By Kristen Mitchell
A cross-disciplinary team of George Washington University researchers have received more than $1.65 million from the National Institutes of Health (NIH) to help develop trauma and injury prevention research capacity in Zambia, addressing a critical threat to health globally and building a network of collaborators.
Through two funded projects the team will help train Zambians in research and build institutional capacity to address the high burden of trauma and injury—a predictable and preventable threat to public health needing more attention in the region, said Adnan Hyder, professor and senior associate dean for research at the Milken Institute School of Public Health.
The university also received NIH funding to continue a separate program in Pakistan, which combined, expands GW’s global impact in the field of trauma and injury prevention.
“I sense that our momentum is building now that these programs are getting off the ground,” said Lynn Goldman, the Michael and Lori Milken Dean of Public Health. “Trauma and injury prevention in low- and middle-income countries is a neglected yet important public health problem that, in large measure thanks to Dr. Hyder, is finally being addressed. I am hopeful that this will become one of our signature efforts.”
GW was awarded a five-year, $1.3 million global health training grant from the NIH Fogarty International Center to work with leaders and faculty at the University of Zambia School of Public Health. This project will seek to address two critical gaps in trauma and injuries treatment in Zambia—a lack of trained human resources and limited data on health, social and economic impacts of trauma and injury. Researchers will seek to document and measure risk factors, evaluate interventions that will address major trauma and mass casualties, and explore the social and functional impact of trauma and injuries across the lifespan.
Much of this work will be done in Zambia with support from GW. Dr. Hyder and Nino Paichadze, assistant research professor at the Milken Institute SPH, are principal investigators on this project, which also brings together Paul Ndebele and Imran Bari, Milken Institute SPH, and Katherine Douglass and Gail Rosseau from the School of Medicine and Health Sciences.
The program will support new graduate degree programs that would strengthen the country’s pipeline of public health and medical professionals trained to address and research trauma and injury. GW will help develop courses specific for trauma and injury and aims to support the University of Zambia’s institutional capacity by training future trainers, lecturers and teachers. The grant will also support research projects for master’s level students.
“In any public health program, you want local ownership, local data, local decision making, so that should be true for trauma and injury in Zambia as well,” Dr. Hyder said. In older models of training, people used to fly to the high income countries to get training, but now we found ways of supporting the institution within the country. It's so important to develop this capacity locally so that they can thrive there.”
A key feature of this program is dual mentorship of all trainees, Dr. Paichadze said. Trainees who participate in the program will be mentored by one faculty from GW and one from the University of Zambia. Through this, students will learn skills specific to their curriculum, but also how to find research questions and how to conduct research in a local setting.
“From our experience in other settings, we know these relationships do not usually end at the end of the training program or training stage,” Dr. Paichadze said. “Quite often they transform into mutually beneficial working relationships, which is very important for the further development of the field.”
The team plans to help develop a national research center and launch an annual symposium highlighting research findings generated through the program, creating space for dialog with policymakers, media and non-governmental organizations on trauma injury.
Additionally, Dr. Hyder and Dr. Paichadze received a $350,000 NIH research grant to help build an electronic traumatic brain injury registry in Zambia. The program, which also includes Dr. Douglass and Dr. Rosseau, will work closely with the University of Zambia School of Public Health and University Teaching Hospital in Lusaka, Zambia, to strengthen the local data infrastructure with a new digital registry in the hospital’s surgical emergency unit. University Teaching Hospital is the referral hospital for the entire country, making it a significant catchment for tracking Zambia’s traumatic brain injuries.
The team will carry out a 12-month data collection, tracking injury causes, circumstances of injury and factors that contributed to injury. They will analyze this information and demographic data to develop intervention strategies and policy recommendations for traumatic brain injury. This includes pre-injury recommendations—for example, implementing stronger motorcycle helmet laws—and post-injury recommendations for clinical treatment and management.
The Milken Institute SPH was also named a sub-awardee to a five-year NIH global health training program to help develop trauma and injury research capacity in Pakistan, a continuation of a long-term collaboration between Dr. Hyder, Dr. Paichadze and leaders at Pakistan’s Aga Khan University. For 15 years, international researchers have been working with Aga Khan University to build capacity in trauma and injury and establish new advanced degree programs. For the first time, Aga Khan will serve as the primary awardee for this $1.3 million project.
This new phase of the project brings together additional institutions in Afghanistan, Kyrgyzstan, Tajikistan, Tanzania and Kenya. GW will receive funding to train and mentor Ph.D. students, assist with research projects and help develop short-term training in countries where greater capacity is needed.
For Dr. Hyder, this project has a personal connection. He received his M.D. from Aga Khan University in 1990 before coming to the United States to complete his education at Johns Hopkins University. He launched the NIH-funded project to build capacity in Pakistan in 2005 while serving as a faculty member at the Johns Hopkins Bloomberg School of Public Health.
Dr. Paichadze came to the United States from Georgia 10 years ago to complete her master’s degree in public health.
“We're very proud as immigrants to be part of this work and to be adding to the diversity of both this country and this university,” Dr. Hyder said. “In addressing a neglected health topic in low-income countries of Africa and South Asia, I feel that this is truly what GW's global research mission is all about.”