Working to create an equitable health system


Working to create an equitable health system

Piper, Mukhethwa and Sara in matching shirts in Thohoyandou, South Africa

Piper, Mukhethwa and Sara in matching shirts in Thohoyandou, South Africa. Photo credit: Center for Global health

Global Student Spotlight

Sara Krivacsy is graduating from UVA’s College of Arts & Sciences with a Global Public Health major and Anthropology minor. She is planning to become a practitioner in global public health at a time of unprecedented change and challenge. She reflects on her experiences at UVA and how it has expanded her perspective for global engagement.

Q. What do you think of most as you graduate in midst of the COVID-19 pandemic? Has it changed your plans?

 Krivacsy: The COVID-19 pandemic has brought to light many of the issues I have been studying such as health systems inefficiencies, the lack of universal health coverage in the U.S., and entrenched disparities in African American communities. The devastating impacts of the pandemic have unscored the importance of building strong health systems and preventative infrastructure on a foundation of equity. As I graduate into the current global environment, I have an even stronger resolve to pursue a degree in medicine so that I can contribute to alleviate suffering at the individual level help create more equitable systems that work for all.

On the global level, I am grateful to the Center for Global Health (CGH) for supporting me through some of the most transformative experiences of my education. It helped me understand the logistics and ethics of conducting health research in low-resource settings and how to be a respectful, cross-cultural partner and collaborator. These real-life experiences have made me a much more thoughtful and inquisitive student.

Q. What sparked your interest in global experience?

 Krivascy: I was fortunate to be part of a humanitarian organization in high school that made annual service trips to Chacraseca, Nicaragua to support the longstanding efforts of a local nonprofit. This experience sparked my interest in global health at a young age and opened my eyes to global inequities.

I came to UVA eager to understand and learn how to break down the structural barriers that create unfair conditions for much of the world. My first engagement with CGH started in the first year with Global Health Case competition. I was working on an interdisciplinary team with students from engineering, nursing, and medicine. The opportunity to engage with students from various backgrounds and receive faculty guidance and feedback gave me confidence to contribute to a team.

Many global health issues are daunting and seemingly intractable. Working alone is not an option if you want to make significant progress. This positive first experience helped me get involved with the center as I followed my passion for addressing health disparities.

I became involved as a member of the Student Advisory Board and became the Case Competition committee chair as a third and fourth year. I also participated as an Editor and the eventual Editor in Chief of Conflux Journal, a global health and research journal affiliated with CGH.

Q. What global experiences did you participate in while at UVA?

Krivascy: I participated in the CGH Scholar program in my second and third year. It provides funding to engage in a mentored global health research project at one of several well-established international partner sites. In my first year, I spent two months in Tohoyandou, South Africa, a town in the rural Limpopo province, working on a project investigating the burden and genetic characterization of malaria in the Lambani region. I worked with my mentor and a fellow UVA student to establish community contacts, develop lab protocol, and test and speciate dried blood spots for several types of malaria. This experience introduced me to the realities of global research and taught me the value of collaborative problem solving.

In 2019, I was a research intern at the University of Global Health Equity (UGHE) in the office of Dr. Agnes Binagwaho, former minister of health of Rwanda and current Vice Chancellor of UGHE. The intern cohort was composed of 4 Americans and 4 Rwandans who worked in cross-cultural pairs. My main task was interpreting data and writing a manuscript describing the results of Rwanda’s pilot program of using HPV DNA tests to screen women for cervical cancer. I additionally attended several conferences and did site visits to various hospitals and Mahama Refugee camp. I learned that Rwanda’s health system is successful because it prioritizes the vulnerable and acts upon the notion that all lives are equal.

Q. What surprised you the most?

 Krivascy: It still surprises me how relevant the lessons I learned abroad are to local issues in the United States. For example, a large portion of my time in South Africa was spent establishing community contacts and gaining the trust and permission of local authorities before we began collecting data for our study. Local support and trust are paramount in any type of research, global or local, and knowing how to communicate goals and expected outcomes to laypeople is essential in ensuring public trust in the scientific community.

As public trust in the American scientific community wanes, illustrated by the rise of anti-vax groups, climate change deniers, and more, the importance of public outreach and communication in research is more important than ever. I hope to apply this lesson from my global experience, as well as many others, to my contributions as a health professional in the U.S.

Q. What would you tell UVA students seeking global health experiences today?

Krivascy: I would encourage students to follow their interests. Connecting with older students and faculty members in your area of interest can be a great way to find opportunities that fit your specific goals and passions.

Given my positive experiences at CGH I would, of course, encourage students to get involved there in any way they can. There are a wide range of activities from Journal Club, the Student Advisory Board, the Case Competition, Global Health Month, and the Scholar program. Engaging in courses and extracurriculars that let you learn about equity issues in Charlottesville can also be a great and important complement to global experiences.