Sustainable Health for Sustainable Communities

Clockwise from left: Dr. Rebecca Dillingham, Sarah Farrell, Dr. Richard Guerrant, Dr. Arthur Garson, and Joy Boissevain
Photo by Tom Cogill

As Dr. Rebecca Dillingham points out, health is a prerequisite for global sustainability. Dillingham, an assistant professor in the Division of Infectious Diseases and International Health, observes that when “people have to deal with such health issues as chronic diarrhea, tuberculosis, and HIV, they are not likely to devote their attention or their energy to such issues as deforestation or water contamination.” 

In some cases, a simple change based on well-established technology can make an enormous difference. For instance, students in the School of Engineering and Applied Science are introducing a household filtration system in the West African country of Cameroon. These filters, which can be created using local materials, can help prevent debilitating water-borne infections, while reducing the need to strip the landscape of wood needed to boil water.

Other interventions require more sophisticated technology. For the last five years, Dr. Eric Houpt, like Dillingham an assistant professor in the Division of Infectious Diseases and International Health, has collaborated with researchers at the Kilimanjaro Christian Medical Centre in Moshi, Tanzania, to create more effective treatments for opportunistic infections associated with AIDS such as tuberculosis (TB). Houpt is now developing a new, faster test for TB based on the polymerase chain reaction, a technique used to identify DNA sequences.

U.Va. has both the mandate and the ability to marshal the range of technologies and expertise needed to address the multifaceted challenges of global health. The focal points for this work are the Center for Global Health and the School of Nursing.

The Center for Global Health was formally created in 2001, though it draws on nearly three decades of pioneering research at U.Va. in geographic medicine. “At the center, our goal has been to create a national model of how a university can make an important contribution to the fight for global health,” says center director Dr. Richard Guerrant. The center’s research agenda has included new approaches to oral rehydration and nutrition therapy for malnourishing diarrhea, new diagnostic tools and vaccines for amebiasis, and the development of novel anti-inflammatory drugs for colitis and sepsis.

Equally important is the center’s effort to inspire the next generation to address the issues of global health and to transmit the information and the perspectives needed to do so effectively.  “Universities are designed to create knowledge and disseminate it,” says Dr. Arthur Garson, vice president and dean of the School of Medicine (now the University’s executive vice president and provost). “This is an area in which we are ideally suited to make a significant difference.”

Each year, the center hosts talented research fellows. To date, more than 80 center fellows have trained at U.Va., all of them returning to their home countries and assuming key positions at universities and ministries of health. For instance, Pascal Bessong, a faculty member at the University of Venda, has established research connections with a network of 15 treatment clinics that are enabling him to trace the way the strain of HIV/AIDS found in South Africa evolves in the face of treatment. 

The center also offers scholarships to about 50 undergraduate, graduate, and professional students at the University each year for research and service projects around the world. The impact of this program cannot be overstated. “Global Health Scholars return to Grounds with a deeper appreciation of the struggles that define daily existence in most of the world, an insight that can change their lives,” says Joy Boissevain, the center’s program administrator. The center also strives to integrate global health issues into the curriculum, having funded the development of new courses in the Schools of Medicine, Commerce, Nursing, and Architecture, as well as in the College of Arts & Sciences.

In the School of Nursing, Sarah Farrell and her colleagues have collaborated on a number of research projects with their counterparts in South Africa since 2003, work that builds on the school’s decades-long experience with poor and rural communities in the United States. Farrell, associate dean of academic programs, notes that the inherent characteristics of public health nursing lend themselves to this joint work. “We are interdisciplinary in approach and we stress long-term relationships with the communities we serve, which help focus our research agenda,” she says. The school has an active chapter of Nursing Students Without Borders, and Farrell herself just returned from South Africa, where she was assisting faculty there in efforts to identify and treat depression.

Dr. Guerrant sees health as a critical component of sustainability in its largest sense.  “Ultimately, sustainability is about creating an environment in which people have the opportunity to realize their full potential and pursue their best aspirations,” says Guerrant. “This means paying attention not simply to the survival of the planet, but also to the health of the people who live on it.”