GHS 610 - Refugee Health Care has been featured in UAB Reporter for April 8, 2019. Click the title below to go to the article. This article features insights from past students and from the professor as well as the importance of Refugee Health.

Refugee health course gives students real-life lessons in ‘where they fit in’

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Every disaster is different. What happens next is generally the same the world over. Whether the trigger is violent conflict or natural catastrophe, people who cross an international border to flee become refugees in the eyes of the law. And that’s when the “humanitarian action machinery,” in the words of the United Nations, springs into motion.

That machinery — UAB’s Elizabeth Elliott, Ph.D., calls it “the humanitarian industrial complex” — has never been busier. Worldwide, there are now more than 25.4 million refugees, according to U.N. statistics, which is the highest total on record. Widespread media coverage means most of us have an idea what a refugee camp looks like. But for those who feel a call to help, there are more important questions: What is it really like? and Is there a place for me? 

Camp life 

Elliott’s course in Refugee Health, part of UAB’s Graduate Certificate in Global Health Studies, is a clear-eyed look at camp communities from the perspective of someone who has been working with refugees since the early 1980s. “My students are thinking about if they want to work internationally or they have already worked internationally and they are taking the certificate to shore up their credentials,” Elliott said. “We provide them with training so that they can go to a refugee camp and have skills to share. Someone who takes the course will be able to work for Save the Children or the U.N. or the International Rescue Committee and have a clue as to what to do and where they fit in.”

A refugee camp is a miniature world that contains “everything in human life,” from pregnant mothers to serious mental health conditions to diseases of aging, on top of any injuries or illness that result from whatever caused the people to flee, Elliott said. Throughout the course, “we pull apart all of the elements that go into creating a physical community,” from site selection to vaccine programs to “engaging people who are traumatized with the mass grief that comes with losing a home – or a homeland,” Elliott said. Once the tents are up and latrines dug, this process of engagement is a critical factor. People need to know about the inevitable dangers of communicable diseases and learn how to escape the specter of family violence. “But you don’t teach to them,” Elliott said. “You say, ‘Who’s a teacher here?’ You have all the professions in a refugee camp. There’s lots of talent. You will find deep resources and be a better humanitarian worker if you let them be the guide.”

Practical training for global needs

Refugee Health is one of several elective courses counting toward the 15-hour Global Health Studies certificate. The program, offered online through the UAB Sparkman Center for Global Health, focuses on practical training in the skills necessary to function effectively in global health.

rep elliott 550px“We provide them with training so that they can go to a refugee camp and have skills to share," Elliott said. "Someone who takes the course will be able to work for Save the Children or the U.N. or the International Rescue Committee and have a clue as to what to do and where they fit in.”

The classes “were very specific to the instruction that I wanted to receive, especially since the professors have an extensive background in each area they teach,” said student Laura Gilmour. In August 2018, Gilmour left her job in medical software sales after 20 years to pursue a longstanding interest in global health and humanitarian issues. In addition to the Global Health Studies certificate, she is completing an MBA at UAB. “I had a great career, but I knew that I wanted to do something that was more impactful,” Gilmour said. “I didn’t know if I was going to work in a humanitarian organization such as the United Nations High Commission on Refugees or CARE, or if I was going to start a nonprofit myself.”

Conversations with Elliott helped Gilmour refine her plans for a nonprofit focused on taking unused medical supplies and equipment in the United States to areas of need around the world. Gilmour launched the nonprofit, HUB Worldwide, in March 2019, with Elliott as a member of her board. (See related story.) “Dr. Elliott has been invaluable,” Gilmour said, as were the lessons from the Refugee Health course. “Unfortunately, the number of refugees is not decreasing each year. It is an issue we will need to learn to effectively address.”

Knowledge without borders

Lyndsey Robinson, a registered nurse in UAB’s emergency department, is working toward the GHS certificate and studying in the School of Nursing Family Nurse Practitioner program, with a focus on rural health. She took the Refugee Health elective because “I find many commonalities between rural communities and refugee populations when it comes to illnesses, resources and roadblocks,” Robinson said. The coursework has “deepened my desire to work with rural, under-served and displaced people” and made her “more passionate about women’s health,” she added.

Robinson and Gilmour both took another elective taught by Elliott, International NGO Management, which is packed with real-life scenarios to prepare students for the unique challenges of international nonprofits. For example: What do you do when an important local figure asks you to give a job to his brother?

This past March, Robinson began working with other Birmingham health care professionals and a Texas-based nonprofit to create a women’s health clinic offering cervical cancer screening in Haiti. “I knew that Dr. Elliott’s first-hand involvement with NGOs and refugee populations as a nurse, educator, writer and liaison on the ground would prove to be extremely valuable for my future aspirations,” Robinson said. “She is not only a mentor but an amazing professor.”


2019 MSTS

Alexandra Khodadadi

Alexandra Khodadadi is a Trainee in the Predoctoral Clinical/Translational Research Program (TL1) in the Center for Clinical and Translational Science (CCTS) and the School of Medicine Additionally, Alexandra is an MSPH Outcome Research Graduate Student in the School of Public Health. She will be traveling to Brazil to work on tobacco cessation in people living with HIV under the mentorship of Dr. Isabel Scarinci. 

Tayyaba Khan

Tayyaba Khan is an Undergraduate Student studying International Health and Human Rights in the College of Arts and Sciences. She will be traveling to Pakistan to work on the social stigma related to Hepatitis C under the mentorship of Mr. Umair Haider. 

Baraa Hijaz

Baraa Hijaz is and Undergraduate Student Studying Neuroscience and Philosophy in the College of Arts and Sciences. He will be traveling to Greece to work in a refugee camp to demonstrate the need for electronic health records (EHR) under the mentorship of Dr. Majd Zayzafoon. 


Human T-cell lymphotropic virus 1/2 and human immunodeficiency virus antibodies identification among transactional sex workers and drug users in the Dominican Repubic

Robert Paulino-Ramireza,*, Leandro Tapiaa , Carlos Ruiz-Matuka , Rebecca Charowb , Henna Budhwanic and Jean-Pierre Routyd

a Instituto de Medicina Tropical & Salud Global, Universidad Iberoamericana (UNIBE), Calle Majoma 13, Los Rios, Santo Domingo, Dominican Republic 22333; b Centro de Orientación e Investigación Integral (COIN), Calle Anibal de Espinosa 352, Santo Domingo, Dominican Republic; c University of Alabama at Birmingham (UAB), School of Public Health, Department of Health Care Organization and Policy, 1720 2nd Avenue South, Birmingham, AL 35294; d McGill University Health Centre: Glenn Site, Research Institute, Block E Suite EM 3-3232, Mezzanine 3M, 1001 Boulevard Décaire, Montreal, Quebec, Canada H4A 3J1

Background: Human immunodeficiency virus (HIV) increases the risk of acquiring human T-cell lymphotropic virus (HTLV) and subsequently HTLV’s progression to tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP/HAM). Existing data have exclusively reported generalized rates of HIV and HTLV-1 chronic viral infections in the Dominican Republic. To our knowledge, no published studies have focused on the rates of HTLV-1/2 in transactional sex workers and drug users, both higher risk groups, in the Dominican Republic.

Methods: From December 2012 to April 2013 we conducted a study to estimate the seroprevalence of HTLV-1/2 immunoglobulin G (IgG) and HIV antibodies among transactional sex workers and intravenous drug users in Santo Domingo, Dominican Republic. Serological status was analysed with behaviour and demographic data.

Results: We collected and analysed plasma from 200 participants with a mean age of 27.4 y in men and 25.2 y in women. The overall weighted seroprevalence of HTLV-1/2 IgG antibodies was 13.91% (95% CI 7.59 to 20.23) in men and 10.59% (95% CI 4.05 to 17.13) in women. The overall weighted seroprevalence of HIV-1 was 13.91% (95% CI 7.59 to 20.23%) in men and 17.65% (95% CI 9.55 to 25.75) in women. Male intravenous drug users had an exceptionally high rate of HTLV-positive HIV co-infection, at 75% (95% CI 44.99 to 105.01). Although there an association has been found between HTLV/HIV co-infections and sex work, the adjusted odds revealed a confounding role of HIV infection.

Conclusions: The results highlight the urgent need for enhanced public health preventive strategies among high-risk populations in the Dominican Republic and other resource-constrained Caribbean settings, as well as global adoption of routine screening for HTLV-associated infections, particularly in these high-risk, underserved populations.

Keywords: Dominican Republic, drug users, HIV, HTLV, sex workers, transactional sex


"Acknowledgements: We express our sincere gratitude to Dr Aida Mencia-Ripley for her thoughtful guidance on the development and revision of this article and to the University of Alabama at Birmingham Sparkman Center for Global Health for their ongoing commitment to improving the health of high-risk populations in resource-constrained settings."

Last week a team of students representing UAB and the Sparkman Center for Global Health spent their Spring Break in an unconventional way – immersed in research and problem-solving innovations for addressing natural disasters in light of climate change. The team members were selected after the UAB Global Health Case Competition in February to participate in the International Emory Global Health Case Competition which was held March 15th-16th in Atlanta.

Congratulations to the UAB Team for Placing 5th in the 2019 International Emory Global Health Case Competition Team

Emory has been hosting Global Health Case Competitions since 2009 and this year’s competition was the biggest yet with 30 participating teams including Vanderbilt, Emory, Cornell, Brown, Yale, University of Melbourne, University of Toronto, and more. The case this year was "A Storm's A-Comin' Implementing Innovative Hurricane Disaster Preparedness Strategies in a Changing Global Climate."

Emory Whole Group

On Saturday, March 9th teams received the case briefing and were instructed to select one of five countries to focus on, either Madagascar, the Philippines, Japan, the Dominican Republic or Mexico. Teams then had until Saturday, March 16th to present their innovative public health solutions to a panel of judges. Presentations lasted 15 minutes, followed by a 10 minute Q&A session with the judges.

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The Sparkman Center has sponsored student teams’ participation in the Emory competition for the past nine years. Especially in light of this year’s extra-competitive field, we are proud to congratulate the UAB team for proceeding to the final round and placing 5th overall! If you'd like your shot at competing in the Emory Competition, make sure to follow the Sparkman Center on Instagram, Facebook or Twitter so you get updates on plans for UAB's 11th annual Global Health Case Competition next spring. 

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From left to right: 

Sloan Oliver is an undergraduate student majoring in Public Health.

Bijal Vashi is masters student in Biomedical and Health Sciences (MSBHS) program. She received her BS in Public Health from UAB.

Oumou Diabate is an undergraduate student majoring in Public Health with a concentration in Global Health Studies.

Amy Jasani is an undergraduate student majoring in Neuroscience combined with the fast-track MPH program in Health Behavior.

Cameron Thomas is an undergraduate student double-majoring in Public Health and Applied Mathematics.

Sufia Alam is an MPH student in the Maternal & Child Health Policy and Leadership concentration. She received her BS in Psychology from UAB.