Victoria Fischman
Breaking the Cycle
I sat in bewilderment in my lecture—stupefied might even be the right word. Here I was learning about global infectious diseases in an academic setting and the veils of non-profit organizations were slowly being lifted to reveal large inefficiencies.
It’s drilled into our minds from day one that non-profits are “do good only” organizations. They help solve some of the world’s toughest problems at a level where the government cannot intervene. While all of this is true, there also seems to be a missing intermediary step that can no longer be overlooked: researching the target communities to ensure effective adaption of donated materials.
I heard two stories that stick with me vividly to this day and drive my passion in health:
The first was of a village in Africa suffering from mosquito born diseases. Meet a non-profit that provides bed nets to the village. Blue bed nets. The villagers don’t adapt to the bed nets given to them by the non-profit and the non-profit is confused. Eventually, research is done on the ground and it turns out that it was customary for this village to wrap their dead in the color blue. Hence, why the villagers were hesitant to sleep under blue material. After spray-painting all of the nets white, the villagers used the nets.
The second story shows what happens when the proper research is never done. This story is about a non-profit focused on building latrines in Central America to prevent many of the infectious diseases borne from defecating in open/public spaces. The non-profit dropped off these latrines without any instruction or training for the recipients on use of the buildings. Thus, when my professor was touring the village for another purpose he saw the latrines and asked to see inside. Meet potatoes. The villages were proudly storing their crops inside the buildings, having found a practical use for the shelters.
My concentration within Human Biology is Global Public Health and Infectious Diseases, lending to my courses concentrated in both of those areas. Again and again I’ve learned about simple solutions to some of the dire problems happening on the other side of the globe. Most of them we don’t even think about here in the United States, such as hookworms. While we have our own set of health concerns to deal with in the U.S., by the beginning of my senior year, it was these bare bones solutions to international problems that drove my passion in health. Through my Senior Reflection my partner, Kari Giberson, and I hoped to artistically relate this passion, and actionable solutions, to the general public. We created “Breaking the Cycle,” to explore the impact of hookworm, one of the world’s most common infectious diseases. Through the story of a young boy named Obi, we begin to understand the daily impact of hookworm on young children in developing countries. Anemia, stunted growth, diarrhea, and absenteeism in school are just a few of the problems associated with hookworm, in addition to its negative economic and societal repercussions. Luckily, simple solutions exist, including an antihelmenthic drug, Albendazole, which effectively kills any worms residing in humans, and the simplest preventative solution: shoes. One of the biggest obstacles facing many infectious diseases is neglect. The science is there, but the attention, funding, and resources to deliver cures and implement prevention methods have yet to catch up. “Breaking the Cycle,” hopes to educate and inspire viewers. Not only will viewers come away with knowledge about one of the most common neglected tropical diseases worldwide, but also will have a unique opportunity to make a tangible difference in a child’s life.
FROM THE BEGINNING
Before coming to Stanford, I thought orthopedic surgery was my calling. I’d always wanted to be a doctor; I was infatuated with wearing scrubs and clogs and knowing the answers to all problems of the human body. I could watch the gory scenes of ER, and was that kid who always checked my urine for hydration levels and my tissues to make sure the color of my snot wasn’t green. During high school I shadowed an orthopedic surgeon do ACL surgery, after ACL surgery, and it seemed like the dream job: no one’s life was on the line and I could help people. As an athlete I was interested in the mechanics of the human body, and the doctors and anesthesiologists actually seemed to have fun in the surgery room. Having a career that revolved around helping others was instilled in me from the very beginning. My mother is an Assistant U.S. Attorney, specializing in violence against women. My father is a psychiatrist. Whether it was my dad sharing stories (withholding names) at the dinner table of particularly sad cases or my mom playing us her domestic violence videos with real police phone calls in them, I knew when I grew up I also wanted to make a difference and touch individuals lives, changing them for the better.
During my junior year of high school, my family and another family raised $25,000 to build a school through “Building with Books.” We traveled to Mali, in Western Africa, and helped a small village, Kessana, build a school. While in Kessana, we visited the local clinic, which consisted of two main rooms. One of the rooms had a mother laying with her two newborn twins. The image of newborns laying there with flies buzzing around them will always stay with me. I was so used to the sterility of western medicine, and had never seen a rural clinic before. I was shocked at the lack of simple supplies we take for granted in the U.S. Later in our trip, back in the city of Bamako, we visited the local hospital—the hub for local clinics, like the one I’d seen in Kessana. Two main problems stuck with me after speaking with a representative from the hospital. The first was refrigeration. Even if foreign doctors send over extra medicine, etc. the hospital doesn’t have the electricity or refrigeration to properly store the supplies. The second was transportation. Just having motorcycles to transport the medicine to the smaller clinics would dramatically increase their outreach. After driving the eight hours on a dusty, potholed road from Kessana to Bamako, crammed into a van overflowing with people, food, and chickens, I could only imagine how much a motorcycle would help their healthcare. Being able to quickly and safely navigate these roads to transport both medicine and doctors would increase access to medical care ten fold.
It was during this visit to Mali that my interest in simple solutions solving large problems developed. I still wanted to be a doctor, but now there was a whole new realm of medicine I had never considered that didn’t involve actual treatment of patients. However, I did not have the scientific background necessary to know what these problems were. I chose Human Biology at the end of my sophomore year because it seemed to encapsulate all of my health curiosities. After the Human Biology core, my fascination with the internal workings of the human body developed. I was also exposed to public health for the first time, something I had never understood before. I used to think the only way to really be involved in healthcare was as a physician or nurse. Now I saw an entirely new avenue to have a greater influence and affect more people than I could as a physician, solely having one on one contact. The blending of public health issues, such as distribution of medicine, and care-giving, intertwined in my head, and haven’t seemed to separate since.
THE PROCESS
In the winter of my senior year I took Dr. Scott Smith’s class, “Parasites and Pestilence: Infectious Public Health Challenges,” which my partner, Kari, took the previous year. During this class, I first learned about hookworm and my passion for infectious diseases fully developed. Before this year, I had a general interest in global public health, inspired by other classes here at Stanford, but had never learned the hard science about diagnosing, treating, and preventing these infectious and parasitic diseases. It was a tough class, and memorizing the life cycle, host behavior, medication and dosage, diagnostics, epidemiology, and prevention methods for upwards of 30 parasitic diseases was no small feat. It was one of those courses where you could do well if you memorized the information, and I found I was not blatantly bored pouring over my Medical Parasitology textbook for hours. I enjoyed learning the information and felt a sense of satisfaction at finding a sector of academia I enjoyed. But I still faced a paralyzing problem: was I more interested in the public health or the medicinal aspects of these diseases?
This question is one I have struggled with every since sophomore year of college. Beginning the Senior Reflection, I described my project as a meld of simple infectious disease prevention and kinetic typography. Another fascination of mine is advertising. I’m obsessed with the way they are created, chosen, where they are put and how they subconsciously affect us. The prospect of creating a video that would touch on these aspects, without seeming like an advertisement was exciting. I was eager to learn a new skill with the kinetic typography, and use my knowledge of infectious diseases to shock people with the simplicity of the answers. However, working on our script, it was clear that finding a way to share the shock of a simple solution was not as easy as I originally thought.
Writing a story and describing an issue are two very opposite techniques of conveying scientific material—the latter more common and trusted. The issue Kari and I constantly struggled over was how to blend the two together in a seemingly natural way that connected viewers to the issue. In many of my human biology classes at Stanford I had lectures use both techniques. I realized in the classes I loved, the lecturer made every topic personable. It was not just a list of the benefits of breastfeeding, but the story of a mother who was told she could not produce enough milk for both of her twins, and had to act rashly in order to start providing for her children. These stories make me interested in medicine and infectious diseases. While the science behind it all is fascinating, without the people and their stories, I see no point. I wanted to give, in two and a half minutes, personality to a parasitic disease many people have never heard of.
This was my first time embarking on a yearlong project. The deadline so far down the line was both calming and distressing. I knew it would all work out in the end—it always does—but the middle was what scared me. What if I didn’t end up with a movie I was proud of? Would this whole year be a waste? We spoke with experts on infectious diseases and global health. We switched from our original focus on malaria to hookworm. We researched and feel in love with positive deviance, then debated its necessity in our story. We went through old class notes and researched current updates on hookworm to find the most pertinent information. We searched for non-profits in line with our goals, and finally found Shoe4Africa.org. We reached out, and hope to send them our video so the organization can use it. We met with an MFA student who guided us through the creative process. He taught us it was okay and necessary to not get it right the first time, to make multiple drafts, and to cut, cut, cut. We watched YouTube tutorial after YouTube tutorial and taught ourselves Adobe After Effects. We grew to love the double screen monitors on Meyer’s second floor.
When our film finally displayed on the screen at Wallenberg, I had an amazing feeling of accomplishment. After the screening Kari and I turned to each other with huge smiles on our faces, expressing the undeniable satisfaction that comes with completing a project you set out to accomplish. Two minutes later we turned to consult each other on if the orange looked a little different on the screen, or if the words seemed to move a little too slowly on one slide. Kari’s extreme attention to detail was a relief for me. I got lucky having a partner who could sit at a screen for ten minutes debating the placement of a period in the same manner I could. During my time at Stanford I’ve worked with many different types of people, some who share my similar work ethic, and others who do not. Each one has taught me a valuable lesson in humility or assertiveness. With Kari, we were both able to let our strengths shine, without feeling like we had to put the other’s light out. A rare combination that worked perfectly.
MOVING FORWARD
“Breaking the Cycle,” is as much about the result as it is about the process. I wish I could tie a little document to the video showing all the trials and tribulations Kari and I went through to come up with the final film. The hours we spent deliberating over one sentence, or even one word. The number of different blogs on Adobe After Effects we read through. The thousands of colors of orange and grey we contemplated. Alas, there is just the movie, which must speak for itself. I am very proud of the end result, and have sent the video to all my friends and family. Yet the majority of the lessons I’ll take away from this project won’t be from meeting the deadline and finishing a product I can share, but from the process.
As I leave college, and search for a plan or a job for next year, I sometimes wish I could just magically be a doctor. Not have to go through the years of post-bac classes, medical school, residency, etc.—but just be a doctor already. I realize though, that this overwhelming wish to be at the end result, is paralyzing me from moving forward; this general fear of the process is stopping it from beginning at all. The Senior Reflection is as much, if not more, about the process as it is about the end result. Workshopping, meeting with mentors, constantly evaluating the project’s end goal—it was all in the name of the process. Heading towards the next big chapter in my life I force myself to remember that the process is a part of life that cannot be avoided. Yes, taking all my pre-med requirements will be painful, and there will definitely be times when I ask myself what am I doing, but I hope there will also be times when I am so grateful and happy for my life and where I am in it.
I am not sure what forces in the universe brought me to Stanford, and gave me my life so far, but I am damn happy they did. I have met some of the most incredibly inspiring people here, and can only hope I have made somewhat of a difference in other’s lives. Whether it was a smile when they needed it, tough love when they didn’t think they did, or just being there to listen, I hope I have helped my amazing friends reach their potential. Everyone has a passion so unique, I sometimes wish I had a clear path of my own to follow, so I would know what to expect and how to get there. Then I remember the process, and how important it is. As my artistic mentor for this project told me, you’ve got to just get those first marks on the page. Whether they’re scribbles or jibberish, they’re there and that’s what matters. It is often the blank page that scares people. But once the ink hits the paper it is easier to chose a direction and go for it. If that route does not work out, it is okay to scrunch up that ball of paper, throw it in the trash and start over. The time was not wasted because you went somewhere and learned something you did not know before. For this lesson I have The Senior Reflection to thank.