I do a lot of curriculum development for both global health programs and oral health programs so that we can marry these two fields. I’m a faculty member right now at the Harvard School of Dental Medicine. I teach our dental students about global health – what it is, and what the role is that dentists need to be playing in global health. I also write curricula for the college here, as well as general competency recommendations for what non-dentists should know about oral health.
My other major project is with the Clinton Health Access Initiative in Rwanda. The Ministry of Health of Rwanda has decided to do a major health reform by way of health education. They are going to scale up the quantity and quality of health care workers across their nation as a means to improve the health of Rwanda. Oral health was not part of the original plan, but our oral health team went in, did our spiel, and now it is. We are currently building the first dental school in Rwanda, which will open in August of 2013. I’m assisting with writing the curriculum for the new dental school. We’re hoping to do a lot of integrated training of nurses, physicians, and dentists on some of the horizontal factors for health and then start phasing in more vertical, technical, skill training that is specific to dentistry.
The most common thing to do after dental school is to go into a practice and work there. Private practice was never my first love, but as a dentist I wasn’t really sure what else there was to do, which is something I’m working on for my own students. I was very passionate about disparities and needs, but I just didn’t have the training to understand it. I started volunteering with migrant populations, and realized that certain populations had much more substantial needs than the inner city populations that I would work with in inner city Denver. That led me to start doing volunteering outside of the U.S. in communities with no dentists or fluoride.
I really started to see that my one or two week a year volunteer missions were never going to even touch the amount of need that was out there. So over the process of four years, I decided I wanted a career change. I trained a dentist for a year to take over and buy my practice from me, and I moved to Boston. I got a Masters in Public Health with a concentration in Global Health from the Harvard School of Public Health, and then somehow managed to convince the School of Dental Medicine to keep me on as faculty (said jokingly). So that is the very quick version, but it took me about four years to transition from a once-a-year volunteer mission trip to a full-fledged career in global health.
As I transitioned out of clinical care and private practice, I decided to look at how to marry the fields of global health and oral health. I went back and studied global health, and I specifically chose a program that didn’t have many dentists in it, because I wanted to see what global health was, who the players were, and where I could fit in. I asked, how can I inject what I know and find a role for myself and my profession in global health?
I think my approach is productive. I could have launched a campaign, fundraised, advocated, or lobbied for oral health programs, but that approach essentially makes it a competition. I mean, we’re competing against the big players like HIV/AIDS. I can’t ever say cavities should be prioritized over HIV/AIDS or over diabetes. Joining forces and figuring out what my role can be in the ongoing global health effort, I feel like will lead to success for everybody. It will kind of eliminate that competition for resources, because honestly we’re never going to win if we take that approach. And health shouldn’t be about winning.
As far as the downside, right now, it’s a challenge because there are not a lot of mentors for me in global oral health. I’m finding strong mentors in dentistry and strong mentors in global health, but there are very few, if any here, who are strong in both. So I try to find a balance of mentors, draw from their strengths, and kind of create my own individual pathway.
People have said what we’re doing is pioneering. And I guess so, but that seems like such a big word. It’s really had for me to be like, “I’m pioneering,” because that just feels like a big responsibility. I think the marrying of global health and oral health is catching on more rapidly in the dental community than in the global health community, but that’s okay. As more and more of our profession is aware and making these efforts, we can continue to penetrate global health better.
I tell students who want to get into global oral health that right now what’s needed is leadership and innovation because it’s a blank slate. Everything is needed, all the way from individual patient care, to pharmaceutical research, to training of dentists, to training of non-dentists. You’ve got to be ready to be a leader, and you’ve got to be innovative and come up with some ideas to start carrying forward.