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My medical elective in The Gambia

At World TB Day 2017 – with members of the TB lab & field teamMedical student Charlotte Grant received a British Society for Immunology Summer Placement Grant to fund her medical elective to The Gambia, working in the MRC Unit on tuberculosis research.  Here, she tells us about the experience.

At various points during my medical degree, I found myself daydreaming about my elective; the final prize for all that studying. The possibilities were endless! Unlike a few of my colleagues whose only criteria included ‘proximity to the beach’, I was dead set on a proper adventure. Africa was at the top of my list. I wanted to experience healthcare in a low income environment and contribute to an important research project. I set my sights on the Medical Research Council (MRC) Unit in The Gambia, which houses a huge number of clinicians and scientists working on disease control and elimination, nutrition, vaccinology and immunology. I contacted Professor Beate Kampmann, who was happy for me to join her team for the duration of my trip.

I was not disappointed. When I arrived at the MRC Unit in the in the early hours of the morning I was struck by the number of people waiting by the gates for the clinics to open. Compared to the dreary greys of Coventry, the colourful traditional outfits were a wonderful sight. In the clinics and on the wards over the next few weeks, I saw common and not-so-common infectious diseases, and witnessed some of the challenges faced by those provisioning healthcare in West Africa. It was the perfect cure for my post-exam lull in enthusiasm for medicine.

The majority of my time was spent in the laboratory. One of the overarching themes of Professor Kampmann’s research group is to create a simple and effective test able to diagnose tuberculosis (TB), and distinguish latent from active infection. TB remains an important global health problem. According to the most recent Global TB Report produced by the World Health Organization, approximately 9.6 million people were diagnosed with TB in 2014, with 27% of cases occurring in the African region. Current diagnostic tests are suboptimal, and in order to have any hope of eradicating the disease, the pool of latently infected individuals needs to be identified reliably. The team are therefore exploring several potential novel strategies, some of which measure the T cell response to TB infection.

My previous research experience centred on autoimmunity. In fact I concentrated on a specific enzyme expressed by regulatory T cells in autoimmune hepatitis. Looking back, it was easy to become blinkered and, in some ways, quite insular, especially during the final few months of my PhD. So the opportunity to think about the immune system in TB infection, and concentrate on effector T cells for a change was very refreshing! It reminded me of my reasons for deciding to study immunology in the first place, all those years ago.

I left eager to start my foundation training and even more determined to make immunological research a significant part of my future career.

While there, one of my most memorable experiences was World TB Day 2017. The event brought together members of some of the biggest tribes in The Gambia, each of which has a distinctive dress and speaks a different language. After a short presentation by members of the MRC, the locals were encouraged to ask questions. Many wondered how their blood samples were used by staff in the laboratory. Others were curious about new vaccination strategies or cures for TB. I realised how important it was to engage the public; firstly to increase the chance of obtaining samples for research purposes, and secondly to increase uptake of diagnostic testing and treatment. This was best exemplified by a play put on by MRC workers from The Gambia. The main character had been cast out from her family after receiving her diagnosis. The message was clear; care for those suffering from with TB, and visit the MRC for treatment!

My elective was better than I could ever have daydreamed of. The place and the people were fantastic. I left eager to start my foundation training and even more determined to make immunological research a significant part of my future career.

Charlotte Grant

Warwick Medical School

The BSI Summer Placement Grant offers support up to £1,500 to both medical students and postgraduate students (PhDs & MScs) who are planning to undertake a formal placement in a selected laboratory for their medical elective or for a summer placement.  Applications to this scheme will reopen in July 2017.  For more information, please visit the grants section of our website