Dawd Siraj is a professor of Medicine in the Division of Infectious Diseases at the University of Wisconsin-Madison. Recently, Dawd has been involved in the creation of a Global Health Program at UW-Madison and has developed a partnership with Jimma University in Ethiopia, where he regularly travels with medical students. In this AFRICA IN OUR LIVES, Dawd explains his interest in public health and his new partnership with Jimma.
Field of study: Infectious Disease, Parasitology, Tropical Medicine, & Global Health
Home country: Ethiopia
What brought you to Madison?
I had always wanted to be in academic medicine. I worked in the field of infectious disease in North Carolina for a long time, traveling frequently to Ethiopia to do global health work. About six or seven years back, we won a CDC grant with the University of Wisconsin to build a residency program in emergency medicine. So, I came to know many faculty members at UW-Madison as we worked together to build this program at Addis Ababa University. During this time, I visited UW-Madison twice and eventually they convinced me that I might have to come on board for good. I officially joined the university two years ago and I’m very happy about that.
Tell us an interesting fact about yourself.
I spend most of my time in medicine, but my hobby is actually astronomy. Astronomy is another field that really makes you wonder about what’s out there and puts everything in perspective. When you figure out how tiny we are compared to how big the universe is, all the bickering and selfishness that you see on a daily basis is made so small. People don’t look at it from that perspective and find the tiniest things to accentuate the differences that we have, instead of really celebrating the universality of us. So, anytime I’m tired or frustrated, I read astronomy or go out and look at a star or a nebula 50,000 light years away and it makes all the pieces fit.
What inspired your interest in public health?
In the world that we live in, if you look closely, almost everything is distributed unevenly, and that includes healthcare. Most of the diseases that you think of as present in low income countries happen here in the U.S. too, but the challenges get magnified in countries with low income and in areas with minimal resources. Understanding and appreciating the underlying reasons for those disparities and trying to put a dent in those problems is what public health is all about. The fact that I grew up in Ethiopia, as well as went to medical school and briefly served there, has given me a perspective whereby I can see those problems from a different angle.
Why did you choose to become involved in building the Global Health program at UW-Madison?
I was in Ethiopia when there was no HIV medication at all – when an HIV diagnosis was a death sentence. I then moved here in 1996 and HIV medications were widely available, making the disease treatable. After seeing this, I promised that I would spend my time working to bridge those access and opportunity gaps. I always wanted to transfer that knowledge, capacity, and access to underserved communities. Engaging young trainees to appreciate the disparities in global health care and inequities of resource allocation is the best way to address issues on a bigger level. The unfortunate reality of most of our global health work is that the science is already known. It is the application of these known facts that is lagging behind, so I challenge trainees on how to transfer and translate this information to those who cannot access it? By building a global health program, that’s what I’m trying to accomplish.
How did your work with the Jimma Institute of Health Sciences begin?
One of the biggest tasks when I first came to Madison was to build a global health program for the department of medicine. I’m a graduate of Jimma University, so when I was looking at where we should have the training site, Jimma came naturally. We’re still in the very early phases, but in a year or so, we’re hoping that it will be a very strong connection which will span throughout the university’s programs.
What do you hope to see develop from the partnership between UW-Madison and Jimma?
Right now we are focused on building a collaborative global health program between the University of Wisconsin-Madison’s Department of Medicine and Jimma University. This will involve three main things. The first is the clinical teaching we plan to conduct at least once a year, taking residents and fellows to Jimma University and staying there for at least a month doing clinical work. The second is educating residents in tropical diseases. Jimma is in a tropical area, so diseases we don’t see here are common at Jimma. The third is research. We have already started doing collaborative work with Jimma scientists and now have three projects with Jimma. In this way, what I’m trying to do is build a site where our residents will have a place to go, but at the same time, Jimma University will benefit from this collaboration, as faculty will travel and be involved in the teaching experience and collaborative research programs.
What is the biggest struggle you have encountered when acting as a cultural mediator for the translation of hospital protocol in Ethiopia?
The biggest issue when you travel to a developing country is that you are in a completely different culture. That’s one of the things we teach our residents and fellows here. The cultural differences translate into norms and behaviors, and some of them may be detrimental to the overall health of the patient, while some might not be. So, how do you act on them? For example, hospitals in Ethiopia are very crowded. Not only are there are a lot of patients, but a lot of family members as well. This puts a big stress on the infection control process in the hospital. But at the same time, you have to count these situations as learning opportunities for the medical professionals. We often see the opposite problem in the U.S., as many people don’t have anyone to take care of them.
Another problem is the education of our patients. Medicine in developing countries is typically a paternal type of delivery. Physicians are expected to make decisions on behalf of the patient, unlike in the U.S. where a doctor presents the patient with all the information and the patient has the right to choose. This is very stressful. For example, it’s not uncommon for us to be involved in cases in Ethiopia where a new diagnosis of cancer or HIV is met and the family absolutely does not want the patient to know, even though the patient is competent enough to comprehend this issue. Our U.S. residents then have to wrestle with this ethical problem. For physicians in Ethiopia this isn’t an issue because it is the way their society functions, and if the family absolutely says they should not be told, the physicians go with that. But for us who are trained in these systems, it’s a big challenge. But that’s what global health education is – to internalize these kinds of differences and make them an opportunity to teach, and with time, try to change systems from within.
What is the most enjoyable part of your job?
I love to be in medicine for a very simple reason. I don’t think there is any other profession that helps you support people who are in need more than this field. To help people in need, and especially to translate the already known knowledge in places where it has never been delivered is really something that’s very addictive.
Published by Aberdeen Leary