Gretchen Birbeck鈥檚 first trip to Zambia came in聽1994, when she was a University of Chicago medical聽student completing an elective at the remote聽Chikankata Mission Hospital, about 75 miles south聽of the capital city, Lusaka.
More than two decades later, she spends half her聽year in sub-Saharan Africa, working to improve care聽for people with seizure disorders.
The Edward A. and Alma Vollertsen Rykenboer聽Professor in Neurology at Rochester,聽Birbeck is the director for聽Chikankata鈥檚 Epilepsy Care Team.聽She鈥檚 also an adjunct faculty聽member at the University of Zambia.
ROCHESTER AND ZAMBIA聽AND MALAWI
People
- 3 alumni living in Malawi
- 3 alumni living in Zambia
- 1 student from Malawi聽in fall 2015
- 7 students from Zambia聽in fall 2015
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A three-week study abroad聽and field school experience聽run by the Department of聽Anthropology, the seminar聽addresses cultural, health,聽social, political, and ecological聽issues in Malawi. Students聽are trained in anthropological聽research methods, and聽the seminar welcomes聽undergraduates and graduate聽students from any university聽and any major. Joseph聽Lanning 鈥�00, 鈥�07 (Mas) directs聽the program. Since 2007, 103聽Rochester undergraduates聽have participated; 17 medical聽students have also taken part,聽beginning in 2009.
Seizure disorders can be聽caused by many medical conditions,聽and they鈥檙e more common聽in the developing world. Neurological聽and psychological disorders聽account 鈥渇or about a quarter聽of the global burden of disease,聽and much of that is in developing聽countries,鈥� says Birbeck.
鈥淭here鈥檚 a disconnect between聽where disease is and where聽experts are,鈥� she says.
She works to redress that聽disconnection, providing clinical聽care and conducting research. As a result, more聽than 3,000 patients have received treatment they聽otherwise wouldn鈥檛 have. And she has helped make聽changes to Zambia鈥檚 national policy that could help聽many more.
She鈥檚 also working to build up the resources and聽networks necessary to conduct clinical trials聽in Africa, and to create education and聽training programs for health care聽providers and researchers.聽She鈥檚 involved in cerebral聽malaria research in聽Malawi and Uganda,聽and mentors postgraduates聽and junior聽faculty carrying out聽research in Zambia,聽Malawi, Kenya, and聽South Africa.
While creating聽access to specialty聽health care is critical,聽Birbeck finds that聽tackling stigma and聽misinformation is also key. The difficulties are聽complex. There aren鈥檛 only problems procuring a聽diagnosis, finding treatment options, and getting聽access to medication. Open flames from fires and聽bodies of water also pose significant threats. 鈥淏urns聽and drowning,鈥� she says, 鈥渁re two of the most聽common causes of death of people with epilepsy in聽developing countries.鈥�
In the years that Birbeck has been traveling to聽Africa, she has seen 鈥渟low inroads鈥� in Zambia for聽treating epilepsy, with improvements in general聽services and better access to information about the聽disease. Meanwhile, a 鈥渞oll back malaria鈥� campaign聽has transformed the incidence of malaria聽seizures in Zambia, though Malawi hasn鈥檛 seen such聽progress. Efforts to deal with malaria haven鈥檛 kept聽pace with those for epilepsy, but there have聽advances. 鈥淚鈥檓 not convinced malaria eradication聽is likely, but there are improvements in infection聽rates,鈥� she says.
Overall, though, Birbeck sees reasons for optimism.聽鈥淭here鈥檚 much more expertise in-country,鈥澛爏he says. 鈥淛unior people are coming back as senior
people, and staying.鈥�
Their efforts are an amalgam of teaching people聽about seizures and making care available to them.聽Both are essential, she says, and her research and聽clinical care are different but interrelated efforts聽to improve the lives of people with epilepsy and聽other seizure disorders. 鈥淲e鈥檙e educating the public,聽but we also work with the health care structure to聽ensure there are providers and treatment,鈥� she says.
