My Route to a Career in Public Health

“Reflect on the time you realized you wanted to work in public health…”

This was one of the requests of Joyce Gaufin, president of the American Public Health Association, during November’s APHA 142nd Annual Meeting & Expo, held in New Orleans, Louisiana. What an appropriate question to ask a room filled with thousands of public health professionals. What a pointed question, it felt like, for me personally, as I returned to my home state – this time, representing Chemonics International among 12,000 of the world’s greatest public health minds.

You see, I was born and raised in Lafayette, Louisiana, “Cajun Heartland.” I went to high school in the sugar cane fields of Cade, Louisiana. Along the way, like many energetic youths inspired by the popular television show E.R., I wanted to be a doctor. I always felt the inner desire to, well, help people. It could have sprouted from the fact that I enjoyed nursing my three brothers back from their injuries to one another, or from the fact that I was able to link an uptick in strep throat, and the subsequent absenteeism at school, to the onset of sugarcane burning season. Family medicine; pediatrics; ear, nose, and throat; pediatric ear, nose, and throat…I bounced around from specialty to specialty, always with the feeling that if I wanted to make a real difference in peoples’ lives, on their mental and physical well-being, it would have to be by providing direct health services. How else? In my view of the world, clouded by burning cane field smoke, it seemed like the best and only route.

From Lafayette to the big city of New Orleans, in pursuit of my life’s goal, I planned my college pre-med route. However, in line with Tulane’s curriculum requirements, in order to graduate I would need to take a “Perspectives Outside the European Tradition” course, and landed myself in “Introduction to International Development 101.”

I heard stories from my teachers about their work across Africa, parts of Asia, Latin America and the Caribbean, and even the great development challenges of New Orleans, post-Katrina. My teachers had worked in disaster response, HIV/AIDS response, food security and nutrition, economic development, and more. In one semester, I had begun to see that in order to really help people, health was only one defined channel. I soon recognized that I wanted to be able to contribute positively to peoples’ lives in more than just way – and all people, any- and everywhere. It was evident to me that in order to follow my calling, I needed to understand some of the other challenges at play. So I decided to major in Economics, International Development, and took on a few extra French classes to brush up on what had, to that point, been considered only feeble Cajun French.

From there, I wrote my essay for medical school applications. I was ready to make my now expanded dream happen. But my academic advisor took me aside and said, “You know, this reads more prevention that diagnosis. Is medical school really what you want to do? Have you heard about the public health profession?”

My answer was an embarrassed, “no.”

Not as its own profession!  Public health was just a blanket term used to describe the health of the public, right? At that point, however, a new world opened up to me – the world of public health, which was influenced by things like the environment, education, policy and governance. In pursuit of this new realm at Tulane’s School of Public Health and Tropical Medicine, I learned about the theories behind global public health. Through my 6-month graduate practicum in Mali, West Africa, I learned about the realities of the ground, global public health in its practical form, and health systems strengthening became a real, palpable thing…not just a popular phrase. I recognized I wanted to approach global public health through a larger, more comprehensive lens, and in order to do that, I needed to work in this bizarre profession embedded in a “perspective outside the Louisiana European tradition.” When I came back to the U.S., now with a West African twist to the Cajun accent on my spoken French, I got a job at Chemonics International.

I have now been at Chemonics for more than 3 years. In my tenure here, I’ve helped to manage a project that has built the capacity of the Malawian government to spray their citizen’s walls with life-saving insecticide. Rather than do the work and deliver the services ourselves, we worked through existing structures and supported the government to lead its own malaria-preventing spray seasons. I was on the project management unit supporting a program that presented today at APHA, one that goes beyond your everyday health approaches to reach the most at-risk populations, hidden in urban settings; our DRC ProVIC project used a proven behavior change approach, “Champion Communities,” strengthened by peer education, to empower groups like men who have sex with men and commercial sex workers with the opportunity and the means to create and define their own community to regularize HIV testing and counseling.

In my role in the Health Practice, I’ve also had the opportunity to liaise with and learn more about our Iraq Governance Strengthening Program, which, in its scope to guide the distribution of power to the regional and provincial levels, also hopes to support an organized decentralization of the Ministry of Health’s functions; and our Southern Africa Regional Environment program, which raises awareness about HIV/AIDS prevention and management as part of its integrated approach to improve the welfare of communities throughout the Cubango-Okavango River Basin.

These cross-sector approaches – integrating health and governance; linking health and education; connecting environment to HIV – are why I continue to work in public health at Chemonics. And when I think about President Gaufin’s question, why I started in this profession, I know my answer. It was a long journey, but I do remember why and how I got into this business: it was to help people. I just now get to do it as a larger part of helping health systems, governments, and countries.

At APHA, I truly enjoyed the opportunity to learn what all of my public health peers are doing to support and push forward the public health movement, globally as well as in my home state. 

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