The Gazette by The Johns Hopkins University

September 6, 2011 • THE GAZETTE

South Africa Continued from page 1 “She knew everything about all of them— their specific behavioral problems, the last time they went to a clinic,” Mehta said. “The organization didn’t have a database. The information was all in her head, filed to memory.” Mehta also admired the woman’s dedication. “She was the center’s only nurse and spent just about all her time there,” Mehta said. “She was a huge inspiration to me.” Mehta and 13 other Johns Hopkins undergraduates traveled to South Africa this summer for the inaugural Public Health Studies Program Abroad in Cape Town, a partnership between Johns Hopkins, the University of Cape Town and five local nongovernmental organizations. The program came as a result of the Johns Hopkins global health awards initiative, unveiled by President Ronald J. Daniels in March 2010. In total, 85 grants were created for students in all divisions to pursue international public health experiences and projects around the globe, including those building upon existing Johns Hopkins partnerships with universities and organizations. As part of the initiative, Johns Hopkins developed undergraduate public health rotations in Uganda and South Africa, building upon the School of Medicine’s and School of Public Health’s 20-year relationships with the Makerere University in Kampala, Uganda, and the University of Cape Town. The Cape Town program this summer was open to 14 undergraduates who had completed one to three years of university study with a focus on public health. The Uganda program will be launched during Intersession 2012 [see box]. Both are subsidized by the President’s Office. The students departed on June 7 for

the six-week Cape Town program, which consisted primarily of one academic course at the University of Cape Town and one community-based learning course centered around the NGO placements where the students interned three days a week. The sites were chosen for their focus on health, including sites dedicated to tuberculosis, HIV and drug rehabilitation. The three-credit course at the University of Cape Town, which met twice a week, provided the students with an overview of public health in South Africa. Using HIV/AIDS as a case study, the students reviewed cultural, political and health systems contributors to the current context. They also spent considerable time on the legacy of apartheid. The program also included structured excursions, including a tour of the city, a walking tour of the Bo-Kaap district, a fullday trip to Cape Point and a trip to Robben Island. One weekend was spent in a homestay in Zwelethemba, outside Worcester. They also spent two days as a group in Johannesburg, where they visited the Apartheid Museum, the Hector Pieterson Museum, and the former homes of Nelson Mandela and Bishop Desmond Tutu, and went on a bike tour of the Soweto township. They next moved to Kruger National Park for a two-night stay, before arriving at the University of Cape Town on June 12, where they lived in the dormitory. The goal was to have the students learn from the experience and contribute directly to the agencies. Mehta certainly did. She, along with the three other student interns, created a monitoring and evaluation kit for the center, built a database and wrote, edited and designed fundraising materials. “My supervisors were great,” she said. “We got to do substantive work, especially given that it was a six-week experience. They valued our input and perspective and made us feel like a valued part of the organization.” Sarah Islam, a senior majoring in public health studies, interned at Kheth’Impilo, a

USAID-funded project that supports clinics in the area. Islam’s primary role was working with HIV/AIDS patient advocates on home visits to be sure that patients were adhering to their treatment regimen, and developing new materials, mostly brochures for an adolescent audience, about HIV prevention and testing. Islam said that she leapt at the chance to study in South Africa. “It seemed ideal, this opportunity to attend a university class and work in the field. Plus, I’ve always admired people like Nelson Mandela and Mother Theresa,” she said. “I was just fascinated by their prophetlike lives, and how they gave up so much. I was particularly drawn to Mandela’s notion of forgiveness after apartheid.” Her first time in the country, Islam said, she was struck by the stark economic disparities in and around Cape Town. The city was very metropolitan and developed, she said, but you didn’t have to travel far to witness hardships. “Just outside the city in the townships is where I saw tin shacks, large garbage piles and lots of children, not in school,” she said. “And all this was no less than half a mile from a golf course.”

At Kheth’Impilo, Islam shadowed the center’s staff and patient advocates on rounds and interviews where she saw firsthand the obstacles they face. In particular, the stigma attached to HIV deterred many males from being tested. “Many of the challenges were cultural,” she said. “I was able to see how important the fields of sociology and anthropology are to public health practice. You can’t really tackle prevention until you understand how to approach it and ask the right questions to target groups.” Lisa Folda, the program’s director and an academic adviser and lecturer in the Public Health Studies Program, accompanied the students on the trip. She called the program a resounding success in every aspect. “The students’ curiosity enabled them to learn so much, and the experience clearly had a deep impact on all of them,” Folda said. “They were also able to make substantive contributions to these agencies in a relatively short span of time. Many students expressed a desire to return.” A new batch of students will return to Cape Town next summer, and Folda said she anticipates the group to be even larger. G

Students wanted for public health program in Uganda

s part of its effort to provide more overseas learning opportunities, the Public Health Studies Program will host an upcoming study abroad program titled Uganda: Childhood Health and Society. During winter intersession 2012, 10 students will study at Makerere University in Uganda in a unique peer-to-peer learning experience. Students will explore the strengths and challenges of health and education programs serving children in the country’s urban and rural settings. Tentative dates are Jan. 3 to Jan. 27.

The three-credit program will include clinic- and school-based site visits, a rural home stay and a visit to the Rakai Health Sciences Program. Students are invited to attend the 2012 Intersession Study Abroad in Uganda information session at 6 p.m. on Thursday, Sept. 15, in the Public Health Studies conference room at 3505 N. Charles St. For more information, go to web.jhu .edu/study_abroad/programs/intersession .html or contact Mieka Smart at msmart@ jhu.edu.

Researchers decode workings of mysterious critical TB drug By Tim Parsons

Bloomberg School of Public Health

or nearly 60 years, Pyrazinamide has been used in conjunction with other medications to treat tuberculosis, but scientists did not fully understand how the drug killed TB bacteria. Pyrazinamide, or PZA, plays a unique role in shortening the duration of current TB therapy to six months and is used frequently to treat multidrug-resistant TB. A new study, led by researchers at the Johns Hopkins Bloomberg School of Public Health, suggests that PZA binds to a specific protein named ribosomal protein S1, or RpsA, and inhibits trans-translation, a process that enables the TB bacteria to survive under stressful conditions. Their

findings, published in the Aug. 11 edition of Science Express, could lead to new targets for developing more-effective anti-TB drugs. “PZA is a peculiar and unconventional drug that works very differently from common antibiotics that mainly kill growing bacteria. PZA primarily kills nongrowing bacteria called persisters, which are not susceptible to common antibiotics,” said Ying Zhang, senior author of the study and a professor in the Bloomberg School’s W. Harry Feinstone Department of Molecular Microbiology and Immunology. “While PZA works very well in the body against TB, it has no effect on the growing bacteria in a test tube, which has made it difficult to understand just how it works.” PZA is converted to the active form of pyrazinoic acid by an amidase enzyme

also identified by Zhang’s group, in 1996. Through a series of experiments, Zhang and his colleagues determined that pyrazinoic acid binds to RpsA, a vital protein in the trans-translation process. Trans-translation is essential for cell survival under stress conditions. Partially synthesized proteins that are produced under stress conditions are toxic to the bacterial cell. It has developed a mechanism called trans-translation to add a short peptide tag to the partially produced toxic proteins so that they can be recognized for degradation by proteases to relieve the toxicity. Inhibition of trans-translation by PZA explains why the drug can eradicate persisting organisms, and thereby shorten the therapy. “There is renewed interest in PZA because it is the only drug that cannot be replaced among the current TB drugs without com-

promising the efficacy of therapy. The identification of the drug target RpsA not only offers a new resistance mechanism to PZA but also opens up a way for designing a new generation of antibiotics that target persister bacteria for improved treatment of chronic and persistent infections, including TB,” Zhang said. The study was conducted in collaboration with researchers from Fudan University and the National Institute of Allergy and Infectious Diseases. In addition to Ying Zhang, the authors are Wanliang Shi, Xuelian Zhang, Xin Jiang, Haiming Yuan, Jong Seok Lee, Clifton E. Barry III, Honghai Wang and Wenhong Zhang. Funding for the research was provided by NIAID and the National Key Technologies Research and Development Program of China.

Shambhala Training

Level One: The Art of Being Human

JHU Affiliates and Neighbors, join us at our 7th Annual CONVERGENCE!

Fri Sept 9th 7:30pm-9pm Sat Sept 10th 8:30am-5pm Level One provides a thorough introduction to mindfulness-awareness meditation and Shambhala principles. Discover the path to developing fearlessness, confidence and gentleness toward ourselves and our world.

John Hopkins University-Community Block Party FREE fun, food, & prizes!

Date: Sunday, September 18, 2011 Time: 2pm – 5pm Location: 3200 Block of St. Paul Street Convergence is for JHU affiliates and residents of the neighborhoods surrounding the Homewood campus.

For more information: Email: commrelations@jhu.edu Phone: 443-287-9900 Follow us on Twitter: @JHUConvergence

Baltimore Shambhala Meditation Center 3501 Saint Paul Street (Marylander Building) Baltimore, MD 21218 410-243-7200 info@baltimoreshambhala.org

Open House Every Thursday 7-9pm

Program Includes:   

meditation instruction individual meetings with teachers group discussions

Program led by Emily Bower

Senior teacher in the lineage founded by

Chögyam Trungpa Rinpoche