Richard Skolnik – Author of Global Health 101
Students regularly come to me asking what they need to know to work in Global Health. They also frequently ask what I wish I had known when I was their age (which was almost too long ago to remember, of course)! Let me offer some comments below on “what I would want to know (and not know) if I were you.” Hopefully, this will help answer at least some of the questions that are on students’ minds, as they think about pursuing a career in Global Health.
Let me start by saying we should discourage students from trying to plan every minute of their life or believing that they lack worth if they are not sure exactly what they want to do professionally. As my friend Robert Hecht, of the Results for Development Institute, says so well, most of what we worked on professionally in our long careers in Global Health did not exist when we were at Yale. There was no AIDS. There was no cry for Universal Health Coverage. There was no GAVI Alliance, Global Fund, or Global Program for the Eradication of Polio. Thus, it is important to have a strong understanding of Global Health issues, the kinds of problems that might arise in the future, and the questions one needs to raise to help understand them. However, it is not possible to “know all the answers now.”
A similar point holds true in terms of your knowledge of both health and development. Some students may wish to specialize in particular topics and on particular regions of the world. However, their career will be best served if they get a broad understanding now of critical issues in health and development, as they play out across a range of countries, and couple that with the beginning of technical specialization. First, this will allow them to put their specialized interests in context. Second, it will help ensure they are learning the lessons of experience from different places and are able to apply them in a range of settings. Third, it will prepare them to work on different parts of the world as needs change. I “lived and died” for Southeast Asia when I was at Yale and the needs there were vast at the time. Yet, I worked largely on Africa and South Asia at the World Bank, at a time when much of Southeast Asia saw very rapid economic growth and a widespread reduction of poverty.
I cannot stress enough how important it is for students to find “role models” as they develop a better sense of what they might wish to do professionally. When I came to Yale, I wanted to be a physician. Then, after spending a year in the Philippines on an Experimental Five-Year BA program, I decided I should work in the new field of “development” instead, with a focus on health and education. Yet, I had no idea what people did in this field, who the key players were, or how they got where they were professionally. I might have heard of the US Centers for Disease Control and Prevention (CDC) and smallpox, but I certainly knew nothing of the great and more silent heroes of Global Health and development. Students can learn an enormous amount from looking for such people, learning about their lives, and seeing if they can attach themselves to them or their work.
In fact, I cannot stress enough the importance of mentors. I realized a little too late in my career how exceptionally important it is to have people from whom one can learn. A huge share of my personal and professional growth is the result of having had a number of exceptional mentors. Those who know me will be amused (but not surprised!) that I was told not to speak while on field visits in my first year at the World Bank. So, I listened carefully that year both to the masterful diplomatic French of my mentors and the well thought out content in their words. From other mentors I learned to speak slowly and take breaths between my words; ensure that ethical issues were paramount in all of our work, even in environments where they were not so explicitly mentioned; to think and act more strategically; and, to understand the emergence of HIV, just as it began. Among many other things, I also learned the centrality of nutrition to all matters health and development. I also learned much about how to manage and motivate people and work diplomatically but rigorously with a wide array of country partners. In the courses students take, the internships they undertake, the summer employment they get, and in their long- run career, they should try to identify people from whom they can learn and then learn all they can from them.
Students should also understand that if they want to work in Global Health, with a focus on the poor in poor countries, then they cannot spend too much time living and working in low-and middle countries. A summer is NOT the same as living in a country for a year or two. Nor are two summers. The best understanding of health and development issues comes from extended periods of time in countries, living as close to local families, as possible. I was fortunate that Yale had both a five-year program in my day and that I could also participate in the Yale-China program when I graduated. I would encourage many more students to take a semester or longer abroad and to do so in places where one can get first-hand experience with health and development problems among the poor. Many students also fail to realize that spending a semester studying in Senegal, or doing a project there on community-based insurance for the poor can actually enhance medical school applications, and not hurt them, as some students believe.
As always, there is much more I could say! However, these are the few points with which I would begin to offer some thoughts on what I wished I had known when I was in college and what I would want students to know, and not know, as they consider a career in Global Health.
Richard Skolnik is a Lecturer at the Yale School of Public Health, where he teaches global health courses at the undergraduate and graduate levels. Richard was previously an Instructor in Global Health at The George Washington University, the Vice President for International Programs at the Population Reference Bureau, and the Executive Director of the Harvard School of Public Health PEPFAR program. Richard worked at the World Bank from 1976 to 2001, last serving as the Director for Health and Education for South Asia. Richard is the author of Global Health 101, a comprehensive, introductory text on global health.
This blog is an adaptation of a piece that Richard Skolnik prepared specifically for Yale students and that will appear in the Yale Global Health Review.
Richard thanks the editors of the review for encouraging him to write that article and agreeing that a version of the piece for a more general audience could appear on his blog. Rachel Skolnik Light provided helpful comments on the draft of this blog.