In a Word: Resilience

group of USD nurses with members of he community in Uganda.

PUTTING INTERDISCIPLINARY RESEARCH INTO ACTION IN UGANDA

Editor’s Note: It seems a lifetime ago that a group of USD faculty members and students travelled to Uganda. But January 2020 was just a few short months ago. That’s when the group, accompanied by USD News Center editor and frequent USD Magazine contributor Ryan T. Blystone, flew to the other side of the world. Their work remains important, even as the world’s attention has shifted in light of the health crisis brought about by the spread of COVID-19.

One definition of research is a “studious inquiry or examination aimed at the discovery and interpretation of new knowledge.” For proof positive of the importance of research,  one should look no further than an Intersession trip by an interdisciplinary group of four University of San Diego faculty members and eight students to Uganda.

For nearly three weeks, spent mostly in the city of Mbarara, the group — accompanied by USD President James T. Harris and his wife Mary for part of the trip — continued a research mission to deliver on the importance of clean water in the region as a major component of public health.

The university’s scientific research, nursing student involvement and relationship-building with academic, spiritual and organization leaders in Uganda has roots stretching back to 2008. What began as a chemistry complement to USD’s Hahn School of Nursing and Health Science’s support for an archbishop’s request to build Holy Innocents Children’s Hospital in Mbarara has blossomed into a valuable research commitment by USD faculty and students.

Jim Bolender, PhD, an associate professor of chemistry and a faculty member since 1996, got involved through then-nursing professor Anita Hunter. She asked Bolender to see if the new hospital — which opened in 2009 and has served 200,000 patients since — would pollute the Rwizi River, Mbarara’s main water source.

“The river does have huge environmental and contamination problems,” says Bolender, who has now traveled to Uganda 20 times. “Over the course of the past 12 years, our project has expanded to include working with Uganda’s National Sewage and Water Corp., testing water at 25 different sites and helping train technicians on their water-testing techniques.”

Martha Fuller, associate professor for the Hahn School of Nursing and Health Science, presents Holy Innocents Children’s Hospital’s Director of Nursing, Karugaba James, with some of many supply items donated from the United States.

Martha Fuller, associate professor for the School of Nursing, presents Holy Innocents Children’s Hospital’s Director of Nursing Karugaba James with some of the items donated from the United States.

The project has grown in scope. Lecturer Keith Macdonald (Biology) and Professors Frank Jacobitz (Mechanical Engineering), Martha Fuller (Nursing) and their respective students have zeroed in on the region of southwestern Uganda. Chemistry study-abroad classes have examined water purification practices; students are working on a joint project with Mbarara University of Science & Technology (MUST) and other local partners. There is an international collaboration between USD, MUST and Holy Innocents with worldwide experts from France, Israel, New Zealand, Washington, D.C., and Berkeley. Additionally, USD faculty met with Mbarara University’s school of medicine, engineering and science faculty to create a local resource and give Ugandans a sustainable water quality monitoring improvement project.

“Our project really covers monitoring and determining what the problems are beyond sanitation,” Bolender explains. “Sanitation is still a huge issue in the developing world, but there are underlying issues that are chemical and are naturally occurring from the geology. There are places that have arsenic and uranium in the water at levels that are above the World Health Organization limits for what people should be exposed to.”

One potential challenge for the project is the lingering effects of the coronavirus (COVID-19), which began afflicting people around the world not long after the USD group left. In March 2020, Uganda imposed a ban on all foreign travelers entering the country to slow the virus’s spread.

While the trip wasn’t affected, the pandemic does give Bolender and all others involved pause as they consider their next move. But one trait this relationship has is a desire to make it work. Put succinctly and positively by Ndaruhutse Ruzaaza Gad, MUST’s education program coordinator, the key is “resilience!”

Experiencing Uganda

The 2020 research trip brought together biochemistry majors Molly Klein, Marci Strong and Kendyl Maher, along with 2019 behavioral neuroscience alumna Natalie North-Cole to assist Macdonald and Bolender with water quality sample collecting at multiple locations as well as testing for several different chemicals, metals and other contaminants.

This was the second trip to Uganda for Klein, Strong and North-Cole. They were enrolled in Bolender’s study-abroad class in January 2019; each returned this year as an experienced researcher.

USD students collect water samples in Uganda.

Natalie North-Cole pumps as Molly Klein collects a water sample in the village of Kyabirukwa in Uganda as other students, faculty and administrators look on.

“It was an awesome class. I learned all the techniques to do the water testing,” North-Cole says. “When the opportunity came to join the team this year, I was excited to do it. I love Uganda, it’s a wonderful place, one that not a lot of people get to experience. The research is so meaningful and the people here are so appreciative that we come and help them with such a critical issue.”

Klein was a leader in collecting water samples at the Nakivale Refugee Settlement — which is the largest refugee settlement camp in Uganda with more than 120,000 people — and at two locations in the Kyabirukwa village, where the entire USD group assisted Holy Innocents staff with a medical clinic, and at a village in Kashongi.

Klein’s Uganda trips have given her a great appreciation of the holistic nature of the work.

“I definitely did not realize how complicated certain issues are, especially something like water quality,” she says. “Clean water is a basic right, everyone should have access — just get a filter for the water. But, in Uganda, you have to think about so many different steps just to drink the water. It’s not just, ‘how clean the water is to drink, but how can we make it sustainable? How can Ugandans implement what we come up with and keep the project running? Is it cost-effective?’ It encompasses a lot more than just the chemistry side.”

Exploring one of those issues is where mechanical engineering senior Christina Kozlovsky and her research comes in.

“Any surface water source we have is going to have bacteria from the runoff into those water supplies,” Bolender says.

Finding solutions is what brought Jacobitz, a Shiley-Marcos School of Engineering professor, back to Uganda after advising on a different student project. Jacobitz met with MUST and engineering department officials on the trip, but he’s also the faculty advisor for Kozlovsky and classmate Ava Bellizzi’s senior design project. They’ve built a water filtration system that they want to provide for use in rural areas of Uganda. Considered a possible remediation device, Kozlovsky tested multiple local items to gauge the effectiveness of filtering bacteria.

“I took the water samples we’d get and run them through plant xylem (plant tissue) testing to see if the bacteria increased or decreased,” Kozlovsky explains. “Ava and I want this device to be sustainable in Uganda using locally found products. Getting the chance to come here, to test the trees that are most found here, is extremely helpful.”

Providing Sustainable Skills

Helpful is just one way to describe the contributions made by faculty and students from the nursing school. The graduate nursing program renewed its interest in contributing as a service and education provider to Holy Innocents’ hospital. Dr. Fuller and three USD nurse practitioner students — Allison Bryden, Shaylyn White and Cara Fratianni — were a visible and valuable presence throughout the trip.

USD student Molly Klein measures the height of a young child during a medical clinic day in the village of Kyabirukwa.

“Taking nursing students to Holy Innocents is a global health educational piece, a service piece,” Fuller says. “We try to provide sustainable service by helping them obtain equipment they can’t, and provide education they wouldn’t otherwise have access to. When we educate someone, we’re providing a skill that can be sustainable.”

The nursing students, all of whom were newcomers to Uganda, each gave one oral presentation to Holy Innocents staff on topics such as basic life support practices, educating staff on ways to better identify deteriorating patients and working with newborn and premature-born babies. For example, Bryden explained a new-to-them method of how best to position a baby who is receiving respiratory support to better enhance ventilation.

The entire USD group worked together throughout the trip, whether it was side-by-side with Holy Innocents staff to serve nearly 500 children at two medical clinics in rural villages or when the nurses, at Fuller’s request, leaned in and learned about the undergraduate students’ water quality project.

“I saw incredible growth among our three nursing students,” Fuller recalls. “I’m very proud of the work they did there. There was a willingness to be open, to open themselves and allow them to be hurt by what they saw. They were able to cope with a lot and that’s a true sign of maturity.”

Finding Strength in Each Other

There were many teachable moments for the whole USD research group in Uganda. There was a lot to savor, especially when seeing the students bond, both in the important work they did and in the friendships that emerged. By the end, the undergraduate and graduate student labels were gone, as had any fear of the unknown that some admitted to having upon arrival.

“One really important aspect of our team dynamic is how many women were on this trip. I feel really empowered being surrounded by strong women in STEM (Science, Technology, Engineering, Mathematics),” says North-Cole. “We’re all supportive of each other and that makes us stronger.”

The Harrises agree. Spending time with the research group and witnessing their work up close made quite an impression.

“This trip reinforced for me the significance of high impact learning practices on our students,” President Harris says. “We have remarkable faculty who are dedicated to the growth and development of our students through engaged scholarship. I had the opportunity to witness this firsthand in Uganda. These types of experiences are the best possible way to help our students grow into global citizens and changemakers.” — Ryan T. Blystone

 

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