When the baby girl showed up in the Malawian clinic, she was limp and on the fast road to an early death. Fogarty Fellow Dr. Amy E. Sims examined her, gave a diagnosis and recommended urgent surgical repair to increase blood flow to her lungs. Without any cardiac surgeons in-country, Malawi's health ministry funded the youngster's travel to India for the procedure. A year later, the child - aptly named Miracle - bounced into the clinic and began playing a thumbs-up game with anyone who'd join in, now on the path to normal life expectancy.
Sims, in her second year as a Fogarty Fellow in pediatric cardiology, sees many mini-sized patients with heart conditions, both in the clinic and as participants in her fellowship research project on cardiac dysfunction in HIV-positive children. Fogarty's Global Health Program for Fellows and Scholars offers postdoctoral and doctoral students the opportunity to spend a year collaborating with a mentor at an established research site in a developing country. The experience is intended to encourage early-career scientists to pursue global health research, provide a training resource to the host institutions and nurture international research partnerships.
Photo courtesy of Dr. Amy Sims
Fogarty Fellow Dr. Amy Sims is studying cardiac
dysfunction in HIV-positive children in Malawi.
Sims says her experience has cemented her career plans. "It really reassured me that what I want to do with my life could be possible, to be involved in global health clinical care and research. In medical school, we're somewhat put on a path and we're expected to go straight to the next step in a linear fashion. The fellowship has opened my eyes to the benefit of integrating research into my lifelong medical career."
Sims chose Malawi for her fellowship, having worked there previously for the Baylor Pediatric AIDS Corp. "That exposure really stuck with me," she said. "You see a lot of things that are just not fair, people not having access to health care and clean water. It's a little overwhelming; you want to do something but don't really know how."
Sims found a way, though, specializing in pediatric cardiology then obtaining a Fogarty fellowship to investigate a health problem important in Malawi. Her study involved 240 children with HIV and 95 controls. She investigated signs of heart function decline using new technology and evaluated exercise tolerance in a six-minute walk test. Sims will present her findings at an international cardiology conference then submit them for publication.
Sims says during her fellowship she learned techniques on how to shape an idea into a feasible research project, along with more tangible skills in data collection and analysis, writing and manuscript polishing. "I have also started to think critically about health problems in Malawi and have begun to develop research questions that I would not have thought about before my fellowship," such as rheumatic heart disease, which devastates many Malawian children, she noted.
Working with mentors in both the U.S. and Malawi has keyed her into networks that she expects will foster collaborations throughout her career. Although her primary mentor in Malawi is an adult infectious diseases doctor, "she gave really great insight in terms of research. I've learned to ask the right questions to the right people and integrate what they have to offer."
Sims places high value on the opportunity to work with Malawians. "It's obvious to say, but it's really important to work with the local people, ask the Malawians' opinions and have them involved in research, because in the end, it will benefit the Malawian population.
Part of her interaction involves teaching. "I've been able to expose medical students to different cardiac diseases in children. Hopefully, I've inspired some of them to pursue pediatric cardiology," she said, which would offer babies such as Miracle easier access to the medical help they need.