BU medical students on Kasungu Hill in Malawi with members of the nonprofit K2 TASO. Peter Minjale (second from left), executive director of K2 TASO, Riya Paluri (CAS’26, CAMED’29) and Alison Chilcott (CAMED’29) (third and fourth from left), and Joel George (CAMED’29) and Jesse Fletcher (CAMED’29) (sixth and seventh from left). Photo courtesy of Alison Chilcott

Student Life

Destination: Africa. BU Medical School Students Spent their Summer Volunteering in Malawi and Ghana

Global Health scholarship offered an opportunity to work for nonprofit organizations, caring for local residents

His summer vacation this year was everything Jesse Fletcher, a second-year student at BU’s Chobanian & Avedisian School of Medicine, could have hoped for: five weeks in the southern African winter, working for a grassroots nonprofit in one of the poorest countries in the world.

“We were tackling serious, serious issues with a positive attitude,” says Fletcher (CAMED’29), who traveled to Malawi with classmates Joel George (CAMED’29), Alison Chilcott (CAMED’29), and Riya Paluri (CAS’26, CAMED’29).

They had arranged the trip through Bridges to Malawi, a Massachusetts-based nonprofit that supports community health initiatives there, and helps place BU medical students with its Malawi-based partner K2 TASO, which works on projects to improve rural health, education, women’s empowerment, and agriculture. Supported by a BU medical school scholarship, the students conducted hundreds of needs assessment interviews as well as home visits for at-risk patients. 

There are two points at which medical students typically engage in global health and are financially supported: The summer after their first year of medical school, through the Global Health Summer Scholarship Program, they participate in research, language immersion, or community health projects; and during their fourth year, a four-week clinical elective is supported by a travel grant. Nine students qualified for Global Health scholarships this summer, with destinations in Africa, Taiwan, and Central America.

The projects that students work on overseas must have legitimate and consequential goals and outcomes, but that is not the only objective, says Joseph Leanza, an assistant professor of emergency medicine and director of global health at the medical school.

“The intention, and often the result, is offering them a broader perspective of how healthcare is practiced in other places, both the pros and cons,” says Leanza, a veteran of numerous global healthcare projects and programs, with ongoing initiatives in Iraq, Ukraine, and Pakistan.

“We hope that they find some purpose or motivation beyond their academic interests, and that they are inspired to work for those with less resources and opportunities,” he says. 

In Malawi, where 80 percent of the population relies on subsistence farming, healthcare needs are diverse and great. Fletcher says he and his classmates were inspired by the energy, dedication, and work ethic of K2 TASO’s executive director, Peter Minjale, who hosted the four students while they were in the country.

“He was just tireless in helping people; he never stopped,” says Fletcher.

The poverty was real and daunting. The medical students occasionally accompanied Minjale on calls to patient homes in the country’s central region, many of which had no running water or electricity. 

“When it rains, a lot of water gets into the house, and when you go inside, typically there’s no power, no overhead lighting,” recalls George. Some patients slept on dirt floors, with bundled clothes for a pillow.

“It’s very different, stepping into a patient’s home, playing with their children and interacting with their family members, and seeing where they sleep,” says George. “This gives me more experience to draw on as I’m talking to patients (in Boston), that there are all kinds of factors that contribute to their health.”

Access to health care in Malawi remains a major issue. Distances between healthcare clinics and hospitals represent a barrier to receiving care. The students’ work with K2 TASO explored ways to incorporate geriatric care and pediatric care into existing centers, like schools.

Despite their limited resources, Malawians recently achieved a major milestone in fighting HIV/AIDS, meeting UN goals for testing, antiretroviral therapy, and viral load suppression.

“K2 TASO has a lot of creative ways of generating money to make sure that the healthcare and the medication are free,” says Paluri. “They harvested honey, grew crops, had a chicken coop and a dairy farm.”

Natasha Soesanto (CAMED’29) had no global health experience when she applied for a scholarship to work for seven weeks on sudden unexpected death in infancy (SUDI) issues in Ghana and Zambia. As an undergrad, she’d volunteered in the United States for a Nepal-based nonprofit and worked as an AmeriCorps case manager at a federally qualified health center, mainly serving refugees from Central America.

Soesanto had a peripatetic childhood. Born in the US, she and her family lived in Indonesia, Singapore, and London, before settling in the San Francisco Bay area. That experience inspired her to explore global health as a medical student.

With funding from the summer scholarship, she worked for Project SHIELD-AC (Survey of Health, Infant Environment, and Social Determinants in African Countries), funded by the American SIDS (Sudden Infant Death Syndrome) Institute, and mentored by Julie Herlihy, a clinical associate professor of global health and pediatrics at BU’s School of Public Health. Soesanto’s goals for the summer included collecting risk factor data, recruiting participants for group discussions and interviews, and leading group discussions with mothers and healthcare providers. She was based in the Ghanaian capital of Accra, working at the Korle Bu Teaching Hospital and in the rural Shai-Osudoku District about 2 hours northeast of the capital.

“I would highly encourage anyone who has that curiosity to at least go overseas and have experiences you’ve never had before, to learn and collaborate with people outside of your own community and understand that the world is a much bigger place,” Soesanto says.

The BU students also found it encouraging that the medical establishment in both Ghana and Malawi incorporated traditional indigenous medicine into healthcare.

“I think seeing that has been a very positive experience for me,” says Chilcott, “just knowing that there are so many ways to do medicine, there are so many ways for healthcare to happen, and that there’s no one right way.”

Not all the goals that medical students set for summer projects could be met. Bureaucratic red tape sometimes played havoc with their relatively short time in-country. While Soesanto was able to conduct focus group discussions, train data collectors, and travel to rural villages, permission from the ethics board in Ghana for risk factor data collection didn’t arrive until after she had returned to Boston.

But the experience motivated her to maintain her Ghanaian contacts, and she continues to participate in weekly Zoom meetings on the research project with Herlihy and the team in Ghana. Soesanto hopes to return to Ghana periodically to continue the work she started this summer and plans on applying for the fourth-year global health elective to travel abroad.

 “For me,” she says, “it’s a huge success because of the connections I made, being able to immerse myself in a different country, learning about their public health system, and figuring out what it takes to establish an international study.”