M.P.H. internships lay groundwork for new cholera study in Haiti

A major new University of Florida study of cholera in Haiti got a jump start from three Master of Public Health students who completed internships in Haiti during the spring 2012 semester.

Emily Robinson, M.P.H., Chad Weber, M.P.H., and Jocelyn Widmer, Ph.D., M.P.H., each conducted internship projects designed to collect baseline data for a new study of epidemic cholera in Gressier, the site of the College of Public Health and Health Professions’ ongoing public health projects in Haiti. The students, who graduated with their master’s degrees in May, are the first UF M.P.H. students to complete internships in Haiti.

“Emily, Chad, and Jocelyn are trailblazers,” said Mary Peoples-Sheps, Dr.P.H., the college’s senior associate dean for public health. “These three outstanding students not only conducted their own projects in support of  cholera research, but they assisted the college in establishing a strong infrastructure for UF interns to live and work in Haiti for years to come.”

J. Glenn Morris, M.D., M.P.H., T.M., the director of UF’s Emerging Pathogens Institute, leads the new study of the transmission cycle of cholera in Haiti. Researchers will identify index case households, conduct surveillance of individual cases of cholera, study environmental samples, track evolutionary changes in the cholera bacteria strain and refine existing models of disease transmission. The study is funded by the National Institutes of Health and the United States Department of Defense.

“The public health students did an exceptional job in their internships,” Morris said. “Each student has a unique skill set that enabled them to collect valuable data that will assist us in our research. Their contributions have helped to build the foundation for our cholera study and future projects in Haiti.”

Slande Celeste, M.P.H., the master’s in public health program internship coordinator, served as the on-site preceptor for the students, facilitating their work in the community. Local agencies FISH Ministries and the Christianville Foundation provided food, lodging and other resources. 

Emily Robinson meets with parents at the Jan-Jan school to describe the survey process and seek input.

For her internship project Emily Robinson performed a community needs assessment that provides data for the cholera study and outlines key community characteristics that could help direct future projects in the area. Her work included meetings with school officials, local government leaders, community members and representatives from non-government organizations. She also directed a survey team that conducted more than 100 home surveys of area families to collect information on basic living conditions, water storage, sanitation and health care access. The survey team also recorded GPS data on the location of the participants’ homes and water sources, crucial information for the nurses who will be making home visits as part of the UF cholera study.

The internship experience offered several valuable learning opportunities, Robinson said, such as how to network in rural communities and understand local politics.

“Sitting in the classroom or conducting surveys on campus is very different from being in the field and adapting to situations as they arise,” she said. “I learned to be patient and that the timeline of research is not as neat and orderly in the field as it is in the classroom.”

Robinson became interested in working in Haiti several years ago. That goal led her to study Haitian Creole and pursue a master’s degree in public health.

“I expected to meet new people, but I did not expect to bond with the community the way I did,” she said. “That was truly life-changing. Not a day has gone by since I’ve been back that I don’t think about them, worry about them and miss them.”

Chad Weber’s project objective was to set up a network of environmental sampling sites and to collect and test microbiologic samples from these sites for cholera.

Chad Weber collects a water sample to test for the presence of cholera.

“Because cholera is such a public health concern in Haiti, especially since the earthquake tore down their already minimal infrastructure, it was a great opportunity to see public health concerns firsthand while using education and training from UF and the Emerging Pathogens Institute to help study it,” Weber said. 

Working in the newly-opened UF Public Health Laboratory in Gressier, Weber ensured that the lab was stocked with the appropriate supplies and that equipment was properly tested and calibrated. Setting up the deep freezer, which uses more electrical power than the rest of the lab combined, was a particular challenge and required a lot of collaboration with local professionals. He also refined laboratory protocols and helped train a Haitian laboratory technician. In the field, Weber established sampling sites that are known natural environments for cholera bacteria, including rivers, estuaries and ponds, and collected baseline data for the UF cholera study.  

“The internship definitely helped me gain confidence in working on real-world problems and gave me the skills to navigate the obstacles inherent in working in a developing nation,” he said. “I feel able to take on challenges more independently now and have learned how to adapt and stay flexible while on the job.”

Jocelyn Widmer conducted a spatial investigation of physical elements of the Gressier area, including housing, infrastructure and access to safe water and adequate hygiene. She used several datasets to analyze the location and conditions of the built environment, information that can be used by UF researchers and non-governmental agencies working in the region.

“I went to Haiti expecting to put aside my experience with urban planning to gain a better understanding of global health,” said Widmer, who holds a UF Ph.D. degree in urban planning and international development. “I didn’t realize how often it was actually the skills associated with my background in the built and natural environment that were recognized as needed. For example, I ran into so many people who would say ‘We need more urban planners in Haiti’ when in the U.S., most people ask ‘What exactly is urban planning?’” 

Jocelyn Widmer interacts with children at Four-a-Chaux beach in Leogane.

Having an understanding of the health risks that can be associated with certain living conditions can inform the work of NGOs who are providing resources in the area, Widmer said. Her maps of housing types in the region, for instance, illustrate the number and location of homes constructed with transitional materials like tarps, which are only designed to withstand the elements for two years.

Widmer will continue her Haiti research in her new position on the faculty at the Virginia Tech School of Public and International Affairs.

“To be able to complete the internship experience in a place that is so complex with regard to the built and natural environment and public health was such a comprehensive and culminating experience to my Ph.D. and M.P.H. work,” she said. “The experience really has paved the way for me as I begin an academic/research career at Virginia Tech.”