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Building HIV prevention awareness for mothers in India

March/ April 2023 | Volume 22 Number 2

By Mariah Felipe

Photo of Dr. Jacqueline Firth

"Medical school is not going to be enough." That's what former Fogarty fellow Dr. Jacqueline Firth said to herself during her first study abroad opportunity in Niger. At the time, she was an undergraduate at Georgetown University shadowing doctors at the national hospital treating a meningitis outbreak. Unfortunately, the hospital was so severely under-resourced that the same needle was used on several patients to do lumbar punctures. Firth says, "I wasn't even in medical school at this point, but I knew then that I needed to pursue a career in public health."

Firth comes from a family of medicine. Her father was a cardiologist, her mother a nurse, and a family of physicians live back in South Africa, where her father was born. Her family background made the decision to enter the medical field easy, though she had always thought she would take the traditional route.

"Initially, I thought I would take a solely clinical approach to it, but those projects helped me to see that public health can have as much impact as taking care of patients directly, so I ended up doing both."

Four years later, Firth became a member of Fogarty's inaugural cohort of Fellows and Scholars in 2004. (Her cousin from South Africa, Dr. Richard Van-Zyl Smit, a pulmonologist, would also join the program a few years later.) During her Fogarty year in Vellore, India, Firth participated in two studies, one focused on surveying HIV exposure among pregnant women and another that tested the water-purifying qualities of moringa, a naturally occurring plant. The survey showed that while there was a low level of HIV among women in India at the time, awareness of HIV prevention methods was low. In her second project studying water purification methods, the team of researchers found that adding moringa did not help water cleanliness levels, though chlorine did. Despite this, the town where they conducted the study had an aversion to chlorinated water and ultimately chose not to use it despite it being the safest and healthiest option.

Firth worked on the manuscripts for both projects, which took longer than usual because "natural disasters seemed to follow me at that time!" She and her housemate in India were in Sri Lanka when a tsunami devastated the region in 2004. And, after completing her Fogarty year in 2005, she arrived at Tulane University in New Orleans just in time to experience the damage and destruction of Hurricane Katrina sweeping through the region.

Today, Firth serves as the Branch Chief of the Pediatric and Maternal Clinical HIV Branch at USAID. She and her team focus on ensuring that mothers and children enrolled in PEPFAR-funded HIV programs worldwide have robust support systems. They work with teams in other countries to ensure they have access to the latest research and best practices in medication protocols, care, retention, prevention, and testing. Specifically, they work to identify mothers and children that might have been missed during HIV testing which usually occures before or after the birth of a child. They also support families whose children are in treatment, especially during adolescence, when many HIV-positive patients no longer want to maintain their drug regimens. She also continues her clinical work by volunteering at the Department of Health's Tuberculosis Control Program clinic in Washington, D.C., once a week.

Firth credits Fogarty and all her experiences from that year with preparing her for today. "Right now, in my USAID role, we help to run programs, but because of the work I did with Fogarty, I know what it takes to run these programs at the other end."

More Information 

Updated March 16, 2023

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