Transformative Research Collaborations in Uganda Prepare MCW Students as Future Global Health Leaders

Ronald Anguzu, MD, PhD, an assistant professor of epidemiology and social sciences in the Medical College of Wisconsin’s (MCW) Institute for Health and Equity, says his experiences as a medical student at Makerere University in Uganda inspired his passion to work in maternal and child health.

Now, as Dr. Anguzu mentors participants in MCW’s Dr. Elaine Kohler Summer Academy of Global Health Research Program, he hopes that those medical students’ experiences in Uganda positively impact their future careers in medicine.

“When I mentor medical students who are interested in trying to get exposed to work that is happening not just here in the US, but globally, I get drawn in to take them through some of the experiences I went through,” Dr. Anguzu says.

The MCW Office of Global Health’s Research Program facilitates 10-week projects by second-year medical students that tackle issues affecting both Milwaukee and countries abroad. Research questions that students have been involved in since 2011 include those that address adolescent health, HIV, toxicology, disaster preparedness, maternal and child health, and infectious diseases.

The research collaboration among the Makerere University School of Public Health, the Child and Family Foundation Uganda (CFU) and MCW was established in 2016 between Makerere’s Harriet Babikako, PhD, MPH, who is also the CEO and team lead at CFU, and Laura Cassidy, PhD, MCW associate dean of global health.

In 2023, 11 students participated in the summer research program, including several who worked with Dr. Anguzu on projects related to maternal and child health and COVID-19 vaccinations.

Among them was Jenna Loewus, a medical student who conducted collaborative research at a CFU Medical Center prenatal clinic to evaluate the association between intimate partner violence and postpartum depression among adolescent mothers in Kampala.

“That taught me a lot, just to have those types of conversations and make those connections with the women so they feel safe enough to tell me what they were experiencing,” says Loewus, discussing deep conversations she had with women about partner violence. “That will help me talk to people in my practice about those serious issues.”

Loewus says that their study found that physical intimate partner violence was associated with postpartum depression. The study also found that emotional intimate partner violence was associated with suicidality.

Fellow medical student Gouri Bollepalli also worked with mothers, joining a project with Makerere University, the Uganda Harm Reduction Network and the Resilient Africa Network that assessed the validity of the Center for Epidemiologic Studies-Depression Scale , which is used to screen adolescent mothers in Uganda. She describes her experience as beneficial and eye-opening.

“The big challenge that we had is the clinic did not have the same infrastructure that we have,” Bollepalli says. “We are working with different resources.”

Those challenges helped Bollepalli learn how to adapt to unpredictable circumstances, something she believes will greatly benefit her in the future.

“When something unexpected happens, let’s deal with it,’” she says.

The mentorship and research program helps these students become more adaptable to situations, enhances their character and ability to care for a diverse patient population, and increases their medical competency, Dr. Anguzu explains.

“It also helps them become more compassionate, especially when dealing with people who in a way are so desperate for care,” Dr. Anguzu says.

Another participant last summer was MCW medical student Evanka Annyapu. Her research will have future implications improving vaccine acceptance, which became a key issue for many during the COVID-19 pandemic. Annyapu evaluated factors related to a caregiver’s willingness to get their children vaccinated for COVID-19 and childhood vaccinations at a CFU postnatal clinic in Kawempe.

Her project included working with the CFU clinic staff to review immunization data from a period of about six years and entering those data into a secure, HIPAA-complaint database. They also collected over 230 surveys about barriers and facilitators to vaccination from mothers and more than a dozen audio interviews, all of which Annyapu feels was vital information.

“People were more willing to get the COVID-19 vaccine for their kids if they were more willing to get the vaccine for themselves,” Annyapu says. “They were 27 times more likely.”

She says the project was especially attractive to her in part due to her own father’s experiences in a small village in India when the Red Cross would show up to provide vaccinations.

“It’s very overwhelming for people with needles to show up and say, ‘Here, get your vaccine,’ with no explanation, no education and no understanding of why they need it,” Annyapu says. “This project was more appealing in the sense that I get to talk to people about why they are afraid of getting vaccines and why or why not they want their kids to get them.”

Madeline Gwinn, a master’s student in the MCW Global Health and Equity Program, says a maternal health course she took previously with Dr. Anguzu sparked her interest in her project, which also involved immunizations.

“He was talking about this project and told me this is what you can lead with,” she says. “He was coaching us all along the way.”

In addition to the research experience, the participants say they benefited greatly from the opportunity to learn about the differences in health care systems abroad and the beauty of other cultures.

“It really felt like they were trying to show us what their community was about, what their village does,” Loewus says. “It was just amazing to have that experience and that they trusted us with that.”

They also appreciated the mentorship that Dr. Anguzu provided.

“No matter how busy he is, he will make time for our projects and our research,” Bollepalli says. “He understands how important mentorship is.”

Dr. Anguzu says he sees great benefit in answering questions students have about research and other experiences they have both at school and abroad.

“I feel like there’s value in helping or supporting students and helping shape their careers, which in a way does impact the communities that they will be researching,” he says. “There are also perspectives from those experiences that they can learn from and share with other providers.”

Funding to support the master’s thesis work, medical student summer research and faculty research is provided by the Dr. Rachel Thompson Global Health Equity Fund, the Wm. Collins Kohler Foundation, and the Medical College of Wisconsin Office of Global Health, respectively.

In Uganda, Dr. Babikako believes the collaboration among the three institutions mutually benefits each. "The partnership offers opportunity for the mentees to experience global health firsthand and apply some research skills,” says Dr. Babikako. “In turn, the host, CFU, its staff and the community learn from the mentees.”

Personally, Dr. Babikako also finds the mentor-mentee relationship rewarding. “Mentoring students from the MCW Institute for Health and Equity is such an honor,” says Dr. Babikako. “This six-week period with the students is always memorable and at the same time extremely productive in what we are able to accomplish from a research and clinical standpoint.”