A few weeks ago, I packed my suitcase and headed out of town for a week in Amsterdam to facilitate a data analysis and management workshop—switching my crisp and clean editor/publisher hat for my worn-in public health hat. It was refreshing to step back into comfortable shoes and play a role that was familiar and speak a language that was native. I met public health professionals from all over the world—Georgia (the country, not the state), Russia, Cote d’Ivoire, Democratic Republic of Congo, Afghanistan, Egypt, Pakistan, Turkey, Thailand, and Croatia.
In 2013, I was five months pregnant and flew to Cote d’Ivoire to facilitate another global public health consultation of this nature. Luck would have it that I was paired with the only female participant in the room—a laboratorian from Sierra Leone. We sat together and analyzed her influenza surveillance data, and I noted that she didn’t have any cases—I mean zero cases, which would be extremely rare—for males aged 30-45 years. I inquired about her data thinking it was a detection issue and I’ll never forget her face as she explained, “that’s because we don’t have a sizeable population in that age range. They all died in our civil war.”
I was overcome with emotion, questions, and subconscious guilt about my ignorance. Of course, I had heard about Sierra Leone’s bloody civil war, but I hadn’t studied it in detail and never before had I met someone who had lived through it. Here was a woman who was very real telling me about unspeakable horrors. It’s not every day that you get to have that type of conversation.
We stopped discussing missing data points in her Excel spreadsheet, and I began to ask her questions about the war. How did her family survive? How many people had she lost? It was a humbling conversation, and I walked away feeling incredibly lucky to have been randomly born in a country that hasn’t experienced a fraction of the violence she described.
(I checked in with her during Sierra Leone’s Ebola epidemic, and she lost her boss to the epidemic. Fortunately, she and her family survived Ebola.)
During the most recent workshop in Amsterdam, I met an epidemiologist from Afghanistan. He went to extreme lengths (a two-week stay in India) to get the appropriate visa to come to the workshop. He had to use his vacation time to get the visa, but that was only the beginning of learning about this man’s dedication to his work.
Influenza surveillance is often conducted using sentinel sites—hospitals and clinics record information, take nasal swabs and submit data for the nth person who comes in meeting the specified case definition (what symptoms and signs qualify someone as a suspected influenza case). A common issue with sentinel sites, clinicians, and nurses will often drop this extra public health data collection if they are not incentivized by the public health sector or if they are busy—as people in clinics tend to be. Public health practitioners will visit sites and chat with the nurses, ask questions about data collection, and encourage them to continue reporting to public health. It’s necessary to keep the sentinel surveillance operating smoothly otherwise you won’t have a full picture of the burden of influenza on your country.
The epidemiologist from Afghanistan described his most recent site visit in order to collect this data, “Site visits are very difficult for us because one clinic of our three clinics is located in a zone under Taliban control. We don’t know if we will be killed when we visit this clinic. We made the visit and I’m here today, so it was good.”
My jaw nearly hit the floor in astonishment. This man is risking his life for influenza surveillance data. He is making decisions every day that I can’t even imagine protecting the public’s health. That’s how much his job means to him. That is his calling in life.
Every day, I am inspired by the people I meet. When we meet people in person, we can see that they are real people with feelings, hopes, and dreams just like we do. They reminded me how difficult life can be and that despite how distant my experiences are from theirs, we were still sitting in the same room trying to accomplish the same things. I am also reminded that there are good people everywhere—even in countries at war—and we are all making the best decisions we can given our circumstances.
Perspective is an equalizer, and we must expose ourselves to as many different perspectives as possible. I hope that I may never experience what it is like to miss an entire population of young men lost to civil war. I hope that I may never know what it’s like to have to decide between visiting a clinic on Tuesday or Wednesday to increase my chances of survival from a group of terrorists. I hope that we can learn from others’ lives so that we don’t repeat the same mistakes. Our challenges are different depending on where we live, and we cannot forget to have empathy for our fellow humans with whom we share this planet.
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