APHL Global Health: My Touchstone

by David Mills, PhD, Director, Scientific Laboratory Division, NM Department of Health

It all began with a late afternoon phone call from my boss, asking if I had any interest in volunteering my time on an APHL project to help public health laboratories in Central America recover from the devastation of Hurricane Mitch. “Sure,” I casually replied, not realizing that my answer was launching me on a journey that, over the next 14 years, would take me to 17 countries on four continents and provide me with some of the most meaningful and rewarding experiences of my professional life.

Looking back, I have to say that I have thoroughly enjoyed the ride. Much of the satisfaction and enjoyment my experiences with the APHL Global Health Program have provided are what I might have anticipated when I first got involved. Philosophically, I had always been a proponent of international assistance and a fan of engineer and inventor, R. Buckminster Fuller, who described the planet as a boat and pointed out the fallacy of the notion that people living in the starboard side of the boat could allow the port-side to sink “without getting their own feet wet, let alone being drowned.” So, international work appealed to me on that level.

In addition, I have always enjoyed travelling and experiencing different cultures, and my work with the APHL Global Health Program has certainly provided that. And then there was the opportunity for adventures; finding time, after the official work of APHL was finished, to squeeze a day or two for personal activities before returning home, e.g. a safari in Tanzania or a visit to the Forbidden City in China. Other “excitements” were smaller, serendipitous and, perhaps because of that, even more memorable. I will always remember stepping off a small plane near Mt. Kilimanjaro at sunset, catching my first intoxicating whiff of dry grass and faint smoke and being told, “You will never forget that; it is the smell of Africa,” or eating breakfast at sunrise on the edge of a Namibian water hole and spying a troupe of baboons, with babies on their backs, moving through the brush on the far side. Nor will I forget an initially staid and formal evening dinner in a Ukrainian garden that (d)evolved into a boisterous evening of singing, toasting (vodka…) and laughing with new friends after the electricity failed and the gathering continued long into the night by candlelight.

Teaching has also always brought me a great deal of satisfaction—I was a university professor before switching to a public health career—so developing courses and providing training to laboratory professionals for APHL has been extremely enjoyable. I have had the good fortune to be able to share the lessons of my professional experiences (successes and failures) with colleagues in other countries and also to learn from theirs.

But what I never could have anticipated so many years ago and what, more than anything, has kept me coming back again and again to volunteer are the inspiration and humility that that I experience on every single project for Global Health. My day job is terrific—as director of a state public health laboratory, I go to work every day in a new multi-million dollar facility equipped with millions of dollars of analytical instrumentation (and a staff engineer to maintain it) and sophisticated engineering safety systems. Our laboratory is supported by a central team that responds immediately to IT issues, and a courier system that delivers specimens overnight. We have access to federal laboratories for specialty testing and technical support and a national organization, APHL, which provides training and professional support. And yet, with all of these resources, I find that much of my time is spent focusing what is perceived as lacking—budget, staff, competitive salaries, flexible work schedules, new instrumentation, software and so on. These challenges, difficult and ubiquitous, are the reality of management in public health. Over time, however, immersion in these details day after day can make the excitement over the greater purpose of the mission and the people we serve fade and seem very far away, and it is this that keeps me coming back to volunteer.

To periodically leave my day job and travel to a place where smart and talented professionals pursue the mission of the public health laboratory, performing testing similar to that in our own laboratories, but under very difficult conditions, is inspiring. What do I mean by difficult? Difficult is a laboratory performing serology testing when it has electricity irregularly for only 2-4 hours per day. Difficult is washing and reusing latex gloves because of their scarcity. Difficult is performing microscopy in a room with high water stains on the walls a meter off the floor and all of the refrigerators on blocks to keep them above the periodic floodwaters. Difficult is not having a single repair technician in the country to service analytical instruments. Despite these incredible challenges, the people I have worked with in country are enthused, dedicated and optimistic about the work they perform and its importance. Seeing how much they accomplish under these circumstances, I often have thought to myself, “If these people had even half of the resources and support that I have in my laboratory, they would leave me in their dust!”

Quite simply, the international projects are my touchstone. They remind me how fortunate we are, and they re-energize me and rekindle my enthusiasm for my career as a scientist in public service… and after each experience, I return to my laboratory able to do my job better than before I left. Without a doubt, I gave my boss the right answer.