sectional Study in Wirtu yedi, Ethiopia. In this neighborhood located in the town of Asendabo near Jimma, Kovalev and Wells (featured in the photo at the top left of this webpage along with fellow students, Thao Do, Gerardo Murguia, Michael Wells, and the local kids for a regular soccer game at the neighborhood park) assessed the choice of caregivers to self-treat symptoms of malaria infection prior to seeking professional medical treatment at a regional health facility. Malaria is one of the most significant public health issues in Ethiopia and its rural communities, like Wirtu yedi, experience a multitude of barriers to modern medical care and proper treatment of this illness due to inadequate access to professional healthcare facilities. The objective of this study was to explore the impact of barriers to healthcare on the prevalence and types of self-medication for malaria. (Spring 2011)

  • Monireh Tofangsazan, MPH (Class of 2012) conducted research on the prevalence of Iron Deficiency Anaemia amongst women of reproductive age in Jimma Ethiopia and surrounding areas. She also conducted health education workshops to community members covering the areas of HIV prevention, STD awareness and prevention, substance abuse, nutrition, personal hygiene, environmental health and awareness and prevention of the spread of infectious diseases. (Spring 2011)

  • Jessica Adamich and Coury Clemens (MSPAS/MPH Class of 2012) explored Emergency Obstetrics and Neonatal Care in Jimma and Asendabo, Ethiopia. In their studies, Adamich and Clemens discovered that researchers have suggested that nearly 75% of maternal deaths in developing countries could be averted if full provision of the key maternal mortality interventions were to be achieved. Adamich and Clemens performed a qualitative cross sectional study examining the opinion of various health care providers at different levels within the referral system in regards to the limitations in emergency obstetric and neonatal care (EmONC). The main objective of this study was to survey and evaluate the attitudes and experiences of health care providers regarding EmONC and to capture data on the interactions between health care providers, referral and receiving facilities, and individual perspectives on what enables or hinders the capacity to provide effective obstetric health care. The study was conducted at Jimma University Maternity Ward, Jimma Health Center, Asendabo Health Center, and the 8 rural towns (kebeles) surrounding Asendabo. Adamich and Clemens were able to gain insight into the psychosocial aspects of this problem for Health Extension Workers (HEWs), Skilled Birth Attendants (SBA), nurses, Health Officers (HO), medical interns, and physicians.The survey developed by Adamich and Clemens showed to be a powerful indicator of what each level of care views as a barrier to delivering better healthcare and may lead to future projects on this research topic. (Spring 2011)

  • Christine Page-Lopez, DO, MPH (Class of 2011) reported adverse reactions to the H1N1 vaccine in La Paz, Bolivia. Christine Page-Lopez recently conducted her field study at Hospital Del Nino in La Paz, Bolivia, one of the largest and oldest state-run hospitals in Bolivia with four subspecialties and a primary care service facility treating patients from all over the country. As the national center for pediatrics, all pregnant women and children under 5 receive free care. The Hospital's emphasis is on infectious diseases and contributes significantly to the national policy in the field of infectious disease control. Page-Lopez worked with pediatric infectious disease physician, Dr. Victor Velasco, creating and distributing surveys to investigate adverse reactions from the H1N1 Influenza Vaccine delivered to the staff of Hospital del Nino and reasons why staff chose not to receive the vaccine and where they received the information they used to form their decisions. (Summer 2010)
  • Alumni, Babak Fatirian and Ryan Manalo (PharmD/MPH Class of 2010)developed asurvey analysis in La Paz, Bolivia. Fatirian and Manalo produced a survey analysis of the drug delivery system of the two hospitals focusing on maternal and child health. The two hospitals that were evaluated were Hospital Del Nino, located in the more affluent section of southern La Paz, and Hospital Los Andes situated in poverty-stricken El Alto, once a shantytown suburb of La Paz and where the current population has increased due to the continued migration from the country side.

    Fatirian and Manalo's findings surmise that (1) national health insurance is limited to the lawmakers approval of medications that are “affordable” to distribute; (2) patients may also face obstacles such as unavailability, unaffordability and insurance coverage problems;    (3) without proper diagnosis and valid prescription, the distribution of drugs can lead to hazardous side-effects and potential resistance; and (4) there is a need for pharmacists to develop more effective interaction with patients, especially when counseling them about their medications.

    Beyond the Project

    In "Operation Warm-Embraced" Fatirian and Manalo assisted children at De Los Andes Community Clinic, also a shelter for abandoned children near Hospital Los Andes, by helping to distribute winter gloves and socks.  The students were also able to assess the nutrition status of the patients treated at Hospital Del Nino and Hospital Los Andes. (Summer 2009)