Five SANTHE trainees hit the ground running on the 16th of January 2017 when they joined 19 Massachusetts Institute of Technology (MIT) students on a week-long MIT course entitled “Evolution of an Epidemic”. The course formed part of MIT’s Independent Activities Period (IAP) - a special four-week term starting in January. This was the first time this course was offered, and the first MIT IAP course to be held in South Africa.
Accommodated at SANTHE’s Lead Institute, the Africa Health Research Institute (AHRI), based at the University of KwaZulu-Natal’s (UKZN’s) Nelson R. Mandela School of Medicine, the course was led by Instructors Professor Bruce Walker, Director of the Ragon Institute of MGH, MIT and Harvard; and Dr Howard Heller from MIT Medical; with guest speakers including Professor Salim Abdool-Karim from the Centre for the AIDS Programme of Research in South Africa (CAPRISA), Professor Thumbi Ndung’u, SANTHE Programme Director, and Dr. Alan Aderem from the Seattle Biomedical Research Institute. In addition to morning lectures, students undertook various afternoon field trips including a visit with local traditional healers; site visits to FRESH (Females Rising Through Education, Support and Health), AHRI, HPP (UKZN’s HIV Pathogenesis Programme); Vulindlela; the Nelson Mandela capture site; and the Africa Center. The course ended with a wrap up at Hluhluwe Game Park.
Walker describes some of the highlights. “The lecture on day one entitled ‘Recognition of an Emerging Epidemic’, was on HIV epidemiology in the U.S. and globally, highlighting the initial recognition of the epidemic by medical, public health, scientific communities, as well as the very slow response of governments. The second day’s lecture was entitled ‘How HIV Causes Disease’, and highlighted how much was learned from studying patients, including persons who control HIV without the need for medications. It also showed how understanding the basic science of HIV led to development of drugs targeted at discrete steps in the viral life cycle. A second lecture that day was on HIV vaccines that are entering efficacy trials. On day three, the ‘Treatment, Activism, Advocacy and Social Justice’ lecture highlighted the critical role that advocacy and activism play both in advancing drug trials in the U.S. and in bringing treatment to Africa.”
The morning lectures were complimented by afternoon field trips. Walker explained how a visit to the traditional healers allowed for a discussion on a program by iTEACH, a local NGO affiliated with Ragon Institute, had successfully engaged them in HIV counselling and testing as well as prevention efforts. The students also visited FRESH (‘Females Rising through Education, Support and Health’), a study located at a shopping center in Umlazi where uninfected young women at high risk of HIV infection are enrolled in an empowerment and life skills program, meeting twice weekly at which time they undergo testing for acute HIV infection. There the students were able to speak to the participants regarding what they see as challenges to protecting themselves from HIV infection. Another day they visited the Africa Health Research Institute (AHRI, formerly K-RITH), which included a tour of the laboratories and a dinner at which Director of the Center for Infectious Disease Control, Dr Alan Aderem, and CAPRISA’s Professor Salim Abdool-Karim, shared their experiences in the Apartheid struggle. On a trip to Vulindlela they were able to see a rural research site and the Nelson Mandela Memorial, followed by a lecture by Professor Abdool-Karim on non-vaccine prevention efforts. Walker noted “we now have the tools to stop the spread of the epidemic, but fall short on implementation.”
Walker said that the overall objective of the course was “to teach students that epidemics are multidimensional – they involve the complex process of recognising them and their cause, understanding the biology to develop treatments and vaccines, and the huge role that policy decisions have in shaping the course of an epidemic, and how advocacy can impact this.”
He said the course put an epidemic in context for the students, “showing them that it is not just dealing with the disease itself, but that societal factors including poverty, policy decisions and advocacy, all play a role.”
Based on the success of this initial course which was supported by MIT, SANTHE, U.S. business leaders and philanthropists Mark and Lisa Schwartz, and U.S. author and businesswoman Lisa Heffernan, Dr Bruce Walker says, “We expect to make it an annual event and hope to partner with the same supporters each year. Unfortunately we had to keep the class size small to remain interactive and will probably follow a similar format in the future.”
Course students, made up of SANTHE interns and Masters trainees and MIT sophomores, juniors and seniors, had the following to say:
|“The course was well tailored and covered very important topics which have enhanced my understanding of HIV epidemic, evolution of HIV, HIV diagnostic methodologies, policy and treatment implications as well as HIV activism, advocacy and social justice. The visits to various sites made the course even more interesting. I also valued the opportunity to meet and interact with my fellow SANTHE trainees.” - Ephraim Chikwanda, SANTHE Intern, Rwanda Zambia HIV Research Group (RZHRG) SANTHE Partner Site, Lusaka, Zambia|
|“This course provided the most remarkable travel experience of my life. It exposed me to the social, political, scientific, and personal challenges that have gone along with HIV for the last 35 years and to what's actively being done in Boston and KwaZulu-Natal to combat the issue. Beyond all of that, this course gave 19 MIT students with varying backgrounds and interests an incredible intercultural medical experience that'll stick with us for a long, long time.” - David Heller, MIT Degree Candidate and B.S. Biological Engineering MD MPH, New Jersey, U.S.A.|
|“The knowledge and experience gained from this course is immeasurable. I thoroughly enjoyed learning more about the different HIV research initiatives and how they came into existence. The lectures presented by Dr Walker and Dr Heller were extremely informative and I feel very fortunate to have met them and their colleagues as well as the other members taking part in the course. I would most definitely recommend this course to anyone pursuing a career in science." – Courtney Wilson, SANTHE Intern, Africa Health Research Institute (AHRI) SANTHE Lead Institute, Durban, South Africa|
|“’Evolution of an Epidemic’ helped me to develop insight into issues of HIV/AIDS management, epidemiology, clinical manifestations, health policies and other opportunist infections. It also provided me with a clear understanding of HIV/AIDS, treatment and the related issues of monitoring adherence and resistance. Finally, I found this course very informative and would definitely recommend it to my colleagues with no reservations.” – Leabaneng Tawe, SANTHE MPhil trainee, Botswana-Harvard AIDS Institute Partnership (BHP) SANTHE Partner Institute, Gaborone, Botswana|
|“This is my favourite course I have taken at MIT thus far. In just one week, I have become even more empowered and driven to make a positive impact in the world.” – Kasite Ugo-beke, MIT B.S. Candidate in Chemical Biological Engineering, Cambridge, U.S.A.|
|“I think this course was unique in that it challenged us to learn about our surroundings in order to further understand the HIV epidemic. It was really interesting to hear about the practices and culture specific to South Africa and KZN that influenced the epidemic, and to then take this information and use it to explore how we can offer better treatment and prevention.” Kimberly Feng, MIT B.S. Candidate in Biology, Cambridge, U.S.A.|
|“I'll start by mentioning that, like all other courses I've taken at MIT, ‘Evolution of an Epidemic’ was extremely rigorous and challenging, demanding that students problem solve and think practically (a task much easier said than done). Lectures synthesised the biology, virology, economics, behavioural science, history, psychology, and politics of the HIV/AIDS epidemic and then proceeded to present problems in the form of patient cases seen by our very own instructors, who were on the frontline of solving this mystery. At the conclusion of the course, we were asked to work in groups to discuss and present solutions to complicated problems (policy of implementing an expensive, partially-effective vaccine, advice for an infected sex worker who can't afford HIV treatment, etc.) that touched on all elements of the course material. I've come away from the course feeling truly able to think critically about many aspects of this epidemic, as well as how to approach similar phenomena.”|
|“However, this course was SO much more than a typical MIT course. Apart from the lectures, what really made this course life-changing was the ability to interact with real people. Not only did we get to view rural hospitals and clinics, but we got to meet and befriend traditional healers (a vital part of South African villages), the women and instructors from the FRESH cohort, and the people who work tirelessly at CAPRISA. Talking one-on-one with the FRESH women, for instance, shattered barriers. They told me stories of hardships they experience that I could not even fathom having to face once, let alone each and every day. They also told me about the music they liked and where they like to go to hang out with friends. Soon enough, we were laughing and hugging, chatting and listening, and singing and dancing. The same happened when meeting the healers and local clinic nurses. And this is where the course deviates from all others. These interactions taught us that those living within the heart of the HIV/AIDS epidemic are people - real, complex, incredible people - in a way that nothing back at MIT in Cambridge could. Layering this experience on top of our newfound scientific knowledge ignited a new kind of passion within us, one fuelled not only by academic curiosity as per usual, but also by love and compassion for our friends whose lives are affected by the spread of this virus.”
“I can definitively say that this course has changed my life. As cliché as that sounds, I find myself viewing my research and career in the context of how it can affect the most good on people not just in my local community, but everywhere in the world. I feel a new consciousness towards the lives of the anonymised patients whose clinical data I analyse in the lab. I also find myself thinking critically about the research I read about, and how practical and beneficial it may or may not be for enacting meaningful change for those living in a situation different than my own.”
“All in all, I cannot say enough about this course. I wish it could have been ten times longer! I would recommend this course to any MIT student of any background; anyone can benefit (themselves, and the world) from the life lessons this course can teach.” – Anna Sappington, B.S. in Computer Science and Molecular Biology, Cambridge, U.S.A.