As a practicing physician, some might find it strange to find you working at the Graduate Institute. How did you wind up here?
I actually started out as an HIV activist in the early years of the epidemic, which was my main motivation for going to medical school. After I started practicing medicine, I became aware that the reasons my patients were getting sick were, ultimately, not biological reasons but social reasons. That’s why I decided to also study anthropology, which gave me tools to understand the global structures that produce inequality and got me increasingly involved in global health, which is how I got to the Graduate Institute, where I now teach global health and medical anthropology.
How does this experience impact your approach to teaching Global Health here at the Institute?
What people like Ilona Kickbusch, Director of the Global Health Centre, and others have shown over the years is that social factors are a much more powerful influence on health than biological factors. Improving the health of peoples – and indeed of the planet – involves understanding and addressing political and social determinants, from the global to the local levels. At the global level, we have developed courses that allow students to understand and operate within the global health system – drawing on history, law, political science and of course anthropology/sociology—in order to tackle those determinants at the international and national levels. But global health is also local, and we also train our students in the approaches that allow them to be effective in the field. As a doctor working with Médecins sans Frontières (MSF), I have learned never to underestimate the importance of diplomacy, humour, humility, curiosity and going out and talking to people where they live. Those practical skills are hugely important and I try and bring that back into the teaching, as many of us do in the Global Health programme.
What is the vision behind the Global Health specialisation, part of the Interdisciplinary Masters?
The most powerful factors shaping our health are structural: the social and political forces that shape our vulnerabilities and exposures to health threats. The vision behind the Global Health specialisation is that you need training in understanding and analysing those forces and their impact on communities and individuals. You need to understand not only the history of diseases but the history of attempts to address diseases in order to learn from over 100 years of global health experience, including its successes – like eradicating smallpox – and its failures – like in the Democratic Republic of the Congo (DRC) right now with Ebola. We need to study anthropology as a tool for analysing, from the point of view of the lived experience of people, what conditions affect health. We need sociology for analysing how these structural factors are organised and the pathways by which they influence health. We need economics to understand the best ways to incentivise institutions and people to shift those structural determinants and improve health. We also need political science and political theory, as global health is a governance issue.
What has been the feedback from students on the global health programmes?
Students love the classes, the proof is in the huge popularity of the classes and subsequent follow-through into our other courses, but they want more. Three reasons emerge from our course evaluations to this effect. Some students have had a lot of experience working in organisations, community groups or as activists and they come to this programme for specialised training in the relevant humanities and social sciences. Then there are students that came to the Institute for our interdisciplinary programmes but wanted more training in global health, since this is such an important issue in international relations and development and because it is a field that touches on so many different things. The third group has never before taken any classes in health or medicine but after an introductory class, or being exposed to global health through an internship, they are excited about the subject and want to learn more. Because of the growing demand for global health teaching, we are increasing the number of courses we have on offer. In addition, we have a partnership with the University of Geneva that allows students who want additional training in “classical” public health, including biostatistics and epidemiology, to take additional courses, or even qualify for a Dual Master in Global Health with just an extra year of training.
If someone is curious about global health, what is one book they should read?
A History of Global Health: Interventions into the Lives of Other Peoples by Randall Packard.