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One Program, Two Professionals, Two Continents, One Disease

By Ami Berger

Kay Schwebke, M.D., and Mariah Carroll, both students in the SJMC's Health Journalism M.A. program, are both passionate about fighting HIV/AIDS. They're fighting the disease on two different fronts: Schwebke as a physician and director of an HIV clinic at HCMC; and Carroll as a photojournalist in the AIDS-ravaged communities of Kampala, Uganda.

Mariah Carroll

Mariah Carroll is no stranger to the SJMC or the University of Minnesota. She was an undergraduate in the School (B.A. '02) and entered the Health Journalism M.A. program in Fall 2005. She also works for the University's College of Veterinary Medicine as a communications associate, where she manages media relations, event planning, and communications projects.

Mariah CarrollHer work in the M.A. program, though, has taken her far from those familiar surroundings. In late 2006, Carroll spent a month in Uganda, creating a photojournalism project documenting the challenges of HIV-infected children in Kampala, Uganda's capital. She visited numerous HIV clinics around the city, interviewing and photographing doctors and their young patients. The outcome of her trip will be her Capstone project for the M.A. program: a publishable documentary about the HIV crisis in children that can be passed back to the doctors she worked with in Kampala.

Carroll's Uganda project grew directly out of her coursework in Jour 8192: Proseminar in Advanced Health Journalism, a seminar course required of all students in the Health Journalism M.A. program. For her final project in the course, which focuses on the media's treatment of complex health issues, Carroll looked at the rates of HIV/AIDS infection in Minneapolis' African-born (mostly Somali) population. "I chose the topic because you don't hear very much about HIV among African-born populations living in the United States," Carroll says. "We hear so much in the media about the AIDS crisis on the African continent, but I wanted to know how that translated to the population living here."

That desire to know fueled the idea for Carroll's Capstone project: a trip to Africa to see--and document--the AIDS crisis for herself. With the help of Dr. Paul Bohjanen, a professor of microbiology and medicine at the University of Minnesota who is also involved with the Infectious Diseases Institute and an AIDS training program in Uganda, Carroll put together a proposal for a month-long stay in Kampala to learn about and document the country's fight against HIV/AIDS in children.

Carroll's proposal included attending an HIV/AIDS conference with Dr. Bohjanen, conducting interviews with doctors, nurses, and patients working with the disease, and an unpaid internship at the Daily Monitor, an independent daily newspaper in Kampala. She presented the proposal to SJMC director Al Tims, who agreed to fund her trip, and on November 17, Carroll arrived in Kampala.

"The trip was unbelievable," says Carroll. "The Ugandan culture is very warm and welcoming, and the children were wonderful and eager to tell me their stories. They also had a lot of questions for me, especially about the snow in Minnesota!" During her time in Uganda, Carroll talked to dozens of doctors, health workers, and children and families struggling with HIV/AIDS. She also photographed many of her subjects, and is now working on integrating both copy and images into a Capstone project that will "tell the untold story of this devastating disease," as she puts it.

"If the HIV/AIDS rate of infection in children continues on its current path in Uganda, it will double in five years," Carroll points out. "There's not enough education and too much poverty in the country, and there's still such a stigma attached--no wants to admit they're infected," she says. She's hoping that her Capstone project, when it's completed, will help people in both the United States and those she met in Uganda with education and understanding the disease and its effects on children and families.

"I hope to produce a publishable piece that I can pass back to the doctors in Kampala," she says. "They are so anxious to learn what more they can do for their patients, and what they can do better. They don't have 'health journalism' in Uganda," Carroll says, "but they still want to know what's new and innovative, and how they can best serve their patients. Hopefully this project can further that educational process."

Kay Schewbke, M.D.

As a physician at Hennepin County Medical Center, Dr. Kay Schewbke helps her patients manage the dual infections of HIV/AIDS and the Hepatitis C virus (HCV). As the medical director of Ingenix, a health technology company, she directs a quality-measurement research program. And as a student in the SJMC's Health Journalism M.A. program, she's studying the relationship between the media's coverage of health issues and how doctors communicate with their patients.

"I joined the program because of my interest in health education and a variety of health care issues," Schwebke says, "especially universal health care and the controlling of health care costs." All of these are critical issues to Schwebke's area of clinical expertise: the education, evaluation, and management of HCV in HIV-infected persons.

Kay SchewbkeThe coinfection clinic Schwebke directs is integrated into the hospital's large, multidisciplinary HIV/AIDS program, and serves patients who are struggling to manage both HIV and HCV infections. Many of Schwebke's patients must struggle with external factors as well, including homelessness, mental illness, and drug abuse. "The main challenges faced by our HIV and HIV/HCV infected patients are the challenges of life, such as substance use, mood disorders, substandard housing, and poverty," Schwebke says. "These social issues can be so overwhelming that it is difficult for patients to focus on health care issues that might not affect them for many years. Often, they are struggling to simply make it through the day."

Part of Schwebke's job is helping those patients with that struggle. It's a difficult part of the job, but according to Schwebke, she's getting better at it with the help of her coursework and instructors in the Health Journalism M.A. program. She loved Jour 5101: Advanced Newswriting and Reporting, taught by visiting associate professor Chris Ison, because it taught her "on the ground" interviewing skills that she's now applying to her interactions with patients. "I love it when I have an extra five minutes to actually talk to someone about what's going on in their life," she says, " and Ison's class taught me how to get the most of out those conversations, how to ask intelligent questions and really listen to the answers. I have to help people make pretty big decisions about their care and their lives," she adds, "so the more infomation I can get out of those discussions, the better I'll be at helping them."

The good news for her patients, says Schwebke, is that new treatments have dramatically improved the outlook for HIV patients in the past decade. "With new treatment options, HIV has now become a chronic disease that can be managed," she says. Ironically, just as new drugs and treatments are dramatically increasing HIV survival rates, Schwebke says that the public's interest in and understanding of the disease is decreasing. "I think that our treatment successes have caused some people to be less concerned about the issue," she says, noting that the media in recent years has focused more on the AIDS crisis abroad and less on the disease's impact on the United States. "The international AIDS issue is certainly deserving of attention, but our challenges at here at home are just as significant, and have been neglected in the press," she says.

It's these kind of gaps in the public's understanding that Schwebke is looking to fill with her work at HCMC and in the Health Journalism M.A. program. "I hope that we continue to make strides in controlling HIV while improving the quality of life of people living with this infection," she says. "And meanwhile, we need to focus our public health communication on prevention with a goal to reduce new infections. I think that there are important health care stories that need to be told," she says, "and I hope to be a part of the telling."

One Program, Two Fields

The Health Journalism M.A. program was created in 2003 in a partnership between the School of Journalism and Mass Communication and the School of Public Health at the University of Minnesota. The program is designed for professionals in two different fields with different needs: journalists and communicators with an interest in covering health issues; and health and medical workers who want to communicate effectively with the populations they serve.

The program curriculum combines study of the disciplines of journalism and health professionals. Journalists take courses that cover the fundamentals of medical research and public health issues, including epidemiology, biostatistics, and environmental health. Health professionals learn basic journalistic principles and story development techniques in courses on news writing, reporting, and ethics. All students take seminars in health journalism and online journalism. The program typically enrolls about a dozen students every year for the two-year course of study.

For more information about the Health Journalism M.A. program, visit www.healthjournalism.umn.edu.