The Leopold Schepp Foundation

Founded in 1925

THE REALITIES OF WORKING IN INTERNATIONAL HEALTHCARE

Rob Patterson, Senior International Public Health Consultant

Rob Patterson, Senior International Public Health Consultant

“I get paid to go around to different countries to improve their healthcare systems.” I think that sentence is why I’ve had a tough time sitting down to write this article. If I write about what I do, well then maybe my good fortune [thus far] will change for the worst! Karma, or something like that will get me. Not many folks do what I do, and it’s quite unusual actually.

I work as a Senior International Public Health Consultant and have been self-employed for most of my life. I’ve always been interested in international affairs—what makes people tick, how are they different and what can we learn from each other? I started on my international path in 3rd grade with my first studies of the French language
and culture. I stuck with it all the way through elementary and high school (head of the International Relations Committee), university, and beyond, never imagining that being able to speak, read, and write would help me. Fluency in a foreign language has become an important component of a professional bag of assets, as it will be on my next trip to French-speaking Africa.

Early on, I knew I wanted to work in healthcare, international healthcare, probably as a doctor. So I studied, did the pre-med track in college, took the MCAT, and then looked at grad schools. By the time I got to senior year in college, however, I wondered whether being a practitioner of medicine was the way to go. Was there something more macro, a bigger/broader way to engage in healthcare? Public Health wasn’t as well known 20 years ago as it is today, so I had to dig a bit to find out about it. I found a public health program at John Hopkins University (JHU) where I completed a dual master’s degree program as a Schepp scholar. The Master’s in International Health Systems is from the JHU Bloomberg School of Public Health, while the other Master’s is in African Studies
and International Relations/Economics from the Paul S. Nitze School of Advanced
International Studies (SAIS). It made sense to learn about not just international health
issues, but also the politics and economics surrounding healthcare delivery and health
status on the ground. Those degrees gave me the academic foundation upon which to build professional experience leading me to my current role as a senior technical
consultant to international health and development entities including the World Bank,
UNICEF, and private-sector firms often contracted by the US Agency for International
Development. I’ve provided public health management guidance/recommendations
to national HIV/AIDS programs in countries in the Caribbean, Africa, Eastern Europe,
and Asia. I also consult on entire healthcare systems, such as during my recent
month-long work in Nigeria.

I’ve been to many places, even Kazakhstan! As I write this article, I’ve slept in my
home bed for just one night in the past two months, and I’m still not home yet. The
work and travel are fascinating, but far from easy. The client may help with the flights,
hotels, and some logistics, but I still need some independence and resourcefulness to
get to where I need to be and then to get the work done. Days and nights can be spent
alone. It’s not work for everybody, but folks comfortable being alone and interested
in quickly making new acquaintances may love my job. There are many new sights,
successes and challenges – professional, personal, and gastronomical. It really is my
dream job, despite having to constantly navigate the hiring and funding vagaries of
international health as a sole proprietor.

Anyone looking to do the sort of work I’ve been describing needs at least the following
to get started as a professional: a relevant graduate degree, experience working in a
developing country (often for at least two years), and command of a foreign language.
Then it surely will also help to know some professionals in the business and have a
dose of good luck and timing. Even with all that, be prepared to start off at a junior
level until you get some seasoning.

Many US citizens want to work in international public health, but it’s not easy
breaking into the field. Newly minted graduates, as well as seasoned professionals,
need to know that they will be competing in a global marketplace for a very limited
number of positions. Many positions outside of the US will be filled by nationals of
the countries in which the development programs will be implemented. Why hire
someone from Kansas to work in Djibouti when one can train and hire staff born and
raised in Djibouti? Expats may be needed for short-term technical consultations and

overall long-term project supervision usually based in the US, but generally not for
long-term, in-country employment. People studying and working toward a career in
international development need to accept these realities. It’s a long haul to get there,
and once there, the work can be intellectually and physically demanding. However,
curious, flexible people ready to work behind the scenes for positive change may enjoy
international health development work, and do well with a bit of luck and persistence.
As you push forward in your studies and career paths, experiment, take risks, and
enjoy life and what you do. Good luck!

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