Sydneysider Jennifer Duncombe is an epidemiologist with Médecins Sans Frontières with 10 placements under her belt. Epidemiologists typically work in three areas: outbreak response/control, surveys and research. Here she shares her experiences working in the field.
Why did you decide to become an epidemiologist with Médecins Sans Frontières?
I remember seeing Médecins Sans Frontières on the news when I was in primary school – I think it was for the Ethiopian famine response – and thinking, “wow, those people are amazing!” I ended up studying public health and worked at NSW Health as an epidemiologist. It was interesting, especially when we had outbreaks like H1N1 (swine flu) and cryptosporidiosis, but outbreaks were few and far between! So I moved to Queensland and started a PhD in infectious disease epidemiology: essentially, modelling dengue fever outbreaks in Asia. I also did a bit of lecturing and tutoring when I wasn't overseas collecting mosquitoes. It was a great learning curve but I quickly became very disillusioned with the competitiveness of academia. I saw a Médecins Sans Frontières ad online saying that they were looking for epidemiologists and I jumped on it and haven't looked back.
"For me, the most challenging part is also the most rewarding: meeting and talking to the people we’re helping"
What are the responsibilities of an epidemiologist with Médecins Sans Frontières?
The work of an epidemiologist is extremely varied and we often have to be creative in our solutions to problems. Surveillance is, of course, a key task. One of my bosses used to call me her 'crystal ball' because I would dissect the surveillance data and make predictions about how the situation would evolve – invaluable when we are planning our activities. The best part of surveillance is getting out in the community to see what is going on and to figure out how best to collect information. I have also done loads of surveys, looking at everything from vaccination coverage, to assessing the impact of war (deaths, sickness), and the nutritional status of children. We also investigate outbreaks and, as a result, help set up interventions such as cholera treatment centres or measles vaccination campaigns. This is my favourite part of the job – I love getting my hands dirty!
What do you find the most challenging aspect of the work?
There are many challenging aspects of working for Médecins Sans Frontières, from constantly expecting the unexpected, to trying to live and work with up to 50 other international staff, to trying to negotiate access to a population that needs help, and the weather (usually very, very hot or very, very cold). But, for me, the most challenging part is also the most rewarding: meeting and talking to the people we’re helping. Hearing stories of pain, loss and immense suffering is incredibly heartbreaking. I always feel so privileged and humbled when people share their stories with me. When an old man shares his last kettle of tea and tells me, with tears streaming down his face, how he and his wife fled Syria but how the rest of his family died as they were all running down the street with bombs going off around them. Words can't ever do those conversations justice.
After 10 field placements, what keeps you coming back?
Articulating an answer to this question is a bit like trying to describe why you love someone. I could say that I relish travelling to crazy places where no one else gets to go, that I meet incredible people who regularly blow me away with their resilience and beauty despite their circumstances, or that I get immense satisfaction from making a little difference in a few people’s lives. But, really, I can't describe why I love this job – I just do.
What advice do you have for other epidemiologists considering this type of work?
Keep an open mind: every day brings different challenges. In each project, I have ended up doing tasks that aren’t in my job description, like distributing blankets, counting drugs or packing ice for vaccination campaigns. We need people who are willing to do whatever needs to be done, for the sake of our patients.