John Mboya first learned of his community’s struggles with access to effective healthcare when he contracted malaria at 11 years old.
Mboya remembers his mother trying a traditional healer to cure him; the closest hospital was 10 kilometers (six miles) away, too far to walk. The healer’s ointments didn’t work after multiple attempts; meanwhile Mboya was missing out on weeks of education. He finally received help from a travelling clinic that happened to have the correct medicine. When his father became ill with schistosomiasis three years later, the hospital was so crowded with people waiting to be seen, that Mboya’s father was unable to receive timely care. He eventually died of the disease.
In Mobya’s native Kenya, many doctors visit hospitals only once a week at a designated time to see patients. Often, people seeking care have to wait for hours, missing paid work and sometimes leaving without seeing a clinician. They often won’t return to the clinic again; instead they will visit local pharmacies where the cost of medicine can be high.
Mboya, who previously worked for IPA, a nonprofit geared towards projects alleviating global poverty, saw this scenario play out regularly and wondered whether there was something simple he could do to improve health care access for his fellow Kenyans.
He decided his answer lay in pursuing his master of public health though Berkeley Public Health’s Online MPH program. In 2021, he applied for—and won—one of 16 Global Public Health fellowships offered to international students. An additional 17 residential Global Health Fellows will be pursuing their degrees in person in Berkeley.
Mboya wants to use his time in the program learning how social behaviors affect access to care, and how health care providers can adjust systems to ensure access. He plans to develop a system that will allow hospital and health care providers to use telemedicine to manage patients anywhere in the county, including those Kenyans who are part of nomadic communities.
He’s looking forward to having conversations with his classmates about how they address healthcare challenges in their countries and speaking with policymakers in Kenya about the importance of community-based health.
Mboya believes that healthcare can’t work “if you don’t involve the community from the beginning until the end and let them participate in their health care and choose what they need.”
Teaching students in place
Deborah Barnett, director of Berkeley Public Health’s online MPH program, likes to say that the Global Public Health Fellowship is about “teaching students in place.” Fellows in the online program are able to utilize Berkeley Public Health’s resources, professors, and the experiences of their fellow students to find intersections between their research and their own communities.
“They’re bringing the ideas and skills from their Berkeley education straightaway into their work. It helps stimulate the kind of discussion and conversation around how you go from learning public health to practicing public health,” said Barnett.
Global Public Health Fellow Abel Wilson Walekhwa works for Ugandan President Yoweri Museveni’s Presidential Initiative on Science and Epidemics (PRESIDE), a think tank of scientists with a core mission to develop products and tools to respond to the COVID-19 pandemic. Data shows that Ugandans in rural communities tend to contract preventable diseases because of lack of both access to healthcare and health education. He’s looking to find solutions to the problem.
“People [in rural areas] don’t have a clear understanding of why these diseases are occurring,” said Walekwha. “When these outbreaks come, they disrupt our economic activities, schools close, people die, people go to the hospital. People lose a lot of time.”
Another fellow, Efison Dhodho, is also seeking an MPH to work on issues of healthcare access, particularly for rural communities.
There are approximately 328,000 people scattered across 100,000 square kilometers of Zimbabwe’s countryside who are taking antiretroviral medications as treatment for HIV. Dhodho, who currently works in strategic information and evaluation at a Zimbabwean nonprofit, the Ophid Trust, is tracking data on patient location and medical records to find ways to improve access for these patients. He plans to use the data he has collected to inform the care and treatment program so that it adopts a more patient-centered approach to care.
“[In] my view, there is [a disconnect] between the health system and the people it sought to serve,” Dhodho said.“The people we serve should be at the center.”
The fellowship will allow him to access the resources he needs to sythesize his data, as well as an international network of professionals to collaborate with. He is even exploring the possibility of creating an interdisciplinary hub for collaborations between UC Berkeley researchers and scientists in Zimbabwe.
Finding new ways to collaborate
Susan Awor, one of several Ugandan fellows, said, “I’ve always been so passionate about addressing disparities among the poorest people in Sub-Saharan Africa. The next step for me is to see how to address these disparities; how to bring health equity to these people.”
Inspired by the collaborative energy of her classmates and professors, Awor is already thinking about ways to explore why diseases previously thought extinct—such as elephantiasis—are returning to Uganda’s rural villages, and how such outbreaks could be controlled through health outreach and education.
Awor is also working on a podcast, Threads of Impact, with Berkeley Public Health alumna Keerthana Rajagopal (2020). The pair met at the new student orientation and now interview faculty about their journeys through public health.
Jane Mwafulirwa, a fellow from Malawi, is constructing a project that will give those living with albinism in her country better access to healthcare. As a general practitioner with a special interest in dermatology, working towards becoming a board certified dermatologist, Mwafulirwa had studied with clinical mentors, but she wanted more public health knowledge; she decided coupling an MPH in epidemiology with her experience in clinical care will help her better serve her patients.
“When I heard about this opportunity and I read about the school, I was inspired,” Mwafulirwa said “This is a place where I can read and learn about complex issues that affect health not just in medicine but things like community education.”