By Andrea Guzman
In spring 2013 Ashley Tsai, a UC Berkeley Bioengineering and Material Science major and Global Poverty & Practice minor, enrolled in Public Health 112, which examines health at the individual and community level through multiple factors. Among the draws to the course were its regular guest speakers, including Dr. Peter Jay Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine.
Hotez is one of the most influential experts in raising awareness about tropical disease research and control, particularly neglected diseases such as hookworm infection, schistosomiasis, and leishmaniasis—which are among the most common infections of the world’s poorest people.
“He was really passionate and inspiring,” said Tsai. “I decided I wanted to learn more about these diseases.”
After Hotez’s lecture, Tsai searched online for laboratories that conduct neglected tropical disease research and found Kohn Kaen University in Thailand, which welcomed foreign students. The research sparked her interest and the laboratory was fortunately English speaking. Through a GPP minor fellowship, she headed to northern Thailand for the summer of 2014.
Tsai soon learned that much of the laboratory’s research was focused on liver fluke infections, which affect the rural poor in more than 50 countries. “Not a lot of people know about these infections,” said Tsai, “and there is not much research or investment in finding out more.”
The transmission cycle for liver fluke goes from infected humans, to snails through human feces, to fish that share habitats with the infected snails, and finally back to humans, who consume undercooked fish that carry the parasite. Infections may range from asymptomatic to presenting symptoms, such as abdominal pain, fever, jaundice, and gallstones. Perhaps most seriously, Southeast Asian liver fluke, the type Tsai studied, is classified as a carcinogen and strongly implicated in cancer of the bile duct. Tsai’s primary job was to compare the snail proteins and the fluke proteins for further research.
Tsai said she was glad to find that very good research is happening at universities in developing countries. “I realized that it’s important to collaborate instead of [universities in wealthy countries] always taking the lead,” she said. “Local laboratories working with local diseases probably have more insight than labs at places like UC Berkeley, because the former know the culture and customs a lot better.”
She also described how the Kohn Kaen lab took a holistic approach in eradicating diseases. Its efforts involved not just documenting disease transmission but focusing on how to stop transmission by collaborating with other universities and with government agencies and community organizations focused on public education and sanitation.
“This approach showed me that technology and science by themselves are like Band-Aids,” said Tsai. “For real change to happen, it has to come from public policy and the local community.”
Tsai said liver fluke is easily treated with a drug, but that the drug does not prevent infection from occurring again. In one of the areas where she and Kohn Kaen University researchers were studying, the problem largely derived from a cultural component: people ate raw fish. Thus to be successful in eradicating the disease there, researchers had to create an education campaign about the dangers of consuming fish that was not cooked.
Sean Burns, the Blum Center’s director of student programs, said Tsai’s field experience allowed her to engage in the kind of interdisciplinary problem solving that is increasingly valued in the fields of development, public health, and poverty alleviation.
“During her practice experience, Ashley began to see that complex development challenges needs complex solutions,” Burns said. “She and her fellow researchers are envisioning solutions that bring together breakthrough lab science with grounded insights into culture, politics, and social behavior. It’s at this intersection, of what we have begun to call “development engineering,” that we will see important contributions to poverty alleviation in the 21st century.”
Tsai’s GPP practice experience at Kohn Kaen University has altered her career plans. “The practice experience taught me that I can live very well on much less material possessions, and that important and fulfilling work is being done in many organizations all over the world,” she wrote after the trip. “As a result, I am now strongly considering a career in the academic or nonprofit sector.”
Tsai plans to attend a masters program in chemical biology with a focus on neglected tropical diseases and health issues that affect the global poor.
“The GPP minor made me want to look into a field of global health, and taught me that policy change is very important as well as working with the community itself,” said Tsai. “Being isolated in a lab and working with science itself is no longer enough.”