8/23 Pre-departure Thoughts: Reflecting and Looking Forward - Michael Dykstra

Global Health Delivery Intensive Graduation

In July 2018, I had the honor of being part of the Global Health Delivery Intensive at the Harvard School of Public Health. We had mid-career professionals from all over the world (26 countries represented), and I learned so much from them. These are photos I took (except those I'm in) at our graduation! 

Even though I’ve been thinking about this journey to Botswana for 16 months already, since I first found the project I’ll be helping with, it still feels surreal that I’m leaving in a few days for 9 months time. I’m leaving all the friends I’ve known (except a couple I made in direct preparation for this trip), my family, my girlfriend, familiar foods, and all other comforts for a new place. This process of leaving has made me want to reflect on my past, my present, and my future, and how each will interact with this experience.

THE PAST

How did I get here? In my mind, this journey began in 6th grade. I was overweight, had very low self-confidence, and was generally dissatisfied with life at the time. I wasn’t popular at church or school and felt like an outsider at both. Once I changed churches and felt accepted myself, I learned that contrary to my prior belief, it seemed that Jesus actually cared for the outsiders in his society. I resolved to seek out people who felt out of place like I had, so that at least they would have one friend.

In high school I met my good friend Nay. He was a refugee from Myanmar, and he introduced me to the expansive world beyond the perspective I could easily see from within my small hometown in rural Michigan. He was also somewhat of an outsider in a small town without much foreign influence. My time with him drove me to want to travel outside the US and to interact more with people different than me. 

I became fairly heavily involved with the international student community during college, but it was really my study abroad which solidified my passions for global health. In Peru, I learned what it’s like to be alone in a country where your understanding of the primary language is insufficient for deep conversations (though it improved substantially!). While certainly different in many ways, it still gave me a glimpse into the individual experience of someone trying to navigate the US with minimal English. I wanted to support them better, since they too were outsiders. Shortly thereafter I went to Guatemala where I learned the importance of caring for people in their first language and the nature of systemic oppression, particularly of the indigenous Mayan people. In the past they were fined in public schools for speaking their first language and forced to speak Spanish, which they may have never spoken before. They were victims of a US-backed genocide in the 1970s-80s. The list goes on. Once I came to understand the ways systems can marginalize groups of people who I cared about, I resolved that I wanted my life to stand in opposition to those systems and lead to improvement in the lives of the world’s most marginalized. I thought the best way to do that was through an MD/PhD, where I could use my technical and research background to develop practical solutions for global health problems, then the MD for implementation.

Since life is full of surprises, I ended up going to Harvard Medical School to get my MD without a PhD attached due to the strength of their global health community and resources. The start of medical school has been fairly structured with no extended time off to travel, so I have not had the chance to travel until now. I’ve continued to be inspired by the work of my classmates, including several all-stars who worked extensively with Paul Farmer and Partners in Health, and it only strengthened my resolve that I needed to go. Last April I first learned about this project, implementing a clinical validation trial for a new mobile diagnostic device for lymphoma (cancer of the lymph nodes), and it seemed like a perfect fit. Implementation science has become a central part of my global health goals. After all, technological development is essential and intellectually stimulating, but implementation ensures or prevents widespread usage of new technologies, and implementation guarantees or precludes the marginalized from reaping their benefits.

PRESENT:

In July, I had the privilege to be a part of the Global Health Delivery Intensive at the Harvard School of Public Health (pictured above), and it was an incredible experience. Our cohort was 56 people from 26 countries. Most of them were mid-careers, so they already had extensive experience to share with those of us not as far in training. I took away practical skills in management, working through cases, and biostats/epidemiology, but what I will remember most is the relationships I formed with my classmates. I hope they will stay with me for many years to come, and I also hope to visit some of them! I’m feeling energized to go and work in the global health space.

Now that I’m moved out of Boston, this is all feeling bittersweet. As I transition out of this phase of my life, I have to say I’m feeling full. I will deeply miss the friends I’m leaving behind, but I am grateful that I have them in my life. It started to hit at my “See you later” party in Boston, which will be the last time I see many of my friends until I return (unless they visit, which they should!). I will miss out on all the memories of their 4th year if they’re going straight through. Even if they too are taking a research year, most will still be based in Boston, so they can maintain consistency and friendships in a way I can’t be a part of.

None of this is to say I have any regrets or second thoughts about taking this research year in Botswana. I don’t. I will grow personally from the discomfort that arises from being in a new and different place. I can’t wait to take pictures there and share them with you through stories on this blog. I am beyond excited about what this year will hold and how it will prepare me to make the impact I desire long term.

FUTURE:

What will this year be like? Will I make lasting friendships? Will I be able to capture star trails above a silhouette of a sleeping elephant (maybe unrealistic, but I can dream)? What experiences will I have and how will they shape me? How will this impact my future? How will I balance a career promoting global health equity with demands on me in the US long term? Will I continue working in Africa or will I return to Latin America, where I already can speak the language? What opportunities may come my way through this program? I don’t know yet, but I’m excited to dive in and share it with you here on my photo blog :)

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