MPH Student Pushes National Agenda on Reproductive Health Education
When
medical student Anjali Kumar traveled to India in 1997 to investigate
sterilization practices in that country, she didn't know the trip would
transform her career.
Kumar had just completed her first year at the University of Washington School of Medicine and was required to do a research project as part of her medical thesis. Already interested in reproductive health issues, Kumar chose India in part because more than 75 percent of women there use surgical sterilization as a method of contraception, she said.
"I wanted to learn the reasons that women considered before making that decision," said Kumar. "Was it personal preference or ignorance of other options?"
Kumar traveled to Tamil Nadu in South India to interview 200 women in urban and rural areas. She found pervasive misconceptions about birth control methods and a lack of basic reproductive health knowledge. Most of the women did not understand how their menstrual cycles worked or how their babies were conceived, said Kumar.
After 25 interviews of doing only strict data collection, Kumar seized the opportunity for education. She started giving brief reproductive biology lessons to the women after the interviews and watched as the new-found knowledge passed from woman to woman, mother to daughter, neighbor to neighbor.
"The knowledge of one woman became the knowledge of the village," said Kumar.
As the project continued, Kumar discovered a passion for public health.
"It was an amazing experience," she said. "I found a field of public health research that I hadn't thought that much about, and I loved it."
Kumar entered the MPH program at HSPH in September 1999 and undertook work that garnered her the Student Recognition Award at the Spring Dinner and Awards Ceremony on May 11. The student-nominated award recognized her "personal initiative to enrich lives and improve the health of persons in the local and global communities through active service and sharing of her time, talent and experience, her equal dedication to improving the academic and social experience of the school for all students, and the strong integration of her public health vision into all facets of her life."
Said Kumar, "When I went to medical school, I went with the intention of helping communities of people. My medical education was fantastic, but I felt that it was too focused on the individual or on the diseases. It didn't give me the bigger picture."
Kumar has shifted her focus to the US, where she feels reproductive health education is sorely lacking.
She is concerned that less than 13 percent of obstetrics/gynecology residency programs in the US require training in first-trimester abortion procedures in a country that leads the developed world in unintended pregnancies, she said.
"You would think that the future physicians of America would need to know about the medical issues surrounding abortions," said Kumar. "But the US has made abortion a political and not a medical issue."
Kumar is on the board of directors of the national organization Medical Students for Choice, which offers opportunities for medical students to learn about abortion practices in the US. When she took a grant-writing course at HSPH, she spotted a way to broaden the scope of the group. She wrote a grant application to send students abroad for internships where abortion is illegal and, conversely, where the practice is not politically controversial.
Kumar sees opportunities for progress in more than just the abortion arena, and she has used her HSPH courses to build an educational platform about emergency contraceptive pills. The FDA first approved the prescription pills in 1998. They are up to 75 percent effective in preventing pregnancy if taken within three days after unprotected sex, and they are more effective the earlier they are used. Kumar is working on a campaign that would allow pharmacists to dispense them directly.
"If you think about it, most unprotected sex is not taking place in the middle of the week when clinics are open," said Kumar. "After-hours access to these pills is critical."
Kumar drafted a position paper for the American Medical Women's Association supporting novel programs such as the pharmacist campaign. The paper became the first written by a student to be adopted by the association. Last November, Kumar was elected student-president of the organization.
During her research into emergency contraceptive pills, Kumar discovered that the American Medical Association (AMA) did not have a position on the issue. She decided to offer them one by presenting a resolution to the Physician House of Delegates of the AMA in Chicago last June. The physicians responded by issuing a policy statement that supports the use of the pills.
Kumar will return to Washington this summer to complete her medical studies and head a research project on emergency contraceptive pills that she developed through an HSPH course.
Kumar said the MPH program was exactly what she was looking foran academic environment with globally aware students and professors.
"I was a bit of an oddball in my medical class because I was among
a handful of students who organized conferences and tried to get my classmates
interested in issues," said Kumar. "They saw me as a cheerleader
for social causes. Then I came to HSPH where everyone is exactly the same
way. My fellow grads are going to make a difference in the world."
