Global Health Students Research Adolescent AIDS in Vietnam as Partnership Grows
This past summer, five Einstein medical students traveled to Vietnam with support from Einstein’s global health fellowship program, to learn from and research a population that is now extremely rare in the United States: children born with HIV. Whereas the Centers for Disease Control and Prevention recorded just 130 cases of HIV among American children in 2016, a 2018 UNICEF report indicates that HIV affected approximately 4,600 Vietnamese children.
As part of this global health fellowship project, the first-year students spent a month in the Southeast Asian nation working with the Worldwide Orphans Foundation (WWO), an international non-governmental organization (INGO) that provides comprehensive care for orphans, as well as children and adolescents suffering from serious diseases.
“This was a learning experience on many levels, from treating HIV and doing research to learning about the importance of cultural sensitivity,” said Dr. Donna Futterman, director of the adolescent AIDS program at Montefiore who helped organize the research project and accompanied the students during their trip.
The new project was a few years in the making, and represents a stronger connection between Einstein and Vietnam. The project grew out of relationships developed through cooperative efforts begun in 2015, when Dr. Frederick Kaskel first traveled to Vietnam with two Einstein students to help on projects involving individuals suffering from chronic kidney disease. At that time, Dr. Kaskel made connections with children’s hospitals and the WWO, which led to additional students traveling to Vietnam to take part in projects in subsequent years.
In late 2018, Dr. Kaskel recruited Dr. Futterman, who also had a personal history with Vietnam, dating back to 1975. She has worked to expand the global health initiative begun by Dr. Kaskel into a collaborative effort between Einstein and the WWO.
An Inside Look at Key Issues
The experience this summer gave the Einstein students a chance to learn how an INGO like WWO can tackle an important health problem. During their visit, they shadowed doctors at a children’s hospital in Hanoi and then spent three weeks working with the WWO in Ho Chi Minh City. They also conducted a research project that included interviewing adolescents who were “aging out” of the WWO’s comprehensive care program to determine the types of services that could benefit from improvement.
They learned that, upon reaching age 18, the Vietnamese teens are no longer able to receive many services, including financial support, from the WWO. The teens shared the difficulties they were having with this transition.
“These are teenagers living with HIV who have complex family histories and living situations,” said Jinsung Kim. “Many of them had challenges with disclosing their HIV status to people they were close with.”
Providing Helpful Feedback
Through their interviews, the Einstein students found that the 18-year-olds needed more information on English classes that would be helpful for getting jobs. Because Vietnam’s tourism industry has grown in recent years, speaking English is a sought-after skill.
Other teens craved helpful insights into how to receive financial assistance for college.
“These 18-year-olds showed a lot of resilience and dedication to their future goals,” said Jinsung. “Many of them were students, while others had jobs or were in vocational training programs.”
When the Einstein students presented their findings to the WWO, the organization’s staff was thrilled with the information provided to them. “They had never had an analysis like this done before, and it really helped them identify what they were doing right and what they needed to improve,” said Dr. Futterman. “I think it helped them to know they were on track and made them feel good about their work.”
Insights on Career Choices
The experience working with the Vietnamese youngsters has led Rie Seu, who had written a thesis on child growth as an undergraduate, to more seriously consider pediatrics as a career. “The trip rekindled my interest in child growth,” she said. “It was fascinating to see the impact of comprehensive healthcare on children. We saw how having one place where they can get pediatric care, see a psychologist, and learn about both social and job life skills is helpful and so important.”
Jinsung also found their work with the children rewarding, but said that it has actually made his decision to choose a career path harder.
“Do I want to work with kids? I don’t know. I had never traveled abroad so I had no idea what to expect. It was such a great experience to learn in a way you can’t learn in a classroom,” he said. “I’ll carry what I learned in Vietnam with me throughout my career.”
A Platform for Collaborative Connections
“There is something special about the experiential learning our students do through their projects abroad that can’t be translated to the classroom or a clinical setting in the U.S.,” noted Jill Raufman, director of medical student global health programs and associate director of the Global Health Center. “Time and time again, I hear students talk about how the experience provides invaluable insights that influence them as they continue their medical education and will inform their approach to taking care of patients.”
Vietnam is one of 40 countries for which Einstein’s Global Health Fellowship program offers supported student fellowships. The evolution of Einstein’s relationship with Vietnam, from Dr. Kaskel’s initial work in 2015 to a collaborative month-long research project, is central to the Global Health Fellowship program’s mission.
“This is something that we can build on,” said Ms. Raufman. “It will be a sustainable, longitudinal, collaborative project, and that’s exactly what we’re looking to do.”
Already, more students have approached Dr. Kaskel about going to Vietnam.
“I think our work thus far has had a positive impact, and this program will persist as we continue to build on it,” said Dr. Kaskel. “Vietnam is very personal for me for a number of reasons, and I’m so glad we have a program where more and more students are asking to take part.”
Posted on: Wednesday, February 19, 2020