In this spotlight we talk to Yolisa Nalule ‘10 about when she first learned the term “public health,”  how a Health Grand Challenges project added a new perspective to how she saw her home country of Uganda, and how she has been combatting the spread of antibiotic resistance, and fighting infectious disease.  Her advice to current students is to travel to find out what you like and what you don’t like to doing in global health—and invest in a few statistics or epidemiology skills.

Erin: What interested you in being a part of the GHP as an undergraduate?

Yolisa: I took Medical Anthropology in my sophomore year, which I had to take for a requirement—my interest was natural science—but I had to take a class on different perspectives of looking at disease. I didn’t even know the term public health at that point and there was a whole field out there. And it was this class and Professor Biehl in a one-on-one office meeting, and he told me it sounds like you’re interested in public health—and I was like what’s that? He told me they were starting a global health certificate program—I was in one of the first cohorts—and he told me I would make a good applicant for the certificate.

I was interested in exploring health at a larger scale than from a Molecular Biology lens—which is what I majored in. The GHP opened my eyes to the different career paths that exist in healthcare beyond becoming a doctor. And [the program] introduced me to how social parts of disease are combined with infections and policy. These intersections made me look outside the box of Mol Bio and I found a new passion. It was this opportunity to work with science and not be in a lab. I even thought about changing my major, however, I also liked learning the about pathogens at a micro-level, but I also wanted to think about health on a bigger scale. And I was able to do that thanks to [Professor Bielhl] and the GHP.

Erin: What are some of your special memories from being involved with the GHP program?

Yolisa:  There are quite a number. I think my favorite the Health Grand Challenges project I did between my junior and senior year in Uganda on future of global AIDS treatment. I designed fieldwork in Uganda to investigate ARV [antiretroviral therapy] treatment failure and resistance. It was my first time conducting interviews, and I talked to doctors, NGO leaders, government leaders. I was talking to people who were actually doing this work—doctors, patients, and those making policy. So it was all of these layers of people that are involved with global AIDS treatment. It was my first field work ever. I was back home—I’m from Uganda—but I was seeing my country in a very different light. I was seeing it from different perspective, this is more than where I live. I started to ask myself, “how can I play a part in the infrastructure of care in my country and play a part in stemming this disease that has affected so many?” This was my most special memory at doing work at Princeton.

Erin: Did you go abroad any other summers while at Princeton?

Yolisa: I did another internship in Kenya, I was an intern and worked at a medical research institute in Nairobi. I had never been to Kenya. I worked in a lab looking at antibiotic resistant pneumococcal vaccine—this data contributed to my senior thesis. They were introducing vaccine to children and it was a wide spectrum vaccine that was supposed that was supposed to help children getting infection but there was some resistance. I worked with Professor Ramanan Laxminarayan (link is external), an economist, he eventually became my boss after I graduated.

Erin: Can you tell me what you’ve been up to since graduation?  

Yolisa: I graduated 2010, I had a job offer to continue my work on antibiotic resistance in Center for Disease Dynamics Economics and Policy (link is external), that was founded by Professor Laxminarayan. I was a health research analyst and I worked on three different research areas. One was understanding and combatting global antibiotic resistance. We had partnerships with five countries and worked to develop country specific policies. I also worked on Affordable Medicine Facility malaria (link is external) a financing mechanism that aimed to expand the supply of ACTs [artemisinin-based combination therapy] for treating malaria. And I worked on a project of extending the cure which focused on combatting antibiotic resistance in the US.
 

I moved to London to do MSc in Control of Infectious Disease at the London School of Hygiene & Tropical Medicine (link is external). After finishing my masters, I got a job working with the Schistosomiasis Control Initiative (link is external) at Imperial College London (link is external) in the department of infectious disease; I've been here for four years! I worked as a Programme Manager for the first three years with Uganda, Tanzania and Zambia. We worked with the Ministries of Health (MOH) to develop policies and strategies and programs to treat and prevent schistosomiasis and deworm and prevent helminth infections. We work to support the MOH in terms of surveillance, financial management, monitoring and evaluation, research, advocacy, and fundraising etc. Recently, I shifted roles and I am a program advisor to Nigeria. We are working on the same challenges in Nigeria but because of the scale of the country, I’m currently just focusing on one country instead of three. We work with Sight Savers International (link is external)and the MOH to implement national programs to eliminate infections that affect school age children.

Erin: What sort of skills—hard or soft—that you gained through the GHP have translated to your life after college?
 

Yolisa: I would say mostly soft skills and perspective. A lot of the programs that I’ve been a part of since graduation the work has been very technical, and when you look at spreadsheets and data and meet with administrators, there is the risk of the people you are trying to help turning into numbers or statistics. And while my interest is in numbers and the natural sciences, it's critical to remember the people you work with every day are more than numbers and figures. In GHP I was forced to continually think about the humanity behind patient and populations—they are not just subjects that you do your statistics on. I can see how easy it would be to do that in my work because you want to get the job done, but I think the GHP coursework has stayed with me because I continue to think about humanity, cultures, people etc. even as I weigh treatment costs and value for money metrics.

I also have the opportunity to work with people across different cultures and countries, and learning to listen and interpret what they need and adapt that to how you can do your job better is a critical skill. I think this helps how I can re-lay not only in how a child gets their medicine but how to talk with people in the MOH because you learn to speak in their language. And they see you not as donor or scientists but as a person that wants to understand all of them and not just the them in the context of a patient or a number. And that was the GHP that helped me, even in my masters that's not something we touched very much. Particularly Medical Anthropology, Global Epidemiology and Diseases in Children, these courses have stayed with me and been very influential in work I’ve done and how I relate to people I work with.

Erin: What do you love about your work now? Is there anything you don’t like as much about what you do?

Yolisa: Selfishly, it makes me feel good that I’m doing good. I work with policy makers and I can see tangible changes in policy from the work that I do, and with the people that are affected by changes in policy. I am giving back to people where I come from and to my continent in general. At the end of the day, I feel like I am making a change and it's impacting people in need and people who are often invisible to those in power and whose voices aren’t heard and I’m using my skill to help them.
 

What I miss in my current job is that I don’t do as much research. I do still love finding out new things and being involved in answering questions that require clinical trials and filling in gaps that need to be filled in by creating evidence. Unfortunately with field implementation, most of the things you are doing are things that have been proven but you are not necessarily making remarkable change. To make remarkable change, as researchers, we need to write 100 papers and then people will sign onto it if it gets past through the WHO [World Health Organisation]. However, I miss being part of the new research.

Erin: I know it’s only a few years out of school, but are you headed in the direction you expected?
 

Yolisa: Yes! Currently, I’m thinking about changing a bit and entering into disease related issues affecting women—moving on from Neglected Tropical Diseases affecting children and focusing on women. I’ve seen that as much as there has been a global push to to focus on women, there is still a huge gap, especially in areas beyond reproductive health. There is a gap in terms of looking at the everyday woman—not just adolescent, pregnant and/or breast feeding women —and the infections/diseases that they are susceptible to—but the women who are just living out their lives and at risk of disease/infection due to being the victims of a patriarchal society and world. It’s something I can personally relate to as well and empathize with as I’ve become a mother and wife.

Erin: Any thoughts, advice, words of wisdom for current GHP students?
 

Yolisa: Travel for sure. Travel even if it's a summer, I wasn’t as lucky some people take a semester or a year abroad, but just the few months I spent in other countries opened my eyes to things I liked and also opened my eyes to things I definitely didn’t want to do! Also, consider which skills that you want obtain to obtain at Princeton. In addition to the critical thinking skills that you get in many of the GHP program courses, it's also important to get some of the technical skills especially for those who major in social sciences and humanities but want to have a career in global health. It’s worthwhile to get basic epidemiology, statistics,  or monitoring and evaluation skills and experience. This is a tangible thing that employers can understand that will put people further than understanding nuances of policy world and culture alone. Even if you hate math, invest and learn a few analytic skills, it will give you an advantage and make you more effective in the field.