Author: chiara_romano

Today was bittersweet, being my last official day of “school” and the beginning of summer as well as several goodbyes. We had a half hour at the beginning of the morning to prepare ourselves for the presentation. Then, our group, as well as the CTI Department, all met together in the conference room. They first went over their agenda and a few other members who work from home also connected by calling. We then presented our idea for the social media project– an Instagram page focused on water access and scarcity. We discussed partnerships, marketing strategies, post content, live stories, and polling. Overall, everyone seemed very impressed! I personally explained three different types of posts that were inspired by other popular accounts: current events like National Geographic, personal stories like Humans of New York, and informational maps like the many trending map accounts. We even made an Instagram for the presentation called water.wellness so that we could demonstrate the features and make real posts. Some faculty members even followed the account! After a few goodbyes, chicken minis, and gifts, the four of us went to Starbucks and said our final goodbyes. We were only at FHI today for about two hours and now I am catching a flight to Europe! I had a great time at FHI360 and am happy to say that I learned a lot about this organization as well as myself and where I see myself in the future.

The four of us with Dr. Dorflinger, Ms. Vasco, and Dr. Nanda.

The four of us with the FHI360 logo.

The first one and a half hours of this morning we finished up all three of our projects– what a relief! We then had four meetings that were relatively back-to-back. First on the schedule was Mr. Bachman and Ms. Cooke, both in the department of procurement. They brought us all kinds of assorted knick-knacks of yo-yos, journals, pens, and stress toys to first discuss all varieties of purchases they make for the company from tchotchkes to cars. They write hundreds of proposals to different organizations, and when chosen, they distribute funding and select which items to purchase. Next we met with former Cary Academy student Hannah Goetz, a Contraceptive Technology Innovation Department intern. She began her college years at Johns Hopkins and transferred to UNC, while discovering her love for public health. She is about to continue working for FHI in Washington DC! Next we met with Ms. Lawton about her work in Behavioral, Epidemiological, and Clinical Sciences with her last research project. She travelled along with a few other FHI employees to understand what aspects of contraception are most favorable along with new ideas altogether for contraception. For a fairly simple objective, it required lots of effort– they needed translators, photographers, interviewers, and more. FHI also teamed up with another company to take their research and to convert it into beautiful presentations and booklets. One particularly interesting booklet described new ideas women had for contraception as well as features that may or may not be preferable: can be purchased from a mobile cart vendor, can be worn like a bracelet, can have no side-effects, can be made purposefully with no previous stigma, etc. Finally we met with Ms. Groves about her work in the Regulatory Affairs Department.

A collage of some pages from the booklet.

Today we spent lots of time working on our remaining two projects– the powerpoint for the theoretical acceptability of the micro-needle delivery system in India and Nigeria as well as organizing literature for adherence and retention of HIV care in Mozambique (both of which are real projects with which we are assisting FHI). While Krishan and I worked on the powerpoint, Salma and RJ worked on the literature organization to be most efficient. First we met with Dr. Ayres, a scientist working within the Contraception Technology Innovation Department. She described lots of new and innovative technologies being developed around the world. One is an oral pill in the shape of a hexagon that opens and can release a drug before reaching the intestines and can self-destruct in a sense if the pH of the intestine is detected! While this pill is not currently being developed for contraceptive use, it may be in the future. Also, a micro-chip is being made that will be inserted into a female with lots of one-month doses of contraceptive hormones that can be released remotely. Next we met with Dr. Harmon, a chemist who works with CTID and CAPRI (Contraceptive Active Pharmaceutical Ingredient Database). This database can be accessed from anyone on the internet through the organization’s agreement with the Gates Foundation and provides information on hormonal contraceptives. Lastly, we met with Dr. Burke who works in Reproductive, Maternal, Newborn, and Child Health. She talked about her work with the Uniject injection system that allows for women in Africa to administer their own hormonal contraception using a one-use needle.

Some drawings of the concepts discussed in our meeting with Dr. Ayres.

Today was the beginning of our second week! We first met with Dr. Kopf, the director of research and development for the Contraceptive Technology Innovation Department. He explained his work in college, researching reproduction in sea urchins as well as phototropism in plants. It was fascinating! He then described how his work with sea urchins initiated his interest in reproduction, leading to his current job in contraception. With his contraceptive work, he explained the way in which hormonal contraception can release at different rates in different depths of the skin. Depo-Provera, a common injectable with hormones, lasts for three months. However, with the new micro-needle patch that FHI is helping to produce, injections can access a shallower layer which could make the drugs last for a longer time of six months with a shorter peak. Rather than a large surge of hormones right after insertion and then a quick decline, a new access point would allow for a slow and steady release. For lunch, we went to Basan, a local sushi restaurant where there was the BOGOHO special– it was delicious! In the afternoon, we talked to Dr. Torjesen who worked as a pediatrician and now leads many projects as she loves problem solving. Afterwards, we attended a meeting of about twenty people from FHI with someone from the National Institute of Health about funding. Before leaving, we joined went to a retirement party and ate some sweets on the way out.

At Basan!

With a spare hour before our first meeting, Dr. Nanda offered to treat us to some Belgian waffles from a local food truck making a special appearance only a block from FHI. Thrilled to receive the invitation, we all excitedly followed her to the truck and waited in line for five minutes, and to our dismay, the waffles ran out! Despite this tragedy, the rest of the day proved to be better. We first met with Ms. Wigley and Ms. Gianone and discussed humanitarian crises- ranging from the blocking of ports in Yemen by Saudia Arabia causing a food shortage to religious attacks across the world. This presentation really moved me seeing this video of an underfed baby crying, just regaining the ability to eat again, with each bone and ligament visible under her paper-thin skin. It really put my world into perspective comparing my 10-month-old brother with sizable rolls to this poor, helpless girl. On a more exciting note, we made huge progress on our group project; an instagram page devoted to educating about water access and filtration while also gaining feedback from the public. Next, we talked to Ms. Tenorio about the protection of human subjects in research and polling, with countless regulations and questions of ethics. Finally, we met with Mr. Healy to talk about his gap year in Senegal. We all thought he had went to Cameroon based on our schedules and many of the employees! His presentation was also moving and made me really consider volunteering more for my community after seeing his amazing work.

The disappointing waffle food truck.

Working on our project!

To begin the day, we met with former Russian cardiologist Dr. Yacobsen and discussed her transition from cardiology to the ECHO department and her work in other countries. From a newspaper ad asking for a new employee well-versed in Russian, she jumped at the opportunity and now works with contraceptives. For further learning in the subject of contraception, we went to the PQC Lab- a laboratory owned by FHI to test anything from cervical caps, mosquito netting, to drugs. At the lab, they filled condoms with water to check for leaks and we even got to watch them explode! All of the testing was fascinating and crucial for the wellbeing of each and every person that FHI helps throughout the world. Back at FHI, we met with Ms. Pirzadeh and Dr. Hubacher, both a part of or have worked with the Contraceptive Technology Innovation Department. Ms. Pirzadeh and Dr. Yacobsen both work under PSTS and work with “Research Utilization” to take data and statistics and transform them into information that is easy to comprehend for a variety of people. Lastly, we spoke to Dr. Hubacher, the “IUD King”. He knows everything there is to know about intrauterine devices- differences between products, prices, and policies in countries. For instance, an IUD in Africa could cost about 50 cents, however here it could cost hundreds of dollars! We also discussed the fascinating trends of IUDs throughout the past few decades, peaking, then plunging, and finally peaking again. The unpopularity was probably caused by a form of IUD that underwent little testing and resulted in an ineffective product with a 6% fail rate and a high infection rate due to the material of the strings.

Condom Testing!

A variety of IUDs available in different countries.

Today, three of our four meetings consisted of members from the Contraceptive Technology Innovation Department- meaning we learned about devices, hormones, and bodily functions we never knew existed. In order to fully appreciate the work of this group, we needed to learn the basics of all forms of contraception on the market and of their purposes, pros, and cons. With Ms. Sergison, we discussed female and male anatomy and contraception basics, with Dr. Dorflinger we learned about more details and differences in contraception, and finally with Dr. Callahan reviewed her latest project- a dissolving contraceptive micro-needle patch. Partnering with Georgia Tech, she and other colleagues are collaborating on this project to make a new and improved form of non-intrusive contraception using progestin, estrogen, and micro-needles. With these elements, this contraceptive is painless, fast, discreet, and disposable. Once placed on the patient’s skin, the small needles are inserted and are released painlessly into the patient’s blood stream delivering the hormones. Next, the patient can remove the patch and dispose of its remains. While also discussing her research in other countries for this project, she also introduced us to another of NHI’s projects- a biodegradable contraceptive implant. With this implant, the hormones could be released through a patient’s arm over the course of a few years and then would dissolve, requiring no treatment after insertion. These medical advances are fascinating! However, the highlight of my day was watching the baseball game from the cafeteria balcony.

A shelf with many forms of contraception within the office.

The baseball game today!

Today, Salma, Krishan, RJ, and I all drove to downtown Durham to FHI360 for our first day of the work experience program. Upon arriving, I knew little about the organization- it’s non-profit, it has a medical focus, and it helps other countries through its international relations. After touring this beautiful office, we sat down with doctors Dorflinger and Nanda to discuss the history, accomplishments, and work of the organization. Primarily funded by the US Government and Gates Foundation, FHI (Family Health International) first focused on the prevention of HIV and later developed many different branches including nutrition, education, and expanded in health while acquiring AED and changing the organization’s name to FHI360. Within the health section, Dr. Dorflinger directs the entirety of the Contraceptive Technology Innovation department and Dr. Nanda is the director of medical research. Next, with Ms. Lorenzetti, we discussed one of the projects with which we will help the health department. With a focus on economics involving health policy, Ms. Lorenzetti is now examining barriers and facilitators of adherence to HIV care in Mozambique. We will help her by sorting through different resources for relevance and categorizing our findings. After a pizza lunch with a few faculty members, we met with library associate Ms. Manion and library manager Ms. Burns to learn more about literary searches using different databases and methods to use for the most accurate search results. All in all, I am very excited for the next two weeks and cannot wait to learn more about this organization!

The view of the Durham Bulls Stadium from the view of the cafeteria on the tour!