Resilience is one of those buzzy buzzwords. But what does it mean, exactly? Bouncing back from tragedy? Conquering obstacles? Having the inner strength to follow a dream when the odds are against you?
For Dr. Vanessa Kerry, the definition is pretty straightforward. It boils down to being prepared. In the world of global health, she says, that means "strong systems, primary care and the ability to respond."
Those are the ideas that will guide her in her new job as Special Envoy for Health Resilience at the World Health Organization.
It's the latest addition to an impressive resume. Kerry was WHO's first special envoy for climate change and health, is director of global health and climate policy at Harvard School of Public Health and is the founder and CEO of Seed Global Health. That nonprofit group has been building resilience in lower resource countries for over a decade, dispatching coaches and mentors to educate and train local healthcare students and practitioners as well as building financial and material resources.
Kerry's activism reflects seminal moments from her younger years. In grade school, she decided she wanted to become a doctor. At age 14, she traveled to Vietnam with her father, former Senator and Secretary of State John Kerry, and was deeply struck by the poverty she saw.
A high-risk delivery
Then came the crisis in Rwanda.
Between her third and fourth years in medical school, she spent time in a hospital in Rwanda. One day she was asked to "be a helping hand" with a woman's labor and delivery, working with a nurse.
Kerry said, "I'm a student." So that was the team — this medical student from the U.S. and a Rwandan nurse.
"The mother was pushing but the baby was not advancing," Kerry remembers. "The shoulder had gotten stuck and so we needed to do the maneuvers to help to deliver." She tried to remember everything she could from time spent in a "labor rotation a while back." There was no imaging, no specific training either she or the nurse had had for this type of situation.
"We were lucky," she says, "Because what we remembered worked." Mother and child survived.
Kerry, now 49, recalls: "I remember walking out of that room thinking, that was extremely distressing — more than that, extremely shocking and terrifying.
She could only conclude "this whole system doesn't work."
That harrowing delivery was the germ for Seed Global Health. She knew that many of her colleagues wanted to work to improve global health. But many of the opportunities involved flying in to perform certain procedures, then returning home.
"They made a contribution in that moment, but what then?"
When she returned to Boston from Rwanda to finish her residency at Massachusetts General, she began hatching the idea of working with the Peace Corps to send doctors and nurses to sub-Saharan Africa as medical educators to train health care workers who could then train others — building a country's internal health care system. Seed's collaboration with the Peace Corps lasted from 2012-2018, focusing on the development of country-led efforts at HIV/AIDS epidemic control.
Today, Seed is active in several sub-Saharan African countries for its training efforts. In Uganda, for example, Kerry says that her group has partnered with the Ministry of Health to build up emergency medicine by training 30 emergency medicine physicians. When an Ebola outbreak occurred there earlier this year, she says that these emergency physicians and other specialists were able to train over 3,000 health workers around the country in Ebola case management and infection prevention and control.
Seed, she says, has taught her that building resilience "is not a daunting task. If you train health workers, they can monitor and provide healthcare, they can provide surveillance, they can provide prevention."
Building responsive healthcare systems is what her new job is all about, she says. "We've been funding disease by disease and crisis by crisis. We can be thinking about this differently."
Her goal is not merely to jump in when a new outbreak occurs. "If a nation does not have a health system infrastructure in place, they will probably not be prepared to respond to the emergency. Resilience means building a system that will already be in place."
And it also means listening to local voices. "Countries know what their priorities are to care for their population," she says. As the resilience envoy, she wants to make sure there is ample funding so "we more effectively address the biggest burdens of disease."
