Serving Africa

Medical professionals in Africa receive training through the master of public health program

The stone buildings of the University of Eastern Africa Baraton provide a beautiful setting for the master of public health program offered to students in Africa.

This year marks the halfway point for the master of public health (MPH) program being offered to health-care workers in Africa, and already results can be seen.

"The assignments given emphasize the activities in the students' own countries," shares Patricia K. Johnston, DrPH, MS, RD, dean, School of Public Health. "The students then return [home] and incorporate what they have learned in the classroom to solve problems."

The School of Public Health, in conjunction with the African divisions of the Seventh-day Adventist Church, is offering a four-year MPH degree program on the campus of the University of Eastern Africa Baraton, Eldoret (UEAB). It is a Seventh-day Adventist university located in the northwest region of Kenya.

The program began in March, 2000, with more than 60 students from 20 countries in the Africa-Indian Ocean, Eastern Africa, and Euro-Africa Divisions, and Southern Africa Union Conference. Program funding came from the Chan Shun Foundation, Swedish Churches Council, employing agencies, and LLU.

The curriculum is focused for students who are currently or will be employed by the Adventist Church, and caters to the needs of African health-care institutions and programs operated by the Church. The response was so positive that the University had to turn away applicants.

Two members of the master of public health program in Africa meet up on the campus of the University of Eastern Africa Baraton.

Students participating in the program come from a variety of professions and are using this opportunity to further their careers and enhance their service capabilities. Approximately half are medical professionals, such as dentists and nurses. The other half are government workers, hospital administrators, or teachers.

"The students are excited about the program," comments Dr. Johnston, who taught a maternal and child nutrition class on the campus of UEAB.

Taught by Loma Linda University faculty, the classes are in a condensed two- to-three-week format. The sessions are held twice a year in March and August/ September, so the Loma Linda faculty and MPH students can utilize the campus of UEAB while its regular students are on vacation.

The MPH students prepare ahead of time for the classes by completing pre-session assignments that are sent to their homes throughout Africa.

This format has proved successful in the past, using sites in Latin, Central, and North America for the master of public health program. Adding a site in Africa is an important step to increasing the amount of qualified professionals on the continent.

The 65 students accepted into the master of public health program came from 20 countries in Africa, and work in health-related professions such as dentistry, nursing, hospital administration, teaching, and government work.

Courses that have been offered to date include environmental health, health administration, philosophy of public health, general statistics, and health behavior change.

"The classes are similar to those taught on the Loma Linda campus," states Dr. Johnston, "but some adaptations are made to meet the needs of people in Africa."

David Dyjack, DrPH, associate professor and chair, environmental and occupational health, School of Public Health, adjusted his class in environmental health to include anecdotes and case studies from Africa.

"It took a fair amount of research to provide such examples," Dr. Dyjack shares. "I personally went to Ethiopia to do air tests, gathering information to use in class." He also visited other areas of the continent, such as Kenya and Tanzania, for this purpose.

The curriculum is modified to accommodate the students' desires as well, particularly if they have a problem in their own country that must be addressed.

While the student body of the University of Eastern Africa Baraton vacations, MPH students and LLU faculty stay in the dormitories and conduct classes on the campus.

In the fall of 2002, Dr. Dyjack will return to teach a class in environmental health of developing countries. This will be a hands-on class, looking at the cooking styles of different African villages and how these habits may affect the respiratory infections and other illnesses of children. Students will have the opportunity to examine how they can implement changes of the cooking styles in their surrounding area to reduce disease.

"The people spend so much time getting food for survival that the environment is not a high priority," Dr. Dyjack comments. "For many of the students, my class was their first exposure to environmental issues."

The students quickly understood how important the topic is in the health-care arena. "They were mature, professional individuals with an enthusiasm for environmental issues," Dr. Dyjack says. "That attitude was very rewarding for me."

The program is faced with many challenges, including international communication, travel, proper visas and passports, and finances.

But civil unrest is one of the major difficulties. Eleven Nigerian students could not attend the first session due to violence around Ile-Ife Seventh-day Adventist Hospital, Ile-Ife, Osun State, Nigeria. A special make-up session was held in August, 2000, for those students.

"Africa is a tragic continent," relates Floyd Petersen, MPH, assistant professor, biostatistics, School of Public Health. "There are many situations that the people of Africa find horrific."

While teaching a class in biostatistics, Mr. Petersen was able to have several long discussions outside of the classroom with the students concerning the politics and health care of Africa.

"These conversations were very interesting," Mr. Petersen comments. "I learned more than I taught."

He also held a forum to discuss sensitive subjects, such as North America's relationship with Africa. "It was one of the most productive forums I've sat in," says Mr. Petersen. He remains in contact with the students, consulting them on research projects.

Dr. Dyjack relates that the experience proved challenging in other, unexpected ways as well. Almost daily, there was an electrical failure. "[The black-outs] reminded me of California," he notes. "It was fun to teach in quasi-darkness. The students brought in flashlights, and we continued with class."

Certain requirements had to be met in order to be accepted. Students in the program have completed a bachelor's degree (or equivalent) from an accredited university or college with a cumulative grade point average of 3.0 (on a 4.0 scale) or greater; are health-care administrators, physicians, or other health-care workers; are currently or will be employed by the Adventist Church; have commitment of sponsorship from their employer; and are approved by their Church division.

Once the students complete the MPH degree, they will be able to manage health-care institutions, develop community health services, identify funding sources, and write grant applications.

With the amount of interest in the program and the needs yet to be met, UEAB hopes to continue the MPH degree program once the four years pledged by LLU have ended in 2003.

"I greatly respect the people who continue the work in Africa, despite lack of resources," says Dr. Dyjack. "They are vibrant, caring people, and I was blessed by that."

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