Andrew Wooyoung Kim, PhD, knew the COVID-19 pandemic could lead to a global mental health crisis, including among his research participants and staff in South Africa. Kim, a biological anthropologist and 2020 Fogarty Fellow, has conducted research in South Africa since 2017 and lived in the country since August 2019. His research primarily focuses on the intergenerational effects of racial trauma on mental health.

As part of his PhD work at Northwestern University, Kim works within the Birth to Twenty study. The study has followed a cohort of South African mother-daughter pairs since the dissolution of apartheid in the early 1990s, a system of institutionalized racial discrimination in South Africa. It attempts to measure how apartheid-related experiences affect birth outcomes, mental health illness, and stress.

While conducting this research, Kim met MGH Center for Global Health’s (CGH) Alex Tsai, MD, Director, Program on Social Policy and Behavioral Health who also was working in South Africa. Tsai’s experience working in global mental health drew in Kim. Soon after meeting, Tsai began mentoring Kim and invited him to join CGH as a post-doc in 2020.

Kim’s inspiration to study the intergenerational impacts of trauma and racial violence came from his own experiences as a Korean American growing up in Georgia.

“My grandparents were survivors of the Korean war and Japanese colonization,” Kim said. “So, over time, I began to wonder how their experiences affected my parents and my parents’ experiences affected me, vis-à-vis my grandparents’ experiences.”

This experience pushed Kim to try and better understand how the not-too-distant legacies of racial trauma produce intergenerational effects. His work has exposed the ways these legacies influence the mental health of present-day South Africans.

When South Africa announced lockdowns and quarantines in March 2020, Kim faced new circumstances. His research had revealed untreated legacies of racial trauma within Soweto—a South African township near Johannesburg—and he knew those legacies could widen racial mental health disparities. He quickly adapted his work.

“Logistically COVID-19 changed a lot,” Kim said. “But there was a lot of opportunity for continuation.”

Aside from adjusting the study to be completely remote, Kim’s team amended it to be responsive to the pandemic by using existing research infrastructure to measure perceptions of COVID-19 risk alongside mental health indicators.

“So much of my research was already about stress, trauma, and mental health,” he said. “I wrote one paper about how childhood trauma and COVID-related stress predicts depressive outcomes. That framework—testing the effects of historical trauma on later health outcomes or people’s reactions to addressing trauma in the future—was already the same framework I was using.”

However, Kim understood one necessary response to COVID-19 needed to go beyond adjusting data collection: “my day-to-day activities became more about taking care of the wellbeing of my research assistants, participants, and myself.”

“The pandemic forced me to engage with my work in a very different manner, in a way that was a lot more direct and hands-on,” he continued. “We turned our study into sort of a psychiatric surveillance system. We would call our patients and ask, ‘How is it going?’ That also meant that my research assistants and myself were this underappreciated set of frontline healthcare workers.”

Additionally, though Kim had already developed some ways to support his staff’s mental health due to the nature of their work, he quickly realized that he would need to do more to support them through quarantines, lockdowns, and other COVID-19 related anxieties.

“I would have these weekly calls checking in on [staff], doing debriefing sessions, and finding different ways to process and cope,” he recalls. “It was an opportunity to engage with my own team’s mental health rather than just the participants.”

As Kim looks ahead to continuing this work as a biological anthropologist, he understands that conducting any type of research must always include steps that prioritize the care of participants and staff.

“[COVID-19] showed me even more of how important these sort of mental health resources are,” he concluded. “And not just for participants, but also people doing this work.”

This work mentioned provide a small snapshot of the breadth of work being completed by the faculty and staff at MGH. To learn more about other initiatives at the Center for Global Health, we invite you to visit our website at globalhealth.massgeneral.org

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