Catz medical student devotes a year to tackling global health issues

Undergraduate Rhiannon Osborne (2016, Medical Sciences) has returned to St Catharine’s College after choosing to delay the start of her clinical studies to spend a year working in global public health, with a particular focus on the right to health and health systems.

Rhiannon explained, “Structural health issues had been an interest of mine for quite some time, but it’s not typically a big feature of undergraduate medical degrees, and looking for a non-traditional medical career path can be quite daunting. The mid-way point between pre-clinical and clinical studies seemed to present an opportunity to develop expertise in this area by working in the field. Having the support of the College made a big difference when it came to organising the year out.”

During Rhiannon’s final year of pre-clinical studies, Professors Stefan Marciniak (2011) and Nicholas Morrell (2013) as Directors of Studies helped to secure the agreement of the Clinical School to postpone the clinical phase of her education until October 2020.

In this article, we take a look at some of Rhiannon’s experiences during 2019 and 2020 – an exceptionally challenging time for healthcare systems around the world.

September 2019 | Shaping Horizons | UK

Rhiannon’s year started not far from Catz when she attended the University of Cambridge’s Shaping Horizons summit. Shaping Horizons is an international leadership summit designed to foster social innovation and diplomacy. To achieve these goals, community leaders from different countries work together in teams to design projects to combat global challenges, such climate change. The week long summit brought together hundreds Future Leaders from across the world, including Rhiannon, to explore different thematic areas and formulate solutions to common issues.

Michaelmas Term 2019 | Médecins Sans Frontières (MSF) | Switzerland

For the next few months of 2019, Rhiannon was based in Geneva, where she worked for MSF as a Policy & Access Intern. The objectives of the charity’s Access Campaign are to overcome barriers to access to essential medicines, stimulate research and development for neglected diseases, and promote health exceptions to global trade agreements.

Rhiannon conducted background research and drafted briefs to support the work of the wider MSF team across three key areas: incentivising innovation in the R&D of antibiotics, the human and analogue insulin markets, and the equitable manufacture and distribution of vaccines. While the latter has been of acute interest for countries since the outbreak of COVID-19, Rhiannon was gathering insights into how public funding had supported vaccine R&D to tackle another virus, Ebola.

Rhiannon comments, “Since the emergence of COVID-19, access to medicines and other health technologies has become of global concern, but inability to access and afford essential medications is common for billions of people across the globe. For example, antibiotics and neglected tropical diseases are largely under-researched because they don’t represent a profitable market, leading to a shortage of innovation and effective health technologies in these areas.”

“Similarly to what happened during the Ebola outbreak, billions of pounds of public funding has poured into COVID-19 research, and it’s incredibly important that public interest is at the core of what is then done with this research.”

Christmas 2019 | The Chios Eastern Shore Response Team (CESRT) | Greece

With an appetite for experiencing health issues first-hand, Rhiannon travelled to the island of Chios in the Aegean Sea, which hosts the Vial refugee camp. By late 2019, an estimated 30­–40,000 people were awaiting asylum in camps on the Greek Aegean islands, including Chios. Rhiannon worked for the Chios Eastern Shore Response Team (CESRT). CESRT aims to meet the immediate needs of refugees and asylum seekers who have arrived after life threatening boat journeys across the Aegean Sea from Turkey. Rhiannon provided emergency relief in the camps and helped the response when new boats landed on the island.

“The horrific conditions facing vulnerable people on the Aegean islands are shocking, but they are also the result of inhumane and ineffective policy-making, which punishes people fleeing immense suffering, often against international human rights law. One of the biggest challenges in Europe is dismantling toxic narratives about refugees and asylum seekers in the public discourse, and you can see the effect that this has on the ground in the way that people are treated. Compassionate, human-rights based reform is desperately needed, and everyone has a role to play in making sure that happens.”

Lent & Easter Terms 2020 | Centre for Infectious Disease Research in Zambia (CIDRZ) & British High Commission in Lusaka | Zambia

In early 2020, Rhiannon arrived in Zambia to take up her role as Tuberculosis (TB) Research Fellow at the CIDRZ (Centre for Infectious Disease Research Zambia) in Lusaka, with a focus on researching infection in children. The CIDRZ TB Department has been assisting the Zambian Ministry of Health in reducing the burden of TB in the country since 2006, and the mentorship of the TB team provided incredible opportunities to develop research skills, work on policy-relevant projects, and build understanding of TB care within the Zambian health system.

By March, the outbreak of COVID-19 was presenting a challenge to communities around the world, including in Zambia. In response, Rhiannon was seconded from the CIDRZ to the British High Commission, in order to provide extra support for the UK’s Department for International Development (DFID) health team working on COVID-19.

Part of this new and unexpected role involved coordinating and managing DFID-funded projects and programming. For example, Rhiannon led the team developing and implementing a geospatial data and mapping project in collaboration with the Zambian government's reaction to COVID-19, which assisted decision-making by creating vulnerability maps of different communities and creating dashboards to track communication interventions. This project has now been featured on the London School of Hygiene and Tropical Medicine’s COVID-19 Hygiene Hub.

As Rhiannon explains, “This and other projects provided fascinating insights into how another government operated in response to the pandemic. I regularly worked with the Zambian Ministry of Health and the Zambia National Public Health Institute on the COVID-19 response, in particular on essential service continuity and public communication. I learnt an incredible amount from my Zambian colleagues about making health systems robust, even with limited resources, and the importance of equity, with a focus on the most vulnerable communities, during disease outbreaks.”

“I also had access to how the UK media were reporting about the response to COVID-19 in Africa, which was striking in its lack of nuance and humanity. Despite the experience of Zambia being very different to the UK, the problems encountered were often similar to those back home. In particular access to testing reagents, logistics for PPE, and contact tracing were big challenges. I would argue that countries like the UK have a lot to learn from lower-resource settings who have focused on getting the basics right at the local level.”

Michaelmas Term 2020 | Looking ahead

Now she’s back in familiar surroundings at Catz, Rhiannon is clear that her recent experiences have solidified her interest in medicine, which she sees as a way to combat injustice and achieve meaningful change in healthcare and other related fields.

“More than ever, I’m committed to finishing my clinical studies and qualifying as a doctor. I’m particularly looking forward to meeting patients and building communication skills. I definitely want to find ways to carry on addressing these structural health issues while I’m at the Clinical School, whether that is advocating for the right to health or influencing policy in the UK.”

Rhiannon will be campaigning on climate change as the national Policy and Advocacy Director at Students for Global Health, which will be advocating for an equitable, health-focused green transition in the lead up to the 26th UN Climate Change Conference of the Parties (COP26) in Glasgow in November 2021. She is also now co-leading a UK-wide campaign to get universities in the UK to commit to making the COVID-19 research conducted at their universities as accessible and affordable to everyone in the world as possible.

Anyone wanting to find out more about pursuing a similar experience is welcome to reach out to Rhiannon on Twitter (@rhiannon_osborn) or email (reo28@cam.ac.uk).