If Abdullah Awash and Aref al-Ahmadi had been late for their first class, they would have had a good excuse. Their country, Yemen, is at war with airports closed and visas to neighboring Saudi Arabia hard to get. So Awash and Ahmadi travelled to Mokha on the Red Sea to board a ship to take up their new graduate scholarship for public health and infectious diseases at the American University of Beirut’s Faculty of Health Sciences (FHS).
Just as they cleared the first checkpoint, however, they heard an airplane followed by the shriek of a missile. Seconds later, warplanes bombed the port. “Everything happened suddenly,” Awash recalled. “It was very dangerous.”
But for these and other graduate students, barriers to education are nothing new. Following a 30-hour boat trip to Djibouti and then a flight to Beirut, they made it to campus on time. “Our main goal was to arrive at AUB,” said Awash. “That’s why we resisted all challenges, all obstacles.”
Aref and Ahmadi were among the first to enroll in the new TDR-supported graduate scholarship scheme aimed at improving implementation research on infectious diseases related to poverty. By involving seven universities across three continents – three in Africa, two in Asia, one in Latin America and one in the Middle East – the initiative also seeks to increase capacity for providing such curricula. AUB in Lebanon is the first to adopt the program.
Over the next four years, TDR is hoping to increase the number of scientists working on malaria, tuberculosis, and 17 neglected tropical diseases. “As these students walk through the gates of AUB, they are the first of a group coming from low and middle-income countries in a region stretching from Morocco to Afghanistan who will be trained over the next four years,” said Dermot Maher, TDR’s coordinator for research capacity strengthening and knowledge management.
The TDR programme will provide nearly a million dollars to FHS/AUB, allowing it to offer scholarships to 11 graduate students to follow a two-year graduate program in public health. Up to 30 additional students may also benefit from the TDR programme at AUB in the following three years, pending funding availability.
For the AUB students, who come from Yemen, Sudan, Afghanistan, Iran, Egypt and Syria , what they all share are challenges. The barriers to wiping out diseases like malaria and tuberculosis are often the same as the ones that Aref and Ahmadi faced on their journey, notably war, poverty, and the lack of mobility. Similarly, there are barriers when dealing with education and health.
In Yemen, one of the world’s poorest countries, lack of infrastructure is a major obstacle to health care. When Awash was only four, his big brother died from malaria during the lengthy journey to the hospital on poor roads. “Personally, two from my family have died from malaria,” said Awash, who is now a vector control specialist and an entomologist with Yemen’s National Malaria Control Program. “So I have a background fighting this disease.”
In Afghanistan, villagers often have to trek over high mountain passes to reach health clinics and schools. But for Saha Naseri, a Kabul Medical School graduate, the geographic barriers were only the beginning. Under the Taliban, education for girls was forbidden. So Naseri learned the basics in clandestine home classes. She attended school for the first time at age eight following the 2001 US-led invasion. “I couldn’t read,” she recalled. “That was tough for me.”
Another more intangible set of barriers are ingrained beliefs hindering people from adopting treatments even when available. In Afghanistan, many believe that polio and other vaccines are part of a stealth campaign to sterilize children. In Egypt, where improperly-administered bilharzia vaccinations caused widespread hepatitis C, it is often healthcare workers themselves who need to be educated. In Yemen, policymakers tend to focus more on dispensing medication for malaria and dengue fever than preventing outbreaks. “We need to change our culture, especially the decision makers,” said Awash.
A main program focus will be implementation research, exploring the barriers between effective healthcare interventions and the people they are designed to reach. “If you want to solve the problems, you have to go to the roots,” said Norhan Bader, a graduate of the Kasr al-Ainy School of Medicine at Cairo University. “It all starts from understanding the real constraint or the real barrier.” Sometimes it might be religious, or cultural, but often it is also gender-related, added Bader.
To identify root causes, it is not only crucial for students to come from the regions where tropical diseases thrive, but also to study in them. “Public health is, in a sense, a social science,” says Jocelyn DeJong, associate dean of the Faculty of Health Sciences and a professor in its Department of Epidemiology and Population Health. “At AUB we try to teach students in a way that’s attuned to the region.”
The AUB scholarship students can pursue either a Master of Science in Epidemiology program or a Master of Public Health. A key selection requirement is the commitment to return home on graduation. For Sudan’s Yusra Mohammed, this means going back to a country where malaria is omnipresent. She dreams of being able to use research combined with social interventions such as theatre or documentaries, to reduce the number of people dying of malaria. “I was looking for this programme,” she maintained. “I think this is a major transformation in my life. I have bigger dreams now.”