On a highway in Nigeria, as a bus barrels along at full speed, an oncoming car swerves into its path. The bus driver scowls but stubbornly holds course until the last second, when he jerks the wheel and careens out of the way, narrowly missing collisions with several other vehicles. Passenger Joseph Nwadiuko (MD ’15), a21-year-old American who plans to begin medical school at Pitt upon his return to the States, exhales.
This isn’t his first bus ride, and by now Nwadiuko, whose parents immigrated to the United States from Nigeria, should know that traffic regulations in his ancestral land function more like polite suggestions than laws. The bus is full of physicians and volunteers like himself setting out on a public health service trip.
Harrowing ride aside, meeting his fellow passengers had an impact on him, Nwadiuko reports six years later. “When I asked physicians in Nigeria about their future career plans, I learned that many of them planned to go get advanced public health degrees herein the U.S. or in the U.K. … and then stay there.”
Those discussions made Nwadiuko wonder how often Nigerian physicians in diaspora return home to help out—not just for brief medical mission trips, but in ways that create lasting change.
Upon his return to the States, he discovered little in the literature on the question, which later prompted a research project at Pitt.
Nwadiuko learned that while many Nigerian-born physicians express a strong interest in improving health care in their home country, they often struggle to find a clear path to doing so because of a lack of information or reliable partners on the ground. (Take a look at his findings published in the June 14, 2016, issue of Globalization and Health.) When he expanded his research, he realized that the same thing held true in many parts of the world with struggling health systems.
Nwadiuko is now taking action on the problem as cofounder and executive director of the Diaspora Health Network, an organization that is equipping U.S.-based health care professionals originally from poorer nations like Nigeria, India, and Mexico to effectively give back to their home countries. (He’s leading the organization while also training as an internal medicine resident at Johns Hopkins, his partner in founding the organization.)
The network’s strategy consists of three steps: resources, training, and placement. Real time reports on the needs of various health systems are provided through online “gateways” at diasporahealthnetwork.org. Training is offered by institutions teaming up with the Diaspora Health Network. For instance, UPMC’s international division funded several attendees at a global health boot camp at the University of California, San Francisco. Once Diaspora Health Network participants are equipped to “do good, well,” the next step is placement. The network is running pilot projects in India and Nepal, where participants are placed at universities to teach courses on health research in an effort to increase the number of trained health researchers.
“Our vision for the long term is to develop a diverse corps of physicians who have experience growing up within a low-income health system, but have also witnessed the potential of what an effective health care system can be,” Nwadiuko says.
“If we can merge those two realities together, we can bring health care to everyone—regardless of how much money they may or may not have.”
When old MacDonald has a virus
BY JASON BITTEL
On any given day, Edward Dubovi (PhD ’75) may peer into his microscope to discover the cells of an alligator, an elephant, or a goat.
“Maybe we’re confronted with an outbreak of [miscarriages] in sheep,” says the Cornell professor of virology. “Or maybe it’s an upper respiratory issue in a cat.”
Whatever the species, it’s Dubovi and Cornell University’s Animal Health Diagnostic Center’s job to track down the virus responsible for the outbreak. Most of the facility’s work focuses on agricultural animals like horses and cows; dogs come in third.
When a mysterious respiratory illness started making its way through the dogs of Chicago in 2015, Dubovi’s laboratory was called in to find the culprit. He’d isolated a canine influenza virus back in 2004 and first thought it might be the same strain. But after two weeks of genetic analysis, Dubovi says, they were able to pinpoint the source of the outbreak as a different virus that had been seen in dogs in China and Korea several years earlier.
But finding a match still left one question: How does a virus jump across an ocean?
The flu isn’t caused by a pathogen that can lie dormant, like malaria or HIV, explains Dubovi. That means for the virus to make its journey, it would have to have traveled in a sick pup. And this is how Dubovi suspects the virus made landfall—incoming companion animals aren’t scrutinized nearly as thoroughly as imported livestock. “Were this a virus of pigs or cows, everybody would have gone nuts,” he says.
Although the dog virus isn’t something most pet owners need to worry about—unless you live in Chicago, of course—it’s an interesting example of what Dubovi’s lab offers. That is, a bridge between the research labs developing theories about emerging viruses and everyday people who need solutions.
“Right now, everyone’s jumping up and down about Zika virus,” he says. “The diagnostic world is coming up with testing and technology to come to grips with that.”
And it’s people like Dubovi who are looking through the eyepiece of the microscope.
Photo by Robert Barker/Cornell Marketing Group
BY CHRISTINE SCHAUER
For someone who hated swimming as a child, Theresa Guise (MD ’85, Internal Medicine Resident ’88) has come a long way. After being persuaded to try scuba diving in adulthood, she became fascinated by underwater flora and fauna. Guise is now an award-winning underwater photographer in addition to a notable endocrinologist. Her photo of red whip coral, which resembles the skeletal muscle fibers she studies, was selected for the November 2015 cover of Nature Medicine (left). In that same issue, her lab at Indiana University published a paper identifying the unique mechanism by which bone, when destroyed by cancer, causes muscle weakness. “That was my biggest career milestone, . . . the marriage between my hobby and my work,” Guise says. Her latest project continues to go below the surface; she’s developing a clinical trial to test drugs on cancer-associated muscle weakness. (In the photo below, Guise is photographing a tiger shark in the waters of Fiji as part of an effort to promote shark conservation. “An ocean without the apex predator shark is an unhealthy ocean,” Guise says.)
Journal cover: Nature Medicine, Vol. 21, No. 11, Nov. 2015, Macmillan Publishers Limited
Photo with shark: Peter De Maagt
Portrait: Steve Brokaw