An interview with Pamela Durán

MiniBio: Dr. Pamela Duran Toledo is a lecturer at Universidad Mayor de San Andres, where her main focus is infectious diseases and parasitology. She started her career of Clinical Laboratories before entering the field of parasitology. Her work has been developed in various institutions including Universidad del Siglo XX in Potosi, as well as INSAD and INLASA. She has also had the opportunity to lead multiple international and interdisciplinary collaborations, including many of which have been carried out in Latin America. Pamela considers microscopy as a key tool in her job, and she has used it in the context of both clinical and basic science, including paleobiology and the study of parasites in mummies. (Picture borrowed from UMSA website).

What inspired you to become a scientist? 

Since I was very young, I always liked nature. I liked watching insects. I would think a lot about the microbiological world. I have a young sister who was often ill, and I would find bugs very interesting. I thought it was a very peculiar world. A bit later, when I had to choose a career, I wanted to study Biology, but the Faculty of Biology was very far away from my home. I had to give up this dream. When my older sister once brought home a syllabus of various study programs, I saw that the career of Clinical Laboratories included subjects like microbiology. I thought this is what I wanted to study – that’s really what caught my eye. For this reason I studied the degree of Clinical Laboratories. Once in this career, I realized I wanted to be a Microbiologist. In the second year of my degree, I became a Microbiology assistant in the degree of Medicine. One of my teachers (lecturers of the subject of Microbiology) gave me as a present, the book “The microbe hunters” by Paul de Kruif. This book tells you the personal story of various scientists who have now been immortalized due to their research and their discoveries in the field of microbiology. As I read this book, I found a lot of inspiration to go deeper into the field of microbiology. It was a turning point in my career, and the beginning of a new era for me. 

You have a career-long involvement in parasitology and microscopy. Can you tell us a bit about what inspired you to choose this path?  

Already during my undergraduate degree I met many professors and specialists in parasitology and microbiology. But one of the most interesting things that happened to me was that, when I was much younger, a few months from finishing my undergraduate degree, when I was still a teaching assistant, one of my professors offered me the chance to join the Ministry of Health as a Malaria technician. When I applied, as my training was in Clinical Laboratories, the head of the program decided to give me and 3 of my colleagues, the chance to work at the National Institute of Health Labs (Instituto Nacional de Laboratorios de Salud, INLASA), as our contribution would be more useful over there. For me this was very lucky. I knew this was something fantastic for my career. INLASA in Bolivia is like the Institut Pasteur – something unreachable. So I was lucky to join this Institute when I was so young, in my first job. But my experience so far had been in Bacteriology, not Parasitology. So malaria was a new topic for me. I started working with Dr. Di Martinez, who is one of the best parasitologists in Bolivia. He is a very inspired person – he started working on parasitology since he was very young, and his enthusiasm was very contagious. I was starting my BSc thesis, and he suggested I do this on a flagellate he had just found in leishmania lesions. He was culturing them, and I would see how he would spend hours at the microscope watching these parasites develop. I found his passion inspiring. He suggested I do my BSc thesis on this parasite, and this was also a turning point for me, when I decided to really commit to becoming a scientist and a parasitologist. I did my BSc, MSc and PhD thesis in his lab, and with his support – he is a great mentor. It’s now been a 20+ year path. Looking back, I don’t regret any of it. With malaria, I started working with blood stages, all with clinical relevance to imported malaria, malaria in pregnancy, etc. We set up many techniques in the lab to study this parasite, and we trained many people to be able to work with this parasite, under the most current quality control and security norms. Chronologically speaking, when I did my BSc thesis, I was working at INLASA – part of my work was with French researchers from IRD, and part of it focused solely on malaria with Dr. Martinez. He was a lecturer at the Faculty of Medicine, so that’s where I did my thesis. I did my MSc in Tropical Medicine, and I worked a lot on malaria, Chagas disease, dengue, etc. Around this time we had the first outbreak of orally-transmitted Chagas disease in Bolivia. I was, at that time, in Spain, and when I came back I found out about this outbreak, and had the chance to focus my thesis on this topic, while working at INLASA. I was working at the laboratory of entomology with a great mentor and now great friend, Dr. Tamara Chavez who opened the door for me, and taught me a lot. There I worked with mosquitoes, and triatomines. The epidemiology component was under Dr. Martinez’s supervision at the Faculty of Medicine – at the Institute of Research in Health and Development (Instituto de Investigaciones en Salud y Desarrollo, INSAD). I defended my thesis as an associate researcher at INSAD. Then I started teaching at the Faculty of Medicine, and that’s when I started my PhD thesis. It was a long way – and it was particularly tough to do this in parallel to my job. I focused my thesis on Chagas disease, in identifying two transmission foci in the Amazonia, where usually there is no domestic transmission. We described two foci, one at the North and one in Alto Beni, La Paz. I did my PhD at INSAD also, which belongs to Universidad Mayor de San Andres. It took me 5 years to complete my PhD thesis – I should say thought that, since we were so few in the program, me and the other 3 PhD students had several commitments beyond our PhD work: we had administrative duties, teaching, project management, etc. Sometimes there were so many things to do that we couldn’t dedicate 100% of our time to our thesis. So we would sometimes stop for months at a time. At some point I had to really decide to put the extra effort to be able to finish on time. In Bolivia, a big problem faced in postgraduate degrees is that many students don’t finish their degree. They start, but stop half-way through. 

Can you tell us a bit about what you have found uniquely positive about becoming a researcher in Bolivia, from your education years?

Education in Bolivia has many deficiencies, but I can’t deny that the years I spent in University were truly wonderful. I did my first degree in Universidad Mayor de San Andres in La Paz, and later, to obtain the BSc degree I studied at Universidad del Siglo XX in Potosi. At this point I was already working and would use weekends to attend workshops and further training. I think the best thing that happened to me during my university years was to be a teaching assistant. I was paid for this work, but above all it helps you gain experience as a lecturer, and discover whether teaching is a path you’d want to pursue. This was very valuable for me, and overall a turning point in my career. 

Can you tell us a bit about your day-to-day work as a group leader at Universidad Mayor de San Andres?

In essence I’m a lecturer – I teach the class of parasitology at the Faculty of Medicine of Universidad Mayor de San Andres. Currently I’m an associate researcher at INSAD as well. So my day-to-day includes a combination of practical classes, teaching, and research. I teach students to do cell culture, insect rearing, parasite culture, animal handling, etc. There are also times when we do field work. We go to the field for several weeks, pick samples, do some tests, etc. I work with other two colleagues, so we rotate and share responsibilities. Among the things I like most is to teach both theoretical and practical classes – I feel the young students are full of energy and I feel re-charged. I love both, lab and field work. I also do lots of administrative things – we don’t have a secretary or assistants. I must confess I find the administrative work very tedious. I do enjoy the lab and so I sometimes feel the administrative duties keep me away from it. 

Did you have many opportunities to interact with other Latin American groups, outside of Bolivia?     

 Yes, from the very beginning of my work in Parasitology in 2002, we started working with colleagues from Latin America. One of the first research projects was under the ‘Iniciativa Amazonica contra la malaria” (AMI), which an initiative that brings together all the malaria-endemic countries in the Amazonia. I started working with them, and we started building projects with the International Atomic Energy Agency ‘Organismo Internacional de Energía Atómica’ (OIEA). Here I met many researchers from Peru, Brazil, Colombia, Venezuela, etc. For a long time I’ve worked together with scientists from the Ministry of Health in Peru and Colombia, and from Fiocruz – one of the most important Institutes for Tropical Medicine in the world, which is in Brazil. In fact my PhD thesis was assessed by a researcher at Fiocruz, Dr. Fernando Monteiro. Later on, and currently I’ve worked together with researchers from Illinois, USA, studying primates as well as other mammals that can act as reservoirs for parasites. We’re currently putting together a paper with our findings. Beyond the blood-borne parasites (Plasmodium, T. cruzi, Leishmania) we’ve also continued to work on zoonotic parasites, and through the OIEA we’ve continued to work with foreign colleagues. Among specific examples, I’ve also continued to work with Dr. Cristian Alvarez (Chilean) who was previously in Zurich but is now back in Chile. We work on hydatid cysts, and we have done important new descriptions of echinococcus in Bolivia, both in cattle reservoirs and dogs. Together with Latin American and Spanish colleagues we’ve worked on fascioliasis. This allowed me to go to Spain for some time to work on Fasciola and its host reservoirs. Altogether, I believe that the most important thing in research is interdisciplinary and international collaboration, especially under the concept of One-Health. It’s the concept that Health does not only refer to human health but also animal health and the environment. Currently, the project we’re working on with our American colleagues is under this umbrella. 

Who are your scientific role models (both Bolivian and foreign)?

In Bolivia, Dr. Di Martinez taught me a lot and has been a great mentor since the beginning of my career. I really admire his career and expertise. Another parasitologist I admire is Dr. Felix Veintemillas, who was an otolaryngologist as well as a tropical doctor. He is one of the most renowned Bolivian scientists of all times. His contributions to Bolivia and to the world in the field of tropical medicine are invaluable. I admire him, I read his papers – I find it amazing how scientists in the previous century did not have access to the Internet and other resources we now have, yet they wrote in a truly fascinating way. Science required a lot more dedication. In an international context, another researcher I truly admire is Carlos Chagas of course. The study of Chagas disease has a special place in my career, so I find it amazing that Carlos Chagas, when he was very young, described not only the parasite but also the disease it causes, the insect vector, the reservoirs, and the mode of transmission. I think Carlos Chagas deserved the Nobel prize of Medicine. Whether he didn’t get it because he was Latin American or whatever the reason, I think science, and the scientific world owe him this recognition. Other scientists I admire include Dr. Fernando Monteiro, Dr. Carlos Pinto Diaz, Dr. Jose Rodrigues Coura from Brazil, who passed away last year and sadly I didn’t have the pleasure of meeting but is a key person in parasitology; Dr. Claudia Herrera – a Colombian molecular biologist currently in the USA; Dr. Martha Muttis, a Colombian parasitologist who is also an extraordinary person and scientist. I think all the people I’ve mentioned share one important trait: in addition to being excellent scientists, they are very nice people. 

What is your opinion on gender balance in Bolivia, given current initiatives in the country to address this important issue. How has this impacted your career? 

In my career, I’ve never felt I’ve been stepped over because of my gender. I felt there was equality. In my area I feel there is no major gender disbalance in Bolivia. Nonetheless, I feel it’s difficult for a woman to prevail in the scientific world. Especially for women who have children, it’s very difficult – to go to the field for weeks on end, it’s almost impossible. I’m not a mother, but I feel I kept delaying the choice of being a mother because of my career. I feel men have an advantage compared to women, but I don’t know if the discrimination is something major. In my area of research, many times during field work, we had to climb up a 4m palm tree, and both men and women did the same job. In my experience it was similar for both genders. 

Are there any historical events in Bolivia that you feel have impacted the research landscape of the country to this day?

An important event that I feel had a huge impact on Bolivian science was the hemorrhagic Bolivian fever a few decades ago. It was a new virus, highly deadly, and it had a detrimental effect in ‘El Beni’, it has motivated a huge amount of studies. A lot of people have died, but many have survived. Many of those who survived are in charge of surveillance in the region. It was an important event for science, and continues to have an impact to this day. Another thing I can think of is that the new Constitution in Bolivia, which was published in 2006, I feel some indigenous populations can now make their voiced heard in terms of the health problems they face. In the past their voices were silenced. Before 2006 and the new constitution, I visited many towns with low resources where literacy rates were very low and where child mortality was very high. In more recent years I noticed that when health officials were giving them instructions on how to sign informed consent forms using their finger prints, they would answer “No, I can read and write”. This means that literacy had improved, and this is a huge step. 

Have you faced any challenges as a foreigner if you have worked outside Bolivia?

The language challenge is always a big problem – our native language is not English, yet the majority of scientific information is in English. Sometimes you have to give lectures in English. While it’s not a huge challenge, it still is a hoop to jump through. A big challenge though, was to have to leave my country when I was very young, and face different challenges all on my own. A negative experience I had was during a postgraduate course. I took several parasites and snails to do some molecular studies in a country in the Global North, in a top University, both of which I prefer not to mention. I had great results, and the work was all very successful. A few months before I had to come back to Bolivia, I had just completed some sequencing and I was amazed with the sequencing results. I took my computer to the professor who was supervising me. A friend on mine later came to tell me I couldn’t bring my results to Bolivia, and they erased everything from my computer. They told me I couldn’t take any results away, because they belonged to the University abroad. I couldn’t understand what was going on. Sharing this experience with other colleagues from Latin America we realized this was relatively common. Perhaps they think that because we are from developing countries, we don’t have the right to access those results we generate as part of our collaborations. This was a very tough experience. I was very young and I was deeply affected by this event. Later on we managed to publish those results, with those collaborators- so we took the ship to safe waters. Still, though, it taught me an important lesson: we have to make it clear to our colleagues in the Global North that not because we come from developing countries, we are any less capable. They cannot and should not step over us or treat us in a condescending way, or with lack of consideration and respect. Since I was so young, when I was offered the chance to stay over there to do an MSc or PhD, I refused. I wanted to come back to my country, where I wouldn’t be subjected to such attitudes. 

What is your favourite type of microscopy and why?

All types of microscopy that allows us to observe parasites. I find the world of parasites very exciting. Unlike other microorganisms, you can observe their entire life cycle, how they change shapes, how they move, how they interact with the host, etc. We’ve done a study on parasites in mummies – we’re writing the first report on paleo-parasites in Bolivia, like Enterobius vermicularis (a nematode). I think a lot can be learned from bright field microscopy. There are more complex techniques involving fluorescence, but bright field has been pivotal for parasitology, and I think it will continue to be. 

What is the most extraordinary thing you have seen by microscopy? An eureka moment for you?

One of the things was seeing some parasites in Leishmania lesions, which I studied during my BSc thesis. What was curious is that Leishmania spp. are usually very demanding parasites in culture. But the one we isolated from the lesion thrived in cultures. Our culture was contaminated with fungi, and the parasites were thriving, nonetheless. We found the interactions interesting, so I went on to study pathogen-pathogen interactions. I would purposefully co-culture them, and my impression was that the parasites were sticking to, and taking advantage of the fungi properties or presence, to survive. I wasn’t able to publish these results, however, when we went on to investigate them at a molecular biology level with collaborators from Brazil, we realized that although they were isolated from Leishmania lesions, they were not Leishmania. They were Crithidia spp.  The other great moment in my career was when we started isolating parasites from mummies. I saw a helminth’s egg in a sample rather quickly. It was a Capillaria, which looks very similar to Trichuris trichuria. This was also a fantastic moment, which happened just before the COVID-19 pandemic. 

What is an important piece of advice you would give to future Bolivian scientists? and especially those specializing as microscopists?

I think scientists are curious by nature, and this is a vital component. Without it, something amazing can cross your path, and you won’t be able to see it – your mind is not prepared to recognize something amazing. I think about this, for example, in the example of Crithidia I mentioned earlier. If we had held on to the idea that this was an odd Leishmania culture, we would have missed an exciting finding! This is true in the field, in the lab, when you read a paper, etc. A curious person will always find new things. Perseverance is also key – sometimes we want to have results very soon, and in field work this is common too. I remember when I would go to the Alto Beni to do experiments and I would take with me traps, animals, etc, and the first few times I would end up crying if things didn’t work out – either because it rained and the traps would get wet, or some sort of mishap. So my first two missions were utterly unsuccessful. The theory said that the insects should be there, but in practice it took a long time until we found them and learned something useful about T. cruzi transmission. 

Where do you see the future of science and microscopy heading over the next decade in Bolivia, and how do you hope to be part of this future? 

This is an interesting question. We sometimes think that with the advancement of technology, microscopy will become obsolete. I think this concept is wrong. Just as we have ever-more complex tools to study genotypes, phenotypes are equally important. Microscopy is a very powerful, and say, in parasitology, it will continue to be key for the fight against parasites. A PCR cannot tell you whether someone is seriously ill with malaria, whether they are acting as a reservoir for transmission. We should think of microscopy as a valuable tool for research and diagnosis which should not be allowed to stay out of date.

 Beyond science, what do you think makes Bolivia a special place to visit and go to as a scientist? 

Bolivia is a wonderful country. I don’t want to leave my country. Bolivia has given me everything I have to this date. It has a huge biodiversity in terms of flora and fauna. We have some of the most important reserves in the world, like the Amazonia. I think whoever comes as a tourist and visits our ecological parks will be amazed by the biodiversity we have. We have different levels: salt flats, plateaus, valleys, lakes, the Amazonia – all of them are full of wonders. There are also ancient cultures, some of which are vastly unknown. A visitor can choose from cold, hot, culture, nature, etc. We have the largest salt flat in the world, and navigable lake at the highest altitude world-wide – Lake Titicaca. Overall, I think visiting Bolivia is a unique life experience, you’ll never forget. 

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