Learning the Complex Connections Between Energy Use and Health

An experience in the Peace Corps helped show Abebe the need for research on complex global health problems.

KULENI ABEBE

Growing up in northern Virginia, Kuleni Abebe imagined she was on a straight path to medical school, one defined primarily by academic pursuit and achievement. But soon after earning her undergraduate degree, she found herself in Otjiwarongo, Namibia, rethinking what it means to have a career focused on health.

Abebe spent two years as a Peace Corps volunteer, teaching in a school that was once open to only the city’s white children. Over time, she saw how systemic issues such as race and economics affected the health of her students and their families.

“I realized that no matter the emphasis on individual health, those external factors had a much bigger impact,” she says. “It really made me want to focus on health at a population level.”

So Abebe ditched her plans to apply to medical school and instead enrolled in Duke’s Master of Science in Global Health program, which she completed in May 2021. She says studying global health opened her eyes to a new path that marries her interests in medicine, health systems and international development.

“The Duke global health program stood out because of the long-term projects in the local and global communities,” Abebe says. “The communities were familiar with the research team. I wanted to be a part of sustainable research.”

At Duke, Abebe joined a research project led by DGHI professor Charles Nunn, Ph.D., an evolutionary anthropologist who has been studying the impacts of development in Madagascar, one of the most biodiverse places on Earth. Although Nunn originally was drawn to the island nation to study its wildlife, his research there now covers a range of topics bridging human, animal and environmental health.

The broad sweep of the project appealed to Abebe. “I really liked how it looked at the larger picture of the environment,” she says. “I wanted to learn as many skills as possible, and this project touches on so many aspects of health, environment and behavior.” She says just sitting in Nunn’s team meetings, which often included experts in ecology, infectious and chronic diseases, environment, statistics and public policy, taught her to think across disciplinary boundaries when taking on complex problems.

Abebe’s thesis research explored one of those thorny intersectional issues. Over the past several years, Nunn and other global health researchers have been examining the use of wood-burning stoves for cooking, which are common in places such as Madagascar. Harvesting wood for cooking contributes to deforestation on the ecologically fragile island, but it also carries health impacts on household cooks who breathe in woodsmoke day after day.

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“The Duke global health program stood out because of the long-term projects in the local and global communities. The communities were familiar with the research team. I wanted to be a part of sustainable research.”

Kuleni Abebe — Master of Science in Global Health graduate

In 2016-17, Nunn directed a Bass Connections team that went door-to-door in the village of Mandena, Madagascar, to document cooking methods and their impact on residents’ health. Researchers used spirometers to test residents’ lung capacity, hoping to learn whether cooks who use wood-burning stoves are more likely to have breathing problems. Although COVID-19 prevented Abebe from traveling to Madagascar herself, she was able to use that data to show that the households’ primary cooks had reduced respiratory function compared to others in the household.

Abebe is quick to acknowledge her data was incomplete, and thus likely raises as many questions as it answers. With more time, she would have liked to examine whether respiratory problems were more common among women, who handle most of the cooking in Madagascar, or whether children who assist in the kitchen are at risk. Meanwhile, another DGHI team led by associate professor Marc Jeuland, Ph.D., is exploring why cooks choose open-fire stoves and what might convince them to adopt cleaner technologies.

“There’s so much we are still learning about the effects,” Abebe says. “I think that’s one of the things I really enjoy about research, that you are constantly asking questions.”

In fact, Abebe isn’t planning to stop asking such questions any time soon. She recently began a job as a research assistant with FHI 360, a Durham-based nonprofit that coordinates research and development projects in the U.S. and around the world. And that means she will continue pushing against the complex, systemic barriers that stand in the way of people’s health.

“I’m the kind of person who really enjoys the process,” she says. “(Research) is the process of moving forward, and as long as we’re not stagnant or becoming content with what we know, that’s a really good place to start.”

CrossingBoundaries

Learning the Complex Connections Between Energy Use and Health

“The Duke global health program stood out because of the long-term projects in the local and global communities. The communities were familiar with the research team. I wanted to be a part of sustainable research.”

Watch Kuleni Abebe's speech

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