Conversation with an MUSC Fulbright Scholarship Recipient

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Guest:  Dr. Lisa Vandermark – College of Nursing

Host:  Dr. Linda Austin – Psychiatry


Dr. Linda Austin:  I’m Dr. Linda Austin.  I’m interviewing Dr. Lisa Vandermark, who is Assistant Professor in the College of Nursing.  Dr. Vandermark, what are your responsibilities in the College of Nursing?


Dr. Lisa Vandermark:  Well, at this point, I do all research.  I’m starting to take on some more teaching responsibilities, and I mostly work with individual students on my research projects. 


Dr. Linda Austin:  Which are about, what?


Dr. Lisa Vandermark:  They’re all about community health and development.  I’ve done this work for a long time, but I do very similar work here in South Carolina as I have done in Southeast Asia and, actually, earlier, in Sub Saharan Africa.  What I’m always doing is trying to help communities get the information that they need in order to plan for a healthier environment and a better quality of life.


Dr. Linda Austin:  I understand you were a Fulbright scholar in Thailand, which is very prestigious, and it’s an incredible honor, I think.


Dr. Lisa Vandermark:  Thank you.


Dr. Linda Austin:  Tell us about the Fulbright experience.  What, that was a year long, is that right?


Dr. Lisa Vandermark:  No.  You are a Fulbright scholar for a year, and you can be there as long as a year, but I was actually there for four months.  And that was because it was hard to leave my responsibilities here at MUSC for a longer time than that.  So, that is actually the minimum that you can be overseas with a Fulbright.  I could go back again a second time.  But what I’m really doing now is trying to collaborate with them to write some grants and to get some research going so that I will go back in that capacity.


Dr. Linda Austin:  And, what, specifically, is your research interest with regard to Thailand?


Dr. Lisa Vandermark:  Well, when I went there, what research I proposed did not turn out to be the research that I did.  And the wonderful thing about the Fulbright is that once you’re in, you have so much flexibility and so much support.  And it’s really an international collaboration that they’re interested in, not the outcome of the research, if that makes sense.


Dr. Linda Austin:  In other words, to form relationships that will endure, is that right?


Dr. Lisa Vandermark:  Exactly.  And, when I went to Thailand, they told me that the reason they liked my proposal in particular was because it had a capacity-building component.  And so, I really had to fit my work into the work that the university in Thailand, in Northeast Thailand, it’s called Ubon Ratchathani, was doing and wanted to do in the future.  So, I went there expecting to do research on infectious disease in the Mekong Valley region.  The university where I was situated is about 40 minutes from the border with Laos, and that is the Mekong River.  But, in the time between my application and to the Fulbright, and going to Thailand, the university got a new dean in the medical school, and his view was that cooperation with Laos was not the priority.  So, I wound up doing research in communities near the university.  And the primary health concerns that arose were obesity, diabetes, and hypertension.


Dr. Linda Austin:  I was about to ask what the carryover is from Thailand to South Carolina, but you may have just described what it is.


Dr. Lisa Vandermark:  And before I went there, I would have said, very little.  I was absolutely shocked when we went to the community health centers and, one after another, when we asked them, what is the disease that you see most frequently, they said, obesity.


Dr. Linda Austin:  Now, one doesn’t usually associate obesity with, Asians.


Dr. Lisa Vandermark:  Not at all.


Dr. Linda Austin:  So, what’s going on, what’s causing this?


Dr. Lisa Vandermark:  As far as I understand, within the last ten years, these communities have gone from having malnutrition and, in some cases, real starvation to a situation where they have plenty of food, and have access to a lot of packaged and prepared foods, that, I think, may be the cause of this obesity epidemic.  But, in Thailand, no one has a real good understanding of why this is happening.  All over Asia, the diseases that we see in the West are now on the rise.  But, in this part of Thailand, it’s the driest, the poorest, and the most disadvantaged part of Thailand, it’s really just emerging.


Dr. Linda Austin:  How fascinating.


Dr. Lisa Vandermark:  And, I understood that probably about 40 percent of the patients that are seen in these fairly rural health centers are overweight.


Dr. Linda Austin:  I could imagine, especially if you were making a connection between obesity, diabetes, hypertension in Asia and South Carolina, there might be many ways of approaching that, at the level of the individual, the culture, the community, economics, etcetera.  What is your approach to that problem?


Dr. Lisa Vandermark:  Well, we were able to do some interviews while I was in Thailand.  Actually, I have a research assistant there who is being paid out of my Fulbright funds, and she is going back to the villages and interviewing important people in the villages, midwives, village elders, health practitioners, traditional health practitioners.  So, we’re trying to get an understanding of this.  But, what people have told us so far is that they think it has to do with the pressures of modern life, and that Thais used to do their own cooking and eat together as a family.  Children would come home from school, you know, like a traditional culture and, now, they’re very pressed.  They’re working hard.  The parents are out of the home, and people are buying more prepared foods, packaged foods.  They’re not eating together, and it’s causing the diet to shift to a much higher calorie, higher fat content diet.


Dr. Linda Austin:  So, if it were possible to encapsulate the insights that you have gained from studying these illnesses that are, of course, so rampant here, in the United States, in a very different culture, what would you say?


Dr. Lisa Vandermark:  I guess what I would say, and it’s not just me, I do this work here, in South Carolina, and I hear it from people in communities, is that you can’t just focus on obesity.  It’s really an issue of quality of life.  You have to look all of the factors.  So, that’s how I look at my work here.  I’m trying to bridge the gap between nursing and geography, which is my field of training.  And a big criticism of community planning has been that community planners are divorced from the communities that they serve.  And nursing is really very involved in the communities that they serve, especially here.  The MUSC College of Nursing just has amazing contacts in the community.  And I feel like it’s such an opportunity for me, here, to link those two.


Dr. Linda Austin:  Explain a little bit more about your background.  You have a PhD in geography.


Dr. Lisa Vandermark:  I do.


Dr. Linda Austin:  You’re in the College of Nursing.


Dr. Lisa Vandermark:  Right.


Dr. Linda Austin:  Explain that link.


Dr. Lisa Vandermark:  Okay.  I know, a lot of people ask me about that.  I was actually a nurse first.  And, I went overseas when I was in my mid-twenties.  I was married to a Foreign Service officer, and I went to school because I couldn’t find a job.  You know, we didn’t have work agreements with a lot of the countries where we lived.  And I wound up getting interested in environmental influences on health, but my career went the way of studying those environmental kinds of causes.  So, I got a master’s degree in Human Ecology from the University of Brussels.  It was in an international program sponsored by the United Nations in five different cities.  So, it had a multinational kind of quality.  It was great.


Then, I was interested in these kinds of interdisciplinary approaches to community environmental management.  So, I tried to do an interdisciplinary PhD back here in the United States.  And I got a letter from Rutgers University saying that I fit in to their geography department, and they funded me.  So, that’s how it happened.


Dr. Linda Austin:  Wonderful path.  So, what lies ahead for you?


Dr. Lisa Vandermark:  Well, I hope to have a little bit of a role in encouraging nursing to adopt geographic information systems the way they have other information technologies.  GIS is used in public health research and epidemiology, but not so much in nursing.  And, at the same time, I think that we can be more vocal advocates for community health, the way we are advocates for individual patient health.  So, that’s what I’m hoping to do.


Dr. Linda Austin:  It sounds fascinating.  What a rich contribution you bring to the College of Nursing, and MUSC.


Dr. Lisa Vandermark:  Oh, thank you. 


Dr. Linda Austin:  Well, thanks for talking with us today.


Dr. Lisa Vandermark:  Thanks a lot.

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