This month we checked in with Kim Lindblade, PhD, who is currently in Guinea to address Ebola.
Lindblade joined the US Centers for Disease Control and Prevention (CDC) as an epidemiologist in 1999 has lived and worked in East Africa, Central America and South-East Asia for CDC. She served as the Chief of the Malaria Epidemiology Section of the CDC-Kenya field station in Kisumu, Chief of the International Emerging Infections Program in Central America, Team Lead for the Strategic and Applied Sciences Unit of the CDC Malaria Branch in Atlanta, Georgia, and is currently the Influenza Director for the CDC office in Thailand.
Among her many accomplishments, Lindblade played a leading role in the design and implementation of the Western Kenya Health and Demographic Surveillance system from 2001-2004. Additionally, she led efforts to verify the elimination of onchocerciasis from three endemic foci in Guatemala between 2004 and 2007. She participated in or led teams for several international outbreak investigations, including aflatoxin in Kenya, diethylene glycol poisoning in Panama, pandemic influenza H1N1 in Mexico, the post-earthquake response in Haiti and more recently, Ebola in Liberia, Sierra Leone and Guinea. Lindblade received her PhD in epidemiology from the University of Michigan in 1999 and has published more than 80 papers in peer-reviewed journals on topics ranging from swimmer’s itch to norovirus and influenza.
You have been deployed in Liberia, Sierra Leone and are currently in Guinea to help address the Ebola outbreak. Please share some of your major observations and/or key learnings with your fellow ASTMH members.
The Ebola response in West Africa has been an overwhelming experience for me; professionally, I felt as if my education and field experience had prepared me very well to contribute directly to the response effort in the affected countries. The response provided a rare opportunity (for me) to be on the front-lines of public health, rather than off to the side working on research projects whose payoff was years away. It was extremely satisfying to participate in case investigations and contact monitoring, and to conduct simple analyses of surveillance data to generate evidence that improved response efforts on a daily basis.
Personally, I was drawn in again and again by my colleagues and by the people touched by Ebola. My colleagues were from all over the world, but they all came to West Africa to do their best to stop Ebola transmission. I was inspired by the physicians, nurses and other healthcare workers who put their lives on the line every day caring for Ebola patients. Equally inspiring were all of the public health professionals who left their families for months at a time to dedicate themselves to fighting the virus. But most of all, I was touched by the people I met in Liberia, Sierra Leone and Guinea, many of whom did not survive, but all of whom showed remarkable courage in the face of a very frightening future. I will not forget their faces or their stories.
Ebola is not an easy disease to transmit, and those of us not directly involved in patient care were at minimal to no risk of Ebola transmission as long as we followed basic precautions. I had no concerns for my safety after my first few days in Liberia. We learned that once safe isolation and treatment facilities are available, Ebola can be fairly easily defeated if the community is willing to engage with the response efforts. The community engagement piece is the most critical, and in Guinea and Sierra Leone, the most difficult. Although it took several months for there to be enough Ebola treatment units (ETUs) throughout the region, the continuation of the epidemic after the establishment of ETUs has been largely due to fear and distrust on the part of the population, which have not always been adequately addressed by the response. However, we are improving community engagement in myriad ways, including incorporation of anthropologists into the response teams, involvement of community leaders and organizations in response activities, and continued presence of response team members in affected areas, but we will have to do better if we are to root out the disease from regions in which it has become particularly entrenched.
For those who are earlier in their career and want to pursue a career path similar to your own, what advice would you give?
In my very biased opinion, there is no better career than an epidemiologist in global health! It’s absolutely marvelous to get to use your brain and your creativity in the service of improving lives. I think a doctoral degree provides a great deal of flexibility in a global health career that may not be as easily available without it.
Students who want a career in global health should take every opportunity to intern or work in resource-limited countries and meet as many people as possible while there. Request informational interviews to get to know the organizations operating in these countries; in addition to learning how things work, and the characteristics of important global health organizations, you’ll make important contacts that are essential to getting overseas positions. Be flexible and low-maintenance! Global health organizations are looking for good people who are team players, who will work well with people from a spectrum of backgrounds, who are respectful and knowledgeable about local customs and who are curious and eager to learn and share.
I will make a special pitch for CDC and the Epidemic Intelligence Service, a great two-year training program for epidemiologists (and yes, even PhDs can learn a lot about public health in EIS) who are eager to be involved in public health programs and research that may not be cutting-edge but is closely aligned to the needs and priorities of resource-limited countries.
You've been involved with the Society in numerous ways over the years -- as a councilor for ACGH, a member of the malaria program committee and as a symposia organizer at the Annual Meeting -- when you look back, how has your involvement in ASTMH helped shape your career?
I think it was [ASTMH Executive Director] Karen Goraleski who referred to ASTMH as our ‘professional home,’ and I find that a very apt description. At CDC, I have moved between malaria, parasitic diseases, emerging infections and influenza, through Uganda, Kenya, Guatemala, Malawi and Thailand, but ASTMH has remained constant throughout, allowing me to reconnect with colleagues from previous lives and stay current on the various diseases I have worked on. Several ASTMH members have been important in my career, including former advisors Mark Wilson from the University of Michigan and Steve Meshnick from UNC, and colleagues Terrie Taylor and Ned Walker from Michigan State, Chandy John from Indiana University and Ann Moormann from the University of Massachusetts. I find the Annual Meeting to be a sort of homecoming.
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