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Pictured at the Sonaba Hospital in in Gujarat, India are Research and Advocacy for Health in India cofounders (from left) Nisha Fahey, Apurv Soni, Jeroan Allison, MD, and Somashekhar Nimbalkar, MD, with a representative of the philanthropy that funded the hospital.
UMass Medical School students are working in Gujarat, India, this summer to improve health care in the mostly low-income rural region. They are conducting health disparities research focused on three distinct conditions: maternal and child health, atrial fibrillation and traumatic injuries under the leadership of UMass Medical School third-year MD/PhD student Apurv Soni and Nisha Fahey, a medical student at Des Moines University College of Osteopathic Medicine.
“Our focus is on how to connect dots between available resources, however limited they may be, and the region’s most vulnerable members,” said Soni. “We’re excited to be engaging disenfranchised communities and individuals with approaches that can help overcome limited resources.”
Soni, who emigrated from India to the United States as a teenager, is determined to help reduce health care disparities, a goal he first envisioned after falling critically ill while visiting family in India. He received excellent care in the local hospital because his family could afford to pay for it, but saw poor children rummaging in garbage cans for food right outside his window. Shocked by the vast chasm between his circumstances and theirs, Soni redirected his focus to address health disparities, setting in motion a chain of events that led to the creation of the Research and Advocacy for Health in India (RAHI) initiative at UMass Medical School.
“In that moment in the hospital room, I was struck by the lack of opportunities and support systems for the children outside the hospital,” he said. “Having the privilege of growing up and immersing myself in two very different cultures has fostered my awareness of persistent health inequities that can only be solved with a collective and participatory effort.”
In 2013 while first-year medical students, Soni and Fahey cofounded the Research and Health in India collaboration between UMMS and Charutar Arogya Mandal (CAM), a charitable trust that operates a hospital, medical school, and nursing school in Gujarat. With its acronym the Hindi word for “pathfinder,” the RAHI partnership promotes the health of people in Gujarat through service, learning and research partnerships between students, residents, researchers and other health professionals at UMMS and CAM.
Research and Advocacy for Health in India Summer 2015 projects and participants
1. Understanding Predictors of Maternal and Child Health – UMMS investigators Jeroan Allison, MD; Tiffany Moore Simas, MD; Nancy Byatt, DO; Milagros Rosal, PhD; Sowmya Rao, PhD; third-year medical students Michaela Tracy, Jasmine Khubchandani, and Haley Newman; and second-year medical students Hannah Rosenfield and Sarah Servattalab. The prospective cohort study is monitoring 200 pregnant women from first trimester to six months postpartum to evaluate nutritional, clinical, and psychosocial risk factors for adverse maternal and child outcomes.
2. Improving Trauma Outcomes – UMMS investigators Heena Santry, MD; Abraham Jaffe, MD; Jeroan Allison, MD; and second-year medical student Brittany Novak. To assess community wide burden of mortality and long‐term disability attributable to road traffic accidents, the team is implementing a trauma registry at a tertiary care center and conducting community based surveys.
3. Feasibility Study: Using Mobile Based Technology to Screen for Undiagnosed Atrial Fibrillation in Rural India – UMMS investigators David McManus, MD; Jeroan Allison, MD; Jay Himmelstein, MD, MPH; Michael Chin, MD; and second-year medical students Anna Handorf and Allison Earon. The feasibility study uses an iPhone-based app in community as well as clinic settings to screen for the presence of atrial fibrillation, a likely but not widely acknowledged cause of stroke, the third leading cause of adult death in India.
Providing mentorship and institutional leadership for RAHI are founding faculty Jeroan Allison, MD, professor and vice chair of quantitative health sciences, professor of medicine and associate provost for health disparities research at UMMS; and Somashekhar Nimbalkar, MD, professor of pediatrics and head of central research services at CAM.
Dr. Allison, who teaches the Social Determinants of Health class for first-year medical students, recalls being approached by Soni following a lecture on health disparities. Upon learning the scope of work that Soni and Fahey had already done in Gujarat before entering medical school, he enthusiastically agreed to be the faculty advisor for their first Office of Global Health Pilot Project Grant, and traveled with them and other UMMS students in the summer of 2013 to establish the child and maternal health project.
Serendipity struck when UMMS trauma surgeon Heena Santry, MD, whose own family hails from the Gujarat region, was inspired personally as well as professionally to launch the RAHI trauma project. Like Soni, Dr. Santry, assistant professor of surgery, grew up in Lowell, Mass., with parents who emigrated from India’s Gujarat region. The large community of Indian transplants in Lowell offer further opportunities for cultural exchanges to address the health disparities south Asian immigrants experience here, as well as in their countries of origin.
“Nisha and I started medical school with some ideas about what we wanted to do, but never in our wildest dreams did we imagine it getting to this point with so much momentum going forward,” Soni said. “None of this would have happened without the support and involvement of UMMS faculty.”
As additional faculty and students come on board, Soni and Fahey continue to inform and manage the expansion of the Research and Advocacy for Health in India enterprise with new endeavors. New projects are in the works to address health disparities for immigrant and other underserved populations in Worcester and in Gujarat. Projects include diabetes prevention and promoting skin-to-skin contact between mothers and their prematurely born babies.
“What Apurv and Nisha started is opening new doors in science, education and research,” Allison said. “Having students from India here is enriching our campus, and our students are having invaluable experiences in India. New opportunities for research collaborations to address health disparities are the building blocks for what has become a major global health initiative at UMMS.”