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International Health

Emily Hurley, MPH ’12

PhD candidate, Program in Social and Behavioral Interventions (SBI)

Emily Hurley fell in love with Mali during her time there as a Peace Corps volunteer. From 2008 to 2010, Emily helped train community health workers in and around her rural village of Dombila. She also taught health classes to secondary school students, trained adolescent peer leaders, and worked with the local health center to establish a rehabilitation and growth-monitoring program for malnourished infants. 

Emily Hurley
Doctoral student Emily Hurley  (second from right) in rural Mali with a midwife and her family.

Now she’s back, to start her field work for her doctoral dissertation. Based at the University of Bamako in Mali’s capital city, Emily is studying the effect of patient-provider communication on adherence to antiretroviral therapy. She’s also wrapping up a study on prevention of malaria in pregnancy. A graduate of the School’s Master of Public Health program and a Sommer Scholar, Emily returned to Hopkins as a doctoral student in 2013 after working at the Johns Hopkins Center for Communication Programs.

Preventing malaria during pregnancy

Malaria is one of the leading contributors to death of pregnant women and their newborn children in Mali, but only about 15 percent of pregnant women receive the recommended doses of anti-malarial drugs that can prevent the disease. Assistant Professor Steve Harvey, SBI, has been leading a research project to uncover the barriers to this preventive treatment. In 2013, he enlisted Emily to help collect qualitative data for the project. Emily speaks French and learned Bambara (the local language) during her Peace Corps years. She recalls going out into a little far off village for data collection with a team of three students from the University of Bamako.

We strapped a couple of mattresses on their professor’s 1986 Jeep and set off down a long dusty road. We stayed in the village of Tanima for a number of days doing interviews, focus groups and observations of prenatal care visits. It was exciting to start to piece together what we learned about women’s experiences in prenatal care, and cultural ideas about health during pregnancy.

One of the team’s main findings was that even though women, their husbands, health workers, and other community members consider malaria to be a major threat to a woman’s health during pregnancy, they rarely talk about preventive treatment (or the multiple doses required). This and other preliminary results are helping to inform development of a new maternal mHealth program in the country that Professor Peter Winch, SBI, is launching—one of the many initiatives Hopkins has helped lead over the past few years in Mali.

Malaria prevention group
Members of the malaria prevention project. Back row: Dr. Steve Harvey, Emily Hurley, Sira Soumaoro. Front row: Dr. Samba Diop, Tenin Diawara,  Nièlé Hawa Diarra.

 

A growing partnership between universities 

Since 2010, a deep partnership has been developing between the Department and the University of Bamako. Winch has led an NIH Fogarty Training grant to support the first public health training program in Mali. And from this grant, many new research projects have been able to develop. It has also allowed Hopkins to host doctoral students and visiting scholars from Bamako. In turn,  “There is great public health research momentum here at the University of Bamako,” Emily reports. “In fact, there are four Hopkins master’s students and one undergraduate student coming this summer.”

Emily has also been coordinating a student team based in Baltimore that meets weekly with Harvey to analyze data and develop articles for publication. Before leaving for Mali in February, Emily participated in person; now she joins via Skype from Bamako. Each student is working on a manuscript for submission to a scientific journal, and each has submitted an abstract for the 2015 annual meeting of the American Society of Tropical Medicine and Hygiene. 

“It’s been great to have students so immersed in the project since literally their first week of school,” says Harvey, and he adds:

This kind of hands-on learning is a fantastic way for students to build their analytical and writing skills. We expect that everyone will have one or more peer-reviewed publications as an outcome. And they will have had an opportunity to affect a critical public health problem.

Improving antiretroviral therapy programs in Mali

The strong relationship between Hopkins and Bamako also made it possible for Emily to propose a research project based in Bamako for her dissertation. Her project received funding from the Fulbright-Hays Doctoral Dissertation Research Abroad Fellowship. She’s currently based at the University of Bamako while she manages her study. The project is investigating how to improve patient-provider communication in HIV care. While the prevalence of HIV is lower than in many sub-Saharan countries, “HIV is extremely taboo and hidden, and there are pockets of Bamako where I have heard the prevalence is increasing,” Emily explains. “There is also a real problem of making sure people who seek care stick with it,” which her project seeks to address.  

Once Emily completes her PhD, she would like to continue in research and academia. “There is a lot to do here in Mali and tremendous opportunity for future research. I love the academic setting, and hope to be a faculty member one day. It would be a dream if I could sustain this partnership and continue to work with the public health program here in Bamako—both in research and in public health training.”