Profile: Fogarty Fellow Dr Akwi Asombang advances cancer research in Zambia

November / December 2015 | Volume 14, Issue 6

Full November / December 2015 Global Health Matters newsletter [PDF < 1M]

Dr Akwi Asombang in white coat with stethoscope seated at desk takes note on pad while speaking with a seated patient

Image courtesy of Dr. Akwi Asombang

Dr. Akwi Asombang's fellowships on cancer risk factors in Zambia
solidified her interest in global health.

By Cathy Kristiansen

Dr. Akwi Asombang wondered about incorporating global health research into her career. While she was in the midst of a gastroenterology fellowship at Washington University School of Medicine, she decided to test the waters by applying for a Fogarty fellowship in Zambia. She was selected and embarked on an experience that would guide her future.

"It was absolutely amazing, it solidified my interest in global health and how I see myself," she said of fellowship, funded by Fogarty's Global Health Program for Fellows and Scholars, which provides yearlong mentored clinical research experience overseas for postdoctoral fellows and pre-doctoral scholars. The National Cancer Institute (NCI) also contributed support. She recalls, "I was able to see opportunities for research, the vast need for more data."

Her fellowship research project examined how antioxidants ward off cell-damaging oxidative stress, which is suspected as a cause of cancer. Fruits and vegetables are key sources of antioxidants. Asombang found although the typical Zambian diet is dominated by vegetables rather than animal products, additionally eating fruits year-round was protective against gastric cancer. Her study also clarified the accuracy of measuring urinary isoprostanes, which are generally accepted as the most reliable biomarker of oxidative stress.

Asombang is especially interested in the early occurrence of gastrointestinal cancers in the Zambian population. These are often undiagnosed or identified too late to treat effectively. The country has few gastroenterologists and lacks relevant data to guide treatment strategies and health policy. "I went there with the intention of looking at gastric cancer," she recalls. "But then I encountered esophageal cancer cases, so our team decided to pursue that as well. Along the way, I got more intricately involved with patient care, a welcome addition to my research portfolio. "Asombang has continued to study not only gastric cancer but also esophageal, colorectal and pancreatic cancers. She is now an assistant professor at the University of Missouri and returns periodically to Zambia to continue her research, having secured further grants after her fellowship. Based on networking done at that time, she has also been invited to lecture at a Zambian university.

Asombang recalls one eye-opening revelation during her fellowship - the difficulty of obtaining laboratory tests, which impacted both research and routine patient care. In the U.S., she was used to receiving laboratory results promptly, even within hours, but her work in Zambia required more hands-on involvement such as collecting blood and urine samples and delivering them to the respective labs. She noted, "Things we take for granted here - the availability of manpower, the limitless supply of the different equipment and tests we use - were not routinely available in Zambia."

She found it necessary to learn some new laboratory techniques, such as making dry ice for storing and transporting samples. She recalls, "We got a tank of carbon dioxide and attached it to a dry ice maker, then transferred it into a secure container. The room became cloudy and we laughed at the fun of it."

Aside from being surprised by a number of logistical challenges during her fellowship, Asombang found some emotional aspects difficult. She diagnosed a 19-year-old woman with colon cancer and, although she arranged for the best care possible, she heard the woman had died a year later. "I built such a bond with her," she remembers. "Her aunt, who used to bring her to the clinic, named her own daughter after me."

Asombang said she is now much more aware of the challenges in resource-limited settings and the great need for more research and clinical interventions. "Being on the ground helped me understand the burden of disease and opportunities for improvement in both patient care and clinic education," she noted. "I believe I am in a stronger position to continue to contribute to what is known about gastrointestinal cancers in Zambia and neighboring countries."

More Information

Learn more about the Global Health Program for Fellows and Scholars
Featured profiles of Fogarty Fellows and Scholars

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Funding news for global health researchers and partners from Fogarty at NIH

On behalf of the Fogarty International Center at the U.S. National Institutes of Health (NIH), the following funding opportunities, notices and announcements may be of interest to those working in the field of global health research. Updates are typically distributed once a week.

Funding Opportunities

NIH funding opportunities focusing on global health and foreign collaboration.

International Bioethics Training:
Master's: International Research Ethics Education and Curriculum Development Award (R25) (PAR-16-081)
Doctoral/Postdoctoral: International Bioethics Research Training Program(D43) (PAR-16-082)
Application deadline: May 18, 2016

NIH funding opportunities for which foreign organizations, foreign components of U.S. organizations and/or other foreign components may apply.

Behavioral and Integrative Treatment Development Program (R01) (PA-16-072), (R34) (PA-16-073) and (R03) (PA-16-074)
Application Receipt/Submission Date(s): Multiple dates, see announcement.
Clinical Development of Minimally-Invasive Bioassays to Support Outpatient Clinical Trials of Therapeutics for Substance Use Disorders (R21) (PA-16-075)and (R01) (PA-16-076)
Application Receipt/Submission Date(s): Multiple dates, see announcement.
NIH Pathway to Independence Award (Parent K99/R00) (PA-16-077)
Application Receipt/Submission Date(s): Multiple dates, see announcement.
NIDCR Small Research Grants for Data Analysis and Statistical Methodology Applied to Genome-wide Data (R03) (PAR-16-070)
Application Receipt/Submission Date(s): Multiple dates, see announcement.
Administrative Supplements for Research on Sex/Gender Differences (Admin Supp) (PA-16-066)
Application Receipt/Submission Date(s): Multiple dates, see announcement.

Information related to opportunities from other organizations focusing on global health and foreign collaboration.

Saving lives at birth: a grand challenge for development, aims to find the tools and approaches to help the mothers and newborns during their most vulnerable hours. The initiative is supported by USAID, the Government of Norway, the Bill & Melinda Gates Foundation, Grand Challenges Canada, DFID, and KOICA.
Submit "Expressions of Interest (EOI)" by February 29, 2016
Global Child Health Fellowships, from the Centre for Global Child Health at The Hospital for Sick Children (SickKids) of Canada, are open to applicants with professional or doctoral degrees.
Application deadline: February 29, 2016

Funding News

NIH funding news that may be relevant to global health researchers.

Notice of Additional Participation in PAR-16-052 Global Noncommunicable Diseases and Injury Across the Lifespan: Exploratory Research (R21) (NOT-TW-16-002)
Request for Proposal (RFP) Announcement: Mycobacterium tuberculosis (Mtb) Quality Assessment Program (TBQA), NIAID-DAIDS-NIHAI2015048 (NOT-AI-16-021)
Broad Agency Announcement (BAA): Development of Radiation/Nuclear Medical Countermeasures or Biodosimetry Devices, BAA-NIAID-DAIT-NIH-AI-2015042 (NOT-AI-16-020)