Recklessly Idealistic and Doing Astonishing Things

When The Heilbrunn Department of Population and Family Health (PopFam) created our Program on Forced Migration and Health (PFMH) in 1998, it was the first of its kind to require students to complete a practicum in a humanitarian crisis. “Within eight years, Hopkins, Harvard and other formal U.S. humanitarian programs offered similar practicum opportunities,” explained Leslie F. Roberts, PhD, professor emeritus of Population and Family Health. 

Those practicums shaped PopFam into the department it is today. For PopFam’s 50th Anniversary, we sat down with Roberts to discuss the unique teaching methods and how practicums enhanced classroom conversations, built a lasting community, and led to amazing things, not only for current students but after graduation.  

What drew you to Columbia and to the PopFam department in particular? 

There were three things: 

One, I really loved that PopFam offered a Professor of Practice role, which essentially meant that I wouldn’t be evaluated by publications or grants. Instead, I’d be evaluated based on how much I worked to improve the world, which is exactly what I wanted academics to do.  

Two, I told my chair and program director that I was never going to write an National Institutes of Health or U.S. National Science Foundation grant and bring in overhead. It just made me so uncomfortable. And Neil Boothby, the head of PFMH at the time, was fine with that. 

Three, I had just run for Congress a few months before and that experience was just soul crushing. But nobody was more supportive and enthusiastic of my run than PopFam. It made this feel like home to me. 

Tell us a bit about having students do a practicum. 

The idea came from Ron Waldman and the former dean, Allan Rosenfield, responding to how badly the American NGOs performed the Rwanda genocide response. 

The practicum—where students would spend at least two months in a crisis environment—was built into the Columbia proposal right from the start. At the time, it was a radical thing that other public health schools didn’t do.  

What’s the biggest impact on the students? 

It elevated the level of discourse, because no matter what topic we talked about, there was someone sitting in class who knew more about it than the professor did.  

But more importantly, it created this intense sense of community, and it was a sense of community that lasted. We conducted surveys of alumni repeatedly, and most PFMH graduates were still working in the humanitarian endeavor ten years after graduation—my colleagues at Hopkins and Harvard couldn’t believe it because their statistics weren’t half as high. 

Tell us more about global opportunities for students. 

A really nice thing that evolved with the practicum was that we built up a database of who had gone where and when. This made it much easier for students to search by what they wanted to do, or where in the world they wanted to work, and find those opportunities. 

Also, many of the faculty would build a role for students into the grants. That wasn’t necessarily the norm in the public health school world or even in other departments. But it very much was the norm for PopFam. 

How do you think PopFam’s resources, global network, and approach to research have helped to shape your work over the years? 

First, the school was sort of recklessly idealistic.  

For example, about a year after our 2004 Lancet study came out saying 100,000 civilians had died in Iraq, an article in the Wall Street Journal essentially accused us of fabricating data and being corrupt. Allan Rosenfield called me and said, “I want you to know if the editorial board of the Wall Street Journal is going after you, you’re doing something important and you’re on the right side.” 

Secondly, the students were both visionary and motivated. I’m most proud, by far, of what I see current and former students doing. 

What do you see as the most pressing challenge in public health right now? 

Hands down, no question—global inequity. 

How do you think the field will change over the next 50 years? And what new developments are you most excited about?

When you think of things like USAID, the main spending was on buying food from American farmers. If USAID was roughly 1% of the federal budget, the emergency humanitarian aid portion is 0.06%.

I think there will be a continuation of the movement to decolonize aid. We’re already seeing this in a big way. People like us who grow up in this land of privilege have unique things to contribute: we understand the culture that motivates the donor nations, we grow up in a culture that values accountability and evidence in the framing of epidemiology and economics, and some of us have decades of field experience. But, little by little we are becoming a tool for locals to use who really understand their culture and needs in a way outsiders cannot. This makes me very happy.