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King Center Predoctoral Research Fellow seeks to make an impact

Christlee Doris Elmera, who works on a King Center initiative to reduce lead exposure, is drawn to the practical nature of research.

Earlier in her academic career, Christlee Doris Elmera thought she wanted to become a public health consultant.

But after she had a chance to consult on a project designed to build a framework for community-based health care, she decided against that career path: She felt her work “would end up in a nice report somewhere” but not “go too much further than that.”

Elmera wanted results—“actual solutions,” she says. So, she turned her attention to academic research, applying to the new Predoctoral Research Fellows Program at Stanford’s King Center on Global Development. The two-year, full-time program is designed to ready individuals for careers in academic research focused on development issues. Last summer, Elmera joined the King Center as part of its inaugural predoc cohort.

Christlee Doris Elmera
Christlee Doris Elmera

“The world needs people to take time to actually find practical answers to questions of global development,” she explains. “That’s when I started thinking about academia. But I had not had academia in mind, so I needed preparation in order to get into that world.”

Elmera is getting plenty of preparation now. As a predoc fellow, most of her first year has been spent working on a King Center initiative focused on reducing lead exposure in Bangladesh and other countries. Helmed by School of Medicine researcher Jenna Forsyth, ’19 PhD, and an interdisciplinary group of faculty including Stanford School of Medicine Professor Stephen Luby, the initiative published a landmark study in 2019 linking lead levels in blood to turmeric in Bangladesh. That data and other studies eventually led to major public health reforms. The research team has since expanded its focus to other countries—including Pakistan and India—and additional sources of lead, such as unregulated battery recycling (because of lead’s extreme toxicity, there is no safe way to reuse lead batteries).

For Elmera, the initiative was “a perfect match.”

“It’s been inspiring to see academic research applied to an actual issue, with solutions and next steps being taken,” she says.

student talking to family about lead abatement
Elmera surveying in Pakistan as part of the initiative, 2022

Elmera, who was born in Haiti and grew up in France, studied public health at Georgia State University and earned a master’s degree in development management and applied development economics at the London School of Economics and Political Science. But she also traces her passion for the field to a personal experience: On a “voluntourism” trip to Haiti in 2017, she became very ill and faced a choice—try to find a doctor in Haiti where she was covered by the insurance that came with her trip or return to the United States where doctors were plentiful but, as someone without health insurance, prohibitively expensive. Ultimately, she flew back to the U.S. and did not receive treatment.

“I thought that was an unfair question to have to answer,” she says. “It definitely made me think about the comparative aspects of public health.”

The King Center’s lead initiative continues to churn out research and results. A forthcoming paper, with PhD student Alandra M. Lopez as the lead author, presents data on two ways of detecting lead in the field rather than through costly, time-consuming laboratory studies. The results are promising, with certain measurements for one of the field tests coming in within 5 percent of the lab method.

Jenna Forsyth
Jenna Forsyth

“The laboratory method remains the gold standard, but the upshot is these are two intermediate techniques that can be really helpful,” Forsyth says. “They don’t require skilled technicians; they’re much faster and cheaper.”

Another initiative project is focused on reducing lead exposure from the batteries in the ubiquitous three-wheeled bikes used to transport small groups of people through city traffic in Bangladesh. The work so far includes a survey of bike and garage owners, drivers, and battery suppliers.

“We’re trying to get a sense for an intervention that would improve battery charging and maintenance or even provide higher-quality batteries,” Forsyth says. “These are all different ways to think about how to improve and reduce the recycling rate.”

Elmera worked on the battery survey—her first experience with work of that nature.

“That came with a lot of learning moments,” she laughs.

Nevertheless, she eventually ended up teaching others how to use the relevant software.

“That was a pretty cool experience, learning through teaching,” she says.

On a trip to Bangladesh in 2022, Elmera also had the opportunity to participate in an environmental sampling pilot for a future study on heavy metal exposure. The pilot exposed weaknesses in some of the team’s original inquiries. For instance, one question asked for a sample from respondents’ water source. But, after visiting with local community members, the team learned that families often have one source for drinking water and other sources for cooking and cleaning.

Elmera says that because of the lead initiative—and a class she took with Luby called Practical Approaches to Global Health Research—she has a better understanding of when field research is appropriate and how it should be conducted. The lead initiative’s long-standing collaborations with local partners and researchers were “great to see,” she added. The initiative has worked closely over the years with partners from the geology department at the University of Dhaka in Bangladesh, the NGO Pure Earth, and the International Centre for Diarrhoeal Disease Research in Dhaka, among others.

Elmera’s intellectual curiosity is “incredible,” Forsyth says. “She’s jumped with two feet into this problem. She’s open to exploring any angle, to getting the skills necessary to figure it out.”

The predoc program at the King Center has been “very good experience,” Elmera says, helping confirm that she wants to pursue a research career but also giving her insight into the world of academia. She credited Nina Buchmann, a King Center fellow and an economics PhD student who has served as a mentor for the predoc cohort, with “teaching us everything that we possibly need to succeed.”

“It’s been great having the space to explore,” she says.