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WOAH. August is over?! It’s hard for me to be in denial any longer, especially since my first day of Senior Year is tomorrow! My last fall semester Shopping Week is kicking off in just a few hours and with three years of wisdom and experience as an undergraduate, I’m still frantically constructing a shopping schedule the night before…

Shopping Week is what we call the first week of every semester when students are allowed to sit in (or walk out!) of any and all classes without any hard feelings. It’s an exploratory week where everyone strives to strike the perfect balance of our favorite professors, homework, and catching up with everyone back on campus! Although I don’t have a shopping schedule yet, I’m not exactly freaking out because we pre-term plan (PTP) which is a system where students enter courses they intend on enrolling in for the next semester in advance. Both Shopping Week and Pre-Term Planning have no strings attached which definitely eases the stresses concomitant to committing to classes!

But before we get too serious talking about commitment and classes, I wanted to wrap up my summer of participating in iSURF (international Summer Undergraduate Research Fellowship) through the Global Health Institute. I was pursuing clinical research in maternal health and nutrition in Dar es Salaam, Tanzania for a total of 9 weeks. I wrote a final report at the end of the program that I wanted to share with you – below is what I submitted!

Nutrition and Global Health Internship

Muhimbili University of Health and Allied Sciences

Dar es Salaam, Tanzania


            The summer internship abroad description depicts clinical trials addressing critical gaps in nutrition and the complex dynamic between these gaps and infectious/chronic disease as well as perinatal, child, and maternal health. The core of these epidemiologic studies entails randomized clinical trials investigating both the safety and efficacy of iron and/or vitamin A supplements during pregnancy in resource-poor settings, with the ultimate goal of positively contributing to the broader global health and health policy agenda.


I am pleased and happy to report that all of these promises of both wide-range and in-depth clinical research exposure that was laced within the internship description were successfully delivered upon completion of the internship.


Although my Tanzanian internship was my first time traveling to the African continent, this summer internship was not my first abroad experience. I spent last summer abroad in Latin America, completing a medical shadowing internship at a private clinic in Lima, Peru as well as a sustainable clean water engineering project in Cochabamba, Bolivia. My South American experiences last summer have imprinted an understanding of the slower pace traditional outside of state lines and most importantly, have honed my patience as well as my ability to both appreciate and adapt to the culture of my surroundings. For my African adventure, I anticipated similar communication barriers and delays concomitant to the abroad lifestyle. To my pleasant surprise, the task list accumulated at a beyond reasonable pace whether that entailed acquiring familiarity with the three studies or advancing the trials along.


My first task involved creating a Standard Operating Procedure (SOP) to regulate and track the flow of participants’ samples and data. The SOP task emerged from necessity as it seemed as if neither a written nor digital record existed; but coincidentally and conveniently, investigating informational flow through shadowing and interviews served the greater purpose of learning the details of the study and its data collection protocol. It was interesting to peak into, poke around, and then ameliorate the gap in procedure. Unlike a laboratory bench experiment, clinical trials are more vulnerable to uncontrolled and unexpected events which call for resiliency and flexibility in problem solving. This realization was also enlightening because it was my first time differentiating between protocol and practice. I admire the type of on-your-toes need for creativity that has proven to be characteristic of working in big scale clinical trials.


Drafting the SOP harmoniously worked hand in hand with the assignment of creating a matrix which visually juxtaposed the study’s various analytical laboratory tests with how the test results are utilized to determine the health conditions of participants. The completion of this task necessitated research beyond the studies’ full protocols. Scientific journals and research articles helped me not only compile the test-condition matrix, but also develop an understanding to the meaning behind once abstract large words and fancy acronyms. It was refreshing to get a big picture sense of the study as well as its details to motivate both the clinical trials and my personal contribution, especially since it is very easy to have research interns work with their heads down without grasping the grander purpose of neither their labor nor the study.


Speaking of working diligently with my head down, I brought it upon myself to familiarize myself with the Microsoft Office program of Access, software that I never heard about before this nutrition research internship. Access serves as a relational database management system that also catalyzes the export of data for analysis. I concentrated on creating Access forms for a different study that also examined maternal health called Cook Smoke with Blair Wylie as the principle investigator. My practice of creating Access forms was quickly put to good use for developing a Compromised Sample Log form. However, creation of this form catalyzed the realization that the LIS database currently in use needed to be revamped to optimize efficiency and cease disappearance of data. A Visual Basic database has been piloted and activated with intentions to record laboratory test results.


The backlogging of the first 6-7 months of 2013 has been initiated and is well underway with the new database. It is easy to perceive repetitive tasks such as entering data or counting slides and blocks as useless, time-killing tasks. However, I tried to keep an optimistic mindset because as minor as my tasks seemed on the surface, they needed to be completed in order to move on to later stages of the study. It is important to experience first-hand multiple aspects of research so that a broader sense of perspective can be more easily achieved.


With a familiarity of both a broad and narrow sense of the trials, the opportune time to visit hospital sites presented itself. I enjoyed and appreciated the diversity of the sites – some sites are located in popular, urban areas while others pop up from unpaved compounds. The drastically diverse landscapes of the sites directly reflect the wide socioeconomic gaps in Dar es Salaam’s population which is an important characteristic to include and analyze within the trials. On-site visits were exciting and eye-opening as I tried to observe and memorize every detail of the hospitals. From the common waiting room to the labor waiting room and all the way to the actual birthing room, I was entranced by all the similarities, but mostly differences, to American and Peruvian hospitals.


The hospital differences grew – in a depressing manner – with the opportunity to shadow Professor Ferdinand Mugusi at the non-paying infectious disease ward of Muhimbili Hospital. Regarding my hospital exposure, my experiences have been relatively sheltered due to high US health standards. Even when I served as a medical shadowing intern in the developing country of Peru, I was based in a private clinic where financial concerns were neither a prominent thought nor a driving factor in every patient diagnosis. Tanzanian physicians tend to favor the cheaper, more non-specific tests, if any tests at all. It is indeed inspiring to witness Tanzanian provisions of free health care to those who cannot afford it. However, it is also distressing to witness crowded conditions within an infectious disease ward where resources are extremely limited. The silver lining lies in the uplifting reassurance of how well the staff strives to evenly distribute the resources available.


As with any developing country, Tanzania is no different in that financial matters both motivate as well as limit its progress. It was ironic how financial constraints also influenced the smooth advancement of the clinical trials. I have experience with money trouble in the context of laboratory bench research and grants, but I have never seen – or have I ever been this moved by – a staff that financially contributes out of their own pocket for the sake of keeping the study alive and running. To say that such efforts are heart-warming would be a grand understatement. Seeing first hand a non-romanticized perspective of research illuminated the people’s passion for their profession – a passion I arduously aspire for as an undergraduate – as well as wholly demonstrates the kind heartedness characteristic of Tanzanian culture.


Another important and intrinsic aspect of Tanzania is their skill to work in teams. During the weekly Thursday Skype meetings with Professor Wafaie Fawzi in Boston, it was always delightful to have everyone gathered in one room, catch up on the details of the study that they are personally responsible for, as well as work towards a common goal and brainstorm solutions to problems that have arisen during the week. The most personally impactful meeting was over the topic of enrollment and raising awareness about the maternal health studies. The catch 22 dilemma consisted of our goals to innovatively enroll new pregnant participants all while not overwhelming the clinic sites. Ideas to collaborate with individual village’s community leaders as well as hire a truck with a speakerphone announcement were debated. Although the solution remains in a grey area, the sound consensus was that the shared goal was to promote our study without demoting the reputations and perceptions of the health care system. The seamless transition from one specific problem of enrollment to the general concern of maternal health programs was a critical moment to witness because it served as a reminder to maintain awareness of each baby step so that in the end, the aggregation of steps creates a path to the ultimate end goal of improving global health.

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SUPER sorry I’ve been MIA these last two weeks! I promise to be more consistent as of now since I’ll be living with a host family (THE nicest host family in the world!) in Peru for the next two months and will have internet access. These past two weeks I’ve been living out one of my personal dreams: Euro-tripping with friends. In a whirlwind of two incredible weeks, we were able to hit up Paris, Venice, Florence, Rome and Barcelona.

Crepes + Eiffel Tower = as Parisian as we could get!

San Marco Plaza in Venice: Home of the Scariest Pigeons

Florence: Illegal but mandatory picture of me and David! Can't believe Michelangelo touched that and I stared at it!

Perfection and Happiness captured at the Leaning Tower in Pisa – mini trip during our stay in Florence

The Roman Ruins are anything but literal

Barcelona but not the Sagrada Familia…oops

The Peruvian group beachside! It's like I never left home 🙂

I never thought I’d be able to freely roam Europe in great company, but the generous Harvard funding that I received for my summer internship in Peru bestowed me the freedom to apply my personal savings towards granting one of my own wishes. Although my Euro-exploration will always be a source of exciting/embarrassing/once in a lifetime stories that will cease any awkward silences to come, I was also without wifi whenever I wasn’t in the vicinity of a McDonald’s or Starbucks which not only made communication slightly impossible, but also made blogging a feat I could not triumph.

My Peruvian internship (don’t worry I’ll definitely be blogging more about this!) and reliable internet access begins at such a clutch time because this summer, Harvard College gives undergraduate students June 4-18 to submit our PTP (Pre-Term Planning).

Since I now proudly hold one year of organic chemistry education under my belt, whenever I see the three letters PTP chained in this specific order, I automatically think of the electron sink cofactor and freak out. Before I was enlightened (cursed?) with this knowledge, I equated PTP as PLP: pre-life planning – the mechanism Harvard used to passive aggressively force students to plan out their lives in concrete. Both these perceptions are entirely wrong.

What is pre-term planning??

PTP can be perceived as a win-win situation. Deadlines for PTP provides the needed kick in the butt for students to start thinking about next semester’s classes, how their graduation requirements fit in during their remaining time at Harvard, and future plans in general. On the administrative end, PTP gives the university a slightly more accurate count of course enrollment so that faculty can prepare and allocate resources as needed such as how many teaching fellows (TFs, pretty much the same as a CA: course assistant or a TA: teaching assistant). A student’s PTP declaration is in no way binding. You can think of it as a casual conversation with a friend who asks you what classes you’re thinking of taking next semester. Here are two official websites that explain PTP:

PTP is a new tool that started the same time I began college (Fall 2010) so you can expect that there have been a few bumps in the road. However, you can also expect that the university is actively working towards smoothing out these bumps – you can see their reaction to student suggestions through this technology forum.

The undergraduate campus newspaper, The Harvard Crimson chronicles the history of PTP pretty well in these successive articles:

But I know it’s the summer and these articles have a lot of words. I’ll try to summarize its history below, especially for those with senioritis – although if reading these blogs is your form of procrastination, I completely condone (and empathize)!

I think PTP was instated because Harvard’s system of course selection is one of the most relaxed I’ve ever heard of. Students do not have to know what courses they’ll be enrolling in until a week after the semester begins. The first week of every semester is termed “Shopping Week” because students are allowed to sit in – or walk out – of any classes they choose in order to sample the class and evaluate if they’d like to commit to the material and professor for a whole semester. With this super chill system, it can be difficult for faculty and administration to anticipate how to allocate resources in a timely manner in order to get the semester rolling. PTP helps give staff a better idea of students’ interests and more adequately prepares them for the upcoming semester.

The theoretical purpose behind PTP is awesome because it aims for optimal efficiency and doesn’t call on too much effort from students. However, in PTP’s early days, the tool used to submit our anticipated classes was absolutely horrible – and even more dreadful if you take into account the technology and coding we have available today. The tool was super redundant and NOT user friendly at all which made every student feel completely technologically incompetent. Also, the university use to request PTP super early i.e. when you haven’t yet become accustomed to the current semester’s workload which encouraged students to not complete PTP as accurately or genuinely as they could have.

The majority of the hassle on the students’ side has been diminished with the new way to submit PTP. With this most recent PTP submission, students are able to submit their intended classes directly through in the same way that students commit to their classes so the routine is not only familiar, but also easy.

Here’s what it looks like now:

much more self-explanatory!

Positive results have also been reported by Harvard: “This early and generally accurate information has allowed us to more effectively allocate course sections and to minimize late TF (teaching fellow) appointments. Possibly related, last fall we had the lowest number of TFs in recent historical memory who scored poorly on the Q (Q guide).”

…proving my original hypothesis that PTP is a win-win. Now it’s up to how much we all win!

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