04.

February 12, 2025

Ms. Ronda Stryker
Mr. William D. Johnston
1925 Idlewild Drive
Richland, MI 49083-9451

Dear Ronda and Bill,

George Q Daley, MD, PhD | Dean of the Faculty of Medicine | Caroline Shields Walker Professor of Medicine 25 Shattuck Street, Boston, MA 02115 | t: (617) 432-1501 | e: George_Daley@hms.harvard.edu

I’m pleased to write you with updates on the Ronda Stryker and William Johnston Funds in Global Health and Social Medicine. Your support of the Department of Global Health and Social Medicine (DGHSM) at Harvard Medical School enables physicians, scientists, and health care workers from around the world to receive top-tier training, conduct groundbreaking research, and treat patients in the most vulnerable communities. 

In the enclosed report, you will learn about the critical projects conducted by HMS faculty and students on issues such as climate change, infectious disease, and childhood development. Your generosity enables these researchers to pursue their meaningful work in places like Peru and Malawi, in the hopes of improving the health and well-being of the most disadvantaged populations.

I deeply appreciate your steadfast commitment to alleviating suffering worldwide and your partnership in our comprehensive efforts to shape the future of global health. In his first year as chair of the DGHSM, Vikram Patel has developed a thoughtful framework that utilizes an interdisciplinary approach to scholarship, education, and strategic partnerships, all aimed at achieving health equity. I am excited by Vikram’s vision, and all of us at HMS appreciate his exceptional leadership and advocacy.

Thank you for your remarkable contributions and support of this vital work. I hope to see you at the next GHAS meeting. 

Dr. Murray initiated two impactful field-based studies that directly stemmed from the discussions in the workshops. These projects have provided valuable qualitative data and insights into climate-related health vulnerabilities.

Landscape Analysis of Water Scarcity and Health in Peru

This project focused on a community in the Andean region of Peru, where climate changes is exacerbating drought and water scarcity. The analysis examined the health impacts of water scarcity and drought on women and children, who are most affected by the lack of access to clean water for drinking, sanitation, and agriculture. Interviews with community members revealed a significant increase in water-borne diseases and malnutrition, as well as growing mental health issues among women who are primarily responsible for water collection and caregiving in the household.

Impact of Cyclones on Health in Malawi

Ongoing Projects and Collaborations

In addition to these two studies, Dr. Murray has represented HMS on the faculty steering committee of Harvard’s Salata Institute for Climate Change, where she helps shape strategic priorities for interdisciplinary climate and health research. 

She has also launched several new projects in Peru, focused on water, irrigation, and disease detection, with local academic partners.

• Water and Irrigation in the Andes: In partnership with the Nature Conservancy, Dr. Murray is working to improve water access and develop sustainable irrigation systems for communities in the Andean highlands. These initiatives aim to reduce the vulnerability of local populations to water scarcity and improve agricultural resilience.
• Wastewater Testing for Infectious Disease Detection: In collaboration with universities in Chachapoyas and Iquitos, Peru, Dr. Murray is piloting wastewater-based epidemiology techniques to monitor the emergence of infectious diseases linked to climate change, such as malaria and cholera, in remote areas of the Peruvian Amazon. This early-warning system will help health authorities respond more effectively to outbreaks.
  

The workshops have led to the development of educational materials and curricula designed to train the next generation of global health professionals on the intersection of climate change and health. Dr. Murray and colleagues are currently creating a case-based course that draws on the real-world examples discussed during the workshops and incorporates findings from their field studies. This course will highlight the challenges local communities face and present potential solutions, equipping students and professionals with the tools they need to respond to climate-health crises.

The second project was a qualitative study of the health impacts of cyclones on displaced populations in Malawi. Interviews with displaced individuals and health workers revealed that, in addition to physical injuries, communities are experiencing higher rates of psychological distress, including PTSD, anxiety, and depression, exacerbated by the lack of adequate mental health care infrastructure. The findings are informing both local adaptation strategies and humanitarian health response plans.

Dr. Jordan received a Burke Global Health Fellowship from the Harvard Global Health Institute (HGHI) to research the impact of climate change on vector-borne and parasitic illnesses in sub-Saharan Africa. Her project examined African Trypanosomiasis outbreaks in Malawi due to tsetse fly habitat expansion caused by warming temperatures. Over the past year, she built models that consider land surface temperature, soil moisture, humidity, and vegetation to identify suitable tsetse habitats over time. These models serve as an early warning system for forecasting potential risk areas. The granularity of the model’s output allows for precision location-based control efforts. Dr. Jordan presented the results from this study during the HGHI Fellow’s showcase. 

Demetrice Jordan, PhD, MPH ’23

In 2024, Dr. Jordan submitted four research proposals, including two on climate change. She was accepted to the National Center for Advanced Translational Sciences AIM-AHEAD AI/ML inaugural cohort, published two book chapters and two manuscripts, and submitted two more manuscripts at the end of the year.

Additionally, this year, Dr. Jordan chaired the guidance committee for a master’s thesis in Global Health Delivery and reviewed applications for the Harvard College Research Program. Funding from the Ronda Stryker and William Johnston Global Health Junior Investigator Fund allowed her to use her justice, equity, diversity, and inclusion (JEDI) background in a formal capacity within the Department of Global Health and Social Medicine by serving on the diversity, equity, and inclusion (DEI) committee.

Dr. Jordan augmented her scholastic endeavors with a variety of service engagements. She was a course tutor for Essentials of the Profession I, a mandatory course for HMS students. She was a guest lecturer in the Climate Change and Global Health Equity course and co-facilitated the DEI-related RCR module she co-developed for Harvard Quad postdocs, titled Research and Inclusion in Academic Research. Dr. Jordan also participated in the Biomedical Science Careers Program’s “Options After Graduate School” panel and presented at the Harvard Global Health Institute’s Career Pathways in Global Health event. 

Lastly, she received several appointments and awards, including a two-year faculty fellowship from the HMS Office of Diversity Inclusion and Community Partnership. She also joined the editorial board of The Professional Geographer, became a member of the College of Social Science Student Excellence Committee, and earned election to the board of directors of the Society of Public Health Education.

As part of the Global Health Research Core, Dr. Miller is the lead epidemiologist and analyst for research projects in Madagascar, Malawi, Rwanda, Russia, Guatemala, and Peru. Her work primarily links research to the service activities of the Global Health Delivery Partnership (GHDP). She is the co-founder and co-chair of the GHDP’s Early Child Development Consortium, an interdisciplinary initiative begun in 2014 that links researchers, developmental psychologists, pediatricians, and program implementers to promote healthy development in children in the lowest-resource settings globally. 

Ann C. Miller, PhD, MPH

In the past year, she and colleagues published a paper in Lancet Global Health determining whether families who use Indigenous or minority languages have an increased likelihood of having their children identified as at greater developmental risk in global population assessments than dominant-language peers. Additionally, she is a co-investigator on projects on child development in Guatemala, India, Peru, and Rwanda; on projects using mHealth (mobile devices) to assess maternal health in Guatemala; and projects on maternal mental health in mothers with children with disabilities in Rwanda. 

Additionally, in 2024, she was a lead trainer in the Intermediate Operational Research Training (IORT) in Rwanda, a program developed by Dr. Bethany Hedt-Gauthier, associate professor of global health and social medicine at HMS,  through her work in the Global Health Research Core, that seeks to provide capacity-building to Rwandan researchers, academics, government officials and program implementers to allow them to define and answer important programmatic research questions for their care settings. Through this program, Dr. Miller is mentoring a cohort of Rwandan students to become first authors on what, for most of them, will be their first research manuscript. She was also a committee member for the thesis projects of two MMSc students. 

During the 2023–2024 academic year, Dr. Lindsey Zeve’s work included teaching, curriculum development, mentoring, and ongoing research for an ethnographic book project examining global inequities in health research. 

Dr. Zeve taught courses on global health and social medicine at the undergraduate, master’s, and doctoral level. She played a  key role in piloting a new course with Professor Joia Mukherjee, associate professor of global health and social medicine at HMS, on global health equity and social medicine, which became a requirement for all first-year master’s students in the department. 

Lindsey Marten “Marty” Zeve, PhD ’19

For the first time, this course united students from the Global Health Delivery and Media Medicine and Health master’s program in one didactic space, fostering community and interdisciplinary learning. Students received it with enthusiasm. 

In addition, Dr. Zeve worked with senior faculty to revise and submit to HMS administration a finalized version of the department’s proposal for a new master’s program in social medicine and mentored undergraduate and graduate students pursuing thesis research in global health and social medicine. Finally, she served as a co-director of HUM 102: Medical Anthropology and Social Medicine, a course required of all first-year medical students at the University of Global Health Equity in Rwanda.

Eugene Richardson, PhD, MD

Dr. Eugene Richardson is an infectious disease physician and ecological anthropologist whose work focuses on biosocial approaches to epidemic disease and climate change. He is Assistant Professor of Global Health and Social Medicine at Harvard Medical School and Assistant Professor of Medicine at Brigham and Women’s Hospital.

In October 2024, the NIH selected Dr. Richardson as a Climate and Health Scholar. Launched in 2023, the NIH Climate and Health Scholars Program aims to enhance the climate and health research capabilities at the NIH. The program’s objective is to assist NIH institutes, centers, and offices in strengthening climate and health expertise in the scientific areas specified in the NIH Climate Change and Health Initiative’s Strategic Framework. Dr. Richardson is collaborating with the NIH Office of Behavioral and Social Sciences Research during his appointment. He will present the culmination of their work in May 2025. 

Dr. Richardson founded and directs the Planetary Health Lab at HMS, which focuses on the interconnectedness of health inequities, climate change, and racism, using an interdisciplinary approach to study the relationship between humans and their environment. He also founded and co-chairs the Global Environmental Change Commission on Climate Justice. 
Over the last year, Dr. Richardson delivered more than 30 national and international presentations of his work. He published six articles and is preparing  a book chapter and journal article on reparations.

Publications

1. Gayedyu-Dennis D, Fallah MP, Drew C, Badio M, Moses JS, Fayiah T, Johnson K, Richardson ET, Weiser SD, Porco TC, Martin JN, Sneller MC, Rutherford GW, Reilly C, Lindan CP, Kelly JD. Identifying pauci-/asymptomatic Ebola virus infection and unrecognized Ebola virus disease among close contacts based on exposure risk assessments and screening algorithms: a cross-sectional study. The Journal of Infectious Diseases 2023;227(7):878-887. doi: 10.1093/infdis/jiac359.

2. Miller K, Rennke H, Richardson ET. Rifampin Associated Renal Failure. Annals of Internal Medicine: Clinical Cases 2023;2(4):e221200. doi: 10.7326/aimcc.2022.1200.

3. Chitre S,* Crews C,* Tessema M, Plėštytė-Būtienė I, Coffee M,† Richardson ET.† The Impact of Anthropogenic Climate Change on Pediatric Viral Diseases. Pediatric Research 2023;95: 496–507.

4. Frankfurter R, Malik M, Kpakiwa SD, McGinnis T, MD, Malik MM, Chitre S, Barrie MB, Dibba Y, Mulalu L, Baldwinson R, Fallah MP, Rashid I, Kelly JD,† Richardson ET.† Representations of an Ebola Outbreak through Story Technologies. BMJ Global Health 2024;9:e013210. doi: 10.1136/bmjgh-2023-013210.

5. Frankfurter RG, Willet V, Richardson ET, Rutherford GW, Baller A, Kelly JD. Infection Prevention and Control Studies for Care of Patients with Suspected or Confirmed Filovirus Disease in Health-Care Settings, with Focus on Ebola and Marburg: A Systematic Review. BMJ Public Health 2024;2:e000556. doi: 10.1136/bmjph-2023-000556.

6. So M,* Goldberg SA,* Lu S, Garcia-Knight M, Davidson MC, Tassetto M, Wong Murray V, Anglin K, Pineda-Ramirez J, Chen JY, Rugart PR, Richardson ET, Abedi GR, Saydah S, Briggs-Hagen M, Midgley CM, Andino R, Seitzman GD, Gonzales J, Lietman TM, Peluso MJ, Martin JN, Kelly JD. Prevalence, patterns, and predictors of SARS-CoV-2 RNA and culturable virus in tears of case-ascertained household cohort. American Journal of Ophthalmology 2024;265:48-53. doi: 10.1016/j.ajo.2024.04.008.

Sam Muhanguzi

Mr. Sam Muhanguzi, a dedicated health care management professional from Rwanda, has been actively engaged in curriculum development and management for medical education at UGHE since 2021. His interests include mental health literacy, equitable health care, social justice, and enhancing health care services. He aims to leverage his expertise to design and implement programs that specifically address the burden of disease in rural and resource-constrained communities. He strongly believes in the power of customized interventions to uplift these underserved populations.

Research Topic: Assessing the economic impact of integrating mental health into primary care in Rwinkwavu, Rwanda: a mixed-methods study

Pradish Poudel, MD 

Dr. Pradish Poudel is a social entrepreneur with a history of working in global health, internal medicine, smart cities and sustainable communities, and climate change. He is the founder and president of Nepal Health Corps. In this role, he has organized clinical outreach for underprivileged populations, mobilizing health care institutions and thousands of medical professionals and students for the health equity movement and health promotion programs. He received the Charles Boelen International Social Accountability Award for his contributions during the COVID-19 pandemic.

Research Topic: Understanding the factors and policies that determine recruitment and retention of doctors in rural Nepal to achieve UHC 2030: a mixed-methods study in Jumla District, Nepal

Saravanan Thangarajan, MDS, MBA, FICOI, FAD

Dr. Saravanan Thangarajan is a health care professional and clinician specializing in maxillofacial prosthodontics. As an associate professor, he mentors undergraduate and postgraduate students. As an academician, he has published several research articles in esteemed international peer-reviewed journals and has received six research fellowships. He significantly influences public health as the State Public Health Consultant for Tamil Nadu, India, where he transformed the 104 Health Helpline into Tamil Nadu’s COVID “war room.” This transformation ensured essential care for patients and disseminated WHO-approved COVID-19 measures to residents. He led innovative digital training programs for ambulance paramedics, expanded mental health tele-counseling services, and improved the maternal and child health system. His work has earned him numerous accolades , including national and international guest lectures and appearances. The Health Minister of Tamil Nadu also recognized him for his efforts during the pandemic.

Research Topic: Oral health and maternal health in India

Mariama Mahmoud, MD, MSc 

Dr. Mariama Mahmoud, a physician from Sierra Leone, holds a master’s degree in Tropical Medicine and International Health from The London School of Hygiene and Tropical Medicine. With over 12 years of experience, she has worked extensively with underprivileged communities on diseases including tuberculosis, HIV, and leprosy. Before joining the MMSc-GHD program, Dr. Mahmoud served as the program manager of the National Leprosy and Tuberculosis Control Programme, where she made significant advancements in holistic patient-centered care. Additionally, she has contributed to TB research and has published articles on leprosy and COVID-19 vaccination studies.

Proposed Thesis Topic: The cost-effectiveness of interventions for the management of drug-resistant tuberculosis and TB/HIV co-infection in resource-constrained settings

Ikechukwu Okereke Nnanna, MD 

Dr. Ikechukwu Okereke Nnanna, a physician born and raised in Nigeria,  provided health care services to the local community as a medical officer at a district hospital with Partners In Health Sierra Leone before joining the MMSc-GHD program. 

Proposed Thesis Topic: Causes of severe acute malnutrition among children under five in Koidu Government Hospital in Sierra Leone

Stephen Wortejieh Picka, BSN, RN 

Mr. Stephen Wortejieh Picka is a registered nurse with over seven years of experience in southeastern Liberia. As an officer with the Ministry of Health, he provided and coordinated curative and preventive services at resource-limited clinics, enhancing health care systems and delivering quality health services to rural communities. He holds a BSc in nursing from William Tubman University and is a trained mental health clinician. Mr. Picka served as the national coordinator for Health Focus GmbH and as a technical advisor for GIZ-HSSEP, where he promoted antimicrobial stewardship, and supported capacity-building initiatives while mentoring health workers.

Proposed Thesis Topic: Assessing factors associated with antibiotics prescription: a study of determinants and implications at JJ Dossen Hospital, Pleebo Health Center, and CRC Hospital in Maryland, Liberia

Dr. Michelle Joseph is a specialist in trauma and orthopedic surgery. She has been a research fellow in the PGSSC for the past two years. She graduated from University College London and trained in the Warwick Orthopedic Program. In 2018, she was elected to the Fellowship of the Royal College of Surgeons of England and appointed National Institute Health Research Clinical Lecturer at the University of Warwick.

Dr. Joseph pursues research interests in strengthening trauma systems in low-middle income countries and developing health equity frameworks. She receives funding from the Department of Defense for project IMPACT (Integrated Military Partnerships and Civilian Trauma Systems), an innovative initiative that seeks to develop a conceptual framework that will guide the integration of military and civilian trauma systems at the policy level. The initiative aims to maximize building trauma capacity through coordinated engagement and integration between the two systems. 

Dr. Joseph leads the Conference Equity Project, supported by funding from the Stryker and Johnston Fellowship Fund. The Conference Equity Project researches the barriers and facilitators to equitable access to conferences. Inequitable access to global health conferences poses a significant problem, predominantly affecting researchers from low- and middle-income countries (LMICs). Too often, known barriers prevent opportunities for collaboration, networking, and contributing to policy-making, thereby widening gaps in global health care advancement.

To fully understand the inequities in global health conferences, Dr. Joseph's team designed sequential studies to analyze the critical barriers and facilitators participants and conference organizers experience. A systematic review of conferences held between 1997 and 2019 showed that only 4% were based in LMICs, and only 39% of attendees were from these regions. Using this data, the team is developing the Conference Equity Framework and Index, a novel diagnostic tool that aims to detect inequities in conference attendance and engagement. 

In addition to her research and teaching roles, Dr. Joseph serves as Chief Strategy and Health Equity Officer for the PGSSC, leading an internal governance initiative on quality improvement and patient safety. She leads the Trauma and Injury Working Group, which she established and will be hosting a series of webinars on trauma care, starting with a focus on road traffic injury. Dr. Joseph also founded the Equity Research Hub, an international group of researchers who aim to become the independent conference equity index rater for global health conferences while supporting research capacity-building in LMICs.

Dr. Bethany Hedt-Gauthier earned her PhD in Biostatistics from the Harvard T.H. Chan School of Public Health. Her research interests include the application, development, and evaluation of research methodologies toward health improvements in populations from resource-limited environments. In addition to methodology development, Dr. Hedt-Gauthier collaborates on operational research projects related to clinical outcomes of patients. Her current work spans a variety of topics, including HIV, TB, malaria, NCDs, oncology, maternal and child health, electronic health systems, data quality assessments, and community health workers in Malawi, Tanzania, Rwanda, and Lesotho.

The Advancing Global Access to Surgery Through Education, Knowledge, and Equity (AGASEKE) Lab

The AGASEKE lab, led by Dr. Bethany Hedt-Gauthier and including PGSSC Fellow Afra Jiwa, conducts research to improve access to high-quality surgical care in rural district hospitals. The team works with Partners In Health/Inshuti Mu Buzima in Rwanda. Research areas include image-based diagnostics and community health worker (CHW) training within the context of Cesarean (C) sections.

 
mHealth Tools for Home-Based Postoperative Follow-Up            

The AGASEKE lab developed a phone-based application integrating clinical decision support and AI image algorithms to screen women for surgical site infections (SSIs) at home following C-sections. C-sections are the most commonly performed procedure in women globally, and women who deliver via C-section are at risk for postpartum complications, including SSIs and anemia. Timely SSI and anemia treatment can reduce the risk of maternal morbidity and mortality. The tool passed usability and acceptability testing and has started prospective validation with a cohort study. Future work includes a randomized controlled trial.            

Research Training and Capacity Building    

In addition to strengthening team research and skills transfer work, the AGASEKE lab participated in the 2024 Intermediate Operational Research Training (IORT). Dr. Hedt-Gauthier launched the IORT program in 2015 to enhance research capabilities in Rwanda. Through IORT, HMS faculty mentor community health workers and train them in basic epidemiology and biostatics concepts and practices. Over the 12-month course, trainees receive three weeks of face-to-face training and in-person and distance mentorship to develop, implement, and write a research project culminating in a scientific manuscript. The program aims to strengthen the research culture within the organization and partnering institutions, build confidence in research skills, and ultimately contribute to the development of evidence-based policies and practices.