Dr Gaya I Ep #3 | A Journey from journalism to public health

doctor and public health expert with nearly two decades of experience in the public health sector she has been working under the world health organization for about 20 years where she spent much of her time leading capacity building initiatives and programs she currently leads all learning training and capacity building for who’s health emergencies program and is responsible for covet 19 trainings amongst others so welcome dr gaia to dot if the podcast we are so pleased to have you with us thank you pastor it’s a pleasure to be here um how have you been how has the pandemic been treating you well i’m very lucky i live in a country where you know we have access to health care to vaccines i’ve been working except for the first six weeks i’ve been coming to work every day um so we are very lucky but it’s been a tough time for everybody um and of course our job is to try and keep people safe from emergencies um and not just the physical safety but also their mental safety their psychosocial safety whether it’s in a pandemic or in everyday life and i think that that’s really the first lesson we have to learn that everything has to be done together uh if you miss one or two important bits it doesn’t matter if you have a vaccine you know you may not have serious illness because you’re vaccinated but you could still be putting others in danger so i think this this holistic approach this integrated approach to anything that’s related to health is really important and it’s it’s especially important during a pandemic yeah 100 uh just to backtrack a little bit um i i know i mentioned in your bio that you know you’re a medical doctor so i guess for our audience it’s good to know you know what pushed you to become a medical doctor in the first place and what your background is well i uh i grew up in sri lanka and sri lankan still by nationality and i grew up in sri lanka in the early 70s where it was really difficult there was an internal conflict going on there were lots of economic issues and from a very young age i think by the age of five we were influenced by our environment our parents you know wishing us to use education uh as a way to develop oneself and one’s family but also picking something that would really help the world help your country your family yeah you know humanity so there’s that value-based ambition was was very strongly um it was a big exposure for me particularly for my mother and uh my family migrated to um england i i grew up in london from about the age of six till about 16. but that foundation of sort of value value-based what i call value-based ambition you’re very ambitious for yourself and you have to work very hard to become a doctor that the whole academic requirement is very hard but i think i was always driven by this need to serve so it seemed you know it seemed that i would become a doctor and and um in a very convoluted way i did i went back to sri lanka when i went back in the early 80s there was a full-blown war again i don’t know where the war follows me or i follow war you know it’s you know i think some of us i don’t know and it was a tragic time and it was the beginning of a decade a couple of you know nearly 30 years of uh internal conflict in sri lanka and at that time universities were closed you know it was a tough time where we were also really trying to understand settle back into that kind of culture but really not agreeing with the politics of what was going on and i’m so frustrated when i did my a levels i was 18 i went and became my journalist not really so i got trained and it was perhaps the most exciting three years of my life i must say i learned so much but then you know i realized i really did not just want to write the news i wanted to make the news and i’m i um because universities were closed it was very difficult i applied for a competitive scholarship and uh china was offering scholarships but we had like 5 000 students who applied for five luckily i got into that and so the whole of my medical education was free one patch you had to go to china and learn chinese before you could go to uh go to university which i did and i think when you’re young and you really want to do something you can do it after i graduate i was given another scholarship to do a year’s study in internal medicine cardiovascular medicine and i came back to sri lanka you know sort of really shiny eyed you know wanting to serve and i did i worked for a few years in the southern part of sri lanka as a young doctor and life is very tough we worked an average of 105 hours a week and that’s it by the way by the time you you graduate you know i was 29 30 and of course it was time to get married have a family and i uh had two children you know within one calendar year wait it was tough hold on you had two kids yeah i i didn’t plan it but i had i had a baby i had a daughter and i was told because of the medical complications i would never conceive again and i should look after this baby but within three months i conceived again so children they were not planned but they loved and it was tough but then my next appointment and uh was into the conflict zones in sri lanka where i couldn’t take my children and my son was only six weeks old and my daughter was one year and six weeks old so i had to take a really difficult decision and leave the clinical you know the the government system of being a doctor and i set up my husband and i uh we set up a a private practice you know i mean you’re a qualified doctor there’s a need but really it wasn’t for me yeah it broke my heart that i would charge people poor people money for help i just i just couldn’t do it so after about six months i set it up as an enterprise and my assessment he continued to do it but i just couldn’t my heart just couldn’t deal with it and then luckily i found a junior i i found a job as a junior lecturer in one of the medical colleges in sri lanka in in colombo and that’s where i discovered public health you know and it was an accident it was really an accident and i realized i really like this because public health is very different from medicine you know medicine is is often about curative services about treatment but public health looks at people in their environment in the social economic cultural context that influence their health and i really really liked it and from there i think i i just it just blossomed i was uh i was head-hunted and i was appointed as director of community health for sri lanka’s largest ngo and they worked in 15 000 villages and you know i was in the conflict zone i was in villages trying to figure out health not medicine you know how to prevent diseases how to promote health and that was my that was my university really that i was head hunted again for save the children uk i read banner and then it was a very difficult time because i actually was a big advocate for children’s rights on both sides of the conflict and of course some some people some extreme parts of sri lankan society decided that i was a traitor because i was speaking up for children on both sides of the conflict both singling tamil and muslim children of course when you’re young you don’t really care you know you think when people challenge you this is an invitation to do more right but what really happened and and where i really changed my mind was when they actually threw a grenade in my office and threatened to kidnap my children so then i thought this is really now affecting my family i can’t do this anymore this is just too much i need to not protect my children so i look for a job abroad and i was very lucky to find a job as a training officer at the world health organization and that was 20 years ago you know and that’s how i came here so for the listeners that uh don’t know is that i know dr gaia since a very young age and this particular story i was not aware and i am in shock and in awe of her of what she just told us because i mean how do you even deal with this type of events in your life when your family is threatened at that level but you want to you’re kind of taught in between uh doing what’s right and what you think is of value and and you want to protect those children as well but you have to protect your family as well yeah but but i think you have to find a way and you have to do both so i just realized i couldn’t do it from there because i couldn’t enjoy their safety and it was a very violent time but but i think it’s about being pragmatic and also appreciating that millions of people around the world each person has their own story they suffer you know but but for me i was from a culture where you you had to face challenges and you had to figure out a way and i really didn’t like feel sorry for myself i was extremely heartbroken because when i first came here because of my nationality i wasn’t allowed to bring my children they were four and five years old and for a mother to leave her children and you know my husband at the time he was the most generous person because he said your career is going to go further than mine so i want you to go and i will take care of the children and so you know that kind of family but also that kind of risk-taking and it took me six seven months to bring them over yeah i came to work i cried every single day you know and we didn’t have internet and whatsapp and skype and zoom you know it was tragic and for months my daughter wouldn’t talk to me because she felt i abandoned her you know so it was this crazy thing but i think i ca i was i was trained in war right so i knew people suffered on a completely different scale and i couldn’t be self-indulgent about myself but luckily things worked out i was able to bring them over and you know my kids are grown up now 25 26 and uh um and yes the scars of that that persist but but um life is a balance of what you do for yourself and for other people i’m just in awe no i don’t think it’s anything like that i think you know it’s a context in which you’re brought up i realized me becoming a doctor was also meant that i’m responsible for my family you know because we lived in a very difficult situation so you have responsibility not just for yourself so you don’t actually think i’m strong or resilient you think what the hell am i going to do now right how am i going to protect the family yeah yeah you ask any mother in the most impoverished village in the world if you want to find the fiercest animal on the planet you go look and look a mother in the eye because that’s the job that’s your biological psychological emotional job is to protect but the issue is we find it difficult to take decisions for the future while sacrificing for the present and my generation did that we could sacrifice for the present in order to have something better for everybody in the future um maybe we were wrong and maybe we’ve scarred our children i i don’t know i mean there’s no right way but i i’m being very honest with you i had no awareness that i was being brave or resilient i just did what i had to do i put one foot in front of the other i was afraid because i didn’t know what would happen but i think if you look at your parents it’s the same they’ve taken so many decisions that people today would consider very courageous but this is normal is it life i mean i guess in needing to survive you do what it takes and then i guess you reflect about your decisions after it’s also a lesson that we mustn’t judge people the world what people present to the world you cannot understand there’s their backstory so when you understand that you have great respect and compassion for other people and their suffering is very real to them exactly and i think that that’s a bit of a celebration i would like to point out is how it takes a village right even to get this going beat with the children and having uh your ex-husband helping supporting you uh then i guess your your mother as well supporting you at that it takes a village to make this happen you’re very humble about it but i think not everyone has to face this type of diversity but um i i wanted to kind of touch base on the wh show and your current work what is it about your your current job that you you’re passionate about and you because you’ve been working close to decades with them what is it about it that that kind of helps you wake up every day and and just keep going the mission of this organization really help for all this really resonates in my heart when i was becoming a doctor or studying i didn’t know this right but i didn’t know there was an organization that was created just to create health for all so you know when i discovered it there was no way i mean i was giving it up the fact that we are always working for public good and for help and not being pushed by or driven by market forces or economic gain that that aligns with my values and it really is a source of pride and joy for me also it’s working for 195 governments right it isn’t just working it’s political because health is political but it isn’t working for a government with a political view and i’m a very independent thinker i’m a disrupter i i am and the establishment so being a journalist taught me to be anti-establishment don’t accept the status quo understand that anybody in power doesn’t want to give it up so that gives me that activist advocate personality while i was still forming and the third thing is it’s a place where you work with people from around the world and you can work at different levels one day i’m in the front line helping you know train people in the you know in the very remote areas of congo during an ebola outbreak the next day i am training ministers of health you know so this big spectrum of work and the mission of this organization and the freedom we have had to grow and really take decisions and shape health it’s just amazing my family think they think i’m a workaholic but that that’s that’s a wrong term i’m not a workaholic i have a mission and this organization helps me uh achieve that i mean there are days i i say i should pay who allow him to that’s the first i’ve heard that but i love it again it’s honest i’m being very honest you know yeah i mean it kind of goes back to what you said earlier working as a medical doctor and then having that shift to become a lecturer and when you started realizing that you were trying to change the concept of health rather than medicine itself and so i guess i’d love to see your take on what you think um health is and how you view integrative health so it’s really been a process of discovery for me because medicine was the goal right but but but i think i’ve always been uneasy about things that are framed in negative ways i don’t like this deficiency based approaches to anything i like what we know i know is the term is asset based approach and over the years over the experience that i actually really noticed the definition of health by who which was actually agreed in 1948 and the definition is really amazing health is a state of complete physical mental and social well-being and not merely the absence of disease so this holistic nature and of course it’s very difficult to measure right so so not just about illness and the absence thereof but there are these other dimensions of mental and social right and what we’ve understood by mental and social has also evolved over the years so it took me i think about 10 years to really get excited about this it was a revelation it was like a discovery in stages and then it just sat with me to say yes that’s right when people are sick we need medical services because we know people are dying because of lack of medical services yeah but that is a big and important contribution but it is not enough i’m trained as a scientist i really believe in evidence-based work so over the last few decades we’ve seen research coming in about how mental health can be achieved and how mental and physical health are what do we mean by social health what do we mean by emotional health by spiritual health so science itself and i’m not talking about biomedical but also the social sciences psychology and others are giving us evidence first understanding about it and second how they all work together now we don’t have all of that understanding but then of course you know when one comes to mid life as i am i’m 56 this year you know after you turn 40 you become you know really quite curious about spirituality and all of that and then that’s when i really started paying attention to some of the ancient wisdom whether it was ayurveda or whether it was any sort of philosophy that has actually kept people happy and well relatively for for millennia right so then i started seeing the linkages and i suppose the older i get and the more professional experience i have the more i’m convinced that health is very complex the sharp edge is definitely you know medical services i i totally agree i mean billions of people are alive because we have vaccines and we understand infection prevention control we have anesthesia we have antibiotics of course we need that but what we’re seeing is it is essential but it is not enough and so my take is evolving um pasha it’s it’s not static and i think this is also emblematic of the fact that humans learn throughout their lives but i certainly have a different view of health than i did when i started being a doctor i really like the definition of the who and the emphasis of it’s not merely the absence of illnesses um where do you think with this concept of kind of integrative way it’s not just about you know the illness uh attacking or treating the illness and it’s more about prevention and recovery um and taking care of your mental health social health and physical health where do you think we are you know as a society or with regards to understanding that real concept about the definition of the who i think we’re in a really exciting place because of one advances in science research but also communication so we’re able to now hear others perspectives share this research so in this fourth industrial revolution where we are now with the proliferation of biotechnology and information technology we actually i can have a very uh if you like accelerated understanding of how they come together i don’t think anybody understands it completely but there’s so much information out there that and the conversations out there are making everybody think so i think we’re really in an age of discovery and acceleration and i’m really actually quite thrilled about it yeah for sure like i think that’s the tricky part like while it’s there’s so much information i think we are confused and overwhelmed by the content that we’re receiving that’s where it’s important for us to be i guess educated around which sources to turn to when we are confused and overwhelmed especially with social media right i think the issue is you know our information that comes at us and particularly sponsored information is because they’re based on products right yeah so yes of course it’s confusing but these are all tools at our disposal what we need to understand is how each person is unique right your wellness your health is made up of so many different things so we need to understand how who we are and what we are and how all of this comes together then we have to have i mean this is really health literacy right what creates health or well-being what prevents negative states from coming up what uh prevents protects right and then when these states come up how do you treat it right a lot of the products are not addressing this complex interaction of things so so for example let’s take people with uh some cancers can’t say it’s a terrible terrible um not just a medical it’s it’s a condition that can destroy families create long-term suffering right because because of treatments we can prolong suffering now the pain related to cancers nobody can manage this without completely doping people up researchers show people who are experiencing cancer and severe pain when they meditate certain types of meditation actually have a great impact on reducing the the pain of cancer so now now these are two schools of thought right now who brings this together and now luckily people are researching together because medicine doesn’t have an answer for that now i’m in no way saying that we do not need western medicine diagnostics treatments no i’m that’s not what i’m saying i’m saying if we bring these uh together we can find you know answers for complex uh questions so it’s really important that we have an open mind but also when that happens there’s a lot of misinformation disinformation where people could be investing a lot of time money effort um in pursuing something that doesn’t have an evidence base as well so it is very very difficult to figure this out what do you think are the resistance that are around it so there’s the lack of evidence do you think there are other things that prevent people from from seeing their health in a more holistic perspective yeah because i think you know health is seen as a product not as a state right so people are selling help so somebody will say join the gym you will be healthy health is a state and it’s not a static state so i think that’s one i think that the point about evidence is really important because if you look at health what has improved help most in the last 200 years without a doubt it’s western medicine it saved billions of lives now western medicine is is really very scientific because it is based on very serious very strong evidence and even the introduction of what we call randomized control trials you know there’s a high standard for evidence so when you have help being protected by medicine and that depends on evidence and yet the other disciplines that could contribute don’t have that same benchmark for evidence of course we’re not going to accept it so culture is rightly focused towards evidence now the issue is we need to take the next step research if you don’t research it you won’t find it yeah in the last 20 years if you take the invention of the functional mri that tool has allowed us to create evidence for meditation because we can see how the brain is functionally changing when somebody is meditating or has meditated for a number of hours now that strong western scientific evidence for this right of course the other thing is in the ancient philosophies there isn’t such a commercial organization around it right so the industry doesn’t invest in that but also don’t forget many of the medicines that we use come from plants and herbs so once they’re discovered and and the evidential they work they’re taken into the western system right and used in different ways but there are many countries who mix both western now you read the traditional and even if you take uh who if i look at my own health insurance when i joined you know we only had health insurance for western medicine now more and more you see it opening up five for a number of valued rate the consultations they will reimburse me for certain acupuncture so you can see slowly this is a geneva that no it’s across the u.n family so we have a joint insurance system but even in a big system like that i mean it’s a big step forward and i think the who starts doing this you know hopefully governments can can start taking an example on it only the other issue is governments and authorities and wh so we have responsibility when we say something is good something works first we have to show that it’s effective we have to do it safe we have to show we’ve tried it in enough populations under otherwise that’s also not fair so i think really the key is to get this integrated research and create the evidence when there’s evidence nobody will have a problem saying it can work yeah that’s really it and also to introduce the more the non-western traditions to come forward and participate in this if they’re serious about that so everybody has a role like it’s not that one sector is keeping everybody else out the practice of health care and medicine it’s scientific it’s an art but it’s also a legal issue yeah we have to feel confident in the in the professional licensing body something actually works first and it has no yes for sure um for alternative medicine practitioners how do you see this gap being bridged so that we can actually verify and validate the existence of these practitioners and that they are people that we can trust yeah i mean it’s a tough question but we can look at it in different ways i think i think if you look at the market economy it’s it’s pushed by demand right so if more and more people are demanding it there is also that thing on that level if you look at practice i really believe they have to also adhere to the same standards that we do in western medicine whether it’s research whether it’s standards of practice whether it’s code or practice whether it’s ethics you know it’s it’s not just learning the science of medicine i think you need to have that then of course third you need government sponsorship i think you need to have that so it can drive more we have to respect that western medicine has come so far because of clients but also because of standards and legal consequences right of not sticking to those standards whether it’s use of products whether it’s behavior whether it’s how we sell things and advise things so i think instead of fighting we should say look at that how can we apply those standards to everything else but most importantly we need these different practitioners to talk to each other start building confidence start doing research together you know and and it’s going to be not fast but it’ll be faster than in in the previous couple of decades because of communication and social media and so on and you touch based on on demand as well and i think that some of the things are also going to kick off as uh people are you know realizing that there’s something that is greater that is in their control what do you think are some of the key things that people can start doing with regards to their health and not illness um so that they start exploring and understanding what they can do to be in control of their health we have a real problem in the world with health literacy and i don’t mean about balance nutrition it’s really a bigger concept about what is health and how can i be in charge of my health the first thing is mindset to say health is big health can be a goal we can say i have help today but it it’s the guiding light that’s the first mindset the second mindset is to be grateful for the help you have you know you have a body your five senses work that mindset of gratitude will make you want to look after your health if you don’t appreciate your health you’re not going to look after your health so i think that mindset of gratitude is really important that will lead to agency the second is look at our mental and physical health because they’re easily measured so physical health i’m not talking about medicine that help so what is what is the most important thing that really affects our health it’s the air we breathe the water we drink the food we eat then the really movement versus rest lots of people to move and they’re not sleeping enough they’re not resting enough right so then once you’ve got that then you say okay there’s a pandemic that’s a risk right how do i protect prevent and if i get sick how do i take care of myself and then how do i get her it could be not that it could be a cold it could be an accident but this concept of prevention protection so i think first is the mindset and the second is just get your basics right you know um if you take about food i mean there was this famous food writer who gave the best nutrition advice ever and it’s only in seven words right eat food not too much mostly plants health is not complicated if we simplify it like this this is great advice right yeah yeah so you have to sort that out then i think the third thing is really that spiritual mental social help we need to be learning all the time growing all the time there’s lots of evidence for spiritual practice for meditation how it doesn’t just make you spiritually better because it reduces blood pressure it reduces inflammation it reduces pain i mean it’s linked to physical if you’re skeptic just look at the evidence and then i think you know last but not least our social health you know if you look at human needs belonging love self-esteem all of this come from social contact and we of course it’s the one thing that we’ve neglected in the last 15 months right because of the of the pandemic but it’s not just because of the pandemic so if you remember nothing today remember eat food not too much i love that on that beautiful note and this message our listeners yes thank you very very very much dr gaia for this uh this interview my pleasure thank you if 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