Emily Herfel, DO, Msc-GH, FACOG (Fellow of the American College of Osteopathic Obstetricians and Gynecologists), is an assistant professor at Duke Department of Obstetrics and Gynecology, an affiliate at the Duke Center for Global Reproductive Health, and a volunteer professor at Kilimanjaro Christian Medical Center in Moshi, Tanzania. Dr. Herfel completed her undergraduate work at John Carroll University in Cleveland, Ohio followed by a Doctor of Osteopathy at Heritage College of Osteopathic Medicine in Athens, Ohio. She completed residency at OhioHealth Doctors Hospital in Columbus, Ohio. She then went on to receive her Masters of Science in Global Health through a Women’s Global Health Fellowship at Duke University. During that fellowship, she received an NIH-Fogarty grant to complete her project in Kisumu, Kenya. I had an enriching conversation with Dr. Herfel to learn more about her experiences within the global health sphere and her passion for reproductive health care.

“Right in the heart of COVID, in July 2020, I moved to Durham to start a two year fellowship. I spent the first year in Durham working in a variety of different roles with the OBGYN Department. I moved to Kisumu, Kenya in September of 2021 to conduct clinical research, and lived there until the middle of August 2022.” She returned from Kenya to join the OBGYN Department in a faculty role, with her primary office in Holly Springs.

When Dr. Herfel and I discussed her time in Kisumu, Kenya, she shared her one year project working on cervical cancer prevention through building a stigma reduction educational video as part of Dr. Megan Huchko’s NIH-funded HPV and cervical cancer stigma research. “My project was specifically developing an educational program aiming to reduce stigma surrounding cervical cancer screening.”  Dr. Herfel, along with a 2021 SRT team, explored educational models that would be considered culturally appropriate and effective through conversations with the local community. “We spent a lot of time talking to the women in the community about their thoughts and concerns about [cervical cancer screening and GYN exams.] A lot of women said they liked getting information from [someone who is familiar like a community healthcare volunteer], but sometimes this creates concerns around confidentiality. Women expressed that clinic healthcare providers exams can be uncomfortable.” Women “thought hearing from someone who’s gone through the screening process before would be really helpful and remain confidential and feel very welcoming. So we created a very short video aimed to be delivered in the clinics.” 

Dr. Herfel and I continued to come back to the importance of input on the local communities and offering programs that would support their specific needs. Reflecting on this theme, I asked Dr. Herfel to share more about the languages that the videos were provided in and how that was decided. “When we go to the clinics, most people feel comfortable speaking their native tribal Luo language. Swahili tends to be in the bigger cities. And then English really only for people who have had some sort of education because it’s only taught in schools. So taking their lead on that, we made the video in Luo and English. And then both videos had Swahili subtitles. A lot of people who have been educated in some way felt more comfortable getting medical information in English.”

Personally, as a student who has taken multiple global health classes that discuss the importance of understanding the local context before implementing programs, I was delighted to hear about the intentionality behind each decision which included the voices of local community members.  I asked Dr. Herfel to explore how she entered a community that was not her own, with empathy and compassion. “I really let the local research team— who has been Dr. Huchko’s team for many years— kind of lead the way. And that was very intentional, because they’re locals and we are serving their community … Being very humble and … learning through asking a ton of questions.” 

In her new role, Dr. Herfel will be serving in a mentorship role for the Duke and Kilimanjaro Christian Medical Center (KCMC) OBGYN residents during their global elective. The Duke OB GYN department and KCMC in Moshi, Tanzania have had a partnership for over a decade.  Along with Dr. Elizabeth Skinner, Dr. Herfel will contribute to capacity building and quality improvement projects with KCMC leadership including building pre- and post-operative surgery and outpatient cervical cancer screening protocols. “I’m excited to get back into the global clinical teaching realm.” Dr. Herfel will spend approximately two months abroad each year, with most of that time mentoring the Duke residents at KCMC.  She also has personal connections with short term clinical experiences in Central and South America that she plans to continue. The rest of the time serving as a generalist OB GYN at Holly Springs seeing patients for GYN and OB care. “I enjoy having a diverse practice.”

In talking with Dr. Herfel, I could feel her global health passion as she discussed the friendships she has made along the way. She shared a story of building friendships with Honduran team members, which she sees almost every year during a short-term medical experience. They even have plans to attend her wedding! Additionally, Dr. Herfel spoke with such passion about her research and mentorship. I was eager to know what the most rewarding moment for her has been. “The lifelong personal connections and friendships that span the world is really what drives me. You originally go for a purpose of expanding healthcare but a lot of times you diversify your life experience in ways you wouldn’t expect if you just stayed in your backyard.”

If you would like to learn more about her work, please contact Dr. Herfel at emily.herfel@duke.edu

Additionally, check out her reflection from the field here.

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