Epidemiology and Humanitarianism: A Platform for Advocacy and Action
With eight years of undergraduate medical school and foundation training behind me, and still eight years of further specialty training ahead, I have taken an unusual turn in my training by coming to the Mailman School to study Epidemiology. In a few weeks, my practicum will take me even further from the well-trodden path of medicine, when I will spend six months in the Democratic Republic of the Congo with the local NGO, Rebuild Hope for Africa. I'll be working with Population and Family Health professor, Les Roberts and fellow Mailman student Eamon Penney to understand the number and conditions of the displaced population in the eastern part of the country.
It is particularly difficult to measure the numbers and mortality rates of internally displaced populations (IDP’s), especially as they are increasingly found outside of camps and interspersed with the rest of the population. To try and improve our understanding of the needs of this population, we are establishing a surveillance system in the city of Goma using community monitors to record the births, deaths and movement of IDP’s in the area.
The DRC is the centre of a prolonged pan-African conflict in which millions have died and been displaced. Yet, during The Core, Roberts regaled us with stories of his work in the country, demonstrating the potential for public health and good measurement to save the lives of thousands of people. Through nationwide mortality surveys, Roberts was able to demonstrate the true scale of the conflict that had previously been grossly underestimated. As a direct result of his work, an increased presence of international aid in the eastern DRC has caused a major decline in the number of deaths.
In Prof. Roberts's work, I learned that we must reach beyond what is easy to measure in the search for something more truthful and that such measurement can and should be a powerful tool for advocacy. After a fall semester filled with exposure to new fields and ideas and a spring full of the complexities of epidemiology and biostatistics, I realized that this was why I came to Mailman. This is a combination of epidemiology and global health that can alter the course of human suffering.
But this is not an easy pursuit. During The Core, I also came across classmates who actively disagreed with the involvement of white westerners in the health affairs of the developing world, citing concerns of neo-imperialism and exploitation. The field is certainly rife with the possibility for ethical abuses. But through an ongoing and often uncomfortable examination of my motives and ambitions, I continue to pursue this work.
I will not veil the selfish motivations that I have: sub-Saharan Africa fascinates me. I like to travel and some part of me likes going to places that others wouldn’t. But these are secondary to what is, for me, a clear moral imperative. Global health is not about condescension or imposition of views and practices. And it is not intended to assuage our collective guilt or compensate for events of the past—it would be wholly inadequate if it were.
This is about recognizing the great inequity of technical and financial resources in the world and attempting to redress the balance. In the same way that I feel it is the duty of governments to care for their citizens without the means to care for themselves, it is also the duty of the world to care for those that the global imbalance of wealth and stability leaves neglected. Neo-imperialism and exploitation may exist, but they do so alongside the formidable progress of the growing field of global health that is improving and saving the lives of millions.
Working in the DRC for the coming six months is the next step along my path in the epidemiology of humanitarian assistance. I hope to apply what I am learning to make a science of how we help can those in dire need, rather than only relying on the experience of individuals in the field and the fragile threads of institutional memory. Simply learning by experience is not good enough because it doesn’t get carried over to new staff and programs.
In both medicine and in public health we have responsibility for the wellbeing of others and as such are in a position of great professional privilege. Certainly we must examine whether what we are doing is right, but we also mustn’t hesitate to take up this platform and act.
By Prudence Jarrett, Epidemiology, MPH '17
If you would like to contribute to Mailman Student Voices, please send a three to five-sentence pitch outlining your topic to mailmancomm@columbia.edu.