I’m a strong believer that public health is a profession of action and is best experienced through a hands on, in-the-field approach. In public health we certainly need to be trained in the classroom and laboratories of the brick and mortar school, but I daresay the real learning takes place with the application of that training out in communities. Whether it’s in the neighborhoods surrounding College Park or in far-away places, there is both a joy in serving others and a satisfaction in learning from the new experiences.
As Dean I spend a lot of time working at my desk and attending meetings, and my current public health mission is dedicated to being part of the team that runs this school. But I do need that hands-on public health experience to keep me focused. I had such an experience in July on a trip to Haiti where I worked side by side with 35 other American volunteers, including my wife and two daughters, in the community of Montrouis. The beauty of this service trip was that it reaffirmed for me that even 33 years after I was granted my MPH, I am still open to learning about the bigger public health picture. Albert Einstein said, “Learning is experience. Everything else is just information.” Whether it was in the realm of educational programs, nutritional support, humanitarian outreach, or the delivery of medical care, each of us walked away with a new perspective on the world. In particular, I was especially perplexed (and admittedly a bit depressed) by the enormity of the needs of the community and the Haitian people generally – did I make a difference by being there? And that lead me to a broader question -- Does what we do in public health make a difference?
The question came to the forefront on our last day in Haiti. After spending a busy day with two other physicians seeing 90 patients in our rural mountain clinic, which was a church converted into exam space and a pharmacy for the day, we were heading back to our living compound. I was hot and tired and perturbed with the limited diagnostic and therapeutic tools available to us to treat those in need of care. Nearing our destination and ready for some rest, a car suddenly intercepted us and out jumped an elderly man who had sliced his hand rather deeply with his machete. We took him to our clinic, and after cleansing the area, we did what we could do to suture the wound together with rather limited equipment. Under less than the best circumstances, we stopped the bleeding, treated him with antibiotics, and hoped for the best. Did this make a difference?
Reflecting on this question during the trip and after, I found some inspiration in the book Mountains Beyond Mountains, by Tracy Kidder, about infectious disease specialist Paul Farmer’s work in Haiti and in the global arena (recommended by Behavioral and Community Health Associate Professor Kerry Green in our June UMD SPH newsletter).
It was perfect timing to be reading this book while in Haiti and my family and I all brought our own copies for a mini book club! It gave me that perspective that I needed, which is exemplified in the title itself. A Haitian proverb says – “Beyond mountains there are mountains.” This describes not only the topography of Haiti, but the challenges that lie ahead of us in public health. Public health problems abound in our own communities and in Haiti. These are the mountains of public health. We solve one problem, then another problem presents itself. We can’t sit back, but must go on and try to solve that next one too. This is how we make a difference.