GSN post-doc joins team tackling deadly infection

International impact: Robin Klar will research treatments for elephantitis in New Guinea

By Sandra Gray

UMass Medical School Communications

April 01, 2011
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Robin Klar, DNSc, RN, will spend six to nine months in Papua, New Guinea, as a post-doctoral fellow with Case Western Reserve University.

At any given time of year, there are scores of students, faculty and researchers off campus—some way, way off campus—in the Dominican Republic, Peru, Ghana, Liberia—providing aid, serving fellowships and gaining experience they can apply to their work, and their patients, here at home. As an ongoing, periodic feature on UMassMedNow, we will profile some of these travelers and give you some insight into the impact—both small scale and large—that the people of UMMS are making on our world. 

What do nurses, statisticians and anthropologists have in common? For the Global Health Research Expanding Advanced Training (GhREAT) project at Case Western Reserve University (CWRU), all three will make vital contributions to addressing a major global health problem. Combining their distinct approaches, experts in those disciplines could improve care for people suffering from a parasitic infection, lymphatic filariasis (LF).

For Robin Klar, DNSc, RN, assistant professor of nursing, the three disciplines “are the perfect triangle for me.” Dr. Klar, who has conducted focused ethnography, a form of anthropological research important to improving health in different cultures and communities, will join the project as a fellow of the Post-Doctoral Traineeship for Global Health Research at CWRU. Funded by a $228,000 grant from the National Institute of Health’s Fogarty International Center and the National Institute of Nursing Research, the project brings together fellows from all three disciplines to study self-management of potential drug treatments for lymphatic filiriasis in Papua, New Guinea.

LF is a parasitic infection, easily and widely transmitted via mosquito bites, that causes blockages and retention of fluid in the lymphatic system, resulting in gross enlargement of the body’s extremities. While practically unheard of in the United States, LF is prevalent in some developing countries. Those afflicted by this chronic disease, which can lead to more serious illnesses, are burdened with considerable physical, psychological and social disabilities, prompting the World Health Organization to call for its elimination by 2015.

“This was a call for team science,” explained Klar, who will be the nursing fellow on a multidisciplinary research team, which also includes a fellow selected by CWRU’s Center for Global Health and Disease and Department of Epidemiology and Biostatistics at its School of Medicine, and a fellow selected by the Department of Anthropology from the College of Arts and Sciences at CWRU. Incorporating behavioral and ethnographic research with a drug trial, each post-doctoral fellow will work with principal investigators from their respective disciplines. Under the direction of Elizabeth Madigan, professor of nursing at CWRU’s Frances Payne Bolton School of Nursing, Klar will conduct a study on self-management of patients with LF, similar to a project she has already done in Ghana. 

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Robin Klar interviews Victoria Owusu, RN, chief public health nurse in Pokuase, Ghana, where Klar conducted ethnographic research similar to her upcoming post-doctoral fellowship project in Papua, New Guinea.

In fact, everything that Klar has done to date has led her to, and prepared her for, the opportunity to draw on her previous experiences and bring all her research interests into a single project with potentially enormous reach. “This is the perfect post-doc for me as an individual and a researcher and a faculty member,” said Klar, whose research examines health promotion behaviors of vulnerable populations, and whose clinical work focuses on the development of community-based and community-oriented care wherever those populations live. “The reason I got interested in global health was that we had a population of immigrants in our backyard that had some health concerns, and we had the opportunity to go over to their country of origin to look at their health care practices. You start to see that there are excellent lessons not only for the country we’re in, but also to bring back to the U.S.,” she said. 

Unlike the typical post-doctoral fellow who has recently earned a doctorate and aspires to a faculty appointment, Klar is a full-fledged faculty member who has been conducting scholarly nursing research since earning her doctorate from Yale University in 2002. Always concerned with epidemiology as a public health nurse, she first became interested in international work 

several years ago when, working with the Department of Pediatrics to investigate Worcester’s high infant mortality, the team discovered that the highest incidence was within Worcester’s Ghanaian immigrant community. This led to the School of Medicine conducting a Community Health Clerkship focused on helping that population, the first to include nursing students, under the direction of Klar’s colleague Rosemary Theroux, PhD, assistant professor of nursing. Klar and Dr. Theroux have since joined forces, traveling to Ghana four times to conduct research with the indigenous population. Those efforts further informed their work at home, while providing much needed assistance abroad. 

And unlike the typical international post-doctoral fellowship for which funds usually are made available to support foreign students coming into this country, this fellowship affords American faculty opportunities to work in other countries. With the full support of GSN leadership to pursue this interesting and unusual opportunity, Klar could well prove a role model for faculty peers across the institution. “This project is connecting a lot of dots in multiple areas including global health, translational research and quantitative research,” she said. From a nursing as well as institutional perspective, Klar is also pleased. “This project serves as a reminder that doctorally prepared nurses are scientists and clinicians. It opens one more avenue of research that we at the GSN and the larger institution can offer to students at all levels . . . who knows what will happen in Papua?” 

Related links: 

International impact: Faculty travel to Ghana seeking clues to Worcester’s infant mortality mystery