As a co-captain of the College's Varsity soccer team and an economics major, Josh Kahane '07 thought he had a plan. Upon graduating, the Newton, Mass. native headed to Boston to begin a position working for a market research and strategyconsulting firm. But something was missing. "As time passed during my first (and only) year of work, I realized I wanted and needed something different," Kahane said--a realization that led him to his current position as a Project Coordinator for a pilot program for HIV/AIDS treatment in Uganda.

Spending time abroad was not an idea that came suddenly to Kahane. In fact, he had been inspired to live and work in a foreign country since a close friend from high school enrolled in the Peace Corps the same spring that he left the Hill. He also studied abroad in New Zealand during his junior year, an experience that "gave me the confidence and comfort to leave home and live in a foreign country for an extended period of time," he said.

While his friend was thoroughly enjoying his work in Costa Rica, Kahane and his "other friends working for investment banks or research firms were unhappy." So he started casually searching online for volunteer opportunities abroad, as well as speaking with his cousin about her experiences volunteering in India.

At the same time that he decided to look at opportunities abroad, Kahane decided he wanted to go to medical school, since he had completed all of the Pre-Med requirements on top of his economics major. "I began having discussions with some family friends who were doctors in the Boston area," he said. "I reached out to them and told them I just wanted to learn more about their career path and decisions that led them there." In speaking with the doctors, he also mentioned that he wanted to spend time working in another country. One of the doctors he met redirected him to a colleague who was doing HIV/AIDS research in Africa with the Ragon Institute, part of Massachusetts General Hospital. He spent two months volunteering in Uganda, after which he was welcomed back full-time to help implement a pilot program that the doctor was interested in conducting.

"My primary responsibility is to implement a pilot study entitled 'Real- Time Adherence Monitoring in Rural Uganda,'" Kahane said. The pilot study is part of the doctor's on-going work with HIV-positive participants' adherence to medication. The treatment is called Anti-Retroviral Therapy, and it suppresses the HIV virus resulting in a drastic increase in the individual's life expectancy. The treatment is available to the majority of the population. The doctors currently monitor adherence by using a bottle cap that fits on the participant's pill bottle and records and stores every opening of the pill cap. The adherence percentage is then compared with the manually-conducted count of the participants' pills at the end of the month. "This doesn't guarantee that the participant has actually taken their medication," Kahane said. But he added that "while this is an imperfect measurement, there have been many studies supporting its effectiveness. The success has been impressive and it is much more cost effective than conducting expensive blood tests, which is what they do in the U.S." With the information they collect from the prescription bottles, Kahane and the team for which he works hope to "intervene and identify the main causes of treatment interruptions." Due to the wireless modem installed in the pill bottles, the researchers receive data within a few minutes of the pill container being opened, marking a huge gain in efficiency from the once-a-month data collection afforded by the old home visits. They are now able to track the information online and are working on setting up alerts to inform them when participants have not taken their medication for more than 48 hours. "Treatment interruptions, if allowed to last, can lead to viral rebound and drug resistance," Kahane said of the importance of his research. These interruptions lead to an increase in the likelihood of death, as well as an increase in the costs associated with drug therapy. In addition to his work for the Ragon Institute, Kahane and a few of his friends volunteer in the local Ugandan school system. They teach a Health and Lifestyle class with the hope to reinforce the importance of healthy habits, both physical and mental. "The class is much more interactive than the student's typical class setting and takes a different approach to ingraining these principles in the students' minds. We have received a lot of positive feedback and support so far," said Kahane. He also helps out with coaching a local girls' soccer team.

While his newfound environment is certainly different from his days of iPlay sports and the Entrepreneur's Club on Mayflower Hill, Kahane regularly draws upon the skills he acquired at the College. "While a college degree in the U.S. is pretty common, that degree goes a long way in developing countries," he said. "The work ethic and problem solving skills I developed at [the College] have definitely provided me with a leg up in many situations and have made me much more comfortable doing the work I am doing," he added. Kahane cites the language barrier (English is the national language of Uganda, but the country is also comprised of over thirty regional dialects) and the fact that everything runs on "Africa time," or fifteen minutes to two hours late, as the most frustrating parts of his job. He has also had to tactfully manage several marriage proposals from African women, who see him as a "ticket out" to what they perceive as a better life in the U.S. However, he said that the "people are incredibly friendly and welcoming," inviting him to join in on family meals, weddings and other celebrations. "I am working with very talented and dedicated Ugandans and I enjoy what I am doing. I am able to understand and see the impact of the work I am doing, and that is extremely rewarding," he said.

"Everyone who might have even a slight inclination to work abroad should. I have never had a more rewarding and enjoyable experience," Kahane said. He encouraged students searching for opportunities abroad to remain open-minded and unhindered by obstacles like language or cultural barriers. In addition, he suggested that students make the most of any connections they might have, whether they be in the form of advice from professors and other students or in the form of grants and scholarships, which are increasingly becoming available to recent graduates who want to spend time abroad. "There are very few times in life that you have the flexibility to live in an unfamiliar area and culture and I truly feel it is worth it. You will provide a significant contribution to the community and also find that you are happy with yourself and what you are doing," Kahane said.

Depending on where his work with the Ragon Institute stands, Kahane plans to return to the U.S. in June. He hopes that by that time, the local Ugandans that he has worked to train will be able to continue the study on their own. Once back in the U.S., he plans to apply to medical school and study for the GMATs with the eventual goal of obtaining a MD/MBA joint degree.