International Day of Women and Girls in Science: Taking on Public Health Challenges at Home and Abroad
International Day of Women and Girls in Science gives us an opportunity to celebrate the achievements of women and girls in our community in science-related fields. This year, we spoke with two MISTI-India alumni about how their passion for science and experiences in India have inspired them to tackle pressing global health challenges.
Shriya Srinivasan
Postdoctoral Researcher at MIT Langer/Traverso Labs
MIT PhD in Biomedical/Medical Engineering ‘20
Tell us about your MISTI experience. What lessons and connections made during your MIT-India/India experience have you been able to implement in your work here in the U.S.?
I traveled to Rise Legs, a prosthetics clinic in Bangalore, India to help implement a new design we’d worked on through MIT D-Labs that connected prosthetic sockets to custom prostheses. Working with engineers, clinicians, and patients during this trip gave me a broad perspective on the various challenges that impede progress in innovation and access to new technologies in these settings. However, seeing firsthand the impact we can have through medical innovations on the lives of patients motivates me to continue to work on global health projects like these.
How has your engineering background contributed to your interest in solving complex problems in the public health sector?
Engineering is a discipline that constantly drives one to seek greater utility, greater efficacy, and reduce the burdens of daily life. The medical field lags behind the technological state of art by at least a decade. As such, viewing the medical field through an engineering lens is a fascinating experience. While observing hospital procedures, using medical technology, or speaking with patients about their conditions, ideas for solutions always come to mind. Most often, I think of a tool or device utilized in one setting that could be easily engineered to solve a challenge in the healthcare field. Other times, it's the application of a basic scientific finding/technique to a healthcare challenge. In either case, the application of engineering principles and design philosophy to healthcare challenges has been a rewarding pursuit for me.
Where do you see opportunities for India to contribute to conversations in global health priorities?
As the second most populous nation, India has built systems that can handle high case volumes, roll out public health measures, and address some key issues cost-effectively. Sharing their strategies would benefit the global conversation, especially with respect to public health issues. Given the diversity in socioeconomic status, age, and cultural factors, which are often juxtaposed geographically and temporally, Indian healthcare professionals are exposed to a great breadth of issues faced by each sector. Communicating the pressing needs of each stratum and contributing their experience in terms of what types of programs succeed or fail with a given segment of the population would bring value to determining and solving global health priorities.
Zahra Kanji
MIT M.S. Candidate in Integrated Design Management (IDM), Engineering/Industrial Management
Harvard Master of Public Health ‘17
MIT B.S. Electrical Engineering
Tell us about your MISTI experience. What lessons and connections made during your MIT-India/India experience have you been able to implement in your work here in the U.S.?
Last IAP (2020), I traveled to Nepal to work on manufacturing an affordable water test. From there I went to India to run a new program we started to teach and inspire how we might use our engineering training towards making improvement in social issues.
How has your engineering background contributed to your interest in solving complex problems in the public health sector?
Engineering was an integral component in the creation of the field of public health. They were closely aligned for years and designed to be a distinct discipline from clinical medicine. MIT was actually one of the key partners in this creation. In the early 1900s, MIT-Harvard joined forces to tackle adverse health effects stemming from water contamination issues and the epidemic in the Boston area. MIT brought the ‘boots-on-the-ground’ approach, water and sanitation engineering while Harvard worked on emerging principles of epidemiology. They set up the first professional public health training program in the US. It was a pivotal collaboration that was driven by this key public benefit externality that was able to finally align MIT and Harvard.
Sadly, the partnership did not last. Harvard was approached by Rockefeller and his wealth to create a new vision for public health. Together, with the London school of Tropical Medicine, and Johns Hopkins, they set the course for the future of the field to be connected to clinical medicine and the American Medical Association, and not include engineering or even (much) epidemiology in it.
I learned about this history when I was a student at Harvard School of Public Health. I was an undergrad at MIT before and loved working on low-tech MedTech devices that could scale and had large systemic impact in public health. I thought I had found my career calling but at HSPH I realized painfully that the field had severed from engineering principles 100 years ago.
Health is dependent on a complex interplay among an array of genetic, environmental, and lifestyle factors. As a result, public health is built on expertise and skills from many areas, including biology, environmental and earth science, sociology, psychology, government, medicine, statistics, communication, and many others. This complexity makes it difficult to understand exactly what public health is and what it does. In non-pandemic times, and in more developed countries, public health operated at a very high efficiency so that we don't see all effects in the general population and we may take for granted all the expertise and hard work that is required to ensure the health and safety of a community.
Public health is very much a systematic field. Systems that play into the determinants of health and cause of disease and the effectiveness of prevention and treatment. Public health is about interventions that prevent disease from occurring and both prolongs life and improves the quality of life. In essence, public health is the absence of disease, the epidemic that didn't happen, the outbreak of foodborne illness that never occurred, the children that did not develop asthma because we changed the societal health determinants. Public health, when operating well, is the disaster that didn't happen and we don't see.
Identify the problem, find the root source of the problem, test interventions/solutions to prevent or control the problem and then assess the effectiveness. Sound familiar? To me, this is exactly what I learned in my engineering classes MIT.
I am personally very interested in bringing public health back to MIT and re-infusing the field with core engineering principles. Perhaps I am “old school” and 100 years too late. With this pandemic we have come full circle and have the opportunity now to bring back together public health and engineering. There are new challenges ahead and I know that MIT can help educate and prepare for these challenges for our modern world.
Where do you see opportunities for India to contribute to conversations in global health priorities?
Public health has always been, and remains, an interdisciplinary field. The global context is always evolving and we need strong systematic principles to help us navigate and not be thrown off our health with every change. The Industrial Revolution brought an explosion of development. There were new jobs (particularly in the cities), new goods, and increased trade. Expansion of the population and mass migration caused explosive growth of cities. Poor workers were often housed in cramped, grossly inadequate quarters. Working conditions were difficult and exposed employees to many risks and dangers, including cramped work areas with poor ventilation, trauma from machinery, toxic exposures to heavy metals, dust, and solvents. We did not figure out the health effects until long after because we did not have a good public health system in place watching for the changes. Consequently, progress brought a whole new set of health problems that were widespread in Europe and in America.
Now that I am back at MIT as a graduate student, I wanted to use my time to figure out how to work on using engineering for public health and other societal benefits. MISTI-India has been instrumental in allowing me to test out different ways I can do this.
India in particular is a fantastic country to work in and try to understand. As a rising global power, India offers an astounding variety in virtually every aspect of social life. Diversities of ethnic, linguistic, regional, economic, religious, class, and caste groups crosscut Indian society, which is also further divided by differences between northern India and southern India. Yet, amid the complexities of Indian life, widely accepted cultural themes enhance social harmony and order. India will have a lot more of an impact in the future and their way of being with the chaos and complexities without linearizing them might be the key to unlocking how we solve some of our complex societal problems.