Global Health Careers: Part I

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.

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 :)