Global Health Institute

At the end of four years of studying Integrative Health Promotion, my classmates and I compared pictures of us from our first year of undergrad with more recent ones. We noticed one thing that was pretty obvious: we all looked like we were now in better physical shape. We soon realized that this was an exception in the academic world, as most of our friends pursuing other programs experienced the exact opposite. They had put on weight and adopted unhealthy habits, like constantly eating fast food, binge drinking, and smoking, as a response to dealing with stress. Noticing this situation led me to reflect on the cause of this discrepancy. What did my cohort do differently? 

Personally, I think that this difference was the result of learning about health, and the ways to restore and maintain it, almost every day for 4 consecutive years. Being aware of all the things we should — and should not — do in order to stay healthy kept me and my classmates from engaging in unhealthy behaviors. This worked to our advantage, but it is impossible to get everyone to go through a health-related degree in order to adopt healthy habits. 

Throughout my career as a health promoter, I have learned to reflect on the determinants behind the health-disease spectrum. Now I ask: "Why did I/he/she get sick in the first place?" Whenever somebody tells me that they are sick (with a curable disease, like a cold or an infection), the first thing I ask is: "Why? Is something weakening your immune system? Have you been exposed to an environment prone to disease?" The answer I get is almost the same every time: "I don't know." From my experience, people don't reflect on the cause of their sickness or ask their doctors about it. They see disease as something that "just happens" to them as if they don't have any control over it. The field of health promotion is founded under the belief that this is not true. Within the field, we move from the question "Why do we get sick?" to "Why do we stay healthy?" This change in the paradigm is empowering in the sense that it helps us realize that (a lot of the time) there is something we can do to prevent getting sick. 

From my experience, a factor that significantly impacts how people see health is the experience of being affected by or having somebody close be affected by a deadly disease. Some of my closest family members have prematurely passed away from a disease or are currently suffering from one. This forced me to be aware of the meaning of being healthy. For those who have not had similar experiences, it is easy to take health for granted and thus maintain unhealthy daily habits. Experiencing disease and loss, however, should not be the only way for individuals to gain a greater appreciation for health. 

That being said, how do we increase health awareness? How do we empower people to take control of their own health? How do we strengthen health systems to support the achievement of this goal? These are questions that I have been trying to answer through my Master’s Degree in Global Health at Georgetown University and through my Global Health Initiative Fellowship. My goal is to be able to strategically answer these questions and share my knowledge in order to improve individuals' quality of life and alleviate the burden of disease on health systems and economies. 

If you look back at pictures of yourself from four years ago, do you remember what choices about your health you were making then? Can you use that reflection to improve the choices you are making now? 

Natalie Fahsen (G’21) is a graduate studying Global Health and a student fellow with the Global Health Initiative.

This semester, I began work in Dr. Steven Singer’s lab, studying the protozoan intestinal parasite giardia. While the learning curve has been steep as a result of the technical skills and background knowledge necessary for conducting wet research, I am tremendously grateful that I have been able to acquire these skills and acclimate to the lab, while also maintaining a larger perspective through the Global Health Initiative Fellowship Program.

One of the foundational principles in the lab is that giardia predominantly infects individuals without access to proper sanitation and can have a slew of adverse effects, particularly on children, such as growth stunting. There is an intrinsic tie between the lab’s research and global health, and the fellowship’s emphases on global health and policy have provided an important perspective to the work. 

I am working with a brilliant graduate student, Heriberto “Eddie” de Leon, to construct DNA plasmids as a current project. We are working to assemble circular molecules of DNA, called plasmids, from several linear strands of genes; we hope to transform these plasmids into other cell cultures, including cell lines of giardia. Earlier in the semester, we assembled a Cas9 plasmid. This name may sound familiar from recent articles about CRISPR technology, which “knocks out” certain areas from the genome of a cell, located in the nucleus. We can use the Cas9 plasmid to perform a variation on the CRISPR knock-out technology which is called “knocking down” genes; this approach regulates genes to prevent their expression rather than cutting them out completely. This process allows for genetic regulation in giardia, which have multiple nuclei and therefore more than one set of DNA per parasite, making traditional CRISPR knock-downs unreliable and inefficient. Having the opportunity to genetically manipulate the parasite will allow us to learn more about its mechanisms. The plasmid we are working on currently is called the CWP plasmid, into which we plan to insert a firefly luciferase gene. This gene codes for a light-producing protein, which we can use for bioluminescent imaging: putting this plasmid into giardia cells which we then use to infect mice will allow us to track the progression and location of the infection in the mice in vivo. 

Both of these projects are specific and small-scale, but are foundational to optimizing further research into the public health issue of giardiasis. Although I was nervous to undertake this unfamiliar and serious endeavor, the fellowship has been an incredible opportunity to delve into the technicalities of lab research and the perspective to understand how this research impacts health worldwide. I am thrilled to continue work in this lab, which harnesses the power of science, technology, and innovation to answer questions and facilitate the treatment of individuals, especially children, suffering from giardia infection.

Eleanor Miskovsky is a freshman in the College of Arts and Sciences studying biology and pursuing the pre-medical concentration. She is currently a Global Health Initiative fellow working in a molecular microbiology lab.