Gregg Greenough was working as a junior high school English teacher when he decided to apply to medical school. He pictured himself working as a doctor serving low-income communities. "I had an affinity for disadvantaged populations," says Greenough, who is now the director of research at the Harvard Humanitarian Initiative. He got his medical degree from Case Western Reserve University School of Medicine, completed his residency in emergency medicine, and then earned a master's in public health (M.P.H.) at John Hopkins University.
"The most important thing for people who want to get into this kind of work is going out and getting your hands dirty." --Gregg Greenough
Photo (top): A team from Médecins Sans Frontières, led by engineer Kathy Dedieu, installed this water pump in a village in Sudan.
Along the way, his interest in disadvantaged populations crystallized into a desire to support humanitarian relief efforts abroad. Shortly after completing his medical degree and M.P.H., he signed up with the International Medical Corps for a stint in Albania during the Kosovar refugee crisis. A few years later, in 2002, CARE International sent him to the Palestinian territories during the second intifada. There, he put his M.P.H. to work: He ran two USAID-funded surveys that looked at nutrition and food security throughout the territories. "The concern was that the shutdown of the cities was creating food insecurity and perhaps acute malnutrition," he explains.
His surveys found that to be true, and the data Greenough collected was among the factors that inspired change: The Israeli government released Palestinian tax receipts and allowed more Palestinians to go back to work, and many of the large nongovernmental organizations (NGOs) changed the ways they delivered food in the region, Greenough says. The experience convinced Greenough that "a well-done study in a population affected by conflict really could make a difference." It was, he says, "an eye-opening experience."
For scientists willing to work in high-risk settings, there are many opportunities to do humanitarian work. Many NGOs and United Nations agencies need researchers who can lead surveys in regions experiencing natural disasters or wars, and organizations that provide aid stress that they often need experts to run single projects. Some researchers find ways to volunteer part-time, providing support for efforts overseas without leaving their desks.
Kathy Dedieu and a team load up donkeys with satchels of vaccines to deliver to Ethiopian villages as part of a vaccination campaign.
"I had no idea Doctors Without Borders needed engineers," says Kathy Dedieu, a water and sanitation engineer, who was working in Hong Kong for Boston-based engineering company Camp Dresser & McKee when she went to a fundraiser for the group. There, she learned that her skills could be valuable to the organization, commonly referred to by its name in French, Médecins Sans Frontières (MSF). She asked her employer for a leave of absence so that she could join an MSF mission. "I thought my first assignment would be in Africa drilling wells," she says.
To her surprise, MSF sent her to China to assist with a project combating the SARS epidemic. There, Dedieu trained hospital staff in anticontamination procedures. "I know how to [put on and take] off protective clothing and how to get in and out of hazardous waste sites without taking any of the contamination with me. It turns out that translates nicely to infectious disease work," she explains.
Her second mission drew on her training in a more direct way. She dug wells and set up systems to deal with sewage and medical waste in Liberia and Sudan. "When I came back from south Sudan, I knew international humanitarian work really suited me," she says, so she signed on full-time with MSF. After several more field missions, she's now leading recruitment seminars in the United States, but she plans to return to the field.
A medical technologist with a bachelor's degree in biochemistry, Karen Poster-Verrill had worked as a laboratory manager in Michigan while raising her children, but she'd always hoped to work abroad on humanitarian projects when they got older. When the time came, she applied to MSF to put her technical skills to use in a humanitarian context.
Many of the skills Poster-Verrill used at her job have translated to humanitarian work. Her first assignment with MSF was to manage a multidrug-resistant tuberculosis (MDR TB) laboratory in Nukus, Uzbekistan. She did not have experience with MDR TB, but she was trained to deal with biosafety level 2 and 3 materials--important skills in a TB lab. MSF provided 2 weeks of training on the specifics of TB before sending her to Uzbekistan.
Karen Poster-Verrill (right) and a lab technician work in a culture lab in Homa Bay, Kenya, Poster-Verrill's latest assignment with MSF.
At first, the assignment was a challenge: It was a Russian-speaking mission, and she had to use a translator to talk to her employees. There were logistical challenges she had never encountered in the United States, such as inconstant heat and electricity. In the end, the arrangement was a success: In addition to supporting patient treatment, she helped MSF launch a study, funded by the U.S. Centers for Disease Control and Prevention and the Foundation for Innovative New Diagnostics, which brought expensive diagnostic equipment to the laboratory, reducing the time it took to diagnose an MDR TB patient from 8 weeks to 10 days.
She grew close to her colleagues. "They were always inviting me to come to their families, to come to their celebrations," she recalls. She had signed on for a 9-month tour but extended it to stay an additional 5 months.
MSF requires applicants to have traveled internationally before they will be considered for a position overseas, and others echo the value of international experience for scientists who want to work in remote or risky settings.
That kind of work isn't for everyone, and some employers look for the kinds of skills needed to thrive in such settings. "Difficult decisions have to be made on the spot," Alessandro Colombo, director of health systems for the International Rescue Committee, said at a conference at the Centre for Research on the Epidemiology of Disasters in Brussels last October, discussing surveys he'd led in Darfur. "In addition to field experience and public health expertise, [researchers] need negotiating skills. Sensitivity to context and political analysis are required to mitigate risks. There are few people with these characteristics who are willing to work in these areas."
"The most important thing for people who want to get into this kind of work is going out and getting your hands dirty," says Greenough. "Understanding the players, the politics, working with local politicians--I think you can only glean that from working in the field." Greenough adds that physicians interested in a career in humanitarian relief should strongly consider training in public health or epidemiology, noting that an M.P.H. degree is almost a "union card" for that kind of work.
The public sector also offers opportunities for humanitarian work. At the U.S. Department of State, a small group called the Humanitarian Information Unit (HIU)in the Bureau of Intelligence and Research includes public health researchers and geospatial experts. In some cases, HIU staff travel to disaster regions; analysts working in Washington, D.C., also create unclassified maps and reports that other agencies can use to respond to disasters, such as the recent flooding in southwestern Africa and last May's earthquake in China.
"One of the problems with humanitarian relief is you don't have people monitoring effectiveness as much as you should," says Lee Schwartz, director of the Office of the Geographer and Global Issues, which oversees HIU. "You don't have structural engineers checking buildings ... [or] people ... monitoring the appropriate nutrition of food packages." He's trying to change that--and that means opportunities for scientists and engineers in an office that has traditionally hired people with degrees in international relations.
"My objective is to change the entire profile of my office so that I hire people with technical specialties," Schwartz says. "I can have my choice of 15 very bright master's in international relations students with experience working overseas and two languages and a strong background in public service, but I can't find a hydrologist who's worked in disaster response, and if I found one, I'd hire them in a second."
Shoreh Elhami (left) teaches two staff members from the Afghanistan Information Management Services how to use a GIS software program called ArcView.
Some scientists find ways to contribute to humanitarian efforts in their spare time. Shoreh Elhami, the geographic information systems (GIS) director for Delaware County in Ohio, is the co-founder of GISCorps, a group that connects geospatial analysts to humanitarian and educational projects that require their expertise. Volunteers donate their time, and the group requesting their assistance covers the volunteers' expenses.
"The whole idea of doing worthwhile work outside of what pays your bills, it gets my heart pumping every day," Elhami says. More and more groups are recognizing the need for geospatial analysis and documentation. GISCorps has provided volunteers to several U.N. agencies and many international nonprofits, says Elhami, who helped launch the group by volunteering her own services for a training effort hosted by the U.N. Office of Coordination of Humanitarian Affairs in Kabul in 2005. Recently, the group sent a volunteer to Thailand to train staff from two nonprofit groups from Burma in the use of GIS software so that they can map human-rights abuses and document the migration of displaced people in their own country.
Even those who aren't available for overseas travel can help. Elhami gets requests for work that volunteers can do at their own computers. In response to the cyclone that hit Burma last May and at the request of the U.N. Operational Satellite Applications Program, GISCorps assembled a team of 31 researchers in five countries who worked together remotely to analyze satellite imagery for data on sites that had been damaged by the disaster. The project helped relief workers respond more quickly on the ground.
Elhami encourages those with full-time jobs, and even students, to consider the value of volunteering. Some requests to GISCorps require analysts with considerable experience, but others can be performed by recent graduates. "If someone can do this a few hours per month, it will bring so much back to them," she says.
Author identification: Robin Mejia is a science writer in Santa Cruz, California.