As the novel coronavirus first spread around the world in the spring of 2020, UMMS student Ann Wolski recalls talking with a colleague about an upcoming international fellowship she’d been planning through the Fogarty International Center.
“There was this question of whether COVID was going to impact my Fogarty fellowship. And I was dismissive: ‘No, that’s months from now!’” Wolski said. “But then as time went by it became clear that I was wrong.”
Wolski’s fellowship in Ghana was ultimately delayed, her time in-country shortened from a year to six months, and the focus of her project altered. But this March Wolski arrived in Ghana – a full eight months after originally planned – the first UMMS student to travel for a global health experience in more than a year.
“We had nearly resigned ourselves to the fact that Ann may spend her Fogarty year Zooming from Ann Arbor, but then a series of things began to fall into place,” said Associate Professor of Ob-Gyn and Learning Health Sciences Cheryl Moyer, Wolski’s U-M mentor on the Fogarty project.
A fourth-year student, Wolski is spending six months at Kumasi’s Suntreso Government Hospital working alongside Ghanaian physician Ashura Bakari on a project that aims to help new mothers identify the signs of jaundice in newborns so treatment can begin early, reducing long-term complications and deaths. Bakari and Moyer are longtime collaborators.
“Ann was going to a place where I knew she would be in good hands and where my partners were excited to welcome her,” Moyer said.
Jaundice is typically identified in healthcare settings via a handheld device that strobes a light into an infant’s tissue and then uses a spectrometer to measure the wavelengths reflected back; yellow is a sign of jaundice.
Those machines are pricey. The icterometer device that Bakari and Wolski are testing is a decidedly low-tech alternative, not typically used in hospitals but a potentially helpful tool for parents at home.
“It looks like a light-to-dark paint swatch that you might get at the hardware store, printed on plastic,” Wolski said. “You use your finger to blanch the tip of the baby’s nose, and then compare the color there to the different color swatches. The idea is, what if we taught mothers how to use this and then sent them home with one?”
Learn more about Global Health Fellowships offered through the Fogarty International Center. Applications open in August.
An at-home feasibility study for the device was to be the centerpiece of Bakari’s own upcoming Fogarty project. Wolski is helping to lay the groundwork, conducting a retrospective medical record survey of more than 1,000 recent births at Suntreso to document the frequency of jaundice screenings, diagnoses, and outcomes. She is also part of a small research team conducting qualitative interviews of providers and new mothers, asking about their familiarity with jaundice, diagnosis, and icterometers.
“Having Ann in Ghana made us expand the study with a qualitative subsection, which will guide us on how best to introduce the icteromoter,” Bakari said. “I would not be able to do all of these things without the help of Ann.”
‘Mixed feelings’ about travel
Allowing Wolski to travel to Ghana during the ongoing pandemic was not an easy decision. While many countries have loosened their travel restrictions (foreign visitors to Ghana must show proof of a recent negative COVID test before their travel and re-test at the airport upon arrival to the country), University-related travel for U-M remains prohibited for most students. Travel is entirely off-limits for undergraduate students. At the graduate level, including Medical School, international educational experiences are evaluated on a case-by-case basis.
“I confess I had mixed feelings about Ann traveling. On the one hand, it is a beautiful sign that maybe – just maybe – things are on their way back to normal,” Moyer said. “On the other hand, I still worry that the situation on the ground could change rapidly and we could second-guess the decision.”
“I am also cognizant about the message it sends when vaccinated Americans start traveling again, especially in places where the vaccine isn’t readily available,” Moyer added.
As medical student who had resumed clinical rotations, Wolski has received the vaccine. Coincidentally, Ghana was the first country in the world to receive vaccinations from the World Health Organization’s COVAX initiative; some 600,000 doses arrived in the country the same week as Wolski. Because health workers are prioritized, the colleagues she is working alongside are increasingly inoculated.
In addition, Ghana’s COVID-19 burden is currently low. The country since April 1 has averaged less than 100 new cases per day, comparable to the daily numbers recorded in Washtenaw County alone. Finally, Wolski’s project involves a lengthy, six-month stay with well-known collaborators who are enthused to host her.
“I still can’t believe that I am in Ghana. I feel really lucky to be here at all,” Wolski said. “It’s a huge privilege, and I’m very aware that I am getting so much more out of this than anyone here.”