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Vital Signs

Around the world in 80 (or so) minutes

By Laura Stephenson Carter

If "geography class" conjures up images of memorizing capital cities and principal products, think again. A course called Global Health and Society is one of the popular offerings of Dartmouth College's Department of Geography. This winter, some 50 Dartmouth undergraduates signed up for the course, which is taught by Drs. Lisa Adams and John Butterly, members of the Medical School faculty. An outgrowth of Dartmouth's Global Health Initiative, the course explores the epidemiology and social impact of infectious diseases in the developing and developed world. Think AIDS and Ebola instead of Cairo and cotton.

Adams's own interest in international health had its roots at DMS, where she earned her M.D. in 1990. She did a primarycare elective at a Navajo reservation in Tuba City, Ariz. Then, during her residency at Harvard's Cambridge Hospital, she did an elective at a Navajo reservation in Shiprock, N.M.

"That started the spark," says Adams, who at the time thought that a career with the Indian Health Service was probably in her future. She loved working in different cultures and even intended to learn the Navajo language. But later she decided to explore international health. A third-generation Albanian, she managed to set up a six-week elective on the cardiology unit of a hospital in Albania.

"That was the life-altering experience. I said, 'This is what I want to do,' " she recalls. Soon after completing her residency in the mid-1990s, she worked on tuberculosis-prevention projects in

Adams, shown in Kosovo in 1996, today teaches global health at Dartmouth.

Kosovo, Albania, Bulgaria, South Africa, Tanzania, and other countries. Then for a couple of years she ran a TB-control program in New York City, while continuing to do international consulting work.

Trips: Along the way, she reconnected with DMS faculty doing international health work. In 2003, she was hired as the coordinator of Dartmouth's Global Health Initiative and as the program director of DMS's DarDar pediatric HIV treatment program in Tanzania. She makes several trips there each year and continues to consult on international TB projects, too.

She teaches at DMS as well, including an elective that "encouraged students to think beyond the health concerns of the United States," says second-year medical

student Dan Kaser. "Dr. Adams is a dynamic teacher," he adds. She also works with the Dartmouth International Health Group, helps bring in speakers on international health topics, and mentors students who travel abroad.

In the undergraduate course, "we focus on infectious diseases, so [students] . . . understand the key causes of global morbidity and mortality," Adams explains. The topics on the syllabus range from the "micro"—basic concepts of epidemiology—to the "macro"—the political, economic, and ethical aspects of providing health care on a global scale.

"This course [provides] a lot of the basic background information that needs to be understood before entering the world of global health," observes freshman Frances Vernon, who hopes one day "to help shape future public-health policy in developing countries."

Senior Brian Christie, who is also interested in a career in international health, adds, "I had no idea that so much about global health is prevention." After graduation, he plans to work in a small village in Kenya, helping to create a self-sustaining community of AIDS orphans and their elders; he expects eventually to attend medical school.

Adams's enthusiasm for the course is infectious. "I'm really excited," she says, "that John Butterly and I, as Medical School faculty, are able to cross over and do teaching at the undergraduate level. It's nice that this kind of cross-fertilization happens at Dartmouth."

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