Alumni profile: Serene Shrestha

Master degree research reveals gaps in Fiji health data and opens up career opportunities in public health and research.

Serene Shrestha was born in Nepal and raised in Fiji, studying medicine and going on to become an Ophthalmology register. She practiced for 5 years before moving into an academic role in Fiji National University’s (FNU) College of Medicine, Nursing and Health Sciences. When the COVID 19 pandemic hit, she began to see things differently. She realised how ill-prepared nations were around the globe, for this kind of health crisis, as well as seeing how Fiji, and other similar nations, face many other global-level public health issues, particularly around climate change, for which they are un- or under-prepared.

With this insight, Serene decided to pursue further study, looking to UNSW after securing an Australia Awards Scholarship. The School of Population Health’s (SPH) double Master degree program appealed, as it allowed her to pursue studies in both public health and global health, which seemed a perfect combination to meet the needs she was identifying in Fiji and beyond.

I think, from Fiji’s perspective, COVID was really eye-opening, revealing how many weaknesses there are in our health system and how, if we’re not prepared, our health system can easily become overwhelmed. And then there’s the effects of climate change, which, for Fiji, are huge. Our islands are slowly being taken by the ocean, our wet and cyclone seasons are longer, which means an increase in infectious disease issues, from dengue, typhoid and leptospirosis. And we have increasing related mental health issues too, as people lose their homes and face the impacts of these changes. This all really got me interested in public health at a global level.

When Serene began her studies, in January 2023, she never imagined that research would become such a defining part of her academic journey. But it was meeting Dr Christine Linhart while studying in the non-communicable diseases unit, that opened Serene to seeing the possibility of conducting research based in Fiji. Having reached out to her FNU colleagues to enquire what research they were doing, and finding their projects didn't align with the areas she felt most passionate about, she approached Dr Linhart.

Dr Christine is amazing. She has close ties to Fiji and comes to Fiji regularly. She has done so much research here. We discussed her research activity at the time and I asked if there was anything happening in Fiji because I’d love to join that research.

Luckily, Dr Linhart had a Fiji dataset perfectly suited to a Master degree level project. Serene’s research analysed death certificate data on drowning in Fiji and compared it to police report data. Drowning is one of the leading causes of injury-related mortality in Fiji, especially among adolescents and younger adults, though, as in most countries, it’s children under 5 years that have the highest drowning rates. In Fiji, many indigenous people live near rivers and oceans, not simply because Fiji is made up of islands, but because bodies of water are a prime source of food and have cultural significance also.

The research came to reveal that poor accuracy on death certification documents meant that many drownings are simply recorded as “unspecified” instead of having a more specific coding type, which would indicate the type of body of water, and the reason the deceased person ended up drowning, i.e. drowned in a natural body of water or in a swimming pool, or was caught in flooding or in a boat accident, etc. The police reports recorded these things, but police reports are not routinely linked to death certification records.

If drownings were coded more specifically on death certificates, it would provide much needed data to government public health drowning prevention programs, and lives could be saved.

These results meant Serene’s research findings existed in two distinct categories.

Aside from making recommendations around things we can do to reduce drowning, there are also recommendations in our published article on how we should be improving data collection in Fiji. While we were finding out about drowning, we revealed big gaps in the data that could be improved with more training around filling out death certification documents.

Because Serene worked in FNU’s College of Medicine, Nursing and Health Sciences, she knew no training was given to medical students on how to complete the death certificates, or the importance of the data those certificates provide. She’s happy to say that the University is developing a short course covering this, to be offered to medical students in future and her research proves how necessary such a course would be.

Serene has gone on to present her findings in government and academic settings in Fiji, so she’s hopeful there’ll be some public health impact as a result of her research, and other related drowning research. 

It’s a great outcome. But like most SPH Master degree students who are new to research, Serene didn’t begin feeling confident. It was the foundational courses, such as Introduction to Epidemiology and Introduction to Biostatistics, as well as the supportive teaching and research teams of the School, that gave Serene the confidence to try.

Like others, I was apprehensive at the beginning because I hadn’t done any research before. But I just had the best experience - such a good experience. Dr Christine Linhart and Dr Amy E Peden were my supervisors. They were so supportive. I felt like I could ask questions at any time. I never felt like I was on my own. There were times when I wasn’t sure which direction to go, and they’d give me the direction I needed to focus on. I got feedback weekly, and sometimes more often! I just cannot sing enough praises, it was a really good experience.

Serene also enjoyed the student experience offered by UNSW.

UNSW was amazing. There was a lot of activities for international students. It always felt like there was a support system in place – we could go to The Nucleus:Student Hub and there were helplines if we were struggling – a lot of support networks, and always something happening.

And UNSW’s campus and location was also important.

UNSW is in such a central location, really convenient. And there’s a lot of green spaces, with artworks hidden here and there. It’s nice to explore. And also getting to explore the other campuses, like the College of Arts in Paddington.

Since finishing her double Master degree in late 2024, Serene returned to her role as lecturer at the Fiji National University, where she stayed about a year, continuing to get more involved in research with clinical Master degree students there. She was made a co-convenor for their research unit, thanks to her experience in post graduate research.

But more recently, Serene has joined the Australia Fiji Health Program (AFHP), which sits under the auspices of the Fiji Program Support Platform, which is an initiative of both the Australian Department of Foreign Affairs and Trade and Australian Aid. Her role is the Technical Specialist in Sexual and Reproductive Health.

I definitely know that being able to secure this role at the AFHP was thanks to my Master degree, because prior to that, my major experience was in ophthalmology and in general practice, and then as an academic/lecturer.

But more excitingly for us, Serene is returning to study a PhD at UNSW in September 2026, with Dr Christine Linhard and Dr Amy E Peden as her primary supervisors, once again. Her topic will be looking at the intentionality of injury-related mortality in Fiji.