SURF 2014 in Malawi

– written by Connor Belson, BS Biology and minor in Business Administration, Class of ’15

I arrived at the University of North Carolina in the fall of 2011 with a head full of ideas—plans for the future, places I wanted to see, experiences I wanted to create. But none of these plans involved Malawi. And none of these plans involved research. However, I now find myself entering my senior year of college in the midst of a life-changing research experience in Malawi’s capital city of Lilongwe. The development of my research experience at Carolina resulted from a series of relationships that have been growing since my freshman year. It began with a shadowing experience with a doctor at Walter Reed Hospital in Washington DC two summers ago, which led to a friendship first built between him and me over discovering that he had attended Ubelson 1NC for undergraduate and medical school, and then strengthened over sharing our love for Carolina basketball, Franklin Street, and lunch at Weaver Street on a Sunday afternoon. He then connected me with several UNC staff members back in Chapel Hill, who, after meeting with all of them in the fall, each connected me with several more. And then, two years and countless conversations later, I was offered the incredible opportunity to travel to Lilongwe, Malawi and work with the UNC Project Research Center for Infectious Diseases at the Kamuzu Central Hospital.

I am pursuing an undergraduate degree in Biology with a minor in Business Administration through the Kenan-Flagler Business School. Because of my interest in both the hard science and financial aspects of the healthcare world, the director of the UNC Project Research Center, Irving Hoffman, asked if I would like to join a team that was working on a new business proposal that would improve access to sufficient healthcare and diagnostic testing for the population of Lilongwe. Because many clinics and research centers in the country operate with a significant lack of resources and cannot provide all of the tests needed for their patients, a majority of individuals who come for diagnosis and treatment are not able to receive a comprehensive set of all possible causes of their illnesses and can risk missing the proper treatments. However, the University of North Carolina’s center at Kamuzu Central Hospital has a full laboratory with the resources to test its patients for any and all possible causes of their illnesses. In order to provide this to a wider portion of the population of Lilongwe, the UNC Project has offered to allow other clinics in the city—those without access to sufficient patient testing—to pay for samples from their patients to be tested in the UNC Project laboratories, ensuring that the patients receive a proper diagnosis. During both of the last two summers, I have traveled to Lilongwe, Malawi to conduct research on this process. In my first trip, I researched the feasibility of the patient sample exchange system. This involved performing a financial analysis of the UNC Project laboratory to ensure that it could handle an increased level of patient samples and conducting market research as a means of identifying potential partner clinics in the area. By the end of the summer, I had generated a final presentation that supported the feasibility of the proposal and that identified the UNC Project’s future partners who could benefit most from the commercialized system.

This summer, through OUR’s Summer Undergraduate Research Fellowship, I was able to travel back to Malawi and research the financial and cultural implications of the new partnerships as they were being implemented. The goal of the research was to identify any barriers that were met along the way and to record how they were resolved, in addition to tracking the additional revenues and expenses that were generated for the laboratory as a result. I designed and incorporated a computerized accounting program to replace the inefficient and unorganized handwritten receipting process, as a way of helping the staff handle an increased influx in work. In addition, a system of transporting the samples between clinics was created, and pricing system for all of the tests was created to make sure the lower-resource clinics would still be able to pay for any tests their patients needed. Thus far, the commercial system for patient samples has generated additional profits that the UNC Project has been using to support the free clinic it provides for patients. In addition, the partner clinics have successfully increased the array of diagnostic tests that they can deliver. Although several cultural issues have been encountered along the way, solutions have been found for all of them, indicating that this system is one that has potential to be incorporated in other low-resource areas as well.belson 2

Because I had never considered research before coming to Carolina, I did not seek out my initial research opportunities. However, I soon learned how integral research can be to other areas of work, like medicine, that had always interested me. And so when the opportunity for international research presented itself to me, I took it immediately, despite knowing very little about what experience I would have or how it would impact my future. Since then, my research with the UNC Project in Malawi has become a defining characteristic of my undergraduate experience at the University of North Carolina. I have used it to help reinforce my desire to work in a medical career. In addition, it has opened the doors of clinical and public health research as potential roads I may find myself traveling down in the future. It has given me countless memories, experiences, useful skill sets, and friendships, and I would now recommend undergraduate research to anyone, including those not currently considering the idea of research. It will provide ways to learn outside of the classroom, to discover hidden interests and passions, to expand important networks of relationships, to see the world, and to enjoy the entire process.