Dr. Grace Dugan is an Australia native who graduated with UGHE’s Class of 2018. She earned her master’s of science in global health delivery while working for Partners In Health, known in Rwanda as Inshuti Mu Buzima, in the pediatric oncology ward at the Butaro Cancer Center of Excellence in northern Rwanda.
Can you describe where you grew up? What were your aspirations when you were younger?
I grew up near Warwick in Queensland, Australia. This is a rural, farming area two hours away from a big city (Brisbane). My main aspiration throughout my school years was to be a novelist, though I did have an interest in social justice and formed an Amnesty International club at my high school. A school careers counselor actually sent me to a rural health careers workshop that was aimed at encouraging rural students into medicine, nursing and allied health. She thought it would be a good fit for me because I had good marks in sciences and it would be a way to do good in the community, but I was completely uninterested. I just wanted to write books.
Can you give a brief overview of your professional background? What were you doing before you began attending UGHE, and what inspired you to apply to the university?
I’m a medical doctor and I had been working in Australia and New Zealand for 3.5 years before getting a job in global health. When I applied for a spot at UGHE I was working in Papua New Guinea in multidrug-resistant tuberculosis (MDR-TB), which was an extremely challenging but deeply rewarding and, without exaggeration, life-changing experience. I had basically jumped ship from the normal career pathway for Australian doctors and figured out that I wanted to work in global health forever, but had no idea what to do next. Just before going to Papua New Guinea, I discovered Paul Farmer’s books and read most of them, so that led me to PIH and then to UGHE. At the time I applied I was in a bad patch in my job, and I wanted something to look forward to in the future. I didn’t expect to get in, and when I did get in I at first decided to ask for a deferment because I felt really bad about leaving my patients. But when I told my wonderful boss, Stenard Hiarsihri, he gave me his blessing and encouragement, and I decided to go.
Can you describe your studies at UGHE? What did you focus on?
It’s a diverse program, which I really liked. We started with a semester that essentially was about the history and politics of global health, then we did research methods, then management, and a practicum. We also had shorter courses in political economy, leadership, and management and communications, which were all great. Everyone is working full time, and I was very lucky to be offered at job at Partners In Health, known in Rwanda as Inshuti Mu Buzima, where I worked in pediatric oncology at Butaro Hospital in northern Rwanda. I based my practicum on one of the huge challenges we faced at Butaro: how best to treat acute lymphoblastic leukemia, which is a common childhood cancer with very challenging treatment. In high-income countries, it is almost always curable, but the treatment is complicated, lengthy and with potentially fatal side effects, so finding the best way to treat it is not easy.
What was the most valuable thing you learned at UGHE? What was your favorite class?
I don’t have a favorite class, there was so much of it that was so wonderful. We were lucky to have a great faculty with an amazing array of practical experience. There were some challenges for our cohort, but I always felt so supported, encouraged and valued. It was so great to be in an institution which shared my values, and it made me feel like the sky’s the limit for what we could accomplish.
How did UGHE prepare you to work in global health? What have you been doing post-graduation?
I was already working in global health prior to and throughout the course, but in largely clinical roles. The master’s of science in global health delivery program gave me more confidence to take on managerial and leadership positions, and to potentially start my own project. A month after graduation, I was working in the Marshall Islands in the central Pacific Ocean, in an ambitious project which involved screening 22,000 people for TB and leprosy, as well as treating 4,500 people for latent TB. The project was led by a CDC doctor, Dick Brostrom, who has been a real leader in working to give TB patients in the Pacific access to high-quality treatment. It was a real privilege to work with him.
What inspires you to work in global health? What are the biggest rewards of working in global health, and the biggest challenges?
I think of the work as an expression of solidarity with some of the world’s most vulnerable people. I find it inspiring to work with others who share a sense of the injustice of how global resources are distributed. It’s also wonderful as a doctor to be able to relieve suffering, though to be able to relieve it you first have to be able see it, and seeing it can be overwhelming. I’ve met doctors from rich countries who’ve told me they couldn’t cope with what they witnessed in poor countries, and didn’t want to work in those environments. For me, I remind myself that incredible suffering is taking place whether I’m witnessing it or not, so I may as well try to lend a hand.
What do you hope to achieve through your career in global health? Why is this work important?
One of my goals is to return to working in Papua New Guinea, where things are really terrible in terms of health care. When I was working there I noticed a sense of fatalism and a desire to blame the people or the culture for their health problems, but in my experience, patients sacrificed an enormous amount to receive treatment and it was possible to accomplish a lot.
What advice would you give to young global health professionals?
UGHE students come from very different backgrounds, and I can only really give advice to those who are like me and come from high-income countries. Working in global health usually involves poor job security and you may want to do unpaid work, as well, so it’s helpful to avoid debt if you can, either from study or from a mortgage. It can be socially isolating so it’s important to look after your friendships, with people who support you and who understand your drive. There are a lot of people who like to complain about how difficult the work is, and that’s not a productive discussion to be having all the time. I get a lot of strength from staying in touch with friends in Papua New Guinea, Rwanda, Peru and the Marshall Islands, who all are really passionate about improving the health of their people.
It’s also good to remember that a lot of people who would really like to do this work are unable to because of other responsibilities, or because they don’t have the skills or the opportunity, so if you want to and you can, then you probably should. It doesn’t matter if it doesn’t lead to anything else or advance your career, the point is to do the work that needs to be done. And if you do one job and find that it didn’t work out, like you didn’t agree with the values of the organization or you didn’t feel you were accomplishing anything, don’t give up. With a bit of reflection and research, you might figure out what you’re hoping to achieve and find the right way to do that.