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| Crete, 2015 |
I was
interested in global health and international work pretty much from the outside
of my interest in medicine as a career. In the dozen or so years since then, the
field has evolved tremendously, shifting towards more long-term and sustainable
solutions and working in partnership with the local medical communities, rather
than the short-term mission-style model.
Back when
I started on this path I had no idea what a career like this entails; in many
regards its still a learning curve and I’m figuring a lot of it out as I go. My
first global health experiences in college were not great, though I didn’t
realize it at the time. I joined a group of students to triage patients and
distribute medications and vitamins during a couple of week-long missions in
Central and South America. At best we were helping with workflow at a quarterly
pop-up clinic, but at worst we were screening for diseases we didn’t have the
medicines or resources to treat, without appropriate medical supervision. While
we probably didn’t do any harm (something that can definitely happen in
situations like this- see this new story for an extreme example),
we certainly weren’t doing
anyone any good.
The
experiences left a bad enough taste in my mouth that I decided to stop working internationally
and for the time being focus on learning good clinical medicine. I put the idea
of international relief on the back burner until I had to skills to truly
contribute something. But when the time came for that, I was a little lost as
to how to go about pursuing a job in the field of global health. With a ton of
guidance from mentors and acquaintances (and even more deep dives on the
internet and google searches,) I found a few different career paths, job opportunities
and fellowships that helped me formulate a much clearer plan for how to use my medical
degree and pediatrics skills to serve others.
So for
starters, here are a couple of things I learned during the last few years that I
think are really important. I will get more into the nuts and bolts of global health
careers in the next post.
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| With the medical director for one of BIPAI's many satellite clinics, Lesotho, 2017 |
1.
Approach
work with humility.
This is really rule number 1, 2 and 3 for doing good work in global health. While
there are definitely things that can be brought to the table as a U.S.-trained
physician, I guarantee my colleagues in Liberia are much more skilled than I am
at dealing with malaria, malnutrition, other diseases we don’t see very often
in our training. The history of global health is not so neat and pretty as you
may think; its riddled with outdated, colonialist and often exploitative
motives and strategies that are better off left behind as we move forward. I will
be learning as much from the physicians and nurses in Liberia as they’ll learn from
me. The absolute last thing many low and middle income countries need is
another foreigner barging in, enforcing ‘better’ Western ideals and leaving a
mess behind, or worse, gaining credit and fame for work and research done in
these countries with no recognition for the health workers on the ground who
were integral to getting this work done. As soon as you realize this work is not
about you, you’ll already be in a better place to make a difference.
2.
Find
a good mentor. Emphasis
on good. I wish this had happened to me sooner. As a woman in medicine, pursuing
a field that is somewhat atypical, I spent quite a few years feeling lost and
rudderless, trying to figure out where I fit in to the big, messy picture that
is global health work. I spent way too much time trying to fit myself into
expectations of what a doctor’s career should be, and then feeling bad about
myself for not really fitting that mold or being happy with who I was becoming
as a physician. That all changed once I found a mentor who actually listened to
me, tried to understand what I wanted to do, and then did everything in their
power to get me to where I am today. I’ll never, ever forget that feeling of
realizing this person was there to help me grow, advise me and achieve my own goals,
rather than push me into a place or position I didn’t quite fit in. This is so,
so crucial, really in any field, but especially for women in medicine and
anyone interested in global health. (Sidebar: it may feel like you need to find
someone who has a lot of global health experience, but I’d argue you should pick a mentor based on their enthusiasm and
investment in you; someone who is as passionate about your career as you are
will be a much better mentor than a more experienced but indifferent person who
happens to work in the field.)
3.
Be
prepared for burn out.
We all know medicine pushes humans to the absolute limits; the long hours,
frustration of trying to navigate a broken system, and constant interface with
human stress and suffering take a toll on everyone (and if someone says it doesn’t,
they’re lying.) These challenges multiply when you enter a system with fewer
resources and higher mortality than we are accustomed to as American health
care specialists. You can’t help anyone if you develop compassion fatigue and burn
out. Know what keeps you going and have an ‘emergency’ plan for those days that
are really, really hard. For me its spending time outdoors and skype dates with
friends and loved ones; for a colleague its Nutella, face masks and venting
sessions with friends in the field. Set time limits to your work days, realize
that you as a single person cannot fix every single problem you encounter, and
give yourself the grace to accept it.
That’s it
for now, I’ll try to write up some of the many, many career options I’ve found
in global health in the next couple of days :)
