Working for the Desmond Tutu HIV Foundation
(Inside a church at Masiphumelele)
The purpose of travelling all the way to Cape Town, South Africa, is to partake in a coveted opportunity to work with the Desmond Tutu HIV Foundation. Over the course of three months, I'll be working as an intern to help with community outreach, operational and epidemiological research, and geographic information system (GIS) mapping and analysis for health promotion and disease prevention for some of the world’s most vulnerable populations. This treasure of a field experience is the culmination of my Master of Public Health degree. Just three days after I return to the U.S., I'll finally be graduating!
Housed within the University of Cape Town, the Foundation is committed to the pursuit of excellence in research, treatment, training and prevention of HIV and related infections in Southern Africa. The DTHF was established in 2004 as a non-profit organization supported by the Archbishop Emeritus Desmond Tutu and his wife, Leah. Alongside groundbreaking research, the clinical and community outreach staff at the Foundation share a common purpose to lessen the impact of the HIV and related diseases on individuals, families, and communities through innovation and passion for humanity.
My preceptor is a Senior Research Officer with extensive training in medicine, public health, and molecular epidemiology. At the Foundation, my work largely consists of assisting my preceptor by conducting geospatial analyses of tuberculosis disease and transmission locations within a local, high burden, township. Masiphumelele, as the community is named, means "we will succeed" in the isiXhosa language, and is located about 40 minutes south from the DTHF headquarters. Masi is home to over 20,000 people who reside in houses or shacks on densely populated land plots. These shacks are constructed from anything that comes to hand-- wooden pallets on-end for the walls, plastic sheeting nailed to the outside to keep out the wind and cardboard cartons pinned to the inside to keep out the cold. A few sheets of corrugated tin and some wood to support it are needed for the roof, as are a few big stones on top to help keep it place in the Cape storms. Because of a multitude of factors including poor ventilation and overcrowding, Masi is an unfortunate hot zone for communicable disease.
Fuelled by HIV, tuberculosis (TB) notification rates in areas around Cape Town are among the highest in the world. TB is the most common opportunistic infection and, despite the country’s large antiretroviral treatment (ART) programme, remains a major cause of death among individuals with AIDS. Ongoing monitoring of TB notification rates in Masiphumelele (since 1996), has enabled the Foundation to describe the impact of the escalating HIV epidemic and subsequently the roll-out of the ART programme on TB burden of disease in this community. Over ten years of molecular epidemiological data including DNA fingerprinting of all TB sputum strains have provided insights into transmission patterns in the HIV infected and uninfected populations. In addition tuberculin skin test surveys in the community schools have provided understanding of high TB infection rates in the community. In collaboration with the UCT Department of Engineering the research team has developed an innovative approach to the study of TB transmission, using measurements of individual-based environmental carbon dioxide monitoring to determine rebreathed liters of air as a surrogate measure of risk of TB infection.
Every two years, my preceptor and her team conduct an independent census of Masi to keep record of important population demographics and characteristics. My first task was to sort through this data and create a series population density maps. I'm currently working on a new TB dataset to elucidate areas in the township where TB outbreaks are occurring based on the DNA fingerprinting of the TB sputum strains. In Masi alone, approximately 120 different tuberculoid fingerprints have been identified which poses a significant public health challenge. For the rest of my internship, I'll be working through these data sets and geospatial analyses to provide the Foundation an accurate depiction of the TB situation in Masiphumelele.
(Left)
A GIF of the choropleth map series displaying the intense population density of housing plots in the township of Masiphumelele, located roughly 25 miles (40 kilometers) south of the Cape Town city center.
While the overall population of Masi is increasing over time, the locations within the community that exhibit this change are erratic.
