2009 Cohort of HGHI Burke Global Health Fellows

Following her Burke Fellowship, Dr. Bassett received a NIH R01 award to conduct a randomized control trial of the relationship between case management and HIV care initiation and TB treatment completion. While she found that patients who worked with a “health system navigator” did not have better outcomes than patients in the control group, she observed that patients in the treatment group who spent more time with their navigators tended to have better outcomes than patients who had less contact with their navigators.

Currently, Dr. Basset is collaborating with a clinic in South Africa to test the impact of mobile HIV and TB screening. She and her team hope to increase the speed with which people are diagnosed so that they can begin treatment more quickly.

Dr. Bassett is an Infectious Disease Specialist at Massachusetts General Hospital and an Associate Professor of Medicine at Harvard Medical School.

Dr. Marcia Caldas de Castro has been studying malaria since 1999. In 2004, she visited Tanzania to study malaria prevention and control efforts in the country’s largest city, Dar es Salaam, where nearly one-quarter of the population was infected. Local government leaders asked Dr. Castro to help them establish an Urban Malaria Control Program (UMCP) to reduce transmission and prevalence of the disease.

To identify the best environmental management strategies for prevention, Dr. Castro set out to better understand malaria transmission in Dar es Salaam. In addition to other data sources, she was interested in using satellite imagery to map potential mosquito breeding sites and at-risk populations. The Burke Fellowship was pivotal in allowing Dr. Castro to experiment with this unconventional, innovative methodology. “Seed funds like the Burke Fellowship provide the opportunity to think broadly, even if there’s a risk involved, and to accelerate the work you’re doing,” Dr. Castro said. “Usually large funders are reluctant to fund this kind of project.”

The Burke Fellowship enabled Dr. Castro to hire research staff to assemble the study’s large dataset. Although they were unable to use satellite data to predict malaria in Dar es Salaam, the images made it possible for them to identify and correct geographical location errors and to build special random samples.

Through the study, Dr. Castro demonstrated the importance of maintaining urban drainage systems and formulated policy recommendations for the UMCP. She trained local program leaders how to manage the program, and the local government established a budget for drainage maintenance. Malaria prevalence fell dramatically during the study and has remained low since Dar es Salaam launched the UMCP.

Since completing her fellowship, Dr. Castro has published multiple papers related to her work in Dar es Salaam and returned to the Amazon to continue studying malaria transmission and prevention. She teaches courses on demographic methods, spatial analysis, and public health field research at the Harvard T.H. Chan School of Public Health, where she is an Associate Professor of Demography in the Department of Global Health and Population.

Dr. Arachu Castro is a medical anthropologist whose primary interest is in understanding the barriers poor populations face in accessing life-saving health care. She has focused most of her teaching and research career on infectious disease and maternal health in Latin America and the Caribbean.

In 2007, Dr. Castro began working with UNICEF and UNAIDS to improve maternal and child health by integrating prenatal care with syphilis and HIV management. Dr. Castro helped seven Latin American countries conduct operational research and translate their findings to national strategies and pilot interventions. In 2009, Dr. Castro was looking for opportunities to build upon this work: “This was not hypothesis-driven research—the goal was to identify a public health problem and to change policy and medical practice. As a result, it was not a project that I could easily support through traditional funding sources. That’s when I came across the Burke Fellowship.”

The Fellowship enabled Dr. Castro to facilitate high-level meetings with country leaders to discuss research results, identify the changes needed to integrate care during pregnancy, and develop action plans. It also provided the support she needed to conduct fieldwork in Nicaragua and the Dominican Republic to pinpoint key barriers to and resources for integration. These and other participating countries have used their findings to change policy and create new partnerships to enhance linkages between prenatal care and sexually transmitted infection (STI) management.

Reflecting on her career, Dr. Castro said: “The Burke Fellowship gave me the opportunity to devote time to leading a large initiative that had a great impact. It gave me a lot of experience, as I was working directly with the AIDS and maternal and child health program directors in these countries.”

While at Harvard, Dr. Castro was an Associate Professor of Global Health and Social Medicine at Harvard Medical School and a Medical Anthropologist at Brigham and Women’s Hospital, Division of Global Health Equity. In 2012, Dr. Castro transitioned to the Tulane University School of Public Health and Tropical Medicine where she is the Samuel Z. Stone Chair of Public Health in Latin America in the Department of Global Health Systems and Development.

Burke Publications

Ettenger A, Bärnighausen T, Castro A. Health insurance for the poor decreases access to HIV testing in antenatal care: evidence of an unintended effect of health insurance reform in Colombia. Health Policy Plan. 2014 May;29(3):352-8. doi: 10.1093/heapol/czt021.

Pérez-Then E, Miric M, Castro A. Facultad de Medicina de la Universidad de Integración de la Atención Prenatal con los Procesos de Detección y Manejo Clínico del VIH y de la Sífilis en la República Dominicana.Fondo de las Naciones Unidas para la Infancia, (UNICEF), 2011.

Dr. Chen is a psychologist trained in mental health and health service research. His interest in geriatric mental health began in New York in the late 1990s, when he participated in a multi-site research project exploring care delivery for seniors with depression. Dr. Chen became interested in how services are delivered to elderly patients with dementia in Asian countries and applied for a Burke Fellowship award to conduct qualitative research in China and Thailand. “The Burke Fellowship presented an opportunity for me to focus on this specific research area,” Dr. Chen said.

The Burke Fellowship enabled Dr. Chen to interview patients, family caregivers, and program administrators in multiple cities across China and Thailand. Through these conversations he learned more about dementia care needs and resources in both countries and determined that there was a persistent need to improve quality of care, primarily through training. “In Thailand they have the human resources—this unique cadre of committed, trained community health workers—but not the information they need to improve their knowledge and skills,” Dr. Chen said. In light of his findings, he successfully applied for a Fulbright scholarship to develop culturally appropriate dementia care trainings for nurses and community health workers. “My confidence and interest in applying for a Fulbright were strengthened by the Burke Fellowship,” he reflected.

The work he accomplished through his fellowship also bolstered Dr. Chen’s confidence to apply for a R21 grant through the NIH’s Fogarty International Center. Using ethnographic research methods, he systematically assessed Thai elders’ health needs and found a significant gap in services and support. Dr. Chen hopes to use these data to inform future interventions and policy development and is working to conduct a similar study in China. In addition, he is interested in exploring the potential impacts of Thai massage and similar therapies on the health of patients with dementia. He is working with another researcher to design a pilot study that will explore the impacts of massage therapy on patients’ (1) agitation and anxiety, (2) depression, and (3) cognitive functioning.

Dr. Chen is Assistant Professor of Psychology in the Department of Psychiatry at Brigham and Women’s Hospital and Assistant Professor of Psychology in the Department of Global Health and Social Medicine at Harvard Medical School.

Dr. Manoj Duraisingh is an infectious disease researcher with a specific focus on malaria. He and his research team at Harvard T.H. Chan School of Public Health are interested in understanding the processes that underlie the pathogenesis of human malarial disease at the cellular and molecular level using genetic approaches in the laboratory. They also conduct field projects with collaborators in malaria-endemic areas, including Sene­gal and India, to determine the relevance of their laboratory findings in different epidemiological settings.

As a Burke Global Health Fellow, Dr. Duraisingh’s award helped expand his research to question how red blood cell variations can influence malaria invasion and growth. This new direction was a close collaboration with investigators at the University of Cheikh Anta Diop in Dakar, Senegal. In the summer of 2011, Dr. Duraisingh mentored a student project to measure the variation in expression of human blood group proteins on the red blood cells from different individuals. This work seeded a much larger project in the lab which is now using global proteomic approaches to identify all the polymorphism that exists on the surface of red blood cells within this population, to identify ones that are determinants of malaria susceptibility.

Since receiving the Burke Fellowship as a junior faculty member, Dr. Duraisingh has been promoted to the position of John Laporte Given Professor of Immunology and Infectious Diseases at the Harvard Chan School.