Creativity & Curiosity


For Leana May, DO, MPH '08, creativity "is a big piece of public health." In fact, it's one of the things she loves best about her work in rural Rwanda, where she's spent the past two years helping to strengthen the country's health care delivery system as a global pediatric fellow in health service delivery, through a fellowship program run jointly by Harvard University, Boston Children's Hospital, and Partners in Health.

A pediatrician, May has partnered with policymakers and physicians in Rwanda to build capacity in general pediatrics, neonatology, and pediatric oncology in a rural district hospital in northern Rwanda and to set standards for pediatric cancer care nationwide.

Thanks to the commitment of its president and minister of health, Rwanda has made enormous strides in health care and is on target to meet most of the Millennial Development goals by 2020, May notes. But challenges persist. There are only a handful of ventilators in the country, for example, and patients from May's region who need ventilation support must travel three hours by ambulance to Kigali—"if one's available," May says. "Many kids die here when all they need is some ventilatory support. But we don't have those capabilities."

May's work requires both resilience and creativity. "In limited-resource settings you have to be creative," she says. "You don't have the financial ability to order lots of tests, or even the technology to get lab results or do the kind of testing we would do back at home. So you rely on basic skills—using your hands, interacting with patients, obtaining thorough medical histories."

But the payoff is huge. "This work is all about finding what fulfills you and what your passion is. It has been the most tremendously amazing experience."

The Lure of the "Why"

Shama Virani, PhD '14, recalls that she was a bit of nuisance as a child: "I used to drive my parents nuts when I was a kid because I always wanted to know 'why?' If I didn't understand the reasons for doing something, then I didn't want to do it."

Asking "why" isn't solely the countermove of the child jousting with her parent. Asking "why?" is also one of the central questions of both the natural and social sciences. A scientist from an early age, Virani says she "wanted to know how the world worked, the science behind it. That led to all kinds of fun science experiments at home." Her curiosity propelled her through an undergraduate education at the University of Wisconsin, where she dual-majored in neuroscience and psychology, and then to U-M SPH, where she earned a doctorate in toxicology.

As a scientist, Virani is chiefly interested in the "whys" relating to cancer. Recently, she's been characterizing breast cancer incidence trends in southern Thailand to identify vulnerable populations and areas for intervention. "Thailand is a middle-income country in an epidemiologic transition," Virani says. "As the country develops economically, people's lifestyles change in terms of diet and other risk factors for breast cancer. More women enter the workforce, they have fewer children, have children later in life, and adopt a more Western lifestyle." Economic development can change the health profile of a country. Virani found that breast cancer rates have been significantly rising for the past 20 years and will continue to do so with the current health care infrastructure, which does not incorporate mammography as a preventive measure.

Virani's parents see the link between the little girl asking "why?" and the adult using cutting-edge science to help explain some of the reasons people get cancer due to their environmental exposures. "Although they didn't always have answers to my 'whys' when I was a child," she says, "my parents continued to encourage me to find the answers so that I could one day become an advocate in global health."

—Bob Brustman