Working in global health requires flexibility: Cindi Snider

By Saumya Ayyagari (’11)

December 1, 2009 — When Cindi Snider headed off to Thailand to spend a year working as an infectious disease and public health preparedness advisor, little did she know that her greatest assets would be flexibility and an open mind.

Snider, who is a PhD student in infectious disease epidemiology in the Gillings School of Global Public Health, spent the 2008-2009 academic year in Chiang Mai, Thailand, working on avian influenza H5N1 (“bird flu”) and malaria. Specifically, she was working with the Kenan Institute Asia’s public health program (PHP), which is focused on strengthening public health capacity in the region.

Snider (right) at a malaria post in Thailand

In partnership with the health ministries of countries in the Greater Mekong Subregion—Thailand, Cambodia, Vietnam, and Lao People’s Democratic Republic—the PHP emphasizes a diplomatic approach to health, building cross-border collaboration on crucial public health problems. “I met a great number of individuals who are trying to make a difference. . .with the limited resources that they have,” Snider said.

As Snider came to discover, doing a lot with very little requires a certain amount of creativity and flexibility. Often people from Western countries assume that other countries should have programs and procedures similar to their own, Snider said. Her biggest take-away from the experience is the knowledge that there is no one right approach anything. “Being adaptive to your setting is really, really crucial,” she said.

Snider’s ability to adapt was tested from the moment she arrived. The plan was for her to live and work in Bangkok, but once she got there, they told her she was needed in Chiang Mai.

women in brightly colored traditional dress in rural Thailand

Women in rural Thailand

Snider noticed the differences between public health programs in Southeast Asia and those in the United States. To a large degree, those differences are the result of the particular diseases endemic to the region. For tropical diseases like malaria, it’s vital that people are diagnosed and treated rapidly, and resources are dispatched at the village level. Health volunteers staff malaria posts where malaria is diagnosed and treated. This community-based approach is especially important for populations—such as ethnic groups living in remote areas of Northern Thailand—that have limited access to more formal health centers.

Snider’s advice to public health professionals working in the developing world:

“It’s just a matter of taking the good aspects [of your home country’s system] and looking at those in terms of potential models. . .instead of trying to replicate,” Snider said.

The Kenan Institute Asia is a Thailand-based, non-profit organization committed to sustainable development in the Greater Mekong Subregion. It was founded in 1996 with funding from USAID, the Thai government, the William R. Kenan Jr. Charitable Trust and UNC’s Frank Hawkins Kenan Institute of Private Enterprise.

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