Today I Moved to London!

Today I moved to London!

Look, I'm the regenerating limb of an axolotl! This photo is from the London Zoo, which I visited last year during the Watson fellowship. How could I stay away from a city with a giant albino axolotl?

I'll be here for two years on a Marshall Scholarship, which funds up to 50 Americans under the age of 26 to go to graduate school in the United Kingdom each year. The scholarship is named for Secretary of State George Marshall. It was established by the British Parliament in 1953 to thank the American people for helping out the UK after World War II with financial assistance called the Marshall Plan. (Throwback to high-school history class, right?)

For all you Yankees out there: the United Kingdom includes England, Scotland, Wales, and Northern Ireland. It's currently part of the European Union, but the people have voted for "Brexit," so the UK is scheduled to leave the EU on October 31, 2019. Stay tuned for some political turmoil.

Me with one of my favorite Brits, Charles Darwin, at the Natural History Museum in London on my Watson year.

There are 48 scholars in my cohort, studying everything from inequalities and social science, to HIV prevention, to law and the internet, to  theoretical physics, to experimental psychology. If you want to read more about what I'm doing in grad school, you can find a couple articles on the Whitman website here and here.

In my first year, I'll be working toward a Master of Science in One Health, a joint program of the London School of Hygiene and Tropical Medicine and the Royal Veterinary College.

The London School of Hygiene and Tropical Medicine entrance.

The Royal Veterinary College entrance. I took these photos last year on my Watson, when I passed through London and toured my dream schools.

The Royal Veterinary College motto is "Venienti Occurrite Morbo," meaning, "confront disease at onset." Gotta love that practical Latin. Maybe the One Health lens expands the motto to include "prevent disease before onset... by protecting ecosystems"?

What’s One Health, you ask? Great question! Think of it as the overlap in a Venn diagram of human, animal, and ecosystem health. It’s where veterinary medicine meets public health meets ecology.

Image credit: University of Alaska Fairbanks.

The term “One Health” was coined in 2005 by a consortium of veterinarians and medical doctors who realized that a lot of diseases cross over between animals and humans. In fact, most human diseases began in animals: HIV, influenza, Ebola, Nipah virus, malaria, yellow fever, the bubonic plague, rabies, anthrax, salmonella, Hendra virus, SARS, MERS, the list goes on. And some diseases actually originated in humans and then spread to wildlife and livestock – like tuberculosis!

Like many old buildings in central London, the London School of Hygiene and Tropical Medicine is ornately decorated. But instead of royal insignias, gargoyles, or the faces of dead white men, LSHTM is decorated with these awesome bronze sculptures called the Guilded Vectors of Disease. I'll sprinkle them throughout the post. Can you identify them all? Bonus points if you can guess what disease they vector.

Here's an easy one.

A disease that passes from animals to humans or vice versa is known as a “zoonosis.” So far, the One Health paradigm has primarily been used to address zoonoses. For example, vets and doctors need to work together to keep domestic ducks and pigs healthy to avoid the emergence of a new human-infective swine flu. Entomologists and doctors needs to work together to stem the flow of diseases carried by mosquitoes, like dengue and malaria. Wildlife  biologists need to be involved when a human disease has a wildlife reservoir, such as the Asian malaria strain Plasmodium knowlesii which is endemic in wild monkeys but can also infect humans bitten by infected Anopheles mosquitoes.

I tell you all that to explain that I am actually not planning to focus on zoonosis. My hope is to use the One Health lens to identify and test ecological solutions to human health problems. There are just so darn many examples of how ecosystem degradation harms human health. Deforestation leads to pediatric diarrheal disease in Cambodia; peat wildfires cause fatal respiratory distress in Indonesia; warming oceans exacerbate paralytic shellfish poisoning from harmful algal blooms in Washington State; nutrient pollution fertilizes freshwater cyanobacteria blooms which release aerosolized toxins in Florida.

One day on my Watson year, I had an epiphany that every one of these problems was a potential solution in reverse – an opportunity to address a human health issue with preventative, upstream, multispecies treatments. Could reforestation be a treatment for children's gut health and access to clean drinking water? Could peat-land conservation be prescribed to prevent lung disease? Could a Washington carbon tax be framed as a solution to shellfish poisoning? Could the Florida Health Department clean up Lake Okeechobee with its human health budget?

The reasons to consider ecological health solutions are myriad. An ounce of prevention is worth a pound of cure, as the saying goes. Preventing disease is more cost effective than treating individual patients. It’s also more equitable, because everyone in a watershed or ecosystem benefits, not just those with insurance, and less toxic, because it lacks the side effects of pharmaceuticals and surgeries.

Taking a wider lens, I am also drawn to this idea because it might be a way to leverage the political power and money that health attracts and use it for ecosystem conservation. I'm so excited to see people becoming more aware of the importance of biodiversity, ecosystems, and the biosphere for a functioning planet. (See Extinction Rebellion, founded less than a year ago right here in the UK.) As we realize that the life of our own bodies and organs depends on ecosystems, I'm hopeful that we'll direct more of our resources to protecting them.

I was walking down a street in the Philippines last year with my sister (who's halfway through her neurology residency, go Lisa!) as she explained how health insurance works, and it gave me an idea. A lot of insurance companies now provide gym memberships to their customers because staying active helps keep people healthy, and it's a lot cheaper to prevent disease than treat it. What if the link between ecosystem health and human health became so clear that insurance companies started funding river cleanups, wetland restoration, tree plantings, and land protection, not just for corporate social responsibility, but because it actually kept their customers healthier and saved them money in the long run?

Anyway, those are some of the ideas that I'm excited to test out.

The scholarship runs for two years, and I don't know exactly what I'll be doing in my second year yet, but it will probably be a second master's degree, and it will definitely be in the UK.

It's been over a year since I started my Marshall application, and two years since I started living out of my backpack. I can't quite believe I'm finally here in London. We even have a studio apartment with a bed and a bookshelf.

Collin models our studio apartment in London.

A fridge! An oven! It might be a bumpy transition from living on Southeast Asian street food to cooking my own meals...

Last night, Collin and I got on a red-eye flight from Philadelphia to Iceland, then Iceland to Gatwick Airport in London. The little screen on the seat in front of me played Iceland tourism ads the whole flight. I was pretty sad I wouldn't be able to stop over for a smooth ride on a five-gaited Icelandic horse, a walk through a glacial ice cave, or a soak in a hot spring surrounded by rolling mossy tundra to the horizons. Hot tip, if you ever decide to visit me in London.... book a long layover in Iceland first!

An Icelandic glacier from the air.

The fields and hedgerows of England greeted us from below.

As always, I love to hear your comments, questions, requests, and updates about what's going on with you. No promises on tropical bug photos this year, though!