Amidst the shacks around their home, my cousin whispered to me: “Is it a problem – someone here has TB, the neighbours” she said as she motioned I come closer. “People used to come here and give them medicine for TB” she added. Now I figured what she talking about and asked “Oh the DOTS, do they wear yellow shirts?”
“Yes they do,” she confirmed. I explained to her that when one starts DOTS therapy, the person is no longer contagious so long as they complete the treatment course. I believed I had explained it all to her, but then her next question threw me off : “ Can we become infected if we share cups with the person with TB?” I first tried to dismiss the relevance of her question by pointing out the conditions under which TB is induced: “Well you know, most people in the world are already infected with the TB bacteria and it is just when our immune system is weak that the disease develops. So you don’t need to worry, because if your immune system is strong, you will not develop TB.” But this answer did not bode well with my conscience! After all, I had a Bachelors Degree in Molecular Biology and I should give a decent answer to my cousin whom I am helping to rewrite matric. I remember my equivocal response, which betrayed my lack of authoritative knowledge on the matter: “Well, TB is spread through the air…” I began, but she already knew that: “ Yes so then can it not be in the saliva if you share cups?” she hypothesized. I was at a loss for words. I did not end up giving a definitive answer. Instead, I though about this at home and realized it related strongly with my desire to do research in epidemiology.
It was not just my cousin that asks this question, because even during the monitoring and evaluation workshop I attended, this issue sparked a debate that lacked resolution. However, I would not be content with searching primary literature for an answer. I want to be part of the primary literature. I would not be content with just accepting a statement from the public health authorities. I want to do the research that informs policy makers. The mode of transmission, the ability of pathogens to be transmitted under a variety of conditions and their distribution in the population, these are questions I seek to clarify using objective approach of science.
Epidemiology, however, offers me not only the objective lens, but the subjective one as well. There is the statistical and biological side of this discipline that is essential to clarify such questions such as the one my cousin asked. And then there is the subjectivity of each one of us. Our health is impacted by our culture and the societal structures we live. Hence, to adequately address public health problems, interventions must bear in mind that humans are at once agents and subjects of hegemonic socio-cultural beliefs. This is union of subjectivity and objectivity is what draws me to epidemiology.
By now, you would have realized that I am both a scientist and humanist. Accordingly, I aspire to one become a researcher in the interdisciplinary field of medical anthropology. As scholars in this field have shown, public health problems are illuminated via an interdisciplinary approach. João Biehl, for instance, published “Will To Live: AIDS and The Politics of Survival” where he drew upon both statistical and ethnographic approaches to expose Brazilians who were left out of the “universal AIDS therapies” that were purported as successful by the powers at be. I believe that a masters degree in epidemiology and biostatistics is the best preparation for such edifying research.