HMS Faculty Fellows

Associate Professor of Medicine, Associate Physician, Massachusetts General Hospital

Mentor: 

Kenneth A. Freedberg, M.D., MSc, Director, Medical Practice Evaluation Center, Massachusetts General Hospital; Professor of Medicine, Harvard Medical School

Division Chief: 

Ruanne Barnabas, MBChB, MSc, DPhil, FIDSA, Division of Infectious Diseases, MGH Francis and Dorothea Reed Endowed Chair in Infectious Diseases, Massachusetts General Hospital; Professor of Medicine, Harvard Medical School; Professor of Epidemiology, Harvard T.H. Chan School of Public Health

Project Title: 

“Optimizing and Scaling Cutting Out Stigma – A Barbershop-Based HIV Stigma Reduction Model”

Project Description: 

Racial and ethnic disparities pose a significant barrier to the "End the HIV Epidemic" (EHE) initiative in the U.S., particularly in the South. In 2020, our team established a partnership with Tennessee barbers and Street Works, a HIV/AIDS community-based organization, to explore barbershop-based strategies to improve HIV care outcomes for Black men in the state. Barbershops, regarded as trusted spaces, have successfully hosted health intervention programs. Our research identified stigma as a key barrier to HIV care, driven by fear, misinformation, and societal judgments. Barbers expressed eagerness to address this stigma and reframe community perceptions of HIV/AIDS. Through this partnership, we developed Cutting Out Stigma, a novel, theory-informed, barbershop-based health education and multimedia intervention whose objectives are to promote men’s sexual health and wellness and combat HIV stigma in the Black community in the highest HIV-burdened counties in TN. We have recruited and trained 52 barbers working in 26 Black barbershops who are now implementing this intervention in Memphis and Nashville. With early evidence of feasibility, acceptability, and effectiveness, the current proposal will focus on 1) understanding drivers of differences in perceived community HIV stigma between barbers and patrons; 2) identifying facilitators and barriers to intervention scale-up and sustainment, and 3)utilizing implementation mapping to identify strategies to address identified barriers to inform future trial design. Through this work, we will develop an adapted intervention protocol that is optimized for scale-up and sustainability that we will implement in the context of a Type II Hybrid implementation/effectiveness clinical trial.

Biography:

Dr. Aima Ahonkhai is an Infectious Diseases and HIV physician scientist. She is an Associate Physician in Medicine at the Massachusetts General Hospital, and also serves as Associate Director of the Bio-behavioral and Community Science Core and Director of the Community Engaged Research Program for the Harvard University Center for AIDS Research. Dr. Ahonkhai’s cross-cutting research focuses on the convergence of epidemiologic, behavioral, and implementation research to understand drivers of health disparities among people living with HIV. Her work also aims to make equity actionable by implementing solutions to improve HIV care outcomes in marginalized and minoritized populations, both globally and locally in the United States. She is particularly interested in the health needs of adolescents and young adults, and utilizing novel strategies (digital health tools, behavioral economics, multimedia communication, etc) in partnership with communities to improve care. Dr. Ahonkhai earned her MD from Johns Hopkins University and her MPH from the Bloomberg School of Public Health.

Instructor of Obstetrics, Gynecology and Reproductive Biology, Massachusetts General Hospital

Mentors: 

Adeline Boadin, M.D., MPH, Assistant Professor of Obstetrics and Gynecology, Harvard Medical School; Co-Director of Global Health, Department of OB/GYN, Massachusetts General Hospital. 

Alexander Tsai, M.D., PhD, Associate Professor of Psychiatry, Harvard Medical School

Department Chair: 

Jeffrey L. Ecker, MD, Chief of Obstetrics and Gynecology; Joe Vincent Meigs Professor of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School

Project Title: 

“Exploring family planning provider comfort with PrEP and family planning service integration in Mbarara, Uganda: A mixed methods exploratory study”

Project Description: 

African women are disproportionately affected by HIV, representing 62% of all new HIV infections in the region. Recent data have demonstrated a high incidence of HIV among African women seeking contraception, prompting multi-stakeholder interest in integrating HIV preexposure prophylaxis (PrEP) into family planning settings where women already receive contraceptive care. Currently, some programs have begun integrating PrEP into family planning settings, with existing demonstration studies focusing on “client-based” barriers and facilitators to PrEP integration. However, there is scarce “real-world” data regarding “provider-based” limitations to PrEP and family planning integration in high-burden settings in sub-Saharan Africa, particularly in Uganda. To characterize “provider-based” barriers to and facilitators of PrEP integration into family planning settings, I will first catalog and then geospatially map family planning access points in Mbarara, Uganda, and ascertain their level of PrEP service integration. Secondly, I will survey family planning providers to characterize their attitudes to HIV prevention, knowledge about PrEP, and willingness to incorporate PrEP counseling and prescribing into their current clinical workflow. Lastly, I will conduct in-depth interviews with a purposive sample of surveyed providers to elaborate a conceptual framework of provider-related barriers to and facilitators of integrating PrEP and family planning services in Mbarara. This proposed study will provide preliminary data necessary to develop a PrEP education package designed to address the needs of family planning providers who will need to integrate PrEP counseling and prescribing into the contraceptive care they provide to at-risk women. This intervention would be piloted in future work.

Biography:

Dr. Rumbidzai Mushavi is a board-eligible obstetrician-gynecologist at the Massachusetts General Hospital and Instructor of Obstetrics, Gynecology, and Reproductive Biology at Harvard Medical School. Her long-term goal is to become an independent investigator with expertise in developing and testing interventions to promote reproductive health and prevent HIV acquisition among women in sub-Saharan Africa. Dr. Rumbidzai Mushavi developed these interests growing up in Zimbabwe at the peak of her country’s HIV epidemic, where she witnessed firsthand its disproportionate impacts on women due to the complex interplay between biology, poverty, gender-inequitable norms, and structural violence. Over the last decade, she has made progress toward my long-term goal by gaining research experience in Mbarara, Uganda, where she has served in many roles, including as project manager to a large NIH-funded cohort study, spending a cumulative total of over 36 months in the country. She has contributed as a coauthor to 6 peer-reviewed publications, including 1 as first author. To achieve research independence, she needs further training in research methods, specifically epidemiology, implementation science, and mixed methods research. Dr. Rumbidzai Mushavi will consolidate this training by achieving 3 tightly linked research aims to characterize barriers to the integration of HIV pre-exposure prophylaxis services into family planning in Mbarara, Uganda. She will be supported in her efforts by Dr. Alexander Tsai (psychiatry, HIV) and Dr. Adeline Boatin (obstetrics/gynecology, sexual and reproductive health). Their track records of mentorship in global health research position them well to help achieve the mentored research aims, compete for an NIH career development award, and advance to research independence.

Instructor, Brigham and Women’s Hospital

Mentor: 

Jeremy Faust, MD, MS, Emergency Physician, Brigham and Women’s Hospital;    Assistant Professor, Harvard Medical School

Department Vice Chair: 

Ali Raja, MD, MBA, MPH, FACHE, Deputy Chair, Department of Emergency Medicine, Massachusetts General Hospital; Mooney-Reed Endowed Chair, Department of Emergency Medicine, Massachusetts General Hospital; Professor of Emergency Medicine and Radiology, Harvard Medical School

Project Title:

“Disparities in Interhospital Transfers for Trauma Patients with Femur Fractures”

Project Description:

Disparities in Interhospital Transfers for Trauma Patients with Femur Fractures. Significant disparities exist in trauma care access and outcomes based on geographic location, EMS transport times, race, and socioeconomic status. Black and Hispanic patients are more likely to reside in “trauma deserts,” areas with limited access to nearby trauma centers, resulting in delayed emergency care. Even after reaching a hospital, patients may require transfer to another facility for specialized treatment, causing further delays. The Emergency Medical Treatment and Labor Act (EMTALA) was designed to prevent patient dumping and ensure initial stabilization, particularly for uninsured and underinsured populations. However, its protections do not extend to definitive care or specialized treatment after initial evaluation, leaving many patients—especially from marginalized communities—vulnerable to inequities in care access. This project will investigate interhospital transfer patterns among patients with femur fractures, a common traumatic injury that typically requires hospitalization and surgical repair. Focusing on hospitals already capable of performing femur fixation, the study will examine how institutional characteristics such as trauma center designation, academic status, and geographic location are associated with potentially avoidable transfers. It will also assess whether race, ethnicity, insurance status, and income level impact the likelihood of being transferred, even when patients present to capable facilities. By leveraging robust state-level emergency department and inpatient data, this study aims to uncover systemic inequities in trauma care delivery. Findings will have critical implications for healthcare policy and may inform efforts to expand EMTALA protections, reduce unnecessary and costly transfers, and ensure equitable access to definitive trauma treatment across diverse populations.

Biography:

Dr. Onyekachi Otugo is a board-certified Emergency Medicine physician at Brigham and Women’s Hospital. Raised in the Washington, DC, Metropolitan area, she pursued her undergraduate education at the University of Maryland, earning a Bachelor of Arts in Art Studio and a Bachelor of Science in Biology. Before entering medical school, Dr. Otugo worked as an Oak Ridge Institute for Science and Education fellow at the Food and Drug Administration’s Office of Women’s Health. Subsequently, she completed her medical degree and obtained a Master of Public Health from Northwestern University. She went on to complete an emergency medicine residency at the Cleveland Clinic Akron General. She then completed a Health Policy Research and Translation fellowship at Brigham and Women’s Hospital, where she also served as the Research Director for the Office of Inclusion, Diversity, and Social Justice upon graduation from the fellowship. In 2021, she graduated with a Master of Public Administration as a John F Kennedy and Adrian Cheng Fellow from the Harvard Kennedy School of Government. She has published articles in USA Today, The New England Journal of Medicine, STAT News, The Journal of Graduate Medical Education, and The Lancet, focusing on access to care and health equity issues.

Physician, Member of the Faculty, Dana-Farber Cancer Institute

Mentor: 

Erica Mayer, M.D., MPH, Associate Professor, Harvard Medical School

Division Chief: 

Sara M. Tolaney, M.D., MPH, Division of Breast Oncology, Susan F. Smith Center for Women’s Cancers, Dana-Farber Cancer Institute.

Project Title: 

“A Phase 2 Trial to Assess the Tolerability of Abemaciclib Dose Escalation in Patients with Early-Stage HR-positive and HER2-negative Breast Cancer”

Project Description:

Abemaciclib has significantly improved outcomes for patients with early hormone receptor-positive, human epidermal growth factor receptor 2 (HER2) negative breast cancer. However, up to 84% of patients experience diarrhea, with 8% grade 3, leading to dose reductions and impacting patients’ quality of life. There is a critical need to understand the mechanisms of abemaciclib-induced diarrhea and develop predictive strategies to mitigate its impact. This study explores the gut microbiome as a predictor of gastrointestinal toxicity. We hypothesize that reduced microbiome diversity and specific microbial compositions increase the risk of diarrhea and that abemaciclib induces shifts in gut microbiome diversity and composition, favoring pro-inflammatory taxa. This research builds on findings from our group that the gut microbiome plays a role in modulating response and toxicity to cancer therapies. The proposed study is a correlational analysis of the ongoing TRADE trial (NCT06001762). Two specific aims guide this project: (1) to determine whether baseline gut microbiome characteristics predict gastrointestinal toxicity of adjuvant abemaciclib and (2) to assess gut microbiome changes during treatment. Stool samples collected pre-treatment, during therapy, and post-treatment will undergo metagenomic and 16S rRNA sequencing to characterize microbiome diversity and composition. Associations between microbiome features, diarrhea severity, and clinical outcomes will be analyzed. This research will provide critical insights into the role of the gut microbiome in abemaciclib toxicity, potentially identifying biomarkers for personalized treatment strategies to improve patient outcomes and reduce treatment-related adverse effects.

Biography:

Dr. Schlam received her medical degree from Anahuac University in Mexico City in 2014. She subsequently completed her Internal Medicine residency at The Jewish Hospital of Cincinnati and then her Hematology and Medical Oncology fellowship at The MedStar Georgetown Washington Hospital Center in Washington, DC. She obtained her Master's in Public Health from the Harvard School of Public Health in 2024. She was faculty at Tufts Medical Center from 2021 to 2024. In 2024, she joined the staff of the Dana-Farber Cancer Institute as a breast medical oncologist and clinical researcher. Her research focuses on drug development, identifying markers of response to novel therapies. She is also the Associate Director of the Dana-Farber Cancer Institute, Early Breast Cancer Program (LEAP)

Instructor, Beth Israel Deaconess Medical Center

Mentor: Ara Nazarian, PhD, Associate Professor of Orthopaedic Surgery, Harvard Medical School; Director, Musculoskeletal Translational Innovation Initiative, Vice Chair of Research Affairs, Carl J. Shapiro Department of Orthopaedics, Beth Israel Deaconess Medical Center

Department Chair: Edward K. Rodriguez, MD, PhD, Chief, Orthopaedic Surgery, Carl J. Shapiro Department of Orthopaedics, Beth Israel Deaconess Medical Center; Professor of Orthopaedic Surgery, Harvard Medical School

Project Title: “Improving open fracture care in Northern Malawi through targeted deployment of affordable device innovations, education, and standardized protocols.”

Project Description: Malawi, a low-income country in southeastern Africa, has a high incidence of open fractures and limited orthopaedic surgical capacity. The Northern Region of Malawi is especially underserved, with 2.3 million people and one orthopaedic surgeon based at Mzuzu Central Hospital (MCH). Building on an established partnership with Malawian colleagues, we will develop, implement, and prospectively evaluate capacity building initiatives to improve open fracture care for the poor in Malawi. Firstly, we will introduce novel medical devices designed for the needs of Malawian patients: 1) an affordable external fixator (AEFIX) clamp, and 2) our low-cost wound vacuum (VATARA) pump. These cost <1% of the industry standard devices and performed comparably in preliminary testing. We will submit AEFIX and VATARA for regulatory approval and introduce them to MCH as a pilot site in Malawi.  Secondly, we will develop a longitudinal educational program with didactics, case-based teaching, and protocols to improve open fracture management at MCH. Annually, we will run three virtual case-based conferences to discuss cases from MCH and a two-week, in-person program with Harvard faculty visiting and teaching MCH staff alongside Malawian colleagues. Thirdly, to examine open fracture care quality at MCH, we will launch a prospective clinical study, enrolling patients with open fractures and recording 1-year outcomes. Patients will be enrolled before and after the implementation of our capacity building initiatives to allow examination of their impact and cost-effectiveness. We believe this may serve as a model for open fracture capacity building throughout Malawi and in other similar resource-limited settings.

Biography: I am an orthopaedic trauma surgeon at Beth Israel Deaconess Medical Center and the Founder and Director of the Harvard Global Orthopaedics Collaborative. I am the first Harvard-affiliated orthopaedic surgeon with 50% protected time for global orthopaedics research, and I divide my time between Boston and sub-Saharan Africa – primarily Malawi, Ethiopia, and Gambia. In Boston, I care for patients with musculoskeletal injuries at Beth Israel Deaconess Medical Center, a Level 1 trauma center, directly supervise and train medical students and orthopaedic residents, as well as mentor trainees in a variety of global health projects. In Malawi, Ethiopia, and Gambia, I oversee clinical research projects and teach research methods, provide clinical training and mentorship, and regularly meet with policymakers and donors to advocate for expansion of orthopaedic and trauma care for the poor and vulnerable. I have dedicated a significant portion of my training and career to the field of global orthopaedics, which aims to understand and address the burden of musculoskeletal disease, especially in resource-limited settings, and to develop solutions to achieve musculoskeletal health equity. I have published 29 peer-reviewed manuscripts and mentored 46 students and residents who share an interest in this field. I have given numerous presentations on my research and global health work at national and international conferences, serve on national and international committees, and frequently perform peer-review of grants and scientific manuscripts in the field of global orthopaedics. I have personally established and continue to oversee productive academic partnerships with colleagues in Malawi, Ethiopia, and Gambia.

Instructor of Neurology, Boston Children’s Hospital

Mentor: Aisha K. Yousafzai, PhD, Professor of Child Development and Health, Department of Global Health and Population, Harvard T.H Chan School of Public Health

Mentor: Annapurna Poduri, MD, MPH, Director, Epilepsy Program, Investigator, F.M. Kirby Neurobiology Center; Associate Chief for Academic Development, Department of Neurology, Diamond Blackfan Chair in Neuroscience Research, Boston Children’s Hospital

Mentor: Gretchen Brion-Meisels, Senior Lecturer on Education, Harvard Graduate School of Education

Department Chair: Scott L. Pomeroy, MD, PhD, Neurologist-in-Chief, Chairman, Department of Neurology, Boston Children’s Hospital; Bronson Crothers Professor of Neurology, Harvard Medical School

Project Title: “Voices for Equity: Tackling Infantile Spasms Inequities through Community Action”

Project Description: Inequities in care are well-described for children with epilepsy from historically marginalized communities, but evidence-based interventions are lacking. There is a paucity of detailed information about root causes, in other words how inequities are produced and reproduced. Participatory action research (PAR) has been used in educational and other settings to co-construct solutions with members of affected communities and analyze the results of the intervention with respect to meaningful outcomes to the community. We plan to use PAR methodology to devise and implement interventions to address racial/ethnic, insurance, and linguistic inequities in pediatric epilepsy care in Boston, using infantile epileptic spasms syndrome (IESS) as a model. Engaging caregivers from historically marginalized groups in PAR can support the development of intervention strategies that are culturally responsive and relevant to their needs. In year one, we will complete ongoing qualitative grounded theory research and recruit community researchers. In year two, we will complete a participatory research action cycle, implementing a co-constructed intervention and analyzing its results.

Biography: My passion is working towards equity for pediatric epilepsy patients through collaboration with patients and their families using a strengths-based model of liberatory education. It is a direct result of patient and colleague interactions that I have had throughout the course of my residency, as I have found a passion for working with children with complex and developmental epileptic encephalopathies. As our knowledge as a field continues to blossom with biomedical research and innovation, equitable approaches to distribution and approval of targeted treatment approaches are needed for neurology patients, like the patients I have had the opportunity to care for during residency. To build my abilities as an educator and advocate, I obtained a master’s degree from Harvard Graduate School of Education and will attend the Palatucci Leadership Advocacy Forum. In addition, I have been deeply engaged with teaching, curriculum development, and education advocacy at Harvard Medical School, Boston Children’s Hospital pediatrics and neurology programs, national initiatives, and with international partners in Peru and Chile. These education and advocacy skills, along with my fluency in Spanish and Portuguese, will help me to translate my equity research into practice and policy.

I was born and raised in Harlem, NYC and all my primary family member still reside there and all work in healthcare. Living alone in a new city, starting a new job away from my family during the COVID-19 pandemic heavily impacted my research progression during my time at UD, specifically, manuscript publication. However, I recently joined the research faculty in the Division of General Pediatrics at BCH as a Senior Research Scientist in September 2022. Although it was difficult to leave a hard-money, tenure track faculty position, I believed the great working relationship with Dr. Phipatanakul and the resources available to support my career development at BCH and Harvard Medical School were unmatched.

Instructor in Medicine, Massachusetts General Hospital

Mentor: Christine S. Ritchie, MD, MSPH, Professor of Medicine, Research Director, Division of Palliative Care and Geriatric Medicine; Director, Mongan Institute Center for Aging and Serious Illness, Department of Medicine, Massachusetts General Hospital and Harvard Medical School

Division Chief: Vicki A. Jackson, MD, MPH, Blum Family Endowed Chair in Palliative Care, Chief, Division of Palliative Care and Geriatrics, Massachusetts General Hospital; Co-Director, HMS Center for Palliative Care, Professor of Medicine, Harvard Medical School

Project Title: “Explore the Serious Illness Communication Needs of Latino Spanish-speaking Patients & Caregivers to Develop Interventions that Support these Needs”

Project Description: The Latino population faces multiple barriers to equitable high-quality care, including low rates of insurance coverage, poor access to care, language barriers, and systemic and institutional discrimination. People living with serious illness have complex healthcare needs and often encounter communication-based challenges when engaging with their health care that can lead to emotional distress and lower quality care. This is further complicated for patients who prefer a language other than English. Serious illness communication is a key element of high-quality palliative care, but it is less likely to occur with Latino Spanish-speaking individuals. However, fewer than one-third of all people with serious illness report having serious illness communication with their clinician and Latino Spanish speaking patients lack access to serious illness communication. We first need to better understand the communication needs of seriously ill Spanish-speaking patients and caregivers.

To address this, I will first investigate the communication experiences and needs of seriously ill Latino Spanish-speaking patients and their caregivers, related to serious illness communication and palliative care. I will then explore barriers and facilitators to serious illness communication from the perspective of medical interpreters, who are often called upon to support this communication for this patient population. I will also explore best practices for partnering with interpreters to support serious illness communication. Finally, together with the perspectives of language-concordant and language-discordant palliative care clinicians supporting seriously ill Spanish speaking patients (in a separately funded effort), I will begin the development of a behavioral change intervention for clinicians to better support and meet the communication needs of seriously ill Spanish-speaking patients.  

Biography: I am an internist and palliative care physician caring for individuals with serious illness. I am passionate about improving the serious illness care experience for Latino Spanish-speaking patients and families. To further my own training, following palliative care fellowship, I was selected as a Commonwealth Fund Fellow in Minority Health Policy at Harvard University. I now serve as the Equity Director for the Division of Palliative Care and Geriatric Medicine. My research interests include understanding the needs of and improving serious illness communication and care for Latino Spanish-speaking patients. As part of this, I hope to better understand the health care experiences of individuals, particularly those from marginalized communities including Latino and Black individuals, in service of designing interventions to improve their access to high quality serious illness communication. I co-lead Health Equity Curriculum and Track for Palliative Care Fellows. I am currently the site co-lead of an institutionally funded United Against Racism Palliative Care project to reduce the inequities in serious illness conversations among Black and Latino people in partner community health centers.

Instructor in Psychiatry, Massachusetts General Hospital

Mentor: David Mischoulon, MD, PhD, Director, Depression Clinical and Research Program, Massachusetts General Hospital; Joyce R. Tedlow Professor of Psychiatry, Harvard Medical Center

Division Chief: Maurizio Fava, MD, Chair of Psychiatry, Vice Chair, the MGH Executive Committee on Research, Executive Director, Clinical Trials Network & Institute, Massachusetts General Hospital; Associate Dean for Clinical and Translational Research, Slater Family Professor of Psychiatry

Project Title:  “Molecular Mechanisms of Whole-Body Hyperthermia for Depression”

Project Description: Major Depressive Disorder (MDD) is a serious mental illness affecting over 200 million people worldwide, and new treatment options are urgently needed. Whole-body hyperthermia (WBH), or elevating the body temperature, is emerging as an effective, rapid-acting, non-pharmacological antidepressant therapy. However, the precise molecular mechanisms are not understood. In this project, we aim to better understand how WBH relieves depression at a molecular level.

Specifically, we are interested in inflammatory mechanisms, as depression is associated with inflammation, and exposing the body to elevated temperature is thought to be anti-inflammatory.  Heat may also enhance the body’s ability to adapt to stress through affecting proteostasis (the balance between building and breaking down proteins). Therefore, in this project, we aim to better understand the impact of WBH on inflammation and proteostasis in patients with depression, and how these responses might contribute to WBH’s antidepressant effect. 

To accomplish this goal, we will analyze samples from a clinical trial of WBH vs. a sham control for patients with depression, asking: 1) what impact does WBH vs. Sham have on molecular markers of inflammation and proteostasis? 2) How do these markers relate to depressive symptoms?

This project lies at this intersection of psychiatry, immunology, physiology, and molecular biology, thus demonstrating multidisciplinary integration.  The outcomes promise a deeper understanding of how WBH contributes to improved mood. Moreover, our findings might help guide further development of this promising intervention for depression.

Biography: Dr. Simmie Foster is a practicing psychiatrist at the Depression Clinical and Research Program (DCRP) and director of the Lab for Hot and Cool Research at the Massachusetts General Hospital (MGH). Dr. Foster completed her MD and PhD at Yale School of Medicine, medical internship at MGH, psychiatry residency at the University of Pennsylvania, and a postdoctoral research fellowship at Boston Children’s Hospital.  She has received multiple awards including a position as a scholar in the Harvard-wide K12 Building Interdisciplinary Careers in Women’s Health program, a Burroughs Wellcome Fund postdoctoral fellowship, a K23 career development award from the NIH, and the Jerome and Celia Reich Award in Depression Research.  She has given a TEDx talk on “Pain and Immunity: What’s Sex got to do with it?” Her research aims to understand the impact of temperature and heat flows on inflammatory responses that contribute to disorders such as Long COVID and depression. The ultimate goal is to develop safe, accessible, temperature therapeutics for the growing problem of inflammatory disease.

Instructor, Harvard Medical School

Mentor: Matthew Bonds, PhD, Associate Professor, Department of Global Health and Social Medicine, Harvard Medical School

Division Chief: Vikram Patel, MBBS, PhD, Paul Farmer Professor and Chair of the Department of Global Health and Social Medicine, Harvard Medical Center

Project Title: “A Geographic Analysis of Community Wastewater as an Early Warning Signal for Emerging or Re-Emerging Diseases with implications on Climate Change.”

Project Description: Global health preparedness requires anticipating emerging threats and coordinating risk reduction efforts. Climate change induced health inequities across the globe force us to consider the amount of risk the most vulnerable populations are facing. Vector-Borne Parasitic Diseases (VBPDs) pose a daily challenge to the ability to survive and thrive for inhabitants of tropical and sub-tropical regions. Early warning signals of surveillance that detect changes in vector-host exposure risk are essential to reducing global health vulnerabilities from VBPDs. Community wastewater can forecast population disease dynamics and provide an early indication of risk well before symptoms are present within a population, potentially preventing outbreaks. This project will leverage geolocated wastewater samples to build a community health profile to determine where infectious disease risk is greatest in southern Africa by conducting wastewater sampling across geographically discreet locations, building an exposure risk model for certain vector borne and parasitic diseases and combining pathogen detection results with socio-ecological factors to map area-level risk. The development of a community health profile framework can provide useful insights that inform outbreak mitigation and prevention campaigns.

Biography: Demetrice “Dee” Jordan is an Instructor in the Department of Global Health and Social Medicine. She holds a dual-PhD in Health Geography and Environmental Science and Policy from Michigan State University (MSU), a Master of Public Health in Global Health and graduate certificate in Global Infectious Diseases from Harvard T.H. Chan School of Public Health.

Dee’s research focuses on the spatial-ecological determinants of disease risk for vector-borne parasitic diseases and Neglected Tropical Diseases of sub-Saharan Africa and the tropics and the role of climate change in emerging and reemerging infectious diseases. Dee also examines issues related to health equity, health disparities, social and environmental justice. She is a trustee for the Society of Public Health Education (SOPHE), a member of Oak Ridge National Lab’s Geospatial Science and Human Security Division’s Scientific Advisory Committee, councilmember of the American Geographical Society (AGS), and the creator of the Celebrating Black Geographers anthology, hosted online by AGS.

Dee is the recipient of numerous awards including an Equity, Social Justice and Advocacy award from the Office of Diversity Inclusion and Community Partnership at Harvard Medical School, a Burke Global Health Fellowship at the Harvard Global Health Institute, and a Burroughs Wellcome Fund Postdoctoral Fellowship.

Instructor in Anaesthesia, Brigham and Women’s Hospital

Chief/Mentor: Michaela K. Farber, MD, MS, Chief, Division of Obstetric Anesthesia, Brigham and Women’s Hospital; Associate Professor of Anaesthesia, Harvard Medical School

Project Title: “Point-of-Care Ultrasound for Acute Obstetric Care: Training Anesthesiologist to Address a Critical Gap on Labor and Delivery."

Project Description: Maternal mortality in the United States has increased more than 50% over the past two decades, with nearly 80% of pregnancy-related deaths deemed preventable and attributed to a delay in diagnosis. Cardiovascular disease, sepsis and hemorrhage remain among leading causes of maternal death. Point of care ultrasound (POCUS) has emerged as a powerful tool for timely recognition and management of these and other forms of maternal critical illness. As an adaptable tool for bedside diagnosis, POCUS can address urgent clinical questions, expedite care, and guide management of hemodynamic instability.

POCUS has become the standard of care for critically ill patients in acute settings outside of the labor and delivery unit, such as the intensive care unit and emergency department, but access to POCUS and appropriate training are rarely available for clinicians providing acute obstetric care. Despite its potential to improve outcomes, routine use of POCUS in patients on labor and delivery is variable and there are no existing standards for obstetric POCUS training or implementation.

We intend to develop and implement a model for obstetric POCUS training and application while simultaneously gathering data to define national standards for its use. We have already piloted this model for neuraxial POCUS and will expand our approach to include transthoracic, lung, gastric and ocular ultrasound. The model will incorporate educational modules via online delivery platforms; hands-on simulation; direct bedside application through clinical prompts; and generation of an image repository to inform an evidence-based algorithm for the use of POCUS for at-risk obstetric patients.

Biography: I am an obstetric anesthesiologist and a specialist in critical care medicine at Brigham and Women’s Hospital (BWH) and Instructor in Anaethesia at Harvard Medical School. My interests focus on the intersections of critical, cardiac, and obstetric care, as well as the development of systems to lower maternal morbidity and mortality. After completing my residency in anesthesiology and chief residency at Massachusetts General Hospital, I pursued subspecialty training in critical care medicine at Columbia Presbyterian Hospital, and obstetric anesthesiology at Brigham and Women’s Hospital.

Since joining the BWH faculty in 2020, I have devoted 100% effort to my clinical practice, during which I supervise medical students, residents, and fellows. I am also engaged in several projects within our institution, locally and internationally to improve maternal outcomes and mitigate disparities in maternal care. These initiatives include:

1. Implementation of a point-of-care ultrasound (POCUS) initiative on the BWH labor and delivery unit;
2. Expansion of the Cardiovascular Disease and Pregnancy Program to include educational and research opportunities for BWH obstetric anesthesia fellows;
3. Engagement with the Massachusetts Department of Public Health Maternal Health Taskforce;
4. Collaboration on high quality and safe obstetric anesthesiology practices between the BWH Division of Obstetric Anesthesia and Phu San Hanoi Hospital, Vietnam.

One area where I have leveraged my combined expertise in critical care and obstetric anesthesia is the use of POCUS to manage acute decompensation on the labor and delivery unit. Most maternal deaths are deemed preventable and attributed to a delay in diagnosis and management of clinical deterioration. POCUS can address focused urgent clinical questions and expedite management at the bedside; however, access to and training in POCUS are rarely available for clinicians providing acute obstetric care. Despite its potential, the use of POCUS during labor and delivery is variable and there are no standards or guidelines for its implementation. Within this context, I lead a team of core faculty who have acquired or are acquiring POCUS certification, with expertise in perioperative ultrasound education, critical care, obstetric anesthesiology, and implementation science. We are developing a model for obstetric POCUS training and application. We have already piloted this model for neuraxial POCUS and will expand our approach to include transthoracic, lung, gastric and ocular ultrasound.

The maternal POCUS initiative is synergistic with my work as Director of the Pregnancy and Cardiovascular Disease Program for the Obstetric Anesthesia Division. Since assuming this role in 2023, I have created a monthly rotation for fellows focused on the acute management of cardiac disease in pregnancy. My vision is to encourage clinical and academic inquiry through formal engagement in the program, and ultimately generate evidence to inform best practices for cardiac disease in pregnancy. This perspective as an educator is an integral part of my approach to improve obstetric care for high-risk patients.

As the only anesthesiologist member of the Massachusetts Department of Public Health’s Maternal Health Taskforce, I contribute expertise on evidence-based critical care to improve the delivery of maternal care in our state. I also advise the Betsy Lehman Center in its policymaking, research, and quality improvement initiatives for maternal health in Massachusetts.

My perspective on public health and policy is informed by years of experience in diverse international settings, including Rwanda, South Africa, and Vietnam. I currently serve as co-director of the BWH Obstetric Anesthesia partnership with the largest maternity hospital in Hanoi, Vietnam, where recent trends in maternal mortality are similar to those in the United States. We are collaborating to build a needs assessment framework to improve maternal health outcomes in low and middle income countries (LMIC). To date, we have developed a model for comprehensive assessment of obstetric anesthesiology practices in LMIC hospitals to provide insight into material and human resources, characterize maternal outcomes, and identify areas for improvement in delivering safe care.