Dr. Sheila Davis knows about her reputation as a firefighter at Partners In Health. She led the organization’s Ebola response in West Africa from 2014 to 2016, then helped transition the teams to rebuilding the health systems in Liberia and Sierra Leone. She was the first one called to help the Haiti team when Hurricane Matthew wreaked havoc in Haiti in October 2016, and when flooding wiped away entire neighborhoods in Lima in the spring of 2017.
Each time, Davis was the steady hand that guided PIH through the literal, or figurative, storm. So it was no surprise that she emerged at the top of a global search for PIH’s next CEO, following the retirement of Dr. Gary Gottlieb at the end of June.
Davis joined PIH as a nursing coordinator in October 2010 and became the chief nursing officer in March 2013. As such, she was instrumental in planning and opening University Hospital, the 300-bed teaching facility built in Mirebalais, Haiti, in the wake of the devastating 2010 earthquake. She has since established PIH’s nursing strategy, while heightening the professionalism and inclusiveness of the organization’s thousands of nurses, midwives, and community health workers. She took on the additional role of chief of clinical operations in January 2017.
Davis sat down recently to talk about her work as an HIV advocate, the positive response she’s received from nurses on her appointment as CEO, and her vision for PIH’s future.
What drove you to become a nurse?
It’s not like I had a calling. My family was very social justice-oriented. My sister is a teacher. My other sister went into human services. My brother went into politics and worked in homeless shelters. My dad is an educator, my mom a social worker. For some reason, nursing just appealed to me because it was a way to work closely with the whole person. It just totally fit.
You were among the first cohort of nurses to care and advocate for patients with HIV. What inspired you to join that movement?
I grew up in rural Maine, where there was nobody I knew who was openly gay. Everybody looked exactly like me. It was very small town. When I moved to Boston to go to school at Northeastern, my nurse preceptor at my clinical site was a gay man whose partner was dying of HIV. This was in January of 1985. I remember visiting him at a local Boston hospital after we got out of work. The nurses hadn’t gone in. The trays were piled up outside. And I remember being very angry and saying, “I’m not going to join this profession because this is horrible. People aren’t treating him like a human.”
It just turned on an advocacy part of me. For me, nursing, social justice, and advocacy were entwined from the very beginning. I became involved with the AIDS advocacy movement in Boston, with AIDS Action, and became a buddy for people who were dying of HIV. I was part of Act Up, an AIDS activist group. Then through my Northeastern co-ops, I worked at the National Institutes of Health when there were a lot of protests happening. The AIDS community was really mobilized and would storm buildings and block entrances fighting to be heard. The media and politicians were not paying attention, so something had to be done.
At that point in the AIDS crisis, everybody died, so it was end-of-life care. I was really privileged and honored to be with people at that point in their lives. Many of the patients were people who were marginalized by society—gay men, people who injected drugs, and those who traded sex for survival. People were disowned by their families and many were alone, so we became people’s families and spent time with them as they were dying.
Can you talk about your time with the Association of Nurses in AIDS Care, or ANAC?
My first job after graduating from nursing school was at George Washington University Hospital in Washington, D.C. on a unit that had only HIV patients. It was just a very bizarre time; our scrubs were the same pink that matched the blood-borne pathogen sign that was hung on every door—a crazy coincidence. Even as nurses, we were ostracized. People would ask me, “As a white, heterosexual woman who doesn’t use drugs, why are you doing this? Why do you care?”
There were no books on how to take care of people with AIDS then. There were nurses in San Francisco and New York City who were doing it, and they started an organization, ANAC. We all just found our way to this group. That became such a sense of community, and source of knowledge regarding how to care for people. All of us are still good friends, 30 years later. We lost so many people. A lot of gay men went into nursing because of HIV, and we lost many nurses too. Every year at the conference we have a Celebration of Life, our memorial service. It is very special to all of us. That’s the one time of year where I really cry, because it’s when I take the time to remember all the people I lost and can grieve together with people who lost so many too.
ANAC is also how I got involved in global work. Although we were all in our early 30s, we were the HIV experts. Because HIV treatment had not been around for very long, there was a small group of us who knew how to treat HIV with antiretroviral (ARV) drugs. They were not easy to take then and made some people really sick. I started working in South Africa, which was amazing. I was not someone who had ever planned on working outside of the United States, but went because I was needed. I am so glad I had the opportunity to do it, because it really changed my life.
ARVs were first introduced in 1996. As a nurse, it must have made your head spin to see HIV change from a terminal illness to a chronic condition.
People talk about the Lazarus effect (from antiretroviral drugs that have dramatically positive effects on HIV patients). It truly was people who were on death’s door. I was taking care of women at Massachusetts General Hospital who would say, “I just need to see my children get through high school.” Now those women have grandkids. It happened in such a short amount of time.
Now we’ve gotten the virus under control, and HIV is a treatable chronic disease, but the social situations that put people at risk and make life hard, we didn’t change. We always said that if we could ever treat HIV, that would be a game changer. And it was for most people. There is not a biological reason why many marginalized groups were overrepresented in HIV. It’s because their lives were harder; they were poor and they didn’t have access to good health care. Targeted information on how to prevent the spread of HIV was not getting into the communities that needed it. When people did try and get care, they were not treated with dignity or respect. People who live in the shadows are vulnerable to all types of infections and diseases, and HIV was no different.
What attracted you to PIH’s work?
I started working at Mass General in January of 1997, and it was the beginning of the turning of the tide for HIV. Joia [Mukherjee, PIH’s current chief medical officer,] was an infectious diseases fellow working with me before she started at PIH. I stayed in touch with her when she left. The HIV world was pretty small, so I knew other people also who worked with PIH. And I actually went to Haiti in 2001 with a friend who is a nurse, and she knew Loune [Viaud, the executive director of Zanmi Lasante, as PIH is known locally], so I was able to meet her long ago.
I knew of and had met Paul [Farmer, PIH’s co-founder and chief strategist,] in the HIV world in Boston. I also had read many of his books. I was critical of the fact that he talked a lot about community health workers and doctors, but not much about nurses in treating HIV in his early books. That has changed a lot. Paul is now one of our best nurse advocates out there. Nurses have been virtually invisible in global health sadly. We are the largest group of professional health workers globally, but are rarely in any leadership roles. Although we were running many of the HIV programs globally, you never saw nurses presenting at conferences or being recognized as the experts, which was very frustrating. I am glad that is finally starting to change,
Then, in 2010 after the earthquake, a nursing colleague named Donna Barry, who was leading PIH’s advocacy and policy work at the time, and Joia reached out and said, “I think you should come here.”
What are you most proud of having accomplished so far?
At PIH, a number of physicians had the opportunity to go to develop professionally while working at PIH. They did master’s degrees. They traveled to other PIH sites and represented PIH globally at conferences and had the opportunity to learn from each other. We never had nurses who did that.
I’m proud that that was able to happen, because there’s so much wealth of experience that was pretty siloed and hidden. We started really investing in nurse accompaniment, and that’s how the PIH Nightingale Nurse Fellowship developed, to give nurses the concrete skills that we need to lead—things we don’t learn in school.
As the new CEO, what words would you use to describe PIH?
I think gritty is a good word, because I think it’s very real. It’s earth. It’s in it. It’s being at the ground level where things happen.
A lot of people may do what we do, provide health care, but not in the way that we do it. Not in the way that we’re listening to others and having the contextual experts driving what we do—and do it from the communities, all the way to the ministries and the global stage. That’s very unique.
What are some of the big challenges ahead, and how do you hope to tackle them?
We have a lot to do. We have great people working very hard to take care of those who are vulnerable and suffering. This takes “the five S’s” we always talk about: staff, stuff, space, systems, and social support. We need funding and the political will to put people first.
Your announcement as PIH’s new CEO sparked an outpouring of support, especially from nurses. How did you absorb that, and what message does your new role send to the larger nursing community?
There’s this Michelle Obama quote that I love. She says, “When you've worked hard, and done well, and walked through that doorway of opportunity, you do not slam it shut behind you. You reach back and you give other folks the same chances that helped you succeed."
I do feel that responsibility. We all should be doing that. The support from nurses all over the world has just been astounding. It’s standing on the shoulders of these giants, and nurses who worked so hard for so many years and never have been recognized.
In many senses, nurses have not had an opportunity to be seen as leaders of a global health organization of this caliber. A nurse in charge of a large Harvard-affiliated NGO? In the past that would have been unheard of. It’s been a battle to have nurses recognized as leaders. That is changing now.
Tell us about your life outside of work.
My daughter is a huge part of my life. As a single mother, she was beside me through the early days of HIV and grew up as part of that community. And my family—my dad and everybody are really important. I like poetry, reading, and writing. The ocean for me is really rejuvenating year round. And then communities, like ANAC, feed me. I have led a life of service in a lot of ways. There are places where the ugliness is, because nurses are witness to very difficult things. Not everyone can relate to that, so you find your outlets. My poetry is fairly raw, because that’s where I can let it out. I only share with a few people now, but maybe more someday.
Do you have a favorite poet? And is there any passage or phrase you turn to for inspiration or solace?
Mary Oliver was my mother’s favorite poet. There are a few of her works that I think are very important that I do think about. And Maya Angelou. There’s that poem, “When Great Trees Fall.” When my sister died a few years ago, I was devastated. I found how poetry can be just so comforting and put words to something that you can’t explain. I go back to that poem a lot.