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Oct. 23, 2013

Melissa Elafros: At home in Zambia

Oct. 23, 2013

Melissa Elafros is a Fellow with the International Neurologic and Psychiatric Epidemiology Program and an M.D./Ph.D. candidate in the MSU Department of Epidemiology and Biostatistics in the College of Human Medicine. She previously earned a Bachelor of Arts in Spanish, a Bachelor of Science in human biology and a Master of Arts in bioethics, humanities and society from Michigan State. 

Five years ago, if you had asked for my perspective on Zambia, I would have promptly requested a map. Fortunately, after three trips full of clinical and cultural experiences, I no longer require a map to inform my sentiments.

I first traveled to Zambia in 2008 to assist my PhD adviser, Dr. Gretchen Birbeck, with training her research team for an upcoming study. After the training, I spent six weeks at Chikankata Hospital in rural Mazabuka, observing and assisting with clinical care. Fresh from my first year of medical school, I was amazed by the extent of disease but encouraged by the resourcefulness of the health care workers.

I returned to Zambia a few years later, again, to assist with a study. I spent three months in Lusaka, the capital, looking for HIV-positive patients admitted with seizures to the University Teaching Hospital. The University Teaching Hospital is the country’s only tertiary care hospital and is the primary training site for the nation’s medical students. Experiences during this trip served as the basis for my dissertation research.

In the fall of 2012, I moved to Lusaka to conduct my research, which examines the intersection of HIV and epilepsy. In Zambia, both of these conditions are common, yet both carry a stigma. This stigma often is associated with depression and poor health outcomes. In addition, treatment options for both HIV and epilepsy are limited and can be associated with severe side effects.

I am working to characterize the experiences of individuals with HIV and epilepsy in Zambia so they can be compared to the experiences of individuals with only HIV and of individuals with only epilepsy. As HIV-positive individuals continue to live longer, more people will be forced to manage HIV and another chronic condition, like epilepsy. Currently, there is little evidence to advise medical professionals and patients in this situation.

I spend most days going bed to bed at the University Teaching Hospital, searching for patients with HIV and epilepsy. Time not spent on my research is dedicated to assisting with other ongoing studies, observing clinical care, and learning two local languages. The staff members that I trained during my first visit to Zambia have become my friends. The health care workers and patients I meet become my teachers.

When I complete my PhD research, I will return to Michigan State University to continue with medical school. My time here has helped me understand this country and its people. It has also helped me understand myself.

Today, if you ask me for my perspective on Zambia, I would smile. Zambia is vibrant. It is passionate and persistent. It is my home.