Margaret To

Margaret (or Maggie, as she prefers) is an MD/MPH student going into her last year at Emory University School of Medicine. She pursued her Master’s in Public Health at the Rollins School of Public Health, concentrating in Global Epidemiology. Before matriculating at Emory, Maggie received her BS in Biology and BA in the History and Philosophy of Science (HPS) from the University of Pittsburgh. As a HPS major, she studied topics ranging from human consciousness to the philosophy of biology. It was here that she would find an appreciation for the intricacies of the human mind. Maggie will be applying into combined residency training in internal medicine and psychiatry. Her research interests lie at the intersection of the two fields. She hopes that her dual training will equip her with the tools necessary to offer holistic care to some of the world’s most marginalized populations, including those living and affected by HIV/AIDs. In addition to global and public health, Maggie enjoys photography and cuddling with her rat terrier, Oreo.


Project: "Feasibility, Acceptability, and Design of Real-Time Adherence Monitoring Among Young Men Who Have Sex with Men"
6/01/2018 - 7/31/2018
Vietnam
 


What does the Kean Fellowship mean to you?
Being a Kean Fellowship recipient is an incredible honor. It reflects ASTMH’s confidence in the project’s clinical significance and its investment in global health research, including the HIV/AIDs epidemic in Vietnam. The Society’s endorsement of my potential in the field of tropical medicine is also a substantial honor. The success of this endeavor lies not just on my shoulders but also on the multidisciplinary experience of my fellow Emory team members: Carolyn Brown, PhD Candidate in Epidemiology, Kathy Trang, PhD Candidate in Biological Anthropology, and Anagha Krishnan, who is currently studying computer science and biomedical engineering at Georgia Tech. Were it not for the Kean Fellowship, my participation in this project in-country would not have been financially feasible. The Fellowship covered my airfare and the expenses of renting an apartment for two months in Hanoi, alleviating much of the financial burden. I am so grateful, as this also gives me more financial flexibility with upcoming residency applications. 

On a more personal front, being in Vietnam has given me an opportunity to explore my ethnic identity and the culture in which my parents were raised. My parents were received by America in the 1970s as political refugees from Vietnam. Neither have returned to Vietnam to visit. Curious as to my ethnic identity, a recent DNA test revealed that I am at least part Vietnamese. The Kean fellowship has aided in the exploration of my ancestral roots in addition to supporting my career in tropical medicine.


What do you anticipate learning?
As with any experience abroad, I hope to increase my cultural and international awareness. This is significant for me, as it also is contributing to increased awareness of ancestral roots and cultural customs. Significantly, I also am learning more about the cultural barriers and stigma that exist in Vietnam for individuals who are HIV-positive, non-gender conforming, and/or struggling with mental illness. The lack of access here is astounding. As of 2014, there is one psychiatrist to every 100,000 people in Vietnam. The literature has demonstrated that HIV/AIDs has a significant psychological burden, including but not limited to depression and anxiety. Apart from psychological impact, HIV infection has known neuropsychiatric complications due to its effects on the central nervous system. Without appropriate access to care, it is no wonder that many in Vietnam struggle to maintain adherence to ARVs/PrEP, although both are available in Vietnam. In addition to accomplishing the aims outlined in the project proposal, I hope to establish connections at Hanoi Medical University and the Center for Research and Training in HIV/AIDs in Vietnam to facilitate possible collaborations in the future.

What interests you about tropical medicine and what problems are you interested in solving?
What appeals to me most about tropical medicine is its focus on low-income and underserved communities. I sought my MPH in global epidemiology to best equip myself with the statistical tools to contribute meaningfully to advancing access to care for marginalized populations at home in Atlanta and abroad. I am particularly interested in the care of those living and affected by HIV/AIDs. Their healthcare suffers from a paucity of dually trained physicians who can recognize the psychiatric co-morbidities and also the opportunistic infectious complexities associated with HIV infection.