Global Voice

Dr. Dan Colley

I am fairly often asked, “How did you get started in global health?” The question, coming from an undergraduate, a graduate student or even a postdoctoral fellow whether they are interested in biomedical research, poverty reduction, international journalism or world peace is understandable. At almost any stage of training or in any phase of life it is challenging to see how to make a leap into some new area or even into a new aspect of your current activities. How do you even get started?

In my case it was happenstance, pure and simple chance, coupled with some subsequent investigating and a willingness to take a running leap off the end of the dock – hoping the lake was deep enough that you could survive the leap and swim your way out of whatever else you found in there, and a partner willing to jump of with you - in my case, my wife.

I graduated from Centre College of Kentucky with an AB degree in Biology, with minors in Chemistry, History and English. Centre had 525 students at that time, and I was the quintessential liberal arts product. With that under my belt, and the thought that I would some day teach in a place like Centre, I went off to Tulane University to get a Ph.D. in Microbiology/Immunology. After a couple of twists and turns in terms of my dissertation area I focused on basic immunology. Armed with a Ph.D. in how to grow and study the responses of rat lymphocytes I joined a well-known cellular immunology laboratory at Yale University School of Medicine at the time of the birth of cellular immunology. It was a heady time to be a postdoc in basic immunology. Almost nothing was known. All findings were new, and of course many of them were subsequently shown to be wrong (or at best naïve), but that is the way science works. At Yale I continued to hone my skills as a basic immunology investigator, publishing papers and giving seminars, so I could go out on the market and find a real job as an Assistant Professor in a Microbiology department – most likely in a medical school. My previous idea about teaching at a Centre look-alike had gone by the wayside when the research bug bit me, and I realized that I wanted to teach, but do it in an environment where I could also pursue a career in this new field of cellular immunology. There were just so many, many fascinating unknowns. How did it all work? How could anything be this complicated? Little did we know at the time how truly intricate, complicated, challenging and intriguing the immune system would turn out to be.

During my second year at Yale my mentor made a speaking tour through Latin America. It was one of those things major scientists do where they give 2 or 3 lectures over several days in some university, and then move on to do the same thing again in the next country. In the time between the lectures they sightsee and meet with faculty and students and discuss the research being done there, trying to give useful insights that sound brilliant. One of my mentor’s stops was Recife, Brazil, where he suggested that the group working on the immunology of schistosomiasis needed some help in terms of “modern” immunology. He then proceeded on to the next stop, and eventually returned to Yale. Six or eight months later he stuck his head into the laboratory and said, “Who wants to go to Brazil?” It so happens that my laboratory desk was next to the door. I immediately stuck my hand up and waved it in his face, and got his attention. At the time neither my wife nor I had a passport. We had never been anywhere beside Canada and Mexico (you didn’t need a passport for those, back in the ‘good old days’). Meanwhile, across on the other side of the laboratory Dougie Naysmith, another postdoc in the lab, was also waving his hand, but he wasn’t next to the door. Once the focus of the question was on me, I asked why. The reply was to teach a course in immunology (which I was sure I could do – albeit maybe not in portugues) and to help reorganize some immunology research on schistosomiasis (which I could neither spell nor pronounce).

This was at a point in my postdoctoral training when I was beginning to look for that elusive Assistant Professor position as a basic immunologist– the real job everyone had been waiting for me to get. Having secured this possibility of going to Brazil for 6 months to a year, to work on this worm infection that I could not pronounce, I set about learning what schistosomiasis was and what I thought schistosomiasis could be in terms of an area of interest for a research career. What I found, by reading a lot, by going and talking with people working on schistosomiasis (there were not many to visit), it appeared to me to be a fascinating focus for cellular immunology research as well as an important global health problem (which was much further down my list of why to jump into it). There were so many unknown aspects of the immunology of this disease of 200 million people, and so few scientists interested in it, I decided it was a great area to get into in my newly acquired position as a Research Scientist at the Veterans Administration Medical Center in Nashville, Tennessee and as an Assistant Professor of Microbiology at Vanderbilt University School of Medicine. Those two entities were kind enough to hire me and then not have me show up for 9 months, while my wife and I went to live in Recife, to learn much more about the world and schistosomiasis.

Upon returning to the States and my new position at the VA and Vanderbilt I set up the life-cycle of Schistosoma mansoni (which required rearing Biomphalaria glabrata snails as the intermediate host and infecting mice) and went about creating a research and teaching career that intimately involved schistosomiasis. Because I had started this career by living in Brazil I have always also studied the immunology of people with schistosomiasis – which necessitates being where there are people with schistosomiasis. So far this has meant that I have set up and pursued collaborative immunology research on St. Lucia, in Belo Horizonte, Brazil, Cairo, Egypt and more recently (the last 17 years) in Kisumu, Kenya. Each of these programs have involved on-site research for me and my trainees, and extensive participation and training of investigators and students in those places. The most rewarding experiences have been when good science has been coupled with good training. It is very fulfilling to see a place and the people in it develop and grow into no longer needing you. After a few years as the mentor of a new project, if you are successful, the main services you provide should be those of perspective and being a “mule.” These days in Kenya, as in Brazil before it, they mainly need me to bring in supplies that cannot be obtained there. Achieving these supposedly peripheral roles is something I cherish.

The rest of my global health journey took me to the Centers for Disease Control and Prevention (CDC) where I became the Director of the Division of Parasitic Diseases in the National Center for Infectious Diseases. This was heady stuff for some one who has never had a course either in parasitology or epidemiology, the two foundational sciences upon which the Division is based. Fortunately there are lots of excellent people there who do know these things, and thus I experienced a very steep, but outstanding learning curve upon my arrival in Atlanta. After nine years at the CDC I moved to UGA to be the Director of the Center for Tropical and Emerging Global Diseases and Professor of Microbiology here at UGA. Throughout the twists and turns of my career path toward more and more global health activities it has been the scientific base that has stood me in good stead. I believe everyone needs to be “credentialed” in something in order to get the opportunity to move to something else. For me that was immunology, and more specifically the immunology of parasitic infections – with a strong focus on schistosomiasis, while dallying in a couple of other infections, such as Chagas’ disease and trachoma. Establishing credentials in something, and a willingness to see beyond the strict boundaries of your own discipline, will very often provide new opportunities – and you can always go seek them out if they do not turn up on your doorstep.

So what’s my answer to the question of how did I get started in global health? Always get the lab desk by the door. Dougie Naysmith, that other postdoc – the one on the other side of the lab, did not get to go to Brazil and work on schistosomiasis. So how did that work out for him? Well, being British, he moved to a faculty position at the University of Bristol, in England, and after about 10 years left the university and was elected a Member of Parliament. Hmmm. I guess it worked out fine for both of us.

Basically, I think you get “credentialed” in something, then take a risk or an opportunity that sounds right for you, and go for it. And remember, you can do global health as a biomedical scientist, a public health official, a nurse, a journalist, a lawyer, a political scientist, a novelist, an actor, an economist, a social scientist, a dentist, a pharmacist, an engineer, an educator, a dancer or a physician. Everyone can bring something to the global health table, and efforts in all these and many more areas are needed out there in the world (which starts on South Lumpkin Street and extends to someplace beyond Outer Mongolia).