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Staff magazine for the Faculty och Medicine at Lund University. Theme: teaming up in Africa.
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nErvE! staff magazine for the faculty of medicine at lund university
issue 4| 2014
vänd för svenska
Capacity building & university partnershipstheme: teaming uP in africa
lunds universitet box 117221 00 lundtel 046-222 00 00www.lu.se
nobel laureate Peter Agre shares his ideas on leadership and researchsPecial feature
news in briefNews in Brief gives you short translated versions of some of the Swedish articles. If you want more information about any of the articles on this page, please email [email protected]
14
gunilla westergren- thorsson, dean
The African continent is currently
experiencing a great amount of
development. Its population
is young and growing rapidly,
and there is vast potential for
higher education and research.
The United Nations’ Millennium
Development Goals of improved
health, increased welfare and
sustainable development in the
poor areas of the world are goals that we can help achieve
through research and education with collaboration partners
in African countries.
In 2010, Lund University decided to establish a collective
strategy for Africa, as part of the internationalisation action
plan. On 21 May 2014, Deputy Vice-Chancellor Eva Wiberg
approved a project plan for strategic collaboration with Africa
on a university-wide basis, which is already in full swing.
Our own faculty started working towards a strategic in-
vestment in African collaboration projects in 2013. During the
autumn of last year we carried out an inventory of existing
collaboration projects in African countries and held a seminar
about African collaboration.
This autumn, myself and several other members of the Fa-
culty of Medicine’s management team spent one week visiting
colleagues and partners in Uganda and Ethiopia. We chose to
visit these particular countries as we have a great number of
well-established and successful collaboration projects already
in place, particularly within the areas of infectious diseases
and public health. The aim of our visit was to strengthen
existing relationships and research platforms, as well as to
identify further opportunities for collaboration. We left with
many concrete ideas of how to develop our research and edu-
cation together with our colleagues in Uganda and Ethiopia.
We are very happy to be taking these new steps towards
our strategic goal of ensuring that “our education and re-
search are to be characterised by a global knowledge per-
spective which stimulates learning capable of contributing to
the solution of global health problems.”
Teaming up in Africa
Primary care research networkCare and treatment that was tra-ditionally carried out in hospitals is more and more commonly pro-vided at local health centres and GP surgeries. This creates new opportunities for research that both the university and Region Skåne are trying to make the most of. As of 2009, Skåne has had a network of health centres in place that are home to PhD students and research coordinators, who act as catalysts for research through e.g. education and supervision for PhD students, Bachelor’s students and medical interns. The network is managed by the Centre for Primary Care Research and its Operations Manager Jan Sundquist.
forum medicumEarlier this autumn, the Faculty of Medicine held a Vision Day for the Forum Medicum project. Ingemar Carlstedt, Steering Group Chairman, explains that
the next step in the project is to ask three architecture firms to draw up proposals for a new building that connects to BMC. The proposals will then be evaluated and plans made for how to
proceed with the build. He says it is important to note that the faculty is not paying for the new building up front, but rather through a yearly rent. As the current HSC building requires extensive refurbishment, the rent increase from a new build would not be much higher than for a refurbished HSC. A new building is a strategic investment in the future.
new statistics courses for Phd studentsAn entirely new level-appropriate set of statistics courses in four stages will be launched in spring 2015. PhD students will then have the opportunity to study statistics on a level that is appropriate for their area of research. This change has come about as a result of a review of existing statistics courses at the Faculty of Medicine and how they meet the increased requi-rements for statistical analysis for e.g. publication of scientific articles.
award for work towards gender equalityThe Faculty of Medicine’s Dean, Gunnilla Westergren-Thorsson, and Assistant Dean, Anna Maria Drake, have been given the 2015 Gunnilla Jarlbro award for courage and strength in their work towards achieving gender equality at the faculty.
PHOTO: Charlotte Carlberg Bärg
Should I know more biology or more programming?
15
The accelerating rate of progress
in science and technology has
transformed traditional categories
of disciplines. The lines between
different subjects are fading and
lots of interdisciplinary fi elds are
emerging. Accordingly, the nature
of biological research has changed
signifi cantly. Many disciplines such
as nanotechnology, information technology, chemistry, mat-
hematics and cognitive science are merging with biology. Bio-
informatics, biostatistics, nanobiotechnology and biophysical
chemistry are examples of inter-disciplines in modern biology.
But what kind of skills do current and future biologists
need in order to be successful in this interdisciplinary era?
How should they manage to improve their capabilities from
mathematics and computer programing to chemistry and wet
lab work?
a common challengeAs a PhD student in bioinformatics, I see this as a common
challenge among students in different fi elds of biology. We
are concerned about not having enough potential to manage
all aspects of our research. People who used to work in wet
labs are afraid of computer programing, and people with
computational background are not familiar with laboratory
work. In my project, sometimes I think that I should improve
my knowledge of mathematics. Programing skills are often
critical, and sometimes without knowing about some wet-lab
techniques, I wonder what my role in the project would be.
In fact, I am trying to improve my skills in different subjects
without being an expert in any of them.
exPert in nothingHow should the education system be organised to deal with
this issue? What is the role of faculties, study administrators
and research consultants to provide opportunities for students
to increase their abilities in diverse eras?
Interdisciplinary subjects are challenging to teach, learn
and evaluate. To be able to research across multiple discipli-
nes, it is important that students understand the perspective
of each relevant discipline, learn how to integrate and keep
balance among them. Evaluation of students’ work is also
diffi cult. Due to the novelty of interdisciplinary research, it is
diffi cult to fi nd examiners who know how all the disparate
parts fi t together. Without a suitable infrastructure, there
would be a risk of ending up being an expert in nothing.
a new landscaPe for learningFuture biologists are trained today. It is necessary to educate
them in a way that they can incorporate biology, mathematics,
physics, chemistry, and computer science to gain interdiscipli-
nary perception. It is crucial for university departments and
research teams to understand the needs of interdisciplinary
research and facilitate learning for students.
Mina Ali is a PhD student at the Department of Laboratory Medicine Lund.
mina alicolumnist
call for columnistsIf you would like to be a part of a rotating group of columnists for Nerve!, then we would love to hear from you. No previous experience required. For more information email: [email protected]
PHOTO: Most photos
biology Programming
12
“We worked on the aquaporins for about twenty years and
bigger and bigger groups got involved. I like to work on the
fringe. I was eager to get involved in field studies in Africa,”
Peter Agre reflects. “I’m now concentrating on malaria be-
cause that’s where my heart is. Aquaporins are taking care of
themselves nowadays. I see science as a series of adventures,”
he continues. “We did explore the aquaporins as a potential
drug target for malaria, but to stay in the lab working on
aquaporins would not permit fieldwork, so I’m following my
heart and need for adventure. I actually intended to work in
tropical disease long before I ever got involved in aquaporins.”
You’ve compared yourself to Huckleberry Finn; so how does Huckleberry Finn deal with setbacks in and out of the lab? “Life is a series of setbacks and if we dwell on setbacks, we’re
constantly in damage repair mode. I think you can learn from
setbacks, and you can learn from other people’s setbacks.
But it’s success that drives your energy. I don’t think it’s good
for a person who’s consumed by remorse over setbacks to go
into science. I guess if someone wants to become a welder
they have to be aware that they are going to get burned
sometimes,” Peter Agre smiles.
There’s one interview where you said that it is really important to hire people who are kind and fit into the family atmosphere of the lab. Why is that so important? “We spend more time with our scientific or academic col-
leagues than we spend with our families. So when you get the
opportunity to build a scientific group, it’s important to recruit
people with the intellectual capacity to deal with conflicts and
problems, and who also have enthusiasm and curiosity to look
for answers to the unknown. If there are clashes of persona-
lity, it ruins everything. It’s not common for a person to have
all bad qualities; it’s usually just a mismatch of interests, and
insensitivity. It’s important to find a place where you fit in well
and you are happy.”
But still; doesn’t science require sharp elbows someti-mes? “Well, yeah. I think challenging people intellectually is part of
science. It’s the data and the interpretation, not the quality of
the person’s life that is the validity of the scientist. You can
challenge the data without insulting the scientist. I think it is
good to have some intellectual conflict. Nobody gets a free
pass; you have to prove the data.”
So, what can you tell me about leadership?“When I was a young scientist I didn’t take it very seriously,
and I’ve had some experiences along the way where the
leadership was not
good, which was very
damaging. I think
leaders who consume
resources to support
themselves or don’t
foster the careers of
young people should
not be leaders. Lead-
ership should be about
generosity – a bit like
being a parent. You
put everything into
your child’s success. If
you can use your posi-
tion to encourage people to fulfill their potential then you’re
an excellent leader.”
You talk about mentors and leaders who are inspiring, but what do you think about teaching? “There are two levels of teaching; there’s lecturing and com-
municating to groups and classes and I’ve done some, but
not a lot, of that. I’ve done more mentorship in terms of
helping the young people in my lab with scientific direction.
Yesterday I had lunch with some junior researchers here at
Lund University’s Faculty of Medicine. I didn’t sit them down
and tell them about aquaporin one and two. It wasn’t infor-
mation exchange, but more of a philosophical discussion, of
the challenges of science and the advantages of science. I’m
sure the local senior faculty could have had a great lunch on
the very same topic. But sometimes, when you are in your
own camp, it’s less convincing than when someone comes
from the outside. We’re trying to encourage young people
to proceed in science. You don’t have to be a genius. That
term works retroactively; when you succeed, then others say
`that’s brilliant´. It’s actually also very lucky. 90% of success is
not brilliance but luck.”
In the past, you’ve called yourself a Bolshevik, and you’ve considered running for senate. Have your travels influenced your political views, or is it the political views that have influenced the travels? “When I was seventeen years old I had the great opportunity
sPecial feature
nobel Prize laureate Professor Peter AgreProfessor Peter Agre is an American physician, professor, and molecular biologist who shared the 2003 nobel Prize in Chemistry with roderick MacKinnon, for the discovery of aquaporins. Aquaporins are proteins that move water through the cell membrane. In the beginning of October Peter Agre was invited to visit the Faculty of Medicine in Lund. nerve met him for a conversation that took a turn for adventure and global health matters.
13
what is you background?I am a British veterinarian (graduate of the Royal Veterinary
College in London) who has lived and worked in Sweden for
over twenty years. I started my professional life in research
working with the Africa Medical and Research Foundation
(‘Flying Doctors’) in a field-based team in northern Kenya
studying the unique dog - man lifecycle of the parasite
Echinococcus granulosus.
In the late 80’s I returned to the UK with my two sons,
and in the early 90’s moved to Sweden. Although animals
play an enormously important role in my life, I decided
that clinical practice was not the job for me. I became in-
creasingly interested in veterinary business management
issues. Most veterinary clinics are run by their veterinary
owners, and a good clinician does not necessarily make a
good business manager.
I have held many workshops and courses around the
world on the subjects essential to a strong business deve-
lopment that are not covered in veterinary college such as
leadership, strategic planning, client communication, deal-
ing with conflicts, coaching and developing your staff, and
so on. I have also written many articles for the veterinary
press, and my book on the subject has been translated into
five languages.
why the medical faculty in lund?The opportunity to work at Lund University, one of Europe’s
leading education and research institutions was one to grab
with both hands and I was delighted to be accepted as
Manager of the Animal Facility in August of this year. This
is a completely new world for me, and it is already proving
to be a very interesting one.
your Passion?On the professional front, enabling people to be at their
best and fulfill their potential. I find human psychology -
what makes people ’tick ‘ - fascinating. It is also interesting
to see how we often create our own limitations - which of
course lead to limitations within an organisation. It is my
job as a leader to identify and remove these barriers and
support the people I work with, so they can reach new and
greater goals.
On the private front, my family, my animals, and time
to be out in nature.
Introducing Caroline Bäcknew manager of the animal facility
to travel in the Soviet Union. This was in 1966 at the height of
the cold war. I travelled in the Soviet Union for about 6 weeks
and saw it up close, camping with the Russians. It was obvious
that the system had flaws, but the people where beautiful,
generous, curious and wonderful. Systems can change and
learn from each other. During the cold war when the Soviets
and the Americans were at loggerheads, it was the contact
between American and Soviet physicists that just kept a little
connection.
I was president of the AAAS, the American Association
for Advancement of Science in 2009-2010 and chairman of
the board 2011-2012. I led scientific groups to visit countries
with adversarial governments, like Myanmar, Iran, and Cuba.
We weren’t there to create regime change, but science has a
special opportunity to connect to people of different cultures
and countries where our governments are adversarial. This is
something very special.”
So let’s turn our focus back to global health. Ebola. is it scarier than malaria? “Yes and no. Yes, because most malaria victims survive. Most
Ebola victims do not survive. It’s also less scary because Ebola
should be tractable; a vaccine should be developed, and I
think will be developed. The fact that it hasn’t is really due to
the neglect of yet another tropical disease affecting a small
number of people in remote areas. No company is going to
make money from that. But now, suddenly it’s in big cities,
with thousands, maybe tens of thousands of victims. We can
largely protect our citizens in countries like Sweden, Germany
and the United States, but a few will get through. Ebola is
extremely frightening. And there are other similar problems
out there. That’s one of the reasons we need to support sci-
entists, because we don’t know which problem is going to
come up next.”
On a more positive note; what would you like to see happen in your field in the near future? “The best thing would be the political prerequisites to prevent
malaria in the most difficult cases, places like Congo. Ebola
is going to be a bit of a setback. I can’t send young people
to places where there’s a chance that they get Ebola. We’re
working to go in to Congo right now – Eastern Congo, the
Katanga province. It is wild with malaria. In many villages
100 % of the children have malaria.”
“We don’t have to kill every mosquito in Africa if we
have proper prevention – rapid diagnosis and treatment. Par-
ticularly for those who are carriers and don’t realize they have
it. I don’t think we need any new basic science discoveries to
make that happen. I’d like really effective malaria vaccines.
Or new tricks: A Swedish scientist at Johns Hopkins, George
Dimopoulos, and a Brazilian scientist independently found
bacteria which colonize the mid-guts of mosquitos and knock
down the transmission of malaria. That would be a simple way
of treating the mosquitos so that they are no longer able to
transmit malaria. If it works it would be brilliant. I don’t want
to jinx them, but it might even be Nobel Prize worthy…”
text & Photo: anna aPPelberg
10
theme: teaming up in africaity
The foundations for increasing collaboration with Afri-can universities are already in place, through initiatives such as the successful partnership with Mbarara Univer-sity in Uganda.
Back in 2001 a formal partnership was established between
the research group for Social Medicine and Global Health, the
Faculty of Medicine at Lund University and Mbarara University
for Science and Technology (MUST) in southern Uganda –
LUMUST.
Mbarara University has a number of international partner-
ships (including Harvard School of Medicine), but their con-
nection with Lund University is among the oldest and most
well-established.
”There is high priority for collaborating with MUST. More
and more universities in Europe and the United States of Ame-
rica have begun to see the value of research and student col-
laboration in Africa. Opportunities for placements, exchange
programmes and degree projects for students, PhD students
and teachers are also highly attractive.” says Anette Agardh,
Associate Professor and Head of Social Medicine and Global
Health.
The first connections between Lund and Mbarara were
made with the help of SIDA (the Swedish International De-
velopment Cooperation Agency) as early as 2001, leading
to a two-way researcher exchange within the area of public
health. There was a strong emphasis on a lively student ex-
change programme from the very beginning.
Within the scope of the programme, four medical students
from Lund and Mbarara were given the task of producing a
report on how student exchange opportunities within the
project could work. The formal partnership then developed
quickly to include several other components such as support
for the development of Bachelor and Master’s programmes
(e.g. a Master’s programme in Public Health), development
of support structures such as library and ICT, administrative
processes, a research policy, new research projects, and a
peer education programme among the students for preven-
ting HIV/AIDS and promoting sexual and reproductive health
and rights.
Anette Agardh and Per-Olof Östergren from Lund Univer-
sity formed a project steering group together with Jerome
Kabakyenga and Gad Ruzaaza from MUST. Over the last 14
years the partnership has both developed and intensified. For
example, more than 50 students from the Faculty of Medicine
have taken part in degree projects and placements at the
hospital and university in Mbarara. They in turn have sent
students to Lund University. Various staff exchanges, joint
courses in public health and research collaborations focusing
on e.g. child and maternal health, and youth sexual and re-
productive health and rights, are a few other examples of ac-
tivities within the LUMUST project. Even Sweden’s healthcare
system has expressed their interest, and staff from Skåne’s
university hospitals have been able to do clinical placements
in Uganda within the framework of the project.
What have you learned from the partnership’s successes and challenges over the years?”It is difficult – nearly impossible – to design a collaboration
project like this and know from the start how it is going to
progress. The strengths of the LUMUST project are that we
were given the opportunity to develop the partnership with
an ‘open agenda’, and that we designed our proposals to be
viable in the real world. That requires understanding from
funders, as well as an equal two-way partnership.” say Per-
Olof Östergren and Anette Agardh.
Curiosity levels were high when the Faculty Board visited
Mbarara in October of this year. Anette Agardh hopes that
even more research and study programmes will create ties
with MUST and other universities in Africa as a result.
text: björn martinssontranslation: elisabeth dawson
To Mbarara and back
about mbarara university for science and technologyThe university was founded in 1989. Science and Medicine are the university’s flagship subjects, and it is currently home to approximately 3,200 students at Bachelor and Masters’ level. Find out more on http://www.must.ac.ug/
Below: Anette Agardh in discussion with Gad Ruzaaza, a col-league at the Medical Faculty at Mbarara University for Science and Technoloy. Photo: Johanna Sandahl
11
theme: teaming up in africa
Bumper to bumper trucks line the motorway that connects the small country of Djibouti on the Horn of Africa to Ethiopia’s capital city Ad-dis Abeba, transporting goods from Djibouti’s harbour into Ethiopia. The abundant transport traffic brings with it prostitution, creating the conditions for the spreading of HIV.
Per Björkman, Associate Professor in infectious
diseases, has spearheaded a research project since
2010 in the city of Adama, Ethiopa, which lies along
this motorway. Just as in many other low-income
countries, many HIV sufferers also develop tuber-
culosis – the most common cause of death among
the world’s HIV-affected population.
He has experience of working as an adviser all
over the world in issues regarding HIV treatment
in poor countries. Access to antiretroviral therapy
(ART) has increased significantly in low-income
countries over the last ten years, yet less than half
of the people in need of treatment actually receive
it.
“What is lacking are practical methods that can
be used for diagnostic purposes in primary health-
care in low-income countries, which is where most
people receive their treatment. We also need to
know how the antiretroviral HIV treatment works
– particularly in patients suffering from both HIV
and tuberculosis. The guidelines that the treatment
recommendations are built on are still, in many ca-
ses, based on studies carried out in high-income
countries.” Per Björkman explains.
In order to answer these questions, researchers are now
collecting patient data from five public healthcare centres
in the Adama region. These healthcare centres are staffed
entirely by nurses, and are the foundation of the Ethiopian
healthcare system. It is where HIV-positive patients go for
their antiretroviral treatment, which has been free of charge
in Ethiopia since 2006.
Per Björkman has put a lot of time and resources into
building a functioning infrastructure for the project. Staff
members at the healthcare centres have been trained, and
a project office has been set up in Adama where two data
handlers are now working to gather and check information.
By this stage the walls of the small project office are lined with
endless reams of patient data.
He emphasises the importance of building a local net-
work. One of the people on the ground is his Ethiopian PhD
student Taye Balcha, who also works at the regional depart-
ment of health.
”In our project the local nurses handle everything to do
with the patients at the health centres.” says Per Björkman.
“They are highly dedicated and take great pride in partici-
pating in, and contributing to research that is relevant for
their patients. This kind of ‘capacity building’ is extremely
rewarding to be a part of.” he continues.
For the last couple of years Patrik Medstrand, Professor of
clinical virology, has also been involved in the project.
“We follow up on how the patients receiving treatment
are doing. Is the virus developing resistance? Are those re-
sistant stems spreading? These are questions we need to
answer.” Patrik Medstrand says. ”This project would have
been impossible if Per had not already established a network
and an infrastructure.” he adds.
Patrik Medstrand also has a PhD student in place in Ethio-
pia – Dawit Aseffa – who works at the Ethiopian Public Health
Institute.
“It is incredibly important for us to have a strong part-
nership in Africa. Initially we had many discussions with the
institute, but they have started coming around as the project
has developed.” says Patrik Medstrand. “The challenge in
this type of research project is to find a long-term source of
funding. Projects like this take years to establish, and years to
complete. That kind of funding does not exist today.”
text & Photo: johanna sandahltranslation: elisabeth dawson
Capacity building in the Adama region
Per Björkman (left) meets staff working with antiretroviral therapy at a health centre in Adama. Pictured right is Patrik Medstrand’s PhD student Dawit Aseffa.