New season, new name, new look, same great content.

Get “Plugged in to Public Health“ with this terrific conversation about global health and the study abroad experience with epidemiology student Emily Jester, who spent time in Romania last summer working and learning about public health, violence, and injury prevention issues there.

Lauren Lavin:

Welcome to a new chapter of our podcast journey. My name is Lauren Lavin, I’m the Executive Producer. And if you’ve been tuning in with us for a while, you might notice something a little different today, our name, the graphics, the music. And we’re excited to introduce you to Plugged in to Public Health, our fresh new brand that reflects our deeper commitment to connecting you with the most critical conversations in public health. Previously known as From the Front Row, our podcast has always been about bringing you closer to the front lines of public health through students’ eyes. Sharing stories, research and insights from those who are shaping this field. As we’ve grown, we’ve realized the need to evolve along with the ever-changing landscape of public health. Our new name, Plugged in to Public Health, captures our mission to keep you informed, engaged, and inspired by the latest developments, ideas and voices from across the public health community, here at the University of Iowa.

So whether you’re a student professional or simply passionate about making a difference, stay with us as we continue to bring you closer to the people and the stories that matter most. To kick off our fresh look, we have Emily Jester joining us this week, and she’s an MPH student at the University of Iowa. We’re going to talk about her experience in Romania, mental health abroad, and how the global perspective can really be beneficial for students in the public health field. Welcome to Plugged in to Public Health. Thank you, Emily for joining us on the podcast today, we are so happy to have you. And could you start off by telling us a little bit about yourself, your personal background, academic background? Just introduce yourself.

Emily Jester:

First of all, thanks for having me. I was born and raised in a tiny town called Keosauqua, Iowa. It’s about an hour and a half drive south of here, and it’s very rural, there are no stoplights in the [inaudible 00:01:54] county.

Lauren Lavin:

I was just going to ask the stoplight question.

Emily Jester:

I had a coworker recently who, she claimed that she was the only county that had no stoplights in the whole county, and I said, “That’s actually not true.” In the town that I grew up in, in Keosauqua, it’s a county seat so it’s the biggest town in the county, and it’s about 900 people.

Lauren Lavin:

Wow.

Emily Jester:

Yes. So we are really rural, I spent 18 years there. I am kind of a legacy student, I did undergrad here at the University of Iowa, I got my Bachelor of Science in Human Physiology, a minor in chemistry with honors and all the fun stuff. And I graduated in May of 2020, which was probably one of the best times, maybe 2008 was a worst time to graduate.

Lauren Lavin:

What a time to be alive.

Emily Jester:

Exactly. Yeah, so I was pre-Med for a long time, and then decided that I didn’t think I was doing it for myself, and I just decided it wasn’t going to be the most fulfilling for me. So I dropped that and then COVID happened. I took a few years to figure things out, and now I’m going into my second year of my MPH program in epidemiology, with the College of Public Health. And I am very, very happy and very content with where I’m at. They’ve treated me very well, there are some really incredible people in that department. I have a lot of good stuff to say.

Lauren Lavin:

How did you decide on going back to school for MPH degree? How’d you settle on that?

Emily Jester:

I wasn’t a hundred percent sure, I didn’t know the differences between the MS and MPH. Because I was getting into the point where, I didn’t really know a lot of people around me growing up who had experience at this level of education, I was kind of going into a lot of this blind. But I liked how I was getting a more comprehensive education and having the core courses, and then just being a well-rounded public health professional from those courses that the MPH program offers. Epidemiology, I knew that that sounded like it resonated the most with me. And I honestly, I just applied for the MPH, I don’t know that it was a super conscious decision other than I liked having comprehensive classes.

Lauren Lavin:

Sometimes those decisions end up being the best decision, so there’s nothing wrong with that. Do you know what you want to do when you’re done with it?

Emily Jester:

Yes. Well, no, but yes. I started the program intending on just doing a master’s. And I think recently I’ve been noticing a lot of disparities in data among different identity groups, and that’s been something that’s been frustrating for me to navigate for classes and research. And so it’s kind of inspired me, I think to… I believe I’m going to apply this fall for the PhD, because of that and many other things.

Lauren Lavin:

[inaudible 00:05:14], yes.

Emily Jester:

Well, thank you.

Lauren Lavin:

I look forward to hearing about how that goes for you. Summer, you’ve participated in Scope Summer School on Violence and Injury Prevention in Cluj, is that how you say it, Cluj?

Emily Jester:

Yes.

Lauren Lavin:

Romania. Could you describe what that was and how you got into it.

Emily Jester:

Before participating in the program, I think it was early in the spring semester I saw some advertisements for the summer school, and it being a global opportunity for college of public health students. And one of my faculty members, Dr. Cara Hamann, she is a co-PI on this project, on the iCreate. The Scope Summer School is a part of the iCreate project, so it’s just something that falls under the umbrella of their capacities and what they’re doing. But I knew from being in class with Dr. Hamann last fall that she was involved in this. We came to class one day and she was like, “Okay, well I’m going to be gone for the next week or two, I’m going to Georgia, the country.” And we’re like, “Oh.”

That was just unexpected and random, but cool, I’d never have heard of anybody who’s traveled there so that piqued my interest at first. And then I saw advertisements for this and honestly, I personally, I have always really loved being able to travel and would… In undergrad, I would sell/donate plasma. I would do whatever it took to go on a trip, travel if it was a service project, or what have you. Kind of tying back to where I grew up, I did have a lot of exposure in early life to some of the realms of violence and avoidable injury. But it was admittedly a field that I don’t know a lot about, and that kind of intrigues me. I love a challenge and I love to learn new things, so I thought as an opportunity to pursue, to fill that gap in my wheelhouse, if you will.

Lauren Lavin:

[inaudible 00:07:33] main objectives and the structure of the program, how long were you there and what’s the goal of it?

Emily Jester:

The Scope Summer School was a weeklong course. The primary goal is to expand research capacity in violence and injury prevention in individuals and students, in the four Eastern European countries that were focused on. So that was Romania, Armenia, Moldova and Georgia. And so we went there and we spent a week in class from nine AM to four PM every day. We had breaks and whatnot, but still managed to get 200,000 steps under my belt even being in class that whole time.

Lauren Lavin:

Oh my goodness.

Emily Jester:

Yeah, so there was a lot to explore. The intention is to just… They brought in a lot of professors from Australia, there was one from the US. Well, there were two from the US but one of them was from Michigan State. They were from Romania, but were currently teaching in Michigan. But they brought them in and they kind of taught us how to develop intervention programs in a way that makes them sustainable and culturally tailored so that they are easier to take on for the residents. And also just something that doesn’t totally interfere with cultural practices or what is the cultural norm in the area because we didn’t want to overstep our bounds anywhere. It’s basically developing these interventions in the context of Eastern Europe.

Lauren Lavin:

So then within this, did you work with students from different nationalities or was it primarily American students in a different location?

Emily Jester:

Our class was probably close to 20 students, I believe. They were mostly from Armenia, Moldova and Georgia, and we had one student from Bangladesh who had been studying in Cluj for a couple months. And then we had another student who was from China, who had been studying in Poland. And there were four of us from the US, so we were a minority in the classroom for sure. So it was a really interesting and unique experience to be in.

Lauren Lavin:

How was that experience? And then can you share any specific insights, or learning, or how being in that multinational experience influenced your learning during that week?

Emily Jester:

It became pretty apparent early on in the trip that these students really had very strong passion and were very welcoming and very kind. Although at first everyone was a little hesitant of each other and I, being a person who loves a challenge, I needed to figure out how can I make my jokes translate and really land with these other students? Because that is a journey in and of itself, sarcasm and step does not translate well all the time. So I just did my best and I really tried to keep putting forth the effort and showing that effort to show them that I did want to make a connection. Which was successful, I made a lot of really great connections and friends and close relationships with all the students. We did have a few opportunities to have some more difficult conversations. The girls that were in our class were telling us how they were… In Armenia specifically, telling us how they were a part of the first generation of women who were actively going to school and working, instead of staying at home and being a housewife.

All of their moms had done that, they were kind of a part of this first generation that’s really breaking a lot of gender stereotypes and boundaries. And just being some incredible human, some of the stories that they were telling. But one of the conversations that we had while we were out to dinner one night, I had asked them… This was with some of the Armenian students. I had asked them what were their expectations or stereotypes of the Americans before meeting us. Because I’m always curious and I’m open to have those conversations, and I’m all about proving people wrong, if it’s negative. And so we had a few conversations about a few different things. One of the students had brought up that she saw a video online recently of a person who was identifying as a camera or something.

And this was entertaining to the Armenians and the other Armenian students in the group. They were kind of giggling and at first I was like, I can’t tell exactly where this conversation is headed at this point, I’m getting a little weary. But I’m also open to continuing this and hearing what’s moving forward. And so they asked me, “Well, isn’t the US just getting really toxic with all this gender identity stuff?” And they were still laughing and having a good time and whatnot, and I actually took the opportunity to try and just gently reframe those thought or perceptions. So I said something along the lines of, I think that there are people who are posting videos like that online to make it appear that that’s what is happening here, but it’s not. And it just causes more harm and hate and violence and negativity, and that’s the conversation in a nutshell. And for the most part, they seemed pretty receptive to that conversation.

And it actually got us to open up later on in one of our class sessions, we actually had a whole discussion on gender. And when was the first influences on your gender, and when was the first time that you remembered having a draw in one way or another? I feel like made those other students feel more comfortable contributing in this conversation later on in the class. So that was really rewarding to see, to sit back and watch happen. There were several times where we had differences in traditions and values, but I also knew that that was more so a product of how they grew up, and does not necessarily have any impact on their value as a person. I just tried to navigate these conversations as gracefully as I could, and calmly as I could. Explaining things in a compassionate, and I think it was successful, so I’m happy with that.

Lauren Lavin:

It sounds like you achieved that, and you were able to open up a dialogue. I think sometimes the hardest part of those conversations is that they can be shut down before they even begin, if you’re not careful and approaching them with a lot of grace on the front end. We’re going to transition back to some of that violence and injury. What were the primary areas of concern regarding violence and injury that you and your group identified within those Eastern European countries?

Emily Jester:

In Eastern Europe, some of the most significant problems, if you will, in violence and injury prevention revolved around self-harm, a lot of road injuries and interpersonal violence. And even outside of that, outside of violence and injury prevention, there were a lot of disparities in healthcare access and health literacy and mental health care. That is something that still can be often very taboo in the region to acknowledge or address or talk about.

Lauren Lavin:

You did a great job segueing into my next question actually, could you provide an overview of the evidence-based intervention program that your group actually proposed after working together for the week?

Emily Jester:

Yeah. So first, little content warning for unaliving. Our group, we were struggling for a while to focus on one specific topic, there’s just so many. We were split up to work in groups where no two students were from the same country, which was also really unique experience.

Lauren Lavin:

That’s really cool.

Emily Jester:

I’ve never been in that context before, and it had challenges and also just a lot of rewards as well. But we had to focus on a specific concern in Eastern Europe, in one of those four countries, the Romania, Moldova, Armenia, Georgia. We in my group had this student from Bangladesh, one student from Moldova and one student from Armenia. And so we kind of came to a consensus on having this passion for addressing, essentially just addressing adolescent suicide in Armenia, Moldova. So our intervention focused on prevention of that through coordinating these crisis trainings in a school setting.

Having these crisis trainings include training teachers on how to navigate these situations. Also knowing how to navigate them within themselves and how to recognize certain flags within themselves and know when to step in. And also including students in that as well, obviously having a slightly different training program for them, but also increasing awareness of the helplines in these countries as well. Because something that we learned along this process was, the students that were in our group didn’t even know that their country had a helpline. And B, in Moldova, their helpline is only available for two hours out of the day.

Lauren Lavin:

What two hours?

Emily Jester:

I think it was like seven PM to nine PM.

Lauren Lavin:

I was going to say, if-

Emily Jester:

So it’s like, make sure you plan accordingly.

Lauren Lavin:

Yeah.

Emily Jester:

There was a significant need. And also with mental health still being very taboo to talk about, it has manifested pretty devastatingly in this population. This was something that our whole group wanted to really focus on.

Lauren Lavin:

I have a follow-up question with that. Is that something that you noticed when you were talking cross-culturally, did you notice that mental health is more taboo in some of these countries? Or do you feel like it’s still just as taboo in America as it is in some of these Eastern European or Middle Eastern countries?

Emily Jester:

It really jumped out at me on this trip was the differences in how… In the progression of mental health care and the differences, the variation among countries or between countries, we in the United States still have a long ways to go with that. But a lot of these students that I was with, they don’t have access to therapy, they don’t regularly go to a psychiatrist. That access is not readily available to them, and people don’t have a lot of conversations. And these are wide-sweeping statements too, there are exceptions and I think there’s this new generation that’s trying to change things and make things more acceptable and more just all-encompassing and compassionate. Although we still have strides to make here in the US, it was a significantly bigger concern in Eastern European countries.

Lauren Lavin:

I think there’s some good context to add into this conversation. What were some of the challenges that you faced while developing this program? I know that you touched on them.

Emily Jester:

I had noticed a partway through the week that some of my group members and some other classmates were having difficulties focusing in class for the whole day. And that led to times where when it was time to work on our project, then those times were unproductive. Because the course concept that we were learning about was everything that we were supposed to apply for these intervention programs that we were developing. Kind of required a lot of attention and focus in class to be able to apply, but we were kind of struggling for a while to get on the same page regarding what we needed to accomplish for our final presentation. I got a little stressed a couple times because I just am a person, I don’t necessarily do things right away per se, but I like to make sure that we’re making progress so that don’t I don’t have to pull an all-nighter.

Lauren Lavin:

Yes, valid.

Emily Jester:

Which was something too that I also learned is, at least in Armenia, there was a student who was from the US on this trip. Well, she’s from Armenia but was living in the US and so she had both cultural context. So she was helping a lot with that, but she was reassuring me by telling me, “When I got married in Armenia, it was so stressful because they just kind of wait until what we would consider the last minute to solidify things, or to make sure that things are done.” Which is, it works for them, it just stresses us out. And so that kind of got increasingly stressful throughout the week, especially when other groups had their projects pretty much completed. And also this is a very important and complex topic, and I didn’t want to do a disservice to it by not giving it the attention that it deserved and compassion that it deserved. And also, I didn’t want to speak on a topic that I was not familiar with.

In the context of Moldova and Armenia, I didn’t want to speak on those if I have no idea what that is like. I was playing this balancing act between stepping in and trying to get things accomplished, but also not wanting to just give my American thoughts and input on the whole thing, when the whole point is to be in the context of Eastern Europe. Throughout that week, I learned a lot of stories from these students about all the war and conflict and genocide that their countries have gone through even in the last. So the implications of that on and their families and them, I have no idea what that is like. And I can only imagine that that definitely has implications on how they navigate the classroom, especially in how trauma manifests in a lot of mental health conditions. And especially when we’re in a region that is not used to talking about these things a lot or addressing mental health in general, it just kind of compounds the issue.

So I had to start reframing my thoughts, approaching the whole thing with more compassion. I just knew that this could likely be just an escapism thing. Like getting distracted in class, it might just be something that their body or their brain has developed as a coping mechanism. I just tried to be more compassionate moving forward and I gave just very explicit written directions on our PowerPoint presentation of information. Because I know for me, if I’m told something and it’s not written down somewhere, I can’t guarantee it’s going to stay.

Lauren Lavin:

Oh, I’m the same way. If it doesn’t make it on a to-do list, there’s a really good chance it’s not happening.

Emily Jester:

Yeah.

Lauren Lavin:

If it’s not written down, it’s gone.

Emily Jester:

Exactly. So I was kind using that approach and just made sure to be really be in what we need, why this information is helpful here, why we need to… Because we’re essentially pitching our intervention and pitching our project to this theoretical funding source.

Lauren Lavin:

How do you think that your intervention or the other ones presented during that time from other groups, will have an impact on their respective communities going forward, or have the potential to?

Emily Jester:

Big part of the curriculum for the summer school was really trying to emphasize the importance of using your community experts, because they’re the ones that know about what is going to work, what is not going to work. What is overstepping on cultural practices or beliefs and what is not. Having these students and these experts being a part of the group and developing the intervention in and of itself, I think that already has us on a solid path to provide helpful results. Hopefully this is something that I think would be really beneficial just because it showed its importance in… While we were working on the project, the students in our group became aware of helplines that they didn’t know of before. I was hoping as a byproduct of this presentation to the class, the whole class itself, that hopefully this helps normalize mental health distress. Or opening the conversation that it’s okay to not be okay, and it’s okay to talk about these things.

Even if this was just the theoretical intervention that we were developing, we somehow hopefully made some sort of impact, even on the classroom itself to normalize the concept and just lead to just a higher quality of life for everyone. And one of the students came up to me after our presentations, and she’s in med school, a lot of the students were either public health students or medical students or both. And she was saying that she had been interested in doing psychiatry in medical school, and this whole presentation opportunity really reinvigorated that passion for her, and got her really excited and passionate to move forward in that field. So that was also really exciting and I just hope that even if we’re making these little impressions just on the people who are receiving the information in the presentation, that makes the whole thing worthwhile. If we’re not able to actually implement this intervention, at least we’re making these smaller impacts on students who are in the area and who can make bigger impacts moving forward.

Lauren Lavin:

Sometimes it’s also planting the seed of getting these thoughts started or the conversations around it started, I think can be just as impactful like you said, for the people who can make a difference. Realistically, you were there for a week and then you have to come back here. And you bring all those conversations back, and you can have a conversation with someone like me and then that disperses out when other people listen to the podcast, and that’s an impact in and of itself. But your impact there is that you had this presentation and then hopefully that that kind of starts some conversation there and you kind of leave that with people who could make a difference there. And that’s equally as impactful even if your intervention doesn’t get implemented in the way that maybe you guys laid it out in-

Emily Jester:

That was so eloquently said.

Lauren Lavin:

We try, sum it up. How has this experience changed or reinforced your perspective on violence and injury prevention, or maybe on public health more broadly?

Emily Jester:

So when I first started my program in epidemiology, I started off with an infectious epi interest. I had worked in the children’s hospital for several years, and I was working there during COVID and we had a really nasty RSV season in tandem with COVID and Influenza seasons. And so that was my first draw towards epidemiology in general. I started with this infectious epi interest, and then over the course of the year that kind of shifted more towards social epi and health in a global context. And social determinants of health, I’ve been just very interested in a lot of these things. I love puzzles, and it all is just this very complex puzzle to figure out. And a person who loves puzzles and challenges, it’s a perfect mix for me. Coming into this program, I didn’t have a lot of formal background knowledge on violence and injury prevention. And learning more about what it is because previously I had only really had exposure to this through Dr. Haman and she does a lot of bike safety stuff.

Growing up as a kid, I’m looking back and I wish I was wearing a helmet and all this stuff that I’m learning about now. But I just didn’t realize that the scope of violence and injury prevention expanded as far as it does, that’s something that really intrigues me. Moving forward in my life career, I’m planning on applying for the PhD in the fall. I just know wherever I go in the future, I will always have this recurring global context, or this recurring focus on prioritizing a global context and cultural context. I plan on prioritizing just global health efforts in the future and making sure that everyone else is good so that we can all be good.

Lauren Lavin:

Final question to wrap it up today, what advice would you give to any other students or professionals who are interested in participating in a program like Scope?

Emily Jester:

My first piece of advice is to not hesitate and do it. If it interests you, definitely do it, travel, it is one of the most rewarding experiences that you can do. And if you do go on these opportunities, expect to be uncomfortable so that it doesn’t come as a shock to you, that will happen. And it’s fine, that’s just the way that life is, and it’s just the differences in how we all navigate life. But you’re not going to have air conditioning all the time, especially when you’re sleeping.

Lauren Lavin:

I may get cranky if I don’t have air conditioning while I’m sleeping.

Emily Jester:

You get sweaty and that’s to be expected. That communication can sometimes be non-existent. You have for example, because I went on this trip with a few people from Iowa and a couple of us decided to extend our flight in Munich because we had a layover in Munich. We extended that layover into a three-day layover. And so we took a train down to Southern Germany and Bavaria. And one of our trains got canceled and we couldn’t seem to communicate with anyone, which was very stressful. Traveling is very stressful in and of itself and transportation. And we tried to just approach it like, okay, it’s part of the experience. We kept telling each other, it’s the climb, we just kept saying that over and over.

And even things like doing laundry are different, we had to drop off our laundry to these women who were working in a different building. We were on the campus and student housing and so we had to drop it off at a very specific time, and we had to have specific bags to hold certain items. And it was a learning experience so make sure to expect to be uncomfortable. And just try to be malleable and try to be as go with the flow as you really can, that’s how you’re going to get the most from these experiences. Also do research, not only for your own safety, for certain identities it can be a different safety concern in different countries. So definitely always make sure that you are up to speed on what’s going on in the country and what perspectives are and how it’s safest for you to travel there.

And then it’s important to put forth an effort to understand somewhat of the culture of where you’re going to. I’m just a person that genuinely likes to hear stories about other people and their walks of life, but showing this effort has always been received well, it’s never not received well. I don’t think it’s common for a lot of Europeans to have tourists from United States who are really engaged and really wanting to understand the cultural context so it’s always received well and appreciated. Showing up and being genuine and authentic is the best way to really build these connections with people.

Lauren Lavin:

I was thinking about, as we were talking of this conversation was also that, I think a lot of times, especially as students, we think that some of these experiences have to be really long. Like it has to be a semester abroad or a summer abroad. This is a good reminder that you can have a really meaningful, impactful experience in the time span of a week. That that was something that kind of amazed me. And especially the depth of conversation that we covered here, is that it seems like you packed a lot of really meaningful experience into what seems like a really short amount of time.

And something that will definitely impact the trajectory of probably your career pathway, because you took effectively a week long trip to somewhere, to learn and study and grow. I think that as students listen to this, that something to really consider is that it might just be saying yes to a commitment of a week, that could really alter the way that you see and view the world as a public health practitioner or medical provider. And that’s not that much of a commitment, so if you can spare a week, it could really change the way and make us more compassionate and global human beings, which I think makes us better off in the long run.

Emily Jester:

I wholeheartedly agree. Romania was a country that I never really expected to ever be able to travel to, so definitely pursue these opportunities even if it’s in a country that you just never thought that you would ever travel to.

Lauren Lavin:

Well, I really appreciate you being on the podcast. I learned a lot, I’m sure our listeners have also learned a lot. Thank you for taking your time out of your day to share with us.

Emily Jester:

Thank you for having me.

Lauren Lavin:

Thank you for joining us on today’s episode of Plugged in to Public Health. We hope you found the discussion insightful and that it sparks some new thoughts about the importance of a global perspective in public health. If you enjoyed this episode, please consider subscribing, leaving a review or sharing it with someone who might also benefit from the conversation. Remember, public health is about all of us, so let’s keep this conversation going. You can reach us at CPH-GradAmbassador@uiowa.edu. Until next time, stay informed, stay healthy, and take care.