by Kate Hoving
“It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of light, it was the season of darkness, it was the spring of hope, it was the winter of despair...” Charles Dickens, A Tale of Two Cities
January 6, 2020. Geneva, Switzerland
Day 1 of W&M’s first winter program in Geneva
“The plan for the first week was morning lectures in a conference room at the World Health Organization (WHO) headquarters. As part of our tour of building on that first day, we went into the ‘situation room’ where a meeting had just taken place, and the wall had a map of the world with arrows showing flights out of Wuhan, China. The screen switched to a generic map of the world as we entered the room, but we had just gleaned one of the first meetings on the new virus that China had announced it had found the week before. The WHO had sent its first announcement about it on January 5. We spent the week hearing lectures from various staff members on health issues such as emergency preparedness, anti-microbial resistance, sexual and reproductive health, and an HR person spoke to the students about working at WHO. The emergency response framework had been fully activated in response to COVID, but at that time, we didn’t know this. The students and I were right there at the beginning of what would later be a world-altering pandemic.” –Iyabo Obasanjo, Geneva winter program director, Assistant Professor, Kinesiology & Health Sciences, and Co-director of the Africa Research Center
Fifteen William & Mary students accompanied Obasanjo on that first winter program to Geneva. They had a week of classes in Williamsburg before traveling overseas.
A year later, in the middle of the pandemic, fourteen William & Mary students and Obasanjo began their Geneva experience as part of the 2nd William & Mary Winter Geneva study abroad program. This time, all sessions were virtual.
This is the story of the those two programs—from creation to implementation—in very different times.
The right man, with the right idea, in the right place, at the right time
John Dennis ‘78, P ’21 is a Reves International Advisory Board Member and Founder and CEO of Mypulses, a research-based, digital health start-up in Geneva. Mypulses develops algorithms for sports, wellness and health using big data analysis of pulse wave forms. As the company website explains, Photoplethysmography (PPG)—used in many wearables to calculate heart rate frequency—is an optical technique that detects changes in blood volume, and can also collect pulse wave signals. With machine learning and with technical advances in PPG pulse wave collection, Mypulses has extended pulse wave analysis well beyond indications of cardiovascular health.
Dennis is uniquely situated at the intersection of medicine, technology and business—geographically and professionally—to create an opportunity to place William & Mary students on the forefront of international health management and technology. Luckily for W&M, he both understands this and is an alumnus who wants to give back to his alma mater.
“The origins of the Geneva program were inspired by a set of circumstances that bundled together looked like an ideal study abroad program,” Dennis explains. “The U.S., out of desire and pure necessity, is in the process of revamping its health care system. Health care costs are soaring and there is ever-growing pressure to move health care from a volume treatment-based system to more of an outcome-based system. An aging American population, which struggles increasingly with obesity and a plethora of related health problems, drives new demands. There is also an increased call for universal coverage. Add to this the rapid growth of digital health, e-health, mHealth and tele-health, and you have all the necessary catalysts for major changes that are occurring in health care.”
Like most entrepreneurs, Dennis sees potential in the challenges.
“Change brings opportunity and in the case of health, it brings jobs—lots of new jobs. It will also require a lot of smart people to think differently about health and wellness,” Dennis says. “In short, W&M graduates are needed from a large number of academic disciplines: life sciences, engineering, math, information technology, management, business, and communications to just name a few. W&M graduates with an international perspective on health will be especially appreciated. How are other countries dealing with these same sets of challenges? Can we learn from their systems and import some of these ideas back to the U.S.? Equally important, as we have learned painfully this past year, how do we deal collectively with pandemics and other health issues that affect us globally?”
Geneva is ideal for the kind of program Dennis envisioned, as it is a hub for global health and healthcare. The World Health Organization (WHO) is only one of many international health-related organizations headquartered there. “These organizations are used to receiving visitors from universities, research institutes and health organizations. They are also a great source for health-related information from their many publications, web sites and seminars,” Dennis explains. He just needed to connect them with W&M.
“Starting three years ago, I contacted the WHO and several other international organizations to explore the possibilities of William & Mary students visiting them to ask questions and to learn from specialists from a wide variety of different health topics. The responses were positive and welcoming.”
Connecting with the right people and programs at W&M
With the international partners interested, Dennis next reached out to his William & Mary connections. He found similar enthusiasm for his initiative across the university.
Dennis credits Sani Silvennoinen, Assistant Vice President, Development & International Advancement; Professor Mike Tierney, Director of the Global Research Institute; and Professor Jennifer Mellor, Director, Schroeder Center for Health Policy, for playing important roles in its creation.
Dennis also connected with the woman who would become the program’s director. “Professor Iyabo Obasanjo was an especially helpful early adopter to the idea, bringing her energy, enthusiasm and knowledge of health and public health policy.”
Sylvia Mitterndorfer, Director of the Global Education Office, welcomed his idea and recognized an amazing opportunity in an area they’ve wanted to grow. “We are deeply grateful for John Dennis’ vision, commitment and support for the program. He and Iyabo had been in touch previously and then at a Reves International Advisory Board reception, John, Iyabo and I met and laid the foundation of what such a program could become. We were thrilled to expand opportunities for STEM students to study abroad, utilize the expanding winter break time to open new opportunities, and allow pre-med students to have the chance to meet directly with world experts.”
Dennis appreciated the Reves collaboration. “The Reves Center was extremely open, encouraging, and helpful in these exploratory efforts and with its implementation. They were early proponents and made many helpful suggestions while always being open and flexible to proposals.” Dennis also singles out Marina Knapp, Global Education Special Programs Advisor, for helping to working to secure COLL 300 credit for the program. Two courses were associated with the program: Universal Health Coverage and Global Health Management and Universal Basic Health Care, and the prerequisite was an introductory course in Kinesiology, Public Health, Biology, Environmental Science, Chemistry or Psychology. In addition to COLL 300, students who completed all coursework would receive three credits.
Knapp in turn gives credit to Dennis for his role, which extended about and beyond coming up with concept and connections. “John was integral in both the in-person and virtual programs. We would never have been as successful in creating this experience without him. He helped coordinate and organize most of our partner meetings and provided in-country support. This program is unique [for Reves] in that we do not have an in-country partner (through a university or travel agent) in Geneva, with whom we would coordinate to help us with those tasks. As a result, many of those responsibilities fell to John.”
Geneva year one: the best of times
The first year of the program, after classes and preparation in Williamsburg, Obasanjo led the group of W&M students to Geneva for two weeks. In addition to the meetings at WHO, they attended seminars at the International Red Cross, Doctors Without Borders and the International Migratory Organization. They supplemented their experiences with multinational organizations by learning about different aspects of medicine and technology: a visit to the Cantonal Hospital of Lausanne (CHUV); a presentation about ways alternative medicine is integrated into patient treatment; and a day spent with start-ups in an incubator dedicated to healthcare near Lausanne. “I am particularly pleased that the students got the chance to learn about Swiss health care directly from a physician,” says Dennis. “With its decentralized government structure and a reliance largely on private enterprise to meet its health needs, the country’s health system is an interesting study for American public health policy.” Another highlight of the program was a presentation by Arthur Appleton ’80, an expert on the Swiss health system and global trade. The students made the most of all that Geneva offered. They visited several museums, including the Nestlé Nutrition Museum and Olympic Museum. Thanks to some lucky timing, their visit happened to coincide with the third winter junior Olympics in Lausanne, allowing the students to enjoy shows and celebrations connected to the Olympic events and to mingle with other young people.
It was a success by any measure. And then the pandemic became real.
Geneva year two: winter of despair?
In spite of the unusual circumstances and accelerated timeline, Mitterndorfer had faith in the capability of the GEO staff. “Building programs and managing the entire cycle is what we do so well. Our in-house expertise is tremendous and exceptional. To create this program so quickly required world-class expertise and wonderful partners to make something happen quickly, especially in the middle of a pandemic.” The pandemic had stopped most interaction, let alone international travel, and the question became whether the momentum of this program could continue, or whether it would be put on pause as so many other educational activities had been.
“In late September it became clear that international travel would continue to remain complex with quarantine and travel requirements which would make travel not possible given the parameters of the program,” Mitterndorfer recalls. “In addition, it was quite clear that the site visits, which represent the key element of the program, could not be done in person and would need to be done per video conferencing remotely.”
Once they made the decision to make it a virtual program, the core team—Dennis, Reves and Obasanjo—went into action to make it happen. As Mitterndorfer stresses, “Having to pivot a program from an in-person to virtual format in the middle of a pandemic underscored the critical importance of strong collaborative partnerships. Without everyone’s flexibility and willingness to innovate this would not have been possible.”
Knapp recalls the first thing they needed to do was confirm that the partners would be willing to meet with the students virtually in January. “Iyabo and John had most of the heavy lifting in switching the curriculum to a virtual format and organizing virtual meetings with our partners.”
Knapp in turn had to readjust the budget and finesse a two-week turnaround for opening the new applications to accepting students. The curriculum they crafted turned out to be amazingly similar to the first year experience.
“We kept the one week visit to WHO which worked well, because with the time difference our mornings were late afternoon in Geneva,” Obasanjo explains. “We did not have any of presentations [of the previous year] from Lausanne, but we could share links to two museums that had virtual tours, including the Olympic Museum.”
And because Appleton also had expertise in international business and law, this year in addition to his health care presentation, he could also speak about ways COVID-19 had affected global trade.
Still, Dennis acknowledges the limitations of a virtual experience. “No, it was not the same thing. The cultural aspects were especially less engaging. Nonetheless, just as many topics were covered over Zoom with WHO specialists [as in the first year].”
But even with the limitations, Dennis found a way to create a bit of the feeling of Geneva and its culture. “The students were deprived of walking the narrow streets of Lausanne, attending live evening events, and entering the grand halls of the WHO. But instead of rolling the fondue cheese threads around their bread chunks as they had in 2020, they saw how fondue was made from a video we filmed of a professional Swiss cook making the fondue in our kitchen.”
The students: resiliance & optimism
The students seemed to take it all in stride and appreciate every aspect. Knapp reports that students who responded to a survey afterwards were “wonderfully positive” in their feedback, especially pertaining to the live interaction with the WHO. “Most if not all are on some version of the pre-med track so there are not many courses available for study abroad that directly relate to the future careers.”
For Nicholas Kaufman ’22, Business Analytics Major and Public Health Minor, is a good case in point. “This program really appealed to me, because its academic focus-- global healthcare coverage and management--was directly aligned with my academic and future career goals. With my specific interests, finding academic opportunities aligned with my goals is often difficult, and this was a unique opportunity to learn with some of the leaders in the field of public health. Additionally, I have always wanted to travel to Europe, and I preferred the shorter winter program to spending an entire semester abroad.”
Kaufman entered the program with a bit of understandable skepticism. “Initially, I was concerned that being virtual would negatively affect my ability to immerse myself in the content of our program and interact meaningfully with other students and lecturers we had on the trip. However, once the program began, I quickly realized that this was not the case, as I feel like I had a really exciting, meaningful experience through the program.”
Kaufman’s favorite part of the program was the expert lectures at the WHO. “I loved the conversations we had around issues such as coronavirus, healthcare in developing nations, and global efforts to foster health around the world.”
Kaufman and the other students as well as Obasanjo singled out Christine Dennis’ lecture on nutrition and health as a highlight of the program. “Christine Dennis gave us resources and tips on how to stay healthy in college,” says Kaufman. “I still use some of her advice to this day!” A practicing nutritionist and naturopath in Switzerland and in the U.S. for nearly twenty years, Christine Dennis is also married to John Dennis and joined John in helping to make the students feel they were experiencing the best of Geneva.
This was Kaufman’s first study abroad experience, and a Reves Winter Scholarship enabled him to participate. Knapp reports that Kaufman was not unique: “[The Virtual Geneva Program] was the first study abroad program through Reves for all the students involved. Also, more than half of our students received funding from the Reves Winter Scholarship.” Even with the reduced program cost--compared to longer programs, and some savings because this year’s was virtual--students who had received scholarships indicated their participation had been dependent on receiving the scholarship. Dennis, in addition to creating and shepherding the Geneva Program, also generously contributed to the scholarship fund.
Mitterndorfer is keenly aware of that aspect. “One of the rewarding elements was that once we pivoted the program to a virtual format, new students joined the program who otherwise would not have participated in the program. We were happy to provide a COLL 300 opportunity to students in the midst of a pandemic and make this accessible, including through scholarships, to students who had not yet had the opportunity to study abroad.”
But the positive comments from him and other students at the end of the program indicate that they don’t consider their virtual experience as a disappointment or pale substitute. They saw this as once-in-a-lifetime opportunity to study in their field.
“Even though this study abroad experience was not exactly the one my classmates or I expected when we registered, I had an incredible experience and will carry the lessons and connections I made on the program for the rest of my life,” Kaufman says. “After the end of the program, I felt like I had a clearer idea of the opportunities that exist in healthcare management and public health, and I felt more confident in the path I have been going down at William & Mary. I also gained credits towards my minor and great perspective to bring to my future courses and career.”
Lessons learned: a spring of hope
For Obasanjo, there were some advantages to the Zoom format. “My usual classes are big, with rarely fewer than 25 students, but in a Zoom course of only 14 students, we could have very good discussions comparing health systems of different developed countries which seemed more effective and concrete than the discussions we had on the same topic in Geneva the year before, because it was towards the end of the second week and students were tired and excited about some of the sights they still wanted to see on their own. Via Zoom there was no distraction and students interacted with each other and asked each other questions about their presentations more than they did while we were all in the same classroom in Geneva.”
Dennis noticed the same thing: “One positive surprise from the virtual Geneva experience was the student participation levels. In the beginning, students hesitated to ask questions or make comments. However, after two or three sessions, participation really picked up with a lively back and forth between the speaker and the students. It is possible that being physically in large WHO rooms or elsewhere can be a little intimidating. On Zoom the students appeared to be more willing to speak out, express their views.”
As Obasanjo says, “Both experiences were great, being in Switzerland with students was a wonderful experience, and doing so virtually was also wonderful but different. Each had its good points but the important part was that in both programs, students got to interact with each other and hear from experts doing important work in global health. Having to go virtually over the last year shows us is that there are possibilities with technology we haven’t tried that would be useful in higher education.”
All parties are ready to continue with the best of both experiences.
The Global Education Office staff are already incorporating lessons learned into planning for Geneva and other programs.
“This was the first virtual/remote study abroad program which we’ve offered, and we learned a great deal about the impact virtual opportunities can have,” says Mitterndorfer. “Reading student reflections about the impact was a powerful reminder that even when physical travel is not possible, virtual programs combining curricular elements, direct discussions with experts onsite, and co-curricular cultural activities have the power to create new high impact experiences for students.”
“The lessons we’ve learned from this program are very valuable as we consider how to continually enhance study abroad programming,” Mitterndorfer continues. “What this might look like in the future is unclear, but given the many different types of models of study abroad run through our office, some of the approaches of this program could enhance pre-program planning among other things. As a result of the success of this program and in light of the ongoing pandemic, the faculty of the International Studies Advisory Committee (ISAC) and GEO created a best-practices guide for virtual programming as a resource for future programs. In the shorter-term, we are building on the Geneva virtual program experience as we design a Prague virtual study abroad program in summer 2021 since the in-person program was canceled due to COVID-19.”
In Geneva, John and Christine Dennis are already planning for the future, too.
“After two years, the Geneva program has grown into an established and well-defined program. The program also has the ability to adopt to the interests of the attending students with emphasis placed in areas of most interest. The interests will undoubtedly change over the years with current topics such as COVID-19 commanding more attention than topics such as tuberculosis, which may be of less current interest. One idea Christine and I have would be to offer more presentations on nutrition next year. What we eat and how we get nutritional balance is key to health. Let’s see which topics are of most interest next year and how we plan accordingly. I look forward to the Geneva program 2022!”