When I moved to Vermont, I spent a year working as an AmeriCorps/VISTA volunteer on adult literacy, which was a powerful and eye-opening experience into the world of public health and vulnerable populations. It inspired me to go on to medical school, where I learned some important life skills like how to doze off standing up, deliver babies, and how to take on the honor of holding hands with people as they died. After residency I did a fellowship in sports medicine and developed a practice in that field. I continued to practice medicine part-time in urgent care while I moved on to work full-time in the for-profit health informatics industry.
I found the informatics work fascinating, mostly because of the challenges and failures that persisted across practices and hospitals despite access to significant resources and infrastructure. It was surprising to me how much inefficiency and lack of interoperability there was, and most didn’t seem to know how to leverage technology for the sake of better outcomes. There was confusion among the actors around government standards and expectations, even among the governing bodies themselves. While this was my first exposure to challenges faced when integrating tech, it wouldn’t be my last. It’s frustrating to see the potential of technology not be realized in what otherwise seemed like an optimal health care setting.
While I was practicing medicine, I was also starting a family. It was during this phase of my life when my career path solidified. When I first met my oldest son, he was 8 months old and living in an orphanage in Addis Ababa. I’ve since gotten to know his birth mom and her story about making the decision to relinquish him. While my younger son’s story is unique as he was several years older when we first me and from a different region of Ethiopia, his birth family faced similar life-changing challenges. Through our family and our Ethiopian family’s experiences, I was drawn to better understand how it could be that such loving families had to make this kind of heartbreaking decision.
I began volunteering for an NGO that implements programming in Ethiopia, Wide Horizons For Children, focused on reducing maternal and child morbidity and mortality, and empowering families. Many of their projects, which typically focus on health, education and financial stability, utilize digital technology for implementation. This may be in the form of using cell phones to access assessment tools to support health extension workers or data collection for school feeding programs. With limited funding and capacity, this NGO faced some of the same challenges I saw during my time in the for-profit informatics world. On their own, they can’t address their digital technology challenges in a way that would allow them to scale-up, innovate, leverage work from other sectors and reduce redundancy or achieve sustainability.
It’s from my experiences in these diverse settings that I’m so motivated and enthusiastic to embrace the work of DIAL. While here, I’m working on creating public facing documents on what we’ve been calling the Advanced Market Commitment vaccine research. This encompasses the work DIAL did with PATH that investigated the market-shaping mechanisms that changed the way vaccines were procured. It also includes new thinking from DIAL and the Tableau Foundation on drawing lessons learned that can expand access to digital markets. Stay tuned for the release of the research! Email me if you’re interested in learning more at rwinokur@dial.global and follow us on Twitter for updates on this work and more.
