Global collaborators at the Heart of the Hutch

Senior study coordinator Peter Mooka helps principal investigators conduct research on Kaposi sarcoma at the UCI-Fred Hutch Collaboration in Kampala, Uganda. Photo courtesy of Peter Mooka

‘Part of the solution’: In Uganda, the 008 study clears obstacles in treatment, transportation

Coordinating research studies takes a lot of work. Someone must screen and enroll participants, carry out diagnostic biopsies and prepare procedures. Throughout the study, someone must collect data and samples, provide transport for participants, and follow up with them.

That someone, for a study known as 008, is Peter Mooka, a senior study coordinator for the UCI-Fred Hutch Collaboration, a program born out of a longstanding relationship between Fred Hutch’s Global Oncology program and the Uganda Cancer Institute.

The Collaboration’s goal is to expand research to build capacity in Uganda and better understand, diagnose and treat infection-related and other high-burden cancers, including Kaposi sarcoma, which is Mooka’s primary focus in the 008 study.

The 008 study is defining the relationship between human herpesvirus-8 replication and Kaposi sarcoma treatment outcomes and evaluating the potential of HHV-8 to serve as a prognostic biomarker in people with Kaposi sarcoma. Kaposi sarcoma, or KS, is a cancer that begins in the lymphatic system or in blood vessels and can appear as lesions on the skin, in the mouth, nose or throat and in the lungs and gastrointestinal tract.

“Some patients can barely walk. They are in a lot of pain,” Mooka said. “By engaging in research, I can be part of the solution, contribute to the science and be part of that group that brings change.”

The entrance of the UCI-Fred Hutch Cancer Centre in Kampala, Uganda Photo by Jiro Ose

But when the COVID-19 pandemic hit Uganda, strict lockdowns in Kampala, where the UCI is located, halted most study activities from March to late September 2020. The lockdowns also affected public transportation, which many participants rely on to make it to treatment.

Even before the pandemic, transportation was one of the biggest obstacles for patients receiving treatment at the UCI. Many if not most Ugandans live in rural areas, and it’s costly and time-consuming to travel for treatment. These challenges often mean that patients are unable to complete their treatment.

According to Mooka, this is where the 008 study stood out in its patient care. To offset costs for participants, the UCI hired private transit services to get patients from their villages — some hundreds of miles away — to the Kampala campus for treatment under the study.

The investment has made all the difference for patients, Mooka said.

“Because of the support from Fred Hutch and the principal investigator, patients are able to complete treatment on time and resume their work and lives,” he said. “I am so grateful for this.”

Heart of the Hutch: Global Oncology edition

We have been profiling people who illustrate the culture and spirit of Fred Hutchinson Cancer Research Center with the Heart of the Hutch series. This edition focuses on Global Oncology.

The man behind the wheel: Isma Lubega's drive to support cancer research

On most days, Isma Lubega is up before the sunrise, and won’t return home until nearly midnight. As a professional driver in Kampala, the capital and largest city of Uganda, Lubega must be on the road by 6 a.m. to beat the city’s traffic jams. He knows the streets well. For years he was a cab driver before being recruited to drive for the UCI-Fred Hutch Collaboration, a program born out of a longstanding relationship between Fred Hutch’s Global Oncology program and the Uganda Cancer Institute.

The collaboration’s goal is to expand research to build capacity in Uganda and better understand, diagnose and treat infection-related and other high-burden cancers. Lubega has been the man behind the wheel since its inception. For the last 14 years, he has been responsible for transporting researchers and study participants to and from the UCI campus and other regional clinics to work on cancer- and infectious disease-related projects and receive treatments.

“I’m responsible for those arriving at the airport in the morning and those leaving late,” he said.

But when the coronavirus hit, Kampala implemented a strict 2 p.m. curfew, after which no private cars or motorbikes could move. Researchers and medical workers were considered essential and allowed to work, but without transportation, they couldn’t move around the city.

“When they locked us down, it was really challenging because I knew all the studies that were going on and how important they were,” Lubega said. “It came to my mind, ‘How can I help?’”

So, he improvised. He rented a motorbike to drive himself to the UCI’s campus car to transport those essential workers and keep their studies running. But it was a daily challenge to get the staff back before 2 p.m. So he worked with the police to get a letter that would permit him to continue driving after curfew.

“If you really stand firm, if you stand your ground in Kampala, you can move around,” he said. “That is the kind of person I am. I can really talk to the police and get my way around.”

Lubega’s passion for the Hutch’s mission and helping those who are suffering is palpable when he speaks. He knows that his work impacts not only the people of Kampala, but the region at large. People from the Democratic Republic of the Congo, Rwanda and other neighboring countries all end up at the UCI with the hope of receiving cutting-edge treatments from one of the only world-class treatment and research centers in Central and East Africa.

“This is how I can help. If study results can bring out solutions to these types of cancer, that is what motivates me. I really get touched about that.”

In South Africa, HIV research continues amid lockdowns

The onset of the COVID-19 pandemic in South Africa — and the strict lockdowns that followed — put in-person work on hold for Bronwill Herringer and other members of the Cape Town HVTN Immunology Laboratory, or CHIL.

The “HVTN” in the lab’s name refers to the Fred Hutch-based HIV Vaccine Trials Network. Much of CHIL’s work directly supports the HVTN in its mission to develop a safe and effective vaccine for HIV infections globally.

As the lab’s repository technician, Herringer is responsible for managing the intake and storage of clinical specimens for the state-of-the-art facility, which measures how study participants’ immune systems respond to candidate HIV vaccines being tested in clinical trials in South Africa and throughout the region.

Herringer is also the central contact for lab staff and outside collaborators involved in managing clinical specimens, which required him to come to the lab while his colleagues worked remotely. In those early months, he oversaw the collection and delivery of the liquid nitrogen tanks needed to preserve specimens.

But getting to the lab proved challenging in itself — Herringer was stopped at police checkpoints where he had to produce a signed permit to perform essential services.

“I must admit it was rather scary,” he said. “Each day, in the beginning of lockdown, we had routine checks, not just on the highways, but also in our residential areas. This happened routinely during the day or night.”

“Then I would work at the lab from Monday through Wednesday and work from home Thursday and Friday,” he said. “Now I work full time at the office to ensure pull requests and samples are ready for any analysis taking place.”

Herringer says he is driven by the organization’s mission and the opportunities the lab provides for professional growth.

He still has the 2018 text message from CHIL’s human resources team telling him he got the job, which he keeps as testimony to the reason he started working there in the first place.

“The thought of working in a team to find a vaccine for the HIV virus was a huge reason I took this leap of faith,” he said. “I cannot think of a greater gift we could one day offer humanity.”