Meningitis on Campus - An Extremely Timely Lecture by a Public Health Nurse Extraordinaire

Yesterday was the final guest lecture in my Humanitarian Logistics and Healthcare class this semester at the Isenberg School and it was extremely timely and interesting.

The students and I had the privilege of hearing from Ms. Ann Becker, who is the University Health Services (UHS) Public Health Nurse and the Unit Coordinator for the Medical Reserve Corps at  UMass Amherst.

The title of her guest lecture was: Meningitis on Campus - Reaching Students During a Meningitis-B Outbreak.

As some of you may have heard, this past Fall there were two cases of Meningits-B, one in late October, and the other three weeks after. Since no linkages between the two cases could be identified, the Centers for Disease Control (CDC) termed these cases an outbreak. Students get vaccinated for other strains regularly but not for the B strain. And, in early March, the CDC confirmed that another case was diagnosed in a Smith College student, so this is now a 5 College outbreak. 

This disease is very rare but it can progress rapidly with extremely dire effects.  I remember last semester when I was teaching my Transportation and Logistics class at the Isenberg School that one of the students in this class knew the first student to contract meningitis-B because they were both in the same fraternity, and he was involved in helping to raise funds for the student's care and recovery.

10-40% of 16-24 year olds are carriers of this bacteria, and the illness is transmitted through direct contact with secretions. Risk factors include large parties and sharing of drinks, cigarettes, etc., and being stressed and not sleeping enough only increases the probability of contagion. It takes at least a week to identify the meningitis strain from a culture and these were sent both to the Massachusetts DPH and the CDC.

The UMass Amherst campus responded extremely professionally. There had actually been simulation exercises in place for a mass vaccination and I had even blogged about this. This was inspired by the cases in the US a few years back on college campuses, including Princeton University. And, at that time, there was not even a vaccine available in the US (but was in Europe). 

The UMass Amherst campus responded with an emergency call center, since, once the news went out, the staff was inundated with calls. Staffing was identified for the initial vaccination clinics and vaccine supply and cold storage had to be managed. It was interesting to hear that the annual flu clinics also served as a prep for the mass vaccination clinics. UMass Amherst, as a university, is in the business of education, and it was essential to have no disruptions to courses. The healthcare staff, with assistance from nursing students and the Medical Reserve Corp, in 3 hours gave 700 vaccinations. "Being prepared and knowing people" helped in the efficiency of the processes as well as their effectiveness. The cost for 10,000 doses was $1.5 million from Glaxo Smith.

In order to reach students, there were numerous communication media that were utilized - from social media and emails to the notification of parents and having a dedicated strip banner with info on the UMass homepage. Also, the MA DPH sent out messages to every healthcare provider in the state. Two shots are required for the vaccine and there was a one week Thanksgiving break in late November with some students also getting their first vaccines from their home healthcare providers.

UMass Amherst had 4 walkin clinics over consecutive days from noon until 6PM and Ms. Becker showed the class an excellent diagram with the flow of the process, which is something all the Operations students enjoyed and appreciated. It began with the registration and asking for the insurance (if students or insurers could not pay, then (bravo) UMass Amherst covered the expense). Impressively, the number vaccinated reached 1,500 per day with the longest wait time of 20 minutes, which is not bad, given the volume of students as well as the severity of the disease.

It was interesting to hear that the processes were aided by the youth of those vaccinated and that they were all ambulatory.

There are still unknowns, however, since we don't have an accurate count of how many students have received the two shots that are needed, as Ms. Becker pointed out in her lecture.  Interestingly, she also mentioned that, after a year of no more outbreaks, can we be considered "in the clear." They do know that more than 3,000 + students have already had 2 shots.

Our University Health Services are continuing with walk-in clinics, which is great and also reassuring, and they have also done an amazing job in educating students as to proper behavior so that this bacteria does not spread.

We presented our fabulous guest lecturer with a certificate and a gift from the Isenberg School and took the group photo below as a memento.

And, in her last slide of her presentation, featured above, we can see our Chancellor, Dr. Kumble Subbaswamy, "saying": Get Vaccinated.

It was very special to have Ms. Becker speak to my class and her expertise and kindness are truly inspiring. We are very lucky to have her at UHS at UMass Amherst!

The Syrian Crisis and a Humanitarian Hero - Dr. Mahmoud Hariri

Today we had the great honor of hosting Dr. Mahmoud Hariri, who is a Scholars at Risk Fellow at Harvard University, as a guest speaker in my Humanitarian Logistics and Healthcare class.
 
 His guest lecture on the Syrian Crisis had been scheduled for March 7, but, since he had gotten into a course at the Macy Institute at Harvard, he asked for a postponement, and I graciously agreed. It was worth waiting for him!

There were logistics involved even in terms of getting him to speak to my class, which meets on Tuesdays and Thursdays at 8:30AM at the Isenberg School of Management. Since he is now at Harvard University for a few months, before returning to his home country of Syria, I arranged for a 6:15AM pickup in eastern Massachusetts and he arrived at the Isenberg School at 8:15AM!  Last night he had been busy speaking on a panel at Harvard and meeting with Syrian doctors until midnight.

Dr. Hariri has to be one of the bravest people I have ever met and, in teaching this course and working on disaster relief and operations research, I have communicated and interacted with many courageous and outstanding scholars and practitioners in this field.

He began his presentation by providing us with an overview of the Syrian Crisis and illustrated his presentation with numerous personal experiences. As a trauma surgeon, he has had to work in (and is now even helping to construct) makeshift hospitals, has driven an ambulance (these are usually covered in mud to camouflage), and has seen healthcare facilities targeted with bombs, especially using a double bomb attack tactic.

He shared with us conditions in prison that are so horrific I will spare you the details, but even children are imprisoned for "crimes" allegedly committed by a parent, which could even involve giving medical care to a patient.

Elderly parents are not spared.

He stated that high school students have three options, once they graduate:
1. become a refugee
2. carry arms and become a militant
3. continue one's education, if feasible.


Through incredible creativity and the novel use of technology he is working on educating medical students in Syria, most of whom will not be trained doing dissections, but will work directly on patients, many suffering from war wounds due to bombs and other weapons.


One hospital that he has worked at was targeted 25 times. The health system in Syria has almost collapsed with more than 50% of those working in hospitals now volunteers.


For security, they have moved hospitals underground and emergency rooms are sometimes located separately from hospitals to reduce the chance of detection and strikes. Dr. Hariri, has, at times, had to operate on patients, who are blindfolded, so that they don't recognize him in the community as a doctor, since medical professionals are targeted.

His creativity, drive to do good and help, have resulted in such innovations as having 5 ICUs being monitored from the US, medical education via smart phone, and with students studying on smart phones. He emphasized the importance of learning English among students in Syria and that even a warehouse of books was destroyed by the regime. Many of the books had been provided by the Dutch.  2 and a half million children in Syria are not in formal schools and mothers are trying to home school children.

Some of the bombs that are being dropped are in the form of toys.


There are now 5,000 Syrian doctors in the US but fewer than 2,000 in Syria.

To show you how dire the situation is, when speaking to militants, he was told that they did not want a hospital located in their area, since it was too dangerous!  What a challenge for operations research and applications of location theory!

Dr. Hariri believes that education is essential and will be pivotal in changing the crisis in Syria, a country in which dozens of weapons have been used in experiments.


His presentation, on Prezi, can be viewed here.


The love for his country, his brilliance, ingenuity, dedication, energy, and passion for doing what is right shone throughout his presentation today.

Below is a photo taken after his lecture. I presented him with a plaque for being a Professor for a Day and also a gift from the Isenberg School.

Afterwards, several students lingered to ask him more questions.

Many thanks to a humanitarian hero - Dr. Mahmoud Hariri, for a lecture that noone in the audience will ever forget.

For a nice article on Dr. Hariri in the Harvard Gazette, click here.