Student Spotlight Webcast

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Across the globe, there is a critical need for public health professionals who understand the global dynamics of humanitarian response.  Hear from USC MPH students as they share their experiences.

By attending you will:

  • Understand the public health needs of populations in disaster and conflict situations
  • Learn about the USC Master of Public Health Online Program from those who know us best-our students
  • Hear firsthand why they chose to pursue an MPH Degree at USC
  • Understand how they implemented classroom learning
  • Hear from USC MPH Online Program Director Dr. Shubha Kumar

Transcript

Hello, everyone, and welcome to the Master of Public Health online program’s Student Spotlight webinar, presented by the Keck School of Medicine at the University of Southern California. My name is Kijuana Carter. I am an enrollment advisor for the Master of Public Health online program, and I’d like to thank you for taking time out of your busy schedule to join us today.

Before we begin, let’s review what you can expect during the presentation. To cut down on background noise, please mute your phone lines as not to disturb the presenters. If you have any questions for our speakers, please type them into the Q&A box in the lower right hand corner of your screen and hit Send. Please feel free to enter your questions as you think of them, and we’ll answer as many as time allows at the end of the presentation. A copy of this recording and slide presentation will be available shortly after.

Here’s a quick look at what we’ll be covering. First, our program director, Dr. Kumar, will share some information about her background and the Keck School of Medicine of USC. Then, we’ll hear from our students, Kate McAvoy and Jenevieve Kincaid. Lastly, we will end the presentation with a brief Q&A session, so again, please type your questions in the Q&A box as you think of them. Also, don’t forget to follow us on Twitter, @USCOnlineMPH and on Instagram, @USCMPHOnline.

Now, let’s begin. Hello, Dr. Kumar. Thank you for joining us today.

Dr Shubha Kumar: Hello, and thank you everyone for joining us. We’re very excited to have you here with us today to learn more about the wonderful work that our students and alums do, and what this program is about. Just a quick background, a little bit about myself. I direct the online Master of Public Health program and I’m also faculty here in the department. I specialize in the area of global health, and really looking at monitoring and evaluation of global health programs, whether they’re having the impact that they intend to have and how the accountability is as far as where is money going and is it being used for the populations that we like to serve, that we’re intending to serve. I teach classes in global health leadership as well as global health ethics, and have worked kind of all over the globe. I’ve been very lucky to work in different spaces of the world.

I’m excited particularly about today’s presentation to share, you’ll hear from our students who are presenting about their work and their humanitarian work in different parts of the world.

A little bit about the program itself, the online MPH program is based within the Keck School of Medicine at USC, specifically within the department of preventive medicine. Our department has over 100 faculty who all specialize in different aspects of public health and do research and teaching in this area. We work together within six broad divisions in terms of global health and disease prevention, biostatistics, epidemiology, environmental health, health behavior. We really have a diverse group of faculty doing research and courses in their diverse areas. We look forward to welcoming more students. And without further ado, I will turn it over to our first presenter, Kate McAvoy.

Kate McAvoy: Hello, everyone. My name is Kate McAvoy. I am class of 2015, and I have a short presentation that gives you kind of an idea of the things that I’ve accomplished and projects I’ve worked on during my Masters and since graduating.

In 2013, I was working in the Gaza strip on an orthopedic surgery project, which is currently a war zone, so in a conflict area. In 2016, I was afforded the ability to go to Colombia and Ecuador, and in Colombia we focused our projects on training local women to become health promoters in their community, as well as a family planning program for young adolescents. In Ecuador, we primarily focused on providing primary health care to the indigenous community.

More recently, in 2018, I was in Uganda for about two months and focused on sort of an introduction for me to refugee health and capacity building, and then moved on to Bangladesh, where I was there for four months. I put the question up here, what do you do when 700,000 people show up at your door? I say that because we need to sometimes understand in a humanitarian context the important role of the community health worker, what it takes to create a community health worker, what is a community health worker. Sometimes, it’s not just about having highly skilled people there, but having people that are highly skilled that are able to train maybe non-licensed people or train lay people to do very important life saving tasks. It’s really about saving as many lives, or what is giving back to the greatest need, to the population as a whole. That’s just a little bit of an overall picture.

To start off talking about one of my first experiences, during my Masters program was a really important trip in the Gaza strip. This diagram here, I found on ReliefWeb. It just gives you kind of a picture of what life is like in the Gaza strip. We have two million people, very small area, so highly densely populated. It is an area of ongoing conflict where people are living in poor socioeconomic status and conditions that are unlivable.

Here, I just have some photos for you to see, just so you can get an idea. We have an x-ray here, and on the left you can see where there’s a bar and some pins, and right above that is a bullet. If you look closely, there’s all shrapnel. These are things that even if the conflict were to end tomorrow, these are ailments that people will have to live with for the rest of their lives. The picture below that is a picture from the OR. We have many children here that suffer from birth defects and birth defects of the musculoskeletal systems. One of the goals that the surgeon that I was working with really wanted to focus on was, how can we improve the lives of the children in this community. To the right, you see a picture of an apartment building, and it’s just so we can kind of think about what our own living situation is like and what their living situation is like, because really to be able to give back to the community, you really need to understand, what does their daily life look like. What are their needs?

The surgeon had visited the Gaza strip and found that there was a need. There was a lot of children that had some physical disabilities that he was able to fix and provide follow-up care for. We had a team of two nurses, two registered nurses, one surgeon, one OR nurse, one vet tech, and one anesthesiologist. You might wonder, why is the vet tech important? Well, the vet tech was important because they also are highly trained in veterinary medicine, but they’re trained in the instruments used in the operating room. So, somebody like that, who is highly skilled maybe in, we’ll say a sister field, is really, really useful to our team because the operating room nurse and the surgeon were able to train her on what we do in the pediatric OR, and that was really great for our team to have her there.

I would like to move on to 2016, where this was a less clinical mission. We called our project, it was me and another nurse, and we called our project Los Niños Saludables, which essentially in Spanish means healthy children. We worked for the mayor of Sabaneta. Sabaneta is a small suburb outside the major city of Medellín in Colombia. They have their Department of Health and Social Welfare of Sabaneta. One of the things the government realized was that women were not going to further their education or not going to work because they weren’t able to have child care, so they created this program called [inaudible 00:09:33], which allowed mothers in the community to open up preschools and day cares in their home or in their community, and the government would give them money to help them do so. They invested a lot of money in nutrition, so they developed a whole nutrition program.

What me and my colleague were set out to do was to do assessments of the sites. We were doing these assessments at each community site. What we realized is that actually, these children are really well cared for, despite coming from areas of extreme poverty or homes that may have some intimate partner violence or substance abuse or some very young mothers, they actually were very well cared for in these preschools and day cares. What we found is that these women that maybe only had a high school education, they just wanted more health information. They wanted resources, but there wasn’t a place for them to go. So we created a pediatric health reference guide, which I’ll show you in just a bit. That was really what they needed, so then we kind of framed them to be health promoters, not only for the children they’re caring for, but for the community. What these women would do is, they would pick a topic from the book, they would meet, sometimes twice a month, and they would decide on which topic they would then go back and talk to the women and the families and the men in their community about. That was really, really helpful and really useful to them and something that they needed.

Some of the action points that I covered already was that we visited and assessed the sites. We hosted a health conference within the community members of Sabaneta. We presented our project for the office of the mayor and they got accepted, so they were able to use them even throughout the sites that we didn’t visit and throughout the community. We had a clothes donation set up and a personal hygiene donation for children. We implemented a health class for children under five at one of the local, I guess you would say, similar to what we have at the YMCA, they had a small children’s after school center that sometimes kids would be at and would play at, so we started offering them a health class, and then they will offer the health class in the absence of us and provide children with personal hygiene products such as soap and toothbrushes and combs. We created and provided a pediatric health reference guide for the community center. We trained local day care employees to be health promoters in their communities.

We donated condoms. We actually discovered that, though condoms were very expensive to buy in small quantities, in this area of Colombia, if you buy 80 to 100 of them, it’s actually very, very cheap. So schools were able to invest in buying larger amounts of condoms to distribute. We created a family planning and reproductive health curriculum for high school classrooms and local adolescents. It was to be used at the local high schools, but also at the Department of Health and Social Welfare center, their community site, for adolescents that maybe are not in school or that have dropped out.

We also created a proposal, was that we identified that there were high rates, high prevalence of teen pregnancy in the area, and that while the single mothers got a lot of support from the Department of Health and Social Welfare, the young men that were dropping out of school, there was no support for them. So we had an incoming intern, and we kind of handed him over the project. We created this, “how to grow a gentleman,” which essentially is just how to help young men that have dropped out of school move forward in their life, and how do we prevent young men from dropping out of school in the future. It was a really nice project, because this community specifically was having boys as young as ten drop out of school.

Then we participated in a university fair for Sabaneta in which we presented to an auditorium full of prospective college students. That was really cool.

Here’s just an example, this was the introduction in Spanish. It just really said what the book is used for and what it’s about. Here’s an example, this was the page we did on asthma. When we were looking up resources, we discovered that despite hospitals and government sites stating that the references were for patients and for families, they were still really advanced. We kind of simplified it, and we did the titles. So here, this one’s asthma, and we did the cause of asthma, the effect of asthma. We tried to include as many pictures as possible. Here, we have the treatment, and then this is health promotion, so how can you recognize the symptoms of asthma early. We have prevention here, how can you prevent asthma in the future, like being around a lot of pets or maintaining a clean house. And then attention, we wanted to make sure, since this was going to be used at a day care or preschool, what are things that a non-medical person needs to look out for for an emergency. If you have a preschool child that maybe is in some distress, what are some of those things that they need to look out for that are going to tell them, “okay, we need to call for help, or we need to get this child to a hospital.”

And then the second book that we created was really a guide on healthy relationships, sexually transmitted diseases, family planning, but more focusing on healthy sexual relationships among adolescents. This is an example of a page we have, I’ll go back, of the first page of our curriculum or our reference guide that we provided to the local high schools and community centers, so that way the teachers can teach.

Here, I have a picture of the model that we used. You can see myself, I’m in the black and white dress with the blonde hair in the first picture on the right. My colleague is in the left with the black pants. We sat with a group of adolescent girls, and we had the girls read off each topic in each page, and then had a question and answer. So it’s not just about us teaching them, it’s about them teaching each other from the information that we presented to them, and allowing them to ask the hard questions. And we also did a condom demonstration and showed them some, how to use condoms, what condoms are used for. We mirrored this class for the boys as well. So that was something really important.

After Colombia, we moved on to a different project in Ecuador, partnered by Timmy Global Health. This is where we completely switched gears, so where we went from community health promotion and curriculum development, we were in Ecuador doing pop-up clinics and working with the indigenous communities. One of the really cool things about the USC MPH program is that you have such a diverse knowledge base to work from, that you can do many different things with the same degree, and many different things that you will love. It’s not something that’s limiting, and it’s something that you can use in many different environments. And for me, coming from a nursing background, that was very important to find a program that gave me a really good knowledge base so I can do something like community health promotion, but then I can also work with indigenous communities in the Andes mountains.

One of the cool things about this project we did in Ecuador was, with Timmy Global Health, they partner with universities, and I know recently they partnered with USC, they teach undergraduate and graduate students about the importance of global health, the importance of giving back. The students will go through the coursework and then they will go on a trip themselves. As a professional, it was two nurses, four primary care providers, they can either be emergency room providers or regular family practitioners, and two of those providers come from outside countries and two of those providers come from Ecuador. So there’s a really large teaching component here, and in addition, they have a local dentist and a local GYN. It’s a really nice collaborative effort.

As a nurse coming to this project for the first time, I had 18 pharmacy students with me. This project specifically, or this week specifically, partnered with Butler University. I had 18 pharmacy students, we had local doctors, we had international doctors. It was really nice to see everything sort of come together. Our role as the nurse, and as the public health professional, was we had 200 people at our doorstep that are coming for clinic, so how do we see the largest amount of patients and see the sickest patients, or the patients with the most needs, in such a short period of time. The top picture on the left is what the center looked like before we set it up. On the right, we have what it looks like from the outside. To the bottom left, these are all patients waiting to be seen, and to the bottom right, that’s just a group of us. That’s me on the right, and then two pharmacy students on the left. The woman standing next to me is actually one of the community health promoters. One of the really, really cool things that this program offered was that the community health promoters act as our translators, but they also ensure that the patients that we referred or that require follow-up get follow-up in the local health centers. So there’s that accountability.

You can see how different my Gaza trip was, to my Colombia trip, to this Ecuador trip, and how having this degree really allows for many different types of opportunities.

Now, I’m going to move on to what I’ve done the last six months, which is work with Medical Teams International. Here, we have some pictures of some of the work I did in Uganda. I know that some of these pictures are hard for us to see, but as public health and global health professionals, we need to also realize that in the areas that we’re working in, sometimes we’re not really going to understand the gravity of the problem until you’re there working within the community. I will say, for me, working in Uganda and focusing on capacity building … As you can see, I’m working with one of the nurse practitioners on the left, and we’re doing newborn care, was really amazing. Having a degree with a focus on global health leadership kind of just builds, so you learn all these clinical skills, but how can you adapt your clinical skills in a refugee setting? How can you adapt your clinical skills to meet the needs of the general population? So, having a degree in public health really kind of brings that picture together for you.

Here, my time in Uganda, on the right you can see, that’s a two year old male who suffered from severe acute malnutrition. In the middle on the top, we have some tropical ulcers. Those come from having polymicrobial infections and they need special treatments for and special wound care. We have a burn just below it. In one day, I could be working on newborn care, to tropical infectious diseases or infectious medicine, to burns and traumas, to severe acute malnutrition. Having an understanding of the importance of all of those things is really important.

Towards the end of my time in Uganda, we found that we were nearing the era of the new Ebola crisis. One of the cool things that we got to do, me and another provider from the UK, was we developed a program design and a proposal to prevent possible Ebola crisis from coming across the border, or to at least identify it in a way that is safe when it does, if it were to come across the border, so that was really cool.

Lastly, I would like to talk about the work I did in Bangladesh. I was in Bangladesh from July to November. Again, I was focusing on capacity building within the Rohingya community. We were capacity building with national nurses, Bangladeshi nurses, that were working in clinics in this refugee camp. One of the things about this refugee camp is that it’s the largest refugee camp in the world. My first slide, when I asked, what do you do when 700,000 people come to your doorstep, this is kind of what it looks like. On the left, you have this man here that’s sitting with the book. He was a community health worker that professionals have trained to go into the community, who, he speaks English and speaks the local language. He talks to the community about health concerns.

But the true importance in the role of the community health worker became evident when they were having a diptheria outbreak. Remember that these people were displaced from their home, displaced from violence, so they’re not easily trusting of outsiders. So having the community health worker can be a very positive bridge for you to build with the community, saying, “Hey, we have all these resources, but what’s the best way that we can get these resources to the community?” The organization trained over 181 community health workers to respond and to regularly provide sort of like a liaison between the clinic and the community.

Fairly early on, my focus was on sexual and gender-based violence, clinical management of rape, and gender-based violence programming. How can we adapt our programming needs to provide safe care for women in the community? So that was kind of what ended up being my role there.

To summarize everything, what I’ve learned from the few places that I’ve been since becoming part of the USC family was that global public health is very complex. It involves many factors such as politics, health status, access to health care, religion, geography, socioeconomic status. I want to remind people that if you are a provider, don’t work out of your scope of practice. Make sure that you understand what your scope of practice is in the place that you’re working, and build on your skill set. If your skill set is infectious disease, even if it’s something as simple as teaching the community you’re working in hand washing, remember that hand washing is something that saves lives in these communities. So you really want to build on the skill set that you already have. You want to be realistic about your goals, so short term goals, measurable goals are ideal.

For example, me and my colleague were only in Colombia for two months. So, what is a realistic need that we can meet while we’re there for the two months? That realistic need was creating a pediatric health guide and a baseline curriculum for a family planning program for local high schools. That was something that was achievable and realistic. You don’t want to make long term plans for a community without handing it over to somebody or having somebody there that can follow through with these goals.

And you always want to find out what the community needs first. A little funny story, something that I learned in Colombia was, I met a woman who was getting her PhD, and she went to Colombia to study leaf cutter ants in a village in the Amazon. The community leader told her, “While that is great, why don’t you learn about something that is useful to this community?” I never forgot that, because since then, she has not left that community, and she provided a toilet and a plumbing system for that small village based on the work she did through her PhD and how she was able to modify something to be what the community needs. We always have to remember that sometimes it’s not necessarily about us or what we want, because we’re there to serve the community and learn from them as well. And always keep an open mind and an open heart. Sometimes certain things are very shocking to us at first, but listening is very important.

So those are just some take-home messages. I’m going to pass this on to Jenevieve, and I welcome any and all questions you guys have at the end.

Jenevieve K: All right, thank you so much, Kate. That was really amazing. Your pictures are just astounding. I really enjoyed it, and I actually learned a little something too.

My name is Jenevieve Kincaid, I am a physician in South Lake Tahoe. Currently, what I am doing is, I’m a wilderness medicine physician. I’m also a research physician. I lead a few studies for the NIH and the CDC in Vietnam, but with my wilderness medicine, I do a lot of disaster relief. I was asked to tell you what classes specifically helped me with my work that I’m doing currently. Pretty much every single one. Every single class that I took. What I’m going to talk about today is an experience, a humanitarian relief experience I recently had. I’m on the El Dorado County search and rescue team, and as you all know, back in November, Paradise had a terrible fire, and the surrounding area also had a terrible fire.

I’m going to go through my experience, and most of the pictures that are in this webinar are ones that I took myself. If anyone has experienced this loss, my heart goes out to you. I look forward to your questions at the end. Let’s get started. This was one of the groups I was in when we were going through the Paradise campfire site. I’ll go over some facts in a few minutes. I have a lot of pictures.

The learning objectives for my talk is, I want to review the facts surrounding the Paradise campfire, discuss the role of CAL-OES, I’ll go over what that actually means in a minute, discuss my particular involvement, and then discuss the health implications and impact of the Paradise fire for civilians and responders.

This is a video, you should all have a link somewhere, it’s just one I pulled off of YouTube of the Paradise fire as it was happening and some of my colleagues who were fighting it.

Facts about the fire. It was located in northern California in Butte County. The dates, the fire occurred basically from November 8th through November 25th, 2018. There were $16.5 billion of loss of property and other damages. Over 150,000 acres were burned. Almost 19,000 buildings were destroyed. We have, approximately 86 to 88 civilians’ lives were lost. We don’t know the exact amount. There’s still three or so missing. As far as injuries were concerned, 12 civilians, five firefighters. The number is actually a lot higher, these are just the official numbers. The cause of the fire is still under investigation. This is just an image of one of the larger homes that was on fire. I did not take this one, this was from the AP, Noah Berger, who took this picture.

I wanted to talk a little bit about the role of CAL-OES and the mutual aid system and the incident command system. CAL-OES is actually the California governor’s office of emergency services, the cabinet level agency responsible for overseeing and coordinating emergency preparedness, response, recovery, and also Homeland Security activities within the state. Because this was such a massive, massive, massive devastating incident, the California governor’s office activated everyone who was in search and rescue, police, fire, just tons and tons of people, to come and respond to this horrible event.

This picture here is a group of us waiting for one of our morning briefings as far as what we’re going to do. If any of you aren’t familiar with the incident command system, this is a structure of how to coordinate large response, like disaster response teams. If you go to the FEMA website, FEMA.gov, that’s F-E-M-A, you can learn all about incident command, you can take some very, very pertinent but dry classes, online classes. You can go to live classes. I recommend going to that. I’ve spent a lot of time working with FEMA on their incident command system. So basically, you have one large leader and then it just trickles down into a leader and a group, a leader and a group, a leader and a group. So you’ll see, with the upcoming pictures that we have a lot of briefing.

This is another briefing we had with a smaller group. Here’s another briefing, that’s actually me in the picture. Here’s another briefing, this was, the gentlemen in the brown jacket, this is actually the deputy I work with with search and rescue in El Dorado County. This was our smallest group briefing. Every morning that we were working, we would have maps set out where we would identify areas of interest. This would be where people may have still been missing, places that had not been searched, fire might still be going on. We would go have drive-bys sometimes if we wanted to see if fires were still burning. Every morning, we would actually look at these maps here.

This is some of the transportation that we had. This is the inside of one of the transportation vehicles, a couple of my colleagues from El Dorado County on our way. This was one of the wealthy neighborhoods that we went through. As you can see, all that was left was brick. This was one of the retirement villages that we went through. Some of the surrounding woods, this was completely beautiful, green woods before the fire happened. This was another home that was destroyed. The fire was so hot that it was burning glass and also aluminum. You would look at your aluminum tires, aluminum wheels. They would just be completely melted. Glass would be completely melted. If you’re not aware, glass, I believe, melts at like 2,000 or 3,000 degrees Fahrenheit. There was a lot of news personnel in the area. This was a typewriter, actually, that we found, that had been almost melted. Here was a truck that we found. A lot of the things that I saw looked completely like, just looked like a movie set. It was really surreal.

I’m going to be interspersing the slide sets with some kind of more upbeat things, just because this is a really serious topic and really serious experience that I had. But while we were there, it was really nice. The governor’s office actually supplied all of us with a ton of food. On the left hand side, this was one day of food. On the right hand side, this is probably what you would get over three or four days of food. I still have some of the food that the California governor’s office gave me in order to respond to this emergency. Everyone look, there’s Nutella. That was really psychological support for me, personally.

What did I do, specifically? Because I’m a physician, I was helping identify human remains. This is me at one of our sites, digging through remains or through ashes, and I did actually find remains at this site. What was I looking for? I was looking for pieces of bone. Unfortunately, due to the heat of the fire, the pieces of bones that we would sometimes find would be as small as an inch. How did I know they were bones? Bones kind of have what’s called a spongy trabecular network. If you think about a sponge, and you think about what it looks like if it were dried, that’s what we were looking for. We also looked for artificial devices that would have been in people, pacemaker wires, knee prosthetics, hip replacements.

If we found what we thought was a human bone, we’d look for, if you know what a skeleton looks like, we would look for that pattern of bones, the way people would be lying or sitting or something like that. We looked for human ash, and I’ll tell you how we did that in a few minutes, and also worked with forensic pathologists doing DNA testing. I don’t have any images, I just want to reassure everyone, of remains that were found, but the images I do have that are coming up are a little disturbing, so I just want to give you all a warning.

What else I was doing, I was helping the teams identify common sites that we would find human remains. This was actually a trailer in the retirement village. This is a wheelchair found at a door. Fortunately, there were no human remains here. But that’s one thing we would find and look for, were quite a few wheelchairs in doorways. We would be looking in cars, people would try to leave Paradise and get overwhelmed with the smoke. How did we know if a car had already been looked through? There was actually a method that the Federal Emergency Management Agency uses in order to communicate. There was an X on here. This is four points of communication showing that this vehicle had been thoroughly looked at multiple times. This was really nice. We’d have this on buildings, on vehicles, we’d have it all over the place, these Xs. We would just use typical spray paint from a store.

We also found remains in bedrooms. In the middle of the image, you’ll see what looks like two bars. Those were bed rails. That’s where else we were looking. We also looked in tubs. That was pretty common, where would find remains. We would sift through a lot of ash looking for pieces of bone. Here, specifically, we found ash on a mantel. This was probably from an urn, and we know that this was human ash, and I’ll show you how in just a minute.

How did we know it was human ash, or we needed to look at an area even closer? We had human remain detection dogs that came from all over the country to help out. These dogs have been imprinted on human remains. There was anywhere from ash, bone, teeth, more recent, I would say fresh tissues. These dogs are really, really amazing, the way you train them.

CARDA is the California Rescue Dog Association, they were the ones who supplied the most dogs for human remains detection. This is actually one of my colleagues, one of the dogs that we worked with. I say one of my colleagues because here is another happy picture. This is my puppy Klaus. He’s now 20 months old. He’s a German Shepherd. This is me again. I’m training him for human remains detection, also for search and rescue in avalanche. He’s amazing.

With all the devastation that we came across, how did we cope? We supported one another. This is one of my colleagues here. We would support one another. We would joke around some, just to kind of try to make people, help each other get through it, because it was pretty rough. Did a lot of exercise, and we all know what exercise does to the spirit. This is one of the colleagues I work with in El Dorado. This road here went on for miles. We actually just walked down it to go to a gentleman’s homestead. We got a lot of exercise with our colleagues.

We found treasures that we would set out for returning residents. I did not take this picture, but I actually saw this nativity scene. This nativity scene was recovered from the ashes. We would set these out, like on cars or in front of where the lots were. Here’s some pictures that I took. On the left up here is a cup, and a Christmas dish, and a couple more cups. We would set these out. This Christmas dish, unfortunately, was broken. I did find one really special Christmas cup that I set out, but I didn’t take a picture of that. This was a figurine, on the bottom left hand side, that we found and we set out. We found a stocking and put it on the person’s chimney. A rocking chair, and also a bicycle, perfectly intact. It was really amazing how you would see nothing but devastation, and then just something perfectly intact that didn’t even get ruined. This kind of helped us cope as well.

We showered together, and that’s how we coped. It’s not what you think, actually. We had required decontamination. I’ll go over some of the chemicals that we were exposed to in a few minutes. The United States Marine Corps and the Army, they had a whole bunch of people running our decon showers. Here’s an inside of the decon shower, with a couple of my colleagues, and here are a couple of the Marines who were helping spray us off. Yes, we had to decontaminate our clothing and our shoes, our hair, everything. We also slept together, and we’d throw things at people if they were snoring too much. My advice for you if any of you go out and do disaster relief, you’ll probably be sleeping in a big giant room. Take earplugs, please.

After the fire is out. Why am I talking about this? Because I’m a physician, not only was I doing the human remains detection, I’m also very concerned about occupational and environmental exposures. That has a lot to do with the research I do with the NIH and the CDC. The slide’s a little small, I do apologize, but I want to talk a little bit about the health implications for civilians. For the acute, or very recent things that would happen to people, with the smoke exposure, they would have respiratory problems. There would be asthma exacerbation, there’d be a lot of increased mucus production, they’d experience headaches, runny nose. Chest pain, people who had cardiac issues were experiencing chest pain because their heart wasn’t getting oxygen the way they needed to. They’d get dizzy, obviously if any of you have ever been around a campfire and you start breathing in smoke too much, you know we’re all going to get dizzy. Our brains need oxygen, not smoke.

A lot of people had experienced or were experiencing acute stress disorder, which is kind of a shortened form of PTSD, it’s that kind of immediate shock of, “Oh my gosh, my life is at risk,” or, “I’ve lost everything.” They were also exposed to a lot of metals and organics. This would be in everything that was burned down, with all the buildings and the trees and the vehicles. There’s just a lot of stuff that they were exposed to.

As far as chronic health implications for civilians, they’re at increased risk of heart and lung disease, COPD, asthma, atherosclerosis, that’s the plaque build-up in your arteries that can cause heart issues, post-traumatic stress disorder, of course. Loss of possessions, security, and finances. I’m not sure if people are aware, just to kind of sidetrack for a minute … After 9/11 there was a lot of premature births, so that’s another thing that we have to be aware of when people are exposed to a lot of smoke, a lot of fire, a lot of material waste that’s been burnt, that that can also affect women who are pregnant.

I’m very concerned about the health implications for our firefighters and mutual aid responders, because not only do we experience all of the acute things, because we’re there putting out fires, sifting through the burnt rubble, the burnt buildings and everything, but we also get exposed to carbon monoxide, benzene, sulfur dioxide, lead paints, metals, organics, other particulates. Long term, we experience the same things as the civilians, but there’s a lot more cancer in firefighters, police officers, and mutual aid responders due to the fact that we would just be on our hands and knees digging through things. We would be fighting fires and experiencing, breathing in the smoke. Even if you had a respirator on, you still were exposed to so much.

So what does this mean? We definitely need some studies to follow people exposed to chemicals of the Paradise fire. Either I or someone else is going to try to set up a longitudinal study to follow some of our health responders and civilians who have been exposed to this fire, just because I know that there’s going to be long term health implications.

Why do I keep doing this? This is another video that you should all hopefully have a link to. If you go to YouTube, you can just look up, “lost cat Timber found in the Paradise fire.” This is just a really sweet video of Timber reuniting with his or her owners at the fire site, at their house. It’ll make you cry.

This is me, last picture that I wanted to show, at one of the sites. Basically there was nothing, and here’s me in my garb. So, there’s my e-mail, if any of you have any questions. I’m also on Instagram, @JenevieveKincaid. There’s more pictures of my Paradise experience there. I’d love to take your questions, and I’m going to pass it on to Kijuana.

Kijuana Carter: Thank you so much, Jenevieve and Kate. We will now try to answer your questions. Again, to submit a question, please type it in the Q&A box and hit Send.

It’s so great to hear from students about their experiences in the program, and more importantly, how they’ve applied what they learned in the program in their careers. I want to actually start with this first question that goes to both Kate and Jenevieve, you can answer it in that order. This is from Matthew [Sobo 00:47:02]. Both of you have been a part of such powerful events and played very pivotal roles. Can you please discuss how the MPH online program at USC and your education and experiences acquired through this program prepared you for these real world events?

Kate McAvoy: Yes. I’m happy to answer this question. I will also answer the question right after it in the same answer, if that’s okay.

Kijuana Carter: Sure.

Kate McAvoy: Great. The second question, from Matthew Smith, says I’ve heard a ton about the Trojan network. Are you both a part of the network, and are you able to share any experiences?

The reason why I’m reading this question is because the first question asks about how the USC online program prepares you for real world events. I will say that there is no program on this Earth that will ever prepare somebody to deal with things like mass rape or devastating fires. With that said, the USC MPH online program and the Trojan network does provide you with a strong network of people, well educated, experienced people, to help you learn how to manage those events. But also, if I ever came back from the field and was like, “Hey, I just spent six months working with women, with 300 women, 200 women, that are all living in a culture of intimate partner violence, and I don’t know how to deal with that,” the Trojan network allows you for a space to connect the dots, to get support from your colleagues. Or if I was saying, “I’m working on this project, and things just aren’t working with the project. Do you have any advice?” It provides you with that support system to help you with those events.

I’m not sure if that answers your question, Matthew and Matthew. But there isn’t a program that can ever prepare you for certain things. It’s more about, does the program offer you that Trojan network, that network of people that you can go to. I could maybe have not spoken to anybody from the Trojan network in a year. But I always know that I can e-mail people from the program, I can e-mail administrators from the program, ask them for advice, ask them for support, and I’ll have guidance. That, to me, is why I chose the program when I was looking for what program would be best for me.

Jenevieve K: [crosstalk 00:50:04]. Oh, sorry, Kate.

Kate McAvoy: No, that’s okay. Jen, you can go.

Jenevieve K: Yeah. I absolutely agree. There is no program that can help prepare you for something like mass rape or like a devastating fire. But I actually found a lot of the classes, when we talked about the structure of responding to community events or disaster response, it really gave me that background knowledge of, it’s like I knew what to expect as far as the structure was concerned. As far as communicating with people all over, I would say even all over the state, all over the world, easy. Because of what I had with USC, just being able to … Doing the online program and communicating with people everywhere, learning how to deal with different cultures and different time zones and different expectations, really helped me quite a bit.

As far as the Trojan network is concerned, hands down, 100%, I still contact people. And like Kate said, it can be a year … I mean, I’m friends with people, we would meet up and we’ll have coffee occasionally. I’ll go to APHA conferences and still see people. It’s just like, any time you see anyone, even in the Paradise fire, you see someone who’s got a USC sweatshirt or something, you’re like, “Hey, fight on,” right? And it just, automatically you have this amazing bond, and there’s so many people, so many resources. If anyone is interested in disaster relief, you can talk to Shubha. That’s Dr. Kumar.

It’s really, really amazing, just the resources that are like, “Hey, I want to do this project,” or, “I need this resource,” or, “I want to get students involved. It’s like, every single time I send an e-mail, I’d have to say within 24 hours, if not sooner, someone has responded to me. I’ve never, and I’ve been in school for a very long time. I have a few letters after my name. USC is probably one of the very best schools I’ve ever attended. This was just amazing. I want them, I keep pushing for a PhD program that’s online. So, just letting you know, Kijuana and Shubha, if you ever had a PhD program …

Kate McAvoy: I’ll second for that PhD program online. If you guys can work on that, that’d be great.

Dr Shubha Kumar: Then I’ll tell you we’re working on it.

Jenevieve K: Sign me up. Just go ahead and say, Jen Kincaid will be one of the students. I don’t even care what it is. As long as it’s with you guys, I’m one of the students.

Dr Shubha Kumar: Oh, thank you. Well, we would love to have you if this materializes.

Kijuana Carter:  Absolutely. Absolutely.

Well, thank you guys for answering that question, or those two questions, because Jenevieve did speak to, a little bit about the Trojan network as well.

Our next question, I would actually like to direct to Dr. Kumar. This is Allison [Navarro 00:53:07]. She states that, I personally want to do something along the corporate wellness guidelines, and I was wondering how USC could assist me in achieving this. It seems like a majority of the focus in this particular seminar is on global health, so just wanted to know what program USC has in this department. So maybe speaking a little bit to the concentrations?

Dr Shubha Kumar:           Sure. It’s a great question. We offer, in addition to global health concentration, we offer a concentration in community health, and that may be the one you’re more interested in as far as looking at domestic health issues. The courses in that track include, of course, public health communication, implementation of public health programs, I believe culture and health. So really more domestic and community health focused, and there’s an opportunity to investigate programs of your interest, so if that’s in the corporate wellness space, or for instance, diabetes in population X space, in the courses you have the opportunity to kind of dig deep into the area that you’re interested in.

With respect to wellness, corporate wellness, actually, funny enough, I have worked on research in that area along with one of our other faculty, Heather Wipfli. Faculty are often doing research in these types of areas, and that will come out in the courses. I would go ahead and take a look at the community health concentration, and the types of research that our faculty are doing, and you will likely find things of your interest.

Kijuana Carter: Great. Thank you so much for answering that. I’d actually like to direct this next question to you as well, Dr. Kumar. What steps are taken and what resources are available to help prospective students in determining which concentration is best suited for the student’s interests before entering the program, considering the concentrations seem to blend together quite a bit as the presenters have pointed out.

Dr Shubha Kumar: Sure. There’s information that you can read about in terms of, on our website and when you meet with Jessica for your orientation call. But also, you don’t have to solidify which track you want to do until you’re at least two semesters into the program. So sometimes that changes for students based on the first set of core courses you’re taking. You might realize that you’re more interested in particular ones than others.

We also, every student has not only the overall student affairs advisor, who is Jessica, who’s there to kind of answer questions and help with tracks, but we also have an academic advisor who you can speak to to get more depth about the different tracks. And then of course, each student is also assigned a faculty mentor that they work with throughout their duration in the program. And you can always speak to the track directors, the faculty track directors, so there’s a lot of resources in terms of speaking to different folks about what track you may want to pursue. And again, you have basically up until at least the second semester of the program to really make a decision on that.

Jenevieve K: And every [crosstalk 00:56:24]. Every faculty person that I came across, every single class that I had, every single person I interacted with at USC, it was shocking, I liked. You know, and not just liked, I respected, and they were so incredibly helpful. My dad passed away when I was in the program, and it was really great how much they support you. [crosstalk 00:56:47]. Sorry, go ahead, Kijuana.

Kijuana Carter:  Oh, I didn’t know, was Kate going to answer that as well? Did she want to chime in?

Kate McAvoy:  I have to agree with what Jenevieve said. When I had planned to do my Gaza mission trip, I was well into the semester nearing midterms. My professor just kind of opened it up to the class and was like, “Hey, Kate’s doing this really awesome thing, and we all need to support her through it,” and that was really awesome for me, to have somebody believe in me while I’m working full time and trying to still give back to the [inaudible 00:57:31] community. They just accommodated it, and that was really awesome.

Kijuana Carter:  Wonderful. Thank you so much, guys, for answering that question. Our next question is, what were your biggest highlights from the MPH program? How were the class schedules? Did you connect with classmates outside of the online class?

I’d like for both young ladies to answer, if Kate can answer first, and then Jenevieve, if you can follow.

Kate McAvoy: For me, this is Kate speaking, some … Oh gosh, I have so many highlights. I think the coolest thing for me, which was something I answered in one of the Q&As here on the computer, but I’ll give you an example. One of my classmates, Alan, is one of the most brilliant men I’ve ever met, and he loves statistics, especially biostats, and loves epidemiology. We worked really well together as a team, and I think it was just really cool to be in a group of people that in some ways are like-minded, but have very different professional backgrounds, have maybe come from different places. There was people that were coming from other countries that were also participating in the course, so kind of like learning from each other, but also you really … Team dynamics is not something that’s easy to learn right away, and it was a really cool way to learn how to work together as a team, just by working on these projects.

The funnest thing was, is that most of the time, the professors were like, “Whatever you want your project to be on.” Like, you have, let’s just say infectious disease would be the large topic. You get to kind of choose a little bit. So for the first time, you’re guiding your own education and enjoying it at the same time. That, for me, was really important. So that was kind of one of the highlights, I think, was working on a diverse team.

Kijuana Carter: Okay. [crosstalk 00:59:47].

Kate McAvoy: Oh yeah, okay, sorry. As far as how the class schedules were, I worked full time and took two classes a semester. Some people only take one. I felt like it was really, really reasonable. I lived on the East coast at the time, so most of my classes were pretty late. I live out on the West coast now. But I think it was maybe one day a week that I really had to devote to, if we had a live online class.

And did I connect with my classmates outside of online class? Yes. The first time I actually met them was at an APHA conference, and I’d only seen their faces like postage stamp size. It was just really fun, getting together at one of our socials and just saying, “Hey, I’ve only seen your face the size of a postage stamp,” because we bonded. I mean, you spend a lot of time working with the team. I really think that this program, if anyone’s interested in doing any type of long distance communications, especially if you’re going to go into global health, or even in the communities, if you have to communicate with someone just a county away, being able to effectively communicate through different media online is super helpful.

I’m still in touch with quite a few people that I did my online classes with, I mean, you know, visiting people. I’ll be in Utah, I’m really sad, one of my friends now, he’s in Washington and I don’t get to see him this time. But we all got together, a big group of us got together for graduation. We all came from around the country, just so we could be together for graduation in Los Angeles. So that was just really special too.

Jenevieve K:                      Yeah, and I would like to second that, that the graduation for me was the same. It was really special to also be able to share that moment with people. For me, I worked full time and did my MPH online full time. While I wouldn’t say that’s something I would highly recommend to others, it was manageable for me. The only time it really became difficult was when I had to do my practicum, because you’re working full time, you’re going to school full time, and you have to do these internship hours. I would say that semester, for me, was really about giving my whole self to my education and the internship as well as my job, whereas the rest of the other semesters were easier to manage with my work schedule.

I hope that … I don’t want to say that this program is easy, by any means. It was definitely, had its challenges. But I always felt supported through those challenges, which was cool. It was a nice feeling at graduation, I will say, when you work full time and you’re in school full time, and then to be there with your colleagues. It felt good.

Kate McAvoy:                    I’m still [crosstalk 01:02:47]. I did take time off for my practicum, but the cool thing is, with my work, because I do so much research with the CDC and the NIH, I actually combined that work with my practicum and was able to expand on the work and got published a few times now. So that was really fun. And the work directly that I did during my practicum was able to be published, which is cool. That was really fun.

Kijuana Carter:                  Wonderful. Thank you, ladies, for answering that question.

I’d like to ask another question. This one is directed to Dr. Kumar. Does the school offer resources to potential internships or jobs post-graduation?

Dr Shubha Kumar:           Yes. We definitely do. We have a list-serv that goes out constantly with internships, job postings. We have a career fair that we put on. There’s a dedicated career counselor that works with our students for the MPH online program. You’ve got lots of resources to work with you in that space, as well as our capstone course, which comes toward the end of the program, also involves some professional development activities and mentoring.

For the sake of time, I’m also going to go ahead and answer a few other questions I see in the chat box, because I see we’re a little over. Another question from Matthew, are all on campus resources available to students enrolled in the MPH online program?

Yes, I would say most on campus resources are available. You’re certainly, for those of you who live in the local area, you’re welcome to come to campus to attend any of the events that we have with speakers, to meet with any faculty in person, with your TAs, et cetera. There are online resources available to help with, writing resources and others, so yes, for the most part the resources are available to students.

Jenevieve K:                      I accessed the psychological services when my dad died, through USC. Yes, I would say pretty much probably everything that I needed, there has not been a single thing that I needed from USC that I wasn’t able to access.

Dr Shubha Kumar:           Great, thank you for speaking to your experience directly.

Another question from Melissa, on my Masters program, can still have a stigma of not being accredited as you would in a traditional classroom setting. From your experience, have you had any trouble with employers? I will direct that back to the students. Jen, if you’ll start, [crosstalk 01:05:16].

Jenevieve K: No, none. Our diplomas do not say online. In fact, when I tell people, it’s an online, kind of executive style program, they’re like, “That’s the greatest thing ever, because we’re trying to set up our own distance program with such and such. Can you help us with that?”

I mean, I’m my own boss now, so I don’t have any problems with myself, which is really great. I fully credit the Masters program to helping me figure out what I needed to do to run research studies and to run organizations and run my own businesses. I mean, you don’t just learn the public health stuff, you learn a lot of human, business, kind of relations and just structurally how to organize things and how to build things and how to evaluate them. Develop, implement, plan. Not in that order, but I’m sure Kate remembers those things. Implementation, planning, development, evaluation, all that stuff.

Kate McAvoy:                    Yeah. I would have to say I agree. I don’t think … The degree says USC. Really, the question only comes up when they see my resume and see that during the time of my degree, I didn’t live in Los Angeles. But at that point, if they’re requiring an MPH for any type of job or assignment, they see USC and they’re like, “Oh, you went to a really good school.” [crosstalk 01:06:49]. They’re more impressed by USC, they don’t even really ask about the online portion.

But also I will say that USC is one of the few schools where, or the few schools that I know of where students that are sitting in the class get a very similar experience to the ones that are online, because it’s the same professors. A lot of the same professors are teaching or have taught both courses. The way that the program is designed, for me, if anything, felt a little bit like more work than going and sitting in class, but for me it just didn’t feel any different, because you do have scheduled time with your professor and your other classmates via webcam every week for each course. So there weren’t, I don’t think … Nobody really cared. That’s really, I guess, the short answer.

Jenevieve K: Especially with USC. It’s such a well … I mean, USC has got an amazing reputation. They’re just one of the finest institutions in the country. Really, like Kate said, people see USC and they say, “Oh, okay, good. You’re hired.”

I mean, really, that was my experience.

Kijuana Carter:                  Wonderful. Well, I want to thank our speakers, Kate McAvoy, Jenevieve Kincaid, and Dr. Kumar, and everyone who participated in today’s webinar. A copy of this recording and slide presentation will be available shortly after. If you have any additional questions, please feel free to reach out to an admissions advisor. Our contact information is listed on the screen.

This concludes today’s webinar. Thank you again everyone, and have a wonderful rest of the day. Bye-bye.