Maximizing Good in the Global Cancer Fight

Tell us about your current role at the American Cancer Society.

In developed countries, a cancer fight means hope. In low- and middle-income countries, it almost inevitably means pain, suffering, and death. Three days after graduating with my MPH from Brown, I started work as the Program Manager for Global Capacity Development and Patient Support at the American Cancer Society. We support 59 cancer-focused civil society organizations in Kenya and Uganda. The goal is to create a critical mass of NGOs that can successfully work with their governments in fighting cancer and meeting the overwhelming demand for quality prevention and care that the over-strained health systems are unable to meet. We make small, but strategic investments in the countries we work with to help change this situation through improved advocacy, planning, data use for decision making, and increased transparency.

You became involved with the Peace Corps in Ukraine in 2005. Tell us about the work you did and why it was important to you.

Before coming to Brown in 2015, I worked for U.S. Peace Corps/Ukraine for almost 10 years, where I managed the agency’s PEPFAR-funded HIV Program. I started in an administrative capacity, but soon I found that many health inequalities stem from stigma and discrimination. We decided to build our program around fighting stigma aimed at vulnerable populations and educating health professionals. Eventually, I came to realize that, in order to effectively manage health programs, I needed to improve my public health research skills – and that’s why I went back to graduate school.

What are the major barriers you face when attempting to solve healthcare issues within your role? Are they policy oriented? Social? Resource?

From my experience in Ukraine and in Africa, lack of health awareness, severe underfunding of health programs, and corruption are some of the major barriers to health. In the global context, one cannot assume that governments will always act with the best interests of their population in mind, so engaging a multitude of stakeholders, including state servants, civil society, private entities, and international organizations is critical to the success of a large-scale health intervention.

The experience of All-Ukrainian Network of People Living with HIV/AIDS is a great example of success. When the Network was created in 2000, HIV treatment was not available in the country, health workers would loudly announce patients’ HIV test results in crowded clinic hallways, pregnant HIV-positive mothers were advised to get abortions, and getting HIV meant slowly dying in shame. Today, the Network is a major watchdog for Ukraine’s health, an indispensable stakeholder working hand-in-hand with (and holding accountable) the Ministry of Health in launching the first major health reform aimed at turning the outdated, inefficient Soviet-era health care system into a modern public health system. This is a prime example of successful cooperation between the government and international donors, led by patient activists. This is what we are now trying to achieve in the cancer space.

How did Brown prepare you to tackle contemporary issues in global public health?

Not a day goes by without my recalling something from my coursework or research at Brown. Two years ago, I was examining the phenomenon of epidemiologic transition as part of Dr. McGarvey’s Burden of Disease in Developing Countries course; and today, I support programs in countries which are increasingly suffering from non-communicable diseases, such as cancer, in addition to the “traditional” burdens of malaria, HIV/AIDS, and other infectious diseases. Brown taught me to look at the distribution of disease through the lens of social determinants of health, and I help our participating organizations to be more effective and efficient in addressing those determinants and eliminating disparities in access to quality health care.

Brown taught me to collect, analyze, and use data, and to share it with partners. I am now using those skills to develop a data management plan for our program, to engage partners in meaningful conversations about the purpose of quality data collection, and to address research fatigue in communities where participants have been studied, observed, measured, and stratified without much visible benefit to those communities. The discussions we had at Brown on global health research ethics and community engagement are now very real in my daily job.

While at Brown, I realized that the maximum good for the maximum number of people should not be achieved at the expense of minority populations. Thanks to Dr. Operario’s LGBT Health class and his excellent mentorship, I always keep gender aspects of health in mind when designing programs or analyzing results.

My studies at Brown were sponsored by the Brown University-Ukraine Collaboration, a global health research group led by Dr. Tim Flanigan that does extensive research with the Ukraine medical community and civil society.  I contributed to the Collaboration by working with an LGBT organization to help them evaluate an innovative HIV testing intervention in Ukraine. I found that Internet-based interventions have great potential for bringing highly stigmatized populations into the cascade of HIV prevention, care, and treatment, but only if those services are organized with adequate standards of confidentiality. I still work with the group on crafting funding proposals and helping them to scale up their interventions.

What is your advice for students in the program now on how to prepare for a career in public health?

I cannot overstate how important practical experience is for your academic success, but even more so, for your future career. Any internship experience, paid or not, any class project experience, may be used to improve and showcase your professional skills. My month-long academic internship turned into a job offer after graduation.

Another thing you’ve heard dozens of times: Your quantitative skills are important.  My goal at Brown was to learn Biostatistics to the extent that I would not fail the finals. I succeeded, but in the process, I learned to appreciate the tables in academic papers – those that used to scare me into reading just the Conclusion section. Now, even though I am not a data analyst, I use those skills daily, and provide feedback on our partners’ data analysis and presentation.

Finally, be attentive to your resume and cover letters. In my current position, I’m surprised how many capable candidates make formatting errors or forget to craft their cover letters to the position they are applying for, or fail to follow up with a thank-you note. Those three little steps do not always go without saying – so make sure you follow those!