From public servant to public health student

Mrinalini Darswal

After two decades as a public servant in India, Mrinalini Darswal came to Harvard Chan School to gain leadership skills in the public health field. After she graduates in May with her DrPH, her mission will remain the same: ‘Keep serving the people.’  

April 25, 2024 – In the 1980s in Jammu and Kashmir, India, Mrinalini Darswal’s household was not like most others.

“Although they came from very traditional Indian families, my parents were very keen to educate their girls,” Darswal said. “They gave me and my three sisters every opportunity and encouragement we needed to get through school and pursue the careers of our choice. I never heard my parents say, ‘You cannot do it.’ That was very unlike the rest of our community.”

This unconditional support “set the trajectory of my life,” Darswal said—a path that has included medical training, a 20-year career with the government of India, and soon, a degree from Harvard T.H. Chan School of Public Health’s Doctor of Public Health (DrPH) program.

Aiming high

Upon graduating from medical school in Jammu and Kashmir and completing her training as a radiologist, Darswal said that her friends and family believed she had reached “the pinnacle of achievement.” But soon after starting to see patients, she wondered if she could make an impact beyond the individuals she was treating.

“I was looking at opportunities to serve the country at scale. I believed I had a lot to give, especially in the social welfare sector, and wanted to help as many people as possible,” Darswal said.

Darswal became interested in government and set her sights on becoming an Indian Administrative Services (IAS) officer. Known as “the guardians of societal interests,” IAS officers can work at a district, state, or national level, providing leadership over policies, plans, and programs across government ministries and departments.

But to even be considered for the position, she would have to pass India’s year-long Civil Services Examination—widely considered one of the most difficult exams in the world, with up to one million candidates each year and around a 0.2% success rate.

“Everyone told me, ‘You won’t make it. You’re wasting your time. Nobody from our state has ever held this position. Especially not a woman,’” Darswal said. “I just thought, ‘Why not?’”

As always, Darswal’s mother believed in her daughter’s abilities, and bought her a one-way ticket to Delhi to get tutoring. And as always, that belief was well-placed. After a year of studying and a year of test-taking, Darswal got the news that she passed the exam and would soon begin serving as an IAS officer—the first ever woman from Jammu and Kashmir to do so.

“It was surreal,” she said. “It was hard for even me to fathom.”

‘200 problems each day’

Darswal’s career in public service was wide-ranging. In the states of Manipur, then Odisha, then Delhi, she supervised the chiefs of every government department in multiple districts, from education, to transportation, to rural development, to health. Presiding over each department’s vision, activities, and expenditures, Darswal said she “faced 200 problems each day.” What should be done about the lack of water supply to remote villages? How might an immunization program reach rural children? Is climate change having an impact on farmers, and therefore the state’s food supply?

“It was a dance floor with a very fast tango going on,” she said. “There was never much time to sit down, analyze, and think through a decision.”

After years of this fast-paced, high-stakes work, Darswal felt the need to take a step back and return to the classroom to “upscale” herself. “There was a lot of new knowledge to gain, and unless I actively pursued it, it would not land at my desk,” she said.

To improve her abilities to manage budgets and resource constraints, Darswal earned a master’s degree in economics from the University of Texas at Austin. Never one to settle, she then enrolled in the DrPH program at Harvard Chan School, determined to carve out a niche for herself.

“Two decades into a career of unspecific, generalized leadership work, I wanted to specialize and focus my energies into the sector closest to my heart—health,” Darswal said.

Learning to lead

If working in government was a fast tango, studying in the DrPH program was a slow dance for Darswal. She received a strong grounding in public health theories and methods, including public health history, policy, research methods, and social sciences. And through the program’s “enabling change” curriculum, she was encouraged to transform as a leader—not only learning about current best practices in leadership, but also engaging in critical self-reflection.

“We took a series of ‘personal mastery classes,’ which over the course of semesters asked us to look inward and think about who we are and who we want to be as leaders,” Darswal said. “That was the first time I’ve been asked to do this sort of thinking. It helped me tremendously—not only as an officer and a leader, but also as a person.”

One key realization Darswal had was how much expectations for leaders have changed since her early days as an IAS officer. “It used to be common to lead hierarchically, with a ‘My way or the highway’ attitude,” Darswal said. “Now, it’s about talking problems through, sharing solutions, looking at whomever you’re working with as a whole person and doing your best to enable them and amplify their voice. Especially for those whose voices are traditionally quieted.”

“All of the instruction we’ve received and practice and reflection we’ve done have really ingrained these ideas and habits in me,” she continued.

The remainder of Darswal’s coursework and research focused on comparing health systems across nations and on strategic health communications, under the guidance of her advisor, Kasisomayajula “Vish” Viswanath, Lee Kum Kee Professor of Health Communication. She studied public health systems, including those in England and Canada; private health systems like that of the United States; and mixed systems similar to India’s, like those in Egypt and Chile. She also studied various approaches to public health communications, especially what worked and what didn’t over the course of the COVID-19 pandemic.

“I know the Indian health system like the back of my hand. But I was not aware of how the rest of the world was approaching health—what other countries’ challenges are, what’s working well in their health systems, how they get information out to their people about how to protect their health. It was helpful to study all of this, with the goal of taking lessons back to my country,” Darswal said.

These lessons helped shape her doctoral thesis, which looked at public-private partnerships in India’s health sector, as well as her thinking on how to tackle the issue she feels most passionately about: financial protection around health care.

“In my country, millions of people fall below the poverty line due to sudden health expenditures they have not budgeted for,” she said. “A sudden illness can impoverish middle-class families like mine. How do we provide coverage and protection against this? How do we make quality health care available, especially as we’re facing epidemics of chronic diseases?”

Serving the people

Darswal looks forward to beginning to help answer these questions after graduation, guided by one simple goal: “Keep serving the people.”

“I’m looking forward to reaching more people with health services and coverage in a better, more sustainable manner, using my experiences as a public servant combined with all that I’ve learned here at Harvard,” Darswal said. “I have researched far and wide, met leaders in practically all fields of health care, and learned how to think about and solve problems holistically. I’ve enjoyed every bit of it. And I’m ready to come at my work better than ever.”

– Maya Brownstein

Photo: Kent Dayton