The Dartmouth Initiative in Global Health and Healthy Development: Project Examples

Several examples of ongoing projects are listed below (some with web links). Readers are urged to contact the faculty listed for more information.

1. The Dartmouth-Kosova Project
2. The DARDAR Project in Tanzania
3. The Dartmouth/Boston University AIDS Training Program

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The Dartmouth-Kosova Project: Strengthening Medical Education in Kosovo

The Dartmouth Kosova Project was established 1999 with funding from the Blessing Way Foundation in NYC as a partnership with the University of Pristina School of Medicine.
The purpose is to: 1) assist the University of Prishtina Medical School to re-establish its medical education programs after the war; 2) allow Dartmouth students and faculty to gain experience in international service.
This student and faculty exchange program continues to flourish and provide meaningful experiences for all involved.
Since the inception of the program there have been more than 60 student and faculty exchanges between the University of Prishtina Medical School and Dartmouth Medical School. (Forty-seven were funded by the Blessing Way and the remainder by other sources.)
As a result of this initial student/faculty exchange effort, Dartmouth Medical School has expanded its programs to Kosova. While much humanitarian aid has left the region, Dartmouth Medical School is committed to working with Kosovar colleagues as they transition into a functional medical and educational community. This provides an extraordinary opportunity for medical students from Dartmouth to be involved in the momentum of a country in the process of development.
Other Dartmouth programs in Kosova include:
• The Gjilan-Partnership in Primary Care Jim Strickler, MD Don Kollisch, MD
•Reproductive Health Project Don Kollisch, MD, Cris Hammond, MPH
•Orthopedics Program John Nutting, MD, Cris Hammond, MPH
•Digital Library at University of Prishtina Medical Center Bill Garrity, MA, Fred Pond, MLS, Ellis Rolett, MD
• HIV/AIDS technical assistance Bryan Marsh, MD
• Obstetrics and Gynecology Elective Leslie Demars, MD
•Otolaryngology Dudley Weider, MD
•TB Control Technical Assistance (with Doctors of the World, USA), Lisa Adams, MD

We have been expanding the program to include Dartmouth College students.
Our program encourages Dartmouth students to address the needs of the medically underserved throughout their professional careers. Current areas of work include projects in community service, public health, and human rights.

We welcome other departments in Dartmouth College to particpate in the Kosova Project. Areas might include, but are not limited to these suggestions: Education, Anthropology, International Relations, Sociology, Psychology, Environmental Studies, Computer Science, Geography, Religion, Theater, Women and Gender Studies.


Contacts:
Dartmouth-University of Prishtina, Partnership
Susan Linsey, MA
Joe O'Donnell, MD

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The DARDAR Project: HIV/AIDS and Tuberculosis in Tanzania

The DARDAR Health Project, sponsored by the NIH/National Institute of Allergy and Infectious Diseases, began in 2000 and is a multi-faceted research initiative based in Dar es Salaam, Tanzania. It involves a partnership between Dartmouth Medical School and the Muhimbili University College of Health Sciences (MUCHS). There are other project co-investigators at Boston University School of Public Health and the National Public Health Institute in Helsinki, Finland.
The project is a double-blind, randomized clinical trial of an investigational heat-killed vaccine—M. vaccae—that has shown protective against tuberculosis in animal models. Early Phase I and II clinical trials conducted by Dartmouth in the USA, Zambia and Finland showed that the vaccine is safe in HIV subjects and induces lymphocyte proliferation responses making it a candidate for the prevention of tuberculosis in HIV infection. The specific aims of the trial are: (1) To define risk factors for HIV-associated disseminated tuberculosis and to assess the relative contributions of reactivation versus new infection in the pathogenesis of disseminated tuberculosis, and (2) To assess the safety and efficacy of a 5-dose schedule of inactivated MV vaccine for the prevention of HIV-associated pulmonary and disseminated tuberculosis. 2274 HIV-positive subjects are being enrolled in the study. A full description of the study, including standard operating procedures, case report forms and other pertinent material can be found on the study webpage at http://www.dartmouth.edu/dms/dardar/
Other activities related to DARDAR and the DMS Section of Infectious Diseases and International Health include:
• The Dartmouth/Boston University AIDS International Training and Research Project (Ford von Reyn, MD, Richard Waddell, DSc., Lisa Adams, MD, Chuck Wira, PhD, Gerald O’Connor, PhD, Sc.D)—see separate webpage (http://www.dartmouth.edu/dms/aitrp/) & description
•DMS IV Elective in International Health through the DARDAR Health Project, a structured 6 week program for fourth year medical students (Ford von Reyn, MD, Richard Waddell, DSc, Elizabeth Talbot, MD)
• Pilot Study to Evaluate HIV/HCV Co-infection Rate in Tanzania and the Use of a New Qualitative HCV Screening Assay (Richard Waddell, DSc, P. M Magesa, MD—MUCHS)
• Optimal Use of Blood Cultures for the Diagnosis of Tuberculosis in HIV (Roni Devlin, MD, Elizabeth Talbot, MD, Ford von Reyn, MD)
We welcome inquiries from other departments and individuals in Dartmouth College who might have an interest in this project or proposals for related research initiatives.
Contacts:
C. Fordham von Reyn, MD
Richard Waddell, DSc

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Dartmouth/Boston University AIDS International Training and Research Program
The Dartmouth/Boston University AIDS International Training and Research Program (AITRP), sponsored by the NIH/Fogarty International Center, began in 2003 and involves a partnership between Dartmouth Medical School, Boston University School of Public Health and the Muhimbili University College of Health Sciences (MUCHS) in Tanzania. The AITRP is a 5-year comprehensive program designed to provide diverse degree and non-degree training to Tanzanian scientists with the overall goal of strengthening research capacity in HIV and tuberculosis at the MUCHS. The program builds on an existing and successful collaboration which has launched the first efficacy trial for a vaccine against tuberculosis among persons with HIV infection. This collaboration has identified critical training needs and has defined key research objectives for positioning Tanzanian scientists to continue to develop and apply programs to control both HIV and tuberculosis.
The AITRP is based on a sequenced plan of training and subsequent research mentored by recognized experts in international public health, health outcomes research, behavioral science, immunology, HIV, tuberculosis and vaccine research. The Program will enhance research capacity in all basic areas (e.g. epidemiology, clinical trials) and will also provide innovative training in new and specialized areas (e.g., mucosal immunity, evaluative clinical sciences) to facilitate the growth and development of novel research projects relevant to the prevention of HIV and tuberculosis in developing countries. The Program is managed by a core faculty group at the three academic institutions with extensive experience in international health training and a strong commitment to ensuring the long-term benefits of the Program for Tanzania. A detailed plan provides for increasing transfer of training and research to Tanzania over the 5-year duration of the Program and for continuous re-evaluation of Program priorities. Guidance and oversight is provided by a Training Advisory Group with outstanding credentials in international public health.
Contacts:
C. Fordham von Reyn, MD
Richard Waddell, DSc
Charles Wira, PhD