I had the opportunity to travel to India twice during my time at The Pitt Graduate School of Public Health to complete field work for my public health practicum and genetic counseling thesis. These trips gave me the opportunity to learn more about how health care practices and needs are different based on the country and the population being served.
My first trip to India focused on learning more about India’s newborn screening practices. As a country, India does not have a national newborn screening program. Different states have introduced pilot programs to screen for various conditions, but there is no uniformity or consistency. Some programs provide the adequate follow up care while others just provide testing and leave the interpretation and subsequent action up to the families. My projects primarily focused on sickle cell disease screening because there are a few select regions within India where sickle cell disease is prevalent. With mentorship and guidance from Dr. Lakshmanan Krishnamurti, I worked with two different sickle cell centers in India to better understand their processes of screening and education for individuals with sickle cell disease. What I learned during this trip was that many of the individuals with sickle cell disease really did not have a true understanding of their disease and had never been taught about their condition. With the other members of the clinic, we determined that an educational tool would be very helpful; therefore, I created a pamphlet titled Living Well with Sickle Cell Disease in the local language of Tamil to distribute to the individuals and families that received care at the Center.
My second trip to India was geared more towards learning about the prevalence of sickle cell disease and genetic counseling practices in India. I spent approximately 2 weeks observing Dr. Dipty Jain along with other physicians at the Government Medical College & Hospital of Nagpur. This center has a large prenatal sickle cell screening program and pediatric sickle cell clinic, so I was able to observe both of these programs and travel to villages to observe outreach clinics and visits with families. Due to the language barrier, I was only able to speak with the physicians and talk to them about their methods of educating and counseling patients, but this was still a valuable lesson to hear from providers about how they educate their patients. Many of the patients in the clinics were of very low socio-economic status and had either limited or no education. This in turn meant that the education provided was very basic and more targeted towards treatment/management compliance rather than providing families with a lot of background information on the etiology of the condition. This was a very valuable lesson because in many of our clinics in Pittsburgh we have the time to spend counseling patients and families about their conditions so that they feel knowledgeable and informed; however, this was not always the case, and more of a luxury, in India. I was fortunate enough to return to one of the clinics that I visited the previous year to speak to some of the teenagers with sickle cell disease. Because I spoke the local language of Tamil, I was able to provide some rudimentary genetic counseling to the teens about the etiology of the condition and why adherence to treatment was important. I was able to have the teens repeat back to me in their own words their understanding of sickle cell disease, and it was a great experience to be able to empower these kids with knowledge about their own health.
The Global Health Certificate provided me with an opportunity to learn about health issues that go beyond national boundaries. I was able to take classes in other graduate schools at Pitt and learn about health and policy from different perspectives. The Global Health certificate allowed me to think about health in an interdisciplinary environment and approach problems from multiple perspectives, as opposed to just my genetic counseling background. In a world where the reach of genetic testing is expanding globally, I believe that the global health certificate will help me be a part of this expansion.