Week 2 : June 9th - June 15th, 2014

On June 10, Dr. Nerurkar returned from Bangkok, Thailand. He reported that "Bangkok looks calm and quiet. Business as usual." He and the students observed a few soldiers at one check point on the way from the airport to central Bangkok, but tourists were not stopped. Dr. Nerurkar reported he "used the Bangkok Metro everyday to commute from the rented apartment to Mahidol Univ and/or SEARCH. Metros were packed with only standing room space. Remembered [him] of traveling in DC or NY metros. Local people were doing their business as usual. Streets were filled with food vendors and other vendors selling everything under the sun." The "general feeling among educated and office staff is ‘things are much better now’." So, life in Bangkok has returned to normal. During the last two weeks, the MHIRT students have also reported that they feel safe and comfortable. So, all is well in Thailand.

Research Related

During week #2, all 9 MHIRT students seem to be having great experiences and learning a lot. The students in Thailand began working on their project during week 1.  Week 2, Michellei dissected 100 mosquitoes, pooling their heads into groups of 10 mosquitoes and then immediately extracting RNA. The mosquito thoraxes were kept in separate tubes; so, if any of the pools were positive, she could test individual mosquitoes to see how many were infected with viruses. She will test the mosquitoes for Dengue (1,2,3,4), West Nile virus, Chikugunya, St. Louis Encephalitis, yellow fever and Japanese encephalitis viruses using PCR. Currently, she is trying to solve a PCR problem with nonspecific binding by using a higher annealing temperature. Kriszel is making progress with her project on identification of enteric-viruses. As of last Friday, she has processes 60 samples for RNA isolation, 127 samples for cDNA synthesis, and concentrated 15 human fecal samples. She has also helped Michellei dissect 10 mosquitoes. Kendrick is busy with data analysis and working directly with biostatisticians. He is working on a side project entitled "The role of HPV clearance on HIV acquisition." Sounds impressive! His Thai mentor has suggested he write an opinion piece which he is now working on. He received data from the "Test and Treat Study" and will begin analyzing it on Monday with the help of his mentor. Kendrick has also spend a significant amount of time shadowing physicians treating HIV-patients. If he has spare time, he helps the girls with their samples at Mahidol. Note: Kenrdick has done a great job in reporting daily activities for the group.

The MHIRT students in Cameroon spent their first week attending the epidemiology conference and having a orientation session. So, they didn’t began their research projects until week 2. Matt started his study on Thf cells by working in the laboratory with Dr. Yunga, making sterile culture medium, assisting in isolating human cord blood mononuclear cells, learning sterile technique, pipetting, and how to use the centrifuge. He also learned to make peripheral blood smears and how to diagnose malaria. Next week, he will be introduced to field work in the clinic. Shayne, who is investigating changes in the placenta of women who have HIV and malaria, spent the week working in the lab, while she waited for clearance to work in the delivery room at central hospital. Shayne spent time working with one of the graduate students, Emile, learning about malaria and laboratory techniques. Chris delved into the literature on immunology, cytokines and biomarkers, in preparation for his study on the use of biomarkers to diagnosis fevers of unknown origin. He made a powerpoint presentation on cytokines which he gave to his mentor. Chris is also working with Prof. Halliday, an Econ professor at UH, to design a quaisi-experimental/observational study on the cost-effectiveness of malaria diagnosis. Finally, Domenick is increasing his knowledge of mosquito biology and identification of viruses within fresh-caught mosquitoes. He spent a few days in the field with Kenji and Elise, an Ades expert. He reports that it is a challenge to catch adult mosquitoes during the rainy season, so, since flaviviruses are vertically transmitter, they are currently collecting mosquito larvae and pupae and rearing them in the insectory. They are finding a lot of Culex and Ades co-existing in shared standing water. Dom recently saw his first PCR from start to finish. So, research projects by MHIRT-Cameroon have begun.

Cultural experiences:

Kendrick reports that last "Saturday: We went to the Siam Nirampit show which was very beautiful! We rode the underground rail system (MRT) and ate at the venue's buffet which had super delicious curry and even some vegetarian Indian food! The show went through some of the history and religious beliefs of Thailand. It had goats, chickens, traditional costumes, Muay Thai, elephants, and a scene about hell and what is considered a sin such as drinking alcohol results in you drinking boiling water and being boiled in water.

Sunday: We went to visit the Grand Palace and Temple of the Emerald Buddha. Michellei and Kriszel have a lot of great shots in from of the many shrines and temples on the grounds."

The first weekend in Cameroon, several MHIRT students attend local catholic and protestant church services. They reported that the services were long (!), but were a wonderfully cultural experience – lots of movement and music. On Sunday, the group was invited to a celebration  in honor of Dr. Rose Leke’s receiving an honorary doctorate from the University of Ghana. Women from her husband’s village came to dance and sing. So, the students were able to see local Cameroonian dancing, hear traditional songs, and participate in the festivities. "What a party it was, and a privilege to be part of an intimate gathering. We dances to the African beat and held money on our foreheads to drop into the drums."

Personal experience we think should be shared

"Dr. Anna took me to feed homeless children on Saturday. There was a child there shivering in the corner, with both of his arms hidden inside his shirt. Dr. Gabriel, who was coincidentally there as a guest, spoke to him and diagnosed him as having severe malaria. He
showed me the child's anemic epithelial layer in the eye, and told me that only a fever above 39 degrees would induce shivering. He promptly arranged for medications for the child. Dr. Gabriel's actions were a reaffirmation of my desire to pursue medicine. I was glad I was there
to see it."  Chris

Comment

We all need to remember that children around the world feel the burden of the HIV epidemic, there are over 17.8 million children who have lost one of both parents to HIV, most of whom live in Africa and S.E. Asia.