Friday, October 21, 2011

Some travelling, physically and mentally, by blogger of the month Ariella Krones

It’s the beginning of the end of our last long break in our first semester of med school.  Whew.  In celebration and badly in need of a break from studying, I took a nap in the hammock outside.  [background: by some stroke of luck, I ended up living in an apartment with a lovely yard and lovely neighbors who own a hammock].  It is finally getting chilly here, which for some reason made the half hour so enjoyable.  Maybe Be’ersheva is finally starting to feel like a home?

Many students at MSIH travel for the sukkot break.  I went with a few friends to Crete.  We were not really sure what to expect, but none of us had been before and we all wanted some change of scenery.  We got that, in many ways, including a day and half of rain.  While we did not get to do as much hiking and exploring as we would have liked, I loved it.  We went for a walk in the pouring rain along the old Venetian harbor, marveling at how the waves that splashed up from the Mediterranean Sea onto our feet looked dark, sharp and altogether cartoonish. 

The old Venetian harbor in Crete on a less-wet day.

When our feet started to squish, we ducked into what looked like an old mosque- domed, but with no turret, and with Arabic artwork outside and in.  There was a small art exhibit inside.  After looking around for a bit at the range of pieces this one artist had made, we went back outside, into the rain.  We then saw another exhibition, and so, with questions about the beautiful leaning buildings and the art space/mosque on the harbor, went in.  After puzzling vocally over the translated explanations of the slice of Cretan history, a very nice man helped us out, explaining that, until about WWI, Crete had been governed by a series of empires including the Venetians and the Ottomans.  Crete is still a fantastically beautiful island, and for the rest of the trip it was fun to work out when the buildings we saw might have been built, and why. 

Lots of cats in Be'ersheva.  Lots of cats in Crete.  Somehow,
the cats in Crete seem to be many times more healthy
and friendly than the cats in Be'ersheva.  Odd.

As you may have surmised by my initial story of napping instead of studying, settling back into class after such a break is a process.  Part of that process, for me, is refocusing on exactly why I am where I am (in medical school).   I have spent some time reading about the new malaria vaccine that has been shown to reduce malarial infections in children by half.  This is very exciting.  The efforts to eradicate malaria have gone through many different phases in the past.  Researchers have attempted to refine mechanisms to remove the parasite from humans, remove the parasite from the vector, most often mosquitoes, and remove the vector from the environment.  The most recent push has been to use bed nets to protect people from the mosquito vectors.   A vaccine in combination with other protective measures could truly change the face of malaria treatment. 

While any advance toward a vaccine for malaria, or a parasitic disease for that matter, is a good one, there are a lot of questions raised.  First in my mind concerns the fact that this is a parasitic disease.  Even if the vaccine worked 100% of the time on all strains of bacteria, would that be enough, or would the parasite be able to live in the vector?  There are also questions of resistance.  Will the parasite evolve beyond the reach of the vaccine, and will immunogenicity wear off?  (Time to start studying immunology)  Most pressing to someone in my position as a medical student, how would we practically integrate a vaccine with less than 100% success rate into primary care settings, along with other methods of prevention, treatment and education, especially when the places that are hardest hit by malaria are often the places with very little primary care?   - blogger of the month Ariella Krones

Some articles to read about malaria:  Follow the links inside the articles to learn more.
Assessing Strategy and Equity in the Elimination of Malaria: