African Dreams

Two Morehead-Cain scholars return from Malawi inspired and forever changed

By Saumya Ayyagari (’11)

A remote, impoverished country in sub-Saharan Africa may not be the first place most undergraduates want to spend their summer vacation, but it was the dream destination for UNC juniors Olivia Myrick and Elizabeth Monier. The two Morehead-Cain scholars were looking for a summer enrichment experience when they heard about UNC Project-Malawi and the work the University is doing on HIV and other infectious diseases in the region. Since both women plan to go to medical school, this seemed like an ideal situation. They immediately emailed everyone associated with UNC Project to inquire about opportunities. Fortunately, MD/PhD student Lillian Brown replied and told them that she could use their help on her Malawi-based research study, and their dream quickly became reality.

myrick and monier with a group of Malawian kids, smiling after a soccer game

Myrick and Monier with Grassroots Soccer

UNC has been actively involved in Malawi since 1989 and in 1996 established a research, care, and training facility called UNC Project in the capital of Lilongwe. A collaboration between UNC, the Malawi Ministry of Health, and Kamuzu Central Hospital, UNC Project provides clinical care to nearly 2,000 patients per week, has about 25 ongoing research projects and employs 300 people.

Myrick and Monier spent six weeks at UNC Project assisting with a research project on HIV partner notification, the subject of Brown’s PhD dissertation. The study’s objective is to determine the best method for getting the sexual partners of patients who are diagnosed with HIV to seek HIV counseling and testing. Brown is also examining community-level factors influencing HIV counseling and testing behavior in Lilongwe in order to learn more about the individual and societal factors that influence HIV testing.

The students worked five days a week in the STD clinic at Kamuzu Central Hospital, where they assisted with entering patient data into an electronic database and helped out with other administrative activities. “I greatly enjoyed working with Elizabeth and Olivia,” Brown said. “They were enthusiastic, motivated, hard workers, and were open to new experiences.”

This was the first time that UNC Project has offered a summer enrichment experience through the Morehead-Cain Scholarship Program. The Institute for Global Health & Infectious Diseases was instrumental in facilitating this initiative. The institute’s mission is to expand global health programs across the University and make the health sciences more accessible to the rest of the campus.

monier and myrick in the hospital, in front of hte surgery board, wearing scrubs

Monier and Myrick at Kamuzu Central Hospital

As they prepared for this exciting—but also intimidating—experience, Myrick and Monier were intent on keeping an open mind. It would have been easy to give in to pre-conceived notions and expectations. “I knew I had to be flexible,” Myrick said. Both women arrived in Malawi directly from a year studying abroad. “We had to walk in there with just the clothes we packed and the willingness to do whatever they needed us to do,” said Myrick, for whom this was a first trip to the African continent. Monier’s background was slightly different—she had been to South Africa—but her outlook was similar. “I didn’t know that much about Malawi,” she said. “I was prepared for whatever.”

Both women hoped to gain as much exposure to medicine as possible, but being able to observe surgical procedures was more than they could have hoped for. “I absolutely loved being able to shadow the surgeries. . .it was such a unique opportunity for an undergraduate,” Monier said. Beaming with excitement, she went on to explain how diagnosis is more difficult in a resource-poor setting. She recalled how one patient came in with lower abdominal pain which was thought to be caused by appendicitis, and the surgeons prepared for an appendectomy. As it turned out, the patient needed a splenectomy, but without access to medical imaging equipment, there was no way of knowing what was wrong until the patient was on the operating table.

Myrick and Monier were fortunate in that they were able to see how the research can have a positive effect on the health of people in Malawi. They spent part of their time with the Tidziwe Outreach Program, which works to educate people in rural villages about the importance getting tested for HIV. “It was fascinating to see the responsiveness of people being tested for HIV/AIDS, becoming aware and getting treatment as necessary,” Myrick said. “It was one way we could make what we were working on in the data room connect to reality.”

For Myrick, the best moment occurred when the women were asked to put together several presentations for Irving Hoffman, who is U.S.-based director of UNC Project and Myron Cohen, who directs the Institute for Global Health & Infectious Diseases. Both were visiting UNC Project during the summer. Myrick and Monier were able to compile everything they had worked on, see how it all fit together, and see how effective it was, even on a small level. “I remember being so excited,” Myrick said, “thinking, ‘We did all this! Look!’”

monier sitting on the grass with two small children in her arms

Monier with Malawian children

In addition to their work at UNC Project, the two women volunteered with two different charities in the area: Grassroots Soccer and Breath for Life. Grassroots Soccer is an international organization that uses soccer in the fight against HIV and AIDS. Grassroots Soccer holds an annual soccer tournament in which teams come together not only to compete, but also to take part in various team building and other educational activities. Monier and Myrick each coached a team.

When they weren’t busy on the soccer field, the students assisted with press releases and other publicity efforts for Breath for Life, an organization that raises money for oxygen concentrators for the children’s ward at Kamuzu Central Hospital. It is common for children infected with HIV to have complications related to respiratory illnesses. “A good oxygen concentrator can do wonders for a baby,” Myrick said. “We saw it.”

Both women would like to work in Africa again, if not specifically Malawi, and possibly on HIV research. Having gained a great deal of knowledge about several major studies going on at UNC Project, they intend to keep up with the studies’ progress and results. The two are also considering establishing a Grassroots Soccer and/or Breath for Life chapter at Carolina with the proceeds going back to Malawi.

As Monier and Myrick reflected on their summer, you could sense how the experience changed them. Both had to contend with reverse culture shock upon their return to the United States. Having already been to Africa, Monier was prepared for it. Even so, her awareness of America’s material privilege was more pronounced this time. Seeing the aisles and aisles of food in the grocery store, for example, was overwhelming. “I am also more appreciative of the medical services we have,” she said. “I take those for granted, definitely.” Myrick returned to the U.S. with an emotional high that soon dissipated. “It’s just the difference of life, of mentalities, structure, day to day experiences is really huge,” she said. “It takes a while to find out where you fit in that gap.”

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Elizabeth Monier (’11) is a double-major in biology and Spanish.
Olivia Myrick (’11) is majoring in Spanish with a double minor in chemistry and dramaturgy.