I am a first-year infectious disease fellow planning a clinical elective in Lusaka, Zambia at the University Teaching Hospital (UTH), which is affiliated with Center for Infectious Disease Research, Zambia (CIDRZ). CIDRZ, the largest healthcare research organization in Zambia, and UTH aim to improve access to health care and implement impactful and sustainable public health programs that address health disparities amongst Zambians.
I plan to spend four weeks working alongside clinicians at UTH where I will gain hands-on clinical experience and a better understanding of the management of infectious diseases in resource-limited settings. This elective will also serve as an opportunity to make connections with future research collaborators and evaluate the laboratory capacity of CIDRZ. During my third year of fellowship, I plan to return to CIDRZ for an extended period of time in a research capacity.
UTH is the main tertiary referral hospital in Zambia serving a catchment population of around 2 million. The population served by UTH has a high burden of communicable diseases including tuberculosis, HIV, and malaria. As UTH is the main teaching hospital in Zambia, I will be working with other clinicians and trainees. I expect that I will learn a lot from them but I also expect that I will teach them. This mutual exchange of expertise will enhance our collective skills and understanding. The hope would be that this collaborative effort will ultimately improve patient care.
Additionally, this clinical elective will serve as an introduction to CIDRZ and the International Center for Excellence in Malaria Research (ICEMR) in Zambia. During my third year of fellowship, I plan to return to Zambia in a research capacity, collaborating with experts at CIDRZ and ICEMR on several ongoing malaria projects. If this research changes clinical practice, then this project may have a larger scale benefit to those at risk of morbidity and mortality from malaria in low- and middle-income countries across the world.
The impact of this elective will be multifaceted. On a personal level, it will deepen my understanding of infectious diseases and better equip me with practical skills that I can apply as a clinician in the United States. There are several infectious diseases that are common in sub-Saharan Africa, but that we do not see often in the United States. Gaining first-hand experience with the clinical presentations and management of infectious diseases such as schistosomiasis, leishmania, and human African trypanosomiasis will make me a better clinician and increase my awareness of diseases that affect immigrants and returning travelers. Furthermore, as tuberculosis, advanced HIV, and malaria are more common in Zambia, I will become more adept at recognizing nuanced presentations and complications of these illnesses.
On a broader scale, the relationships I build will lay a strong foundation for future research collaborations. By gaining a better understanding of the challenges affecting clinicians in Zambia, I will be better equipped to identify the most critical research questions that can impact patient care. This groundwork is essential for developing targeted interventions aimed at reducing the burden of malaria and other vector-borne diseases. The ultimate aim is to create solutions that not only benefit Zambia but also have a positive impact on other low- and middle- income countries facing similar challenges.
In essence, this elective is a steppingstone towards a career dedicated to improving global health. The experiences and connections I make will have a lasting impact, enabling me to contribute meaningfully to the field of infectious diseases and drive positive change in healthcare practices worldwide.
I spent clinical time on the Infectious Disease service at University Teaching Hospital in Lusaka, Zambia. Care involved second/third line outpatient HIV management and inpatient care mainly of tuberculosis and advanced HIV. I also traveled to Nchelenge, Zambia where I assisted with an ongoing clinical trial of children with severe malaria and thrombocytopenia as well as mosquito surveillance.
