Working in Global Health: Katie Kralievits

I grew up with a close connection to Haiti. My maternal grandparents lived in Port-au-Prince for many years, and several of my family members were born there. In the late 1950s—in part due to political instability—my family fled Haiti for Miami, Florida, but continued to speak Haitian Creole and maintain close contact with their friends back in Port-au-Prince. This influence continued for decades, and I was raised to have a deep appreciation for the Haitian people and culture. I learned about Partners In Health while in graduate school and, prior to joining the organization, supported it mainly because of its work in Haiti.

As an undergraduate at the University of Notre Dame, I didn’t have a clear academic focus. I intended to major in chemistry and decided, at the mature age of 17, to pursue medical school. However, in my first two years of college, I realized I much preferred calculus and Spanish to chemistry, and switched my major to mathematics, while still considering a career in medicine.

To buttress potential medical school applications, I shadowed physicians, worked in a research lab, and conducted literature reviews for a physician in Miami, but I wasn’t invested in any one topic, nor was I particularly committed to pursuing medicine. During my senior year, I was fortunate to secure a clinical research job in Miami, but with graduation less than a month away, I was told that the position’s funding was eliminated. Plan A went out the window. While I was stressed to be jobless, I was also relieved since I knew my interests lay elsewhere.

I turned to my advisor, who suggested a Master of Science in Global Health degree at Notre Dame. After learning more about the program and the potential opportunities it offered, I applied and was admitted.

Within weeks of starting, I realized how little I knew about global health. The program provided an excellent introduction to this emerging field, while allowing me to discover career opportunities that suited my interests and strengths. Over the course of the year, I conducted a thesis research project, which culminated with two months of “field experience” in Peru. While I had traveled abroad many times before—mostly to Greece, where my father is from, and around Europe—this was the first time I’d worked and lived in a low-resource setting. And while my research project seemed elementary at the time—and even more so a few years later—it gave me the opportunity to gain work experience abroad.

The greatest benefit of the academic program was the opportunity to connect with and learn from leaders in the field, including representatives from the World Health Organization, the U.S. Centers for Disease Control, Catholic Relief Services, and others. During the semester, I met Dr. John Meara, who was then chairing the Lancet Commission on Global Surgery. He spoke about the Program in Global Surgery and Social Change at Harvard Medical School and the Lancet Commission’s goal of improving access to surgical care in low-resource settings. His research, which was heavily quantitative, was interesting to me, and I asked if I could help. Dr. Meara started sending me introductory papers on the topic, and I was assigned a small project to work on for the Commission.

I was grateful for even a chance to work for an organization I admired so much.

Finding a job in global health after graduation was next to impossible. That year, I applied to at least 30 entry- to mid-level jobs. I was finally offered a one-year research associate position with a widely-recognized Catholic international aid organization in Lusaka, Zambia. I was nervous, yet excited, and figured this would be another good opportunity to gain additional field experience.

In summer 2014, I moved to Lusaka, where I received a warm welcome from my Zambian and American colleagues alike. After a few months, however, I had accomplished very little. I quickly realized the challenges of working for a massive U.S.-based organization—each decision required half a dozen steps to receive approval from headquarters. Most importantly, I felt disconnected from the work we were doing. Patients and recipients of our services were termed “beneficiaries,” and there was minimal regard for their opinions on how we could better serve them and their communities.

Similarly, being an expat in this part of Africa was often uncomfortable. While I can’t complain about my accommodations nor about the friendships I made, unapologetic segregation in the workplace was the norm. I distinctly remember the organization’s leadership urging me to “be careful” when spending time with my Zambian friends, who were far more accomplished young professionals than me. 

During my tenure in Zambia, a catastrophe was wreaking havoc on the other side of the continent: the Ebola epidemic. Though thousands of miles away, I closely followed its development, and it was during this time that I rediscovered PIH’s work. I was impressed by its rapid response to this emergency and its prioritization of patient care. When reading the website one evening, I stumbled on the employment page and saw a posting for a research assistant. I was thrilled, as it was the only posting for which I was qualified on paper. I submitted my application that night and waited—for four months.

When I received a phone interview, I was grateful for even a chance to work for an organization I admired so much. Though a fraction of the size of my then employer, I knew PIH’s work was different. The organization seeks to provide quality health care to those living in abject poverty. Rather than reaching the most patients for the least amount of resources—a priority, I quickly learned, for many organizations—its goal is to raise the standard of services for those without access to health care.

I left Zambia a few months before my term was complete and have been working with PIH for two years. Every day I am inspired by the work being done by my colleagues in Boston and in the 10 countries where we work.

My job as a research assistant is multifaceted, and I have the privilege of working with an incredibly collaborative team. On any given day, we coordinate and support the research for Dr. Farmer’s writing commitments, from articles to op-eds to textbook chapters, and prepare materials for events, including lectures and classes. This provides me with the opportunity to learn from and work with Dr. Farmer and his academic colleagues, who are leading experts in their fields.

This role has also taught me the meaning of accompaniment, one of PIH’s core values. I often travel with Dr. Farmer and experience firsthand the complexities and daily demands of his life as a physician, professor, and public figure. Though the hours can be unpredictable, I am always in awe of Dr. Farmer’s ability to juggle dozens of commitments, while never failing to maintain constant follow-up on his patients—whether in Haiti or Rwanda or Boston—his students, and his colleagues from around the world.

I also have the chance to meet young and enthusiastic students interested in pursuing a career in global health. I often receive similar questions, and I continue to offer the same advice:

1. Do something that interests you. As an undergraduate and graduate student, I wasn’t particularly interested in going to medical school. And that’s okay. Global health is about much more than providing medical care abroad—something I didn’t understand before I pursued my master’s degree and worked in Peru and Zambia, and now with PIH. There is room for everyone interested in this work, so I encourage students to pursue their interests and direct them toward a career of serving others.
2. Get “field experience.” I say this in quotes, because the field can mean rural Africa or a marginalized neighborhood in one’s own hometown. It’s imperative to spend time understanding the experiences—and suffering—of others to better serve those in most need.
3. Aim low. This may seem like bad advice, but when I was applying for jobs as a graduate student, I was looking for opportunities for which I was totally unqualified. I often hear young (and often inexperienced) students express concern about pursuing an entry-level job, or one with administrative duties. After encouraging them to get involved in any way possible, I gently remind them that if they are committed to this work, no task is too small.

In my two years with PIH, I’ve learned just that: No task is too small. And that’s because the mission of the organization continues to motivate me every day and in every aspect of my role.