When 'shelter in place' means nothing: Rethinking global health with Sabina Faiz Rashid

What is global health—and who gets to define it? 

For decades, the field has claimed universality while being shaped largely by specific institutions, priorities, and assumptions. But what happens when we center the places where most global health “problems” are identified? What does it mean to tell someone living in a Dhaka slum to shelter in place during a pandemic? 

In this episode, Salma is joined by Dr. Sabina Faiz Rashid, Professor and Mushtaque Chowdhury Chair in Health and Poverty at the BRAC James P. Grant School of Public Health in Bangladesh; Director of the Center of Excellence for Gender, Sexual and Reproductive Health and Rights; and Honorary Professor at the Liverpool School of Tropical Medicine. As a medical anthropologist whose career has been rooted in the alleys, kitchens, and courtyards of Dhaka’s urban slums, Dr. Rashid has spent decades challenging how we think about health, poverty, gender—and whose knowledge counts. 

Together, they examine what global health often misses: the over-reliance on disease-focused indicators, the tendency to blame individuals for choices that are shaped by circumstance, and the habit of designing interventions far from the communities they attempt to serve. Drawing on vivid examples from Dr. Rashid’s ethnographic work, they explore how a mother’s health depends not only on symptoms or clinical markers, but on whether water runs for 20 minutes today, whether her husband finds work, and whether she has more than one egg to feed her children. 

The conversation moves from methodology to power. Salma and Sabina discuss why qualitative and quantitative approaches both matter—and why neither is meaningful without genuine community partnership. They also consider the limitations of current “decolonization” conversations, suggesting that simple binaries obscure the complex power dynamics that exist both between and within countries. 

This episode is an invitation to rethink global health from the ground up—its assumptions, its methods, its politics, and its future. It’s a conversation for anyone who believes public health must reflect the lived realities of the people it aims to serve. 

 

Useful resources:  

- "Sabina F Rashid, PhD." BRAC University, www.bracu.ac.bd/about/people/sabina-f-rashid-phd. Accessed 24 Nov. 2025. 

- Rashid SF. Poverty, Gender and Health in the Slums of Bangladesh: Children of Crows. Routledge; 2024. 

 

Host: Dr. Salma Abdalla  Editors: Catalina Melendez Contreras and Zachary Linhares  Marketing: Kinkini Bhaduri  Music: Eden Avery / Melting Glass from Epidemic Sound https://www.epidemicsound.com/track/2fqOXWpHab/ 

 

The views and opinions expressed by the guest in this episode do not necessarily reflect those of their institution, the funders, or the podcast team.  

Episode Transcript

(00:05):
Welcome to Complicating the Narrative, a podcast that takes on the challenging questionsin public health by embracing complexity rather than avoiding it.
I'm your host, Salma Abdalla Today, we're exploring what it means to lead, teach, andpractice public health from a non-Western perspective.
Public health as a field often represents itself as global, yet much of its knowledge,language, and priorities have historically been shaped by Western institutions.

(00:31):
So what happens when we shift the center of gravity?
What happens we start from Dhaka instead of Geneva or Nairobi instead of New York?
My guest today has been doing exactly that.
Dr.
Sabina Rashid is professor at the School of Public Health at University in Bangladesh,where she was also dean between the years of 2013 and 2023.

(00:52):
Professor Rashid has spent decades working at the intersection of anthropology and
with a particular focus on how poverty, gender, and health intersect in the life ofmarginalized communities.
Her writing represents years of deep anthropological engagement with communities whosevoices are often absent from global health conversations.
Sabina, welcome
to the podcast.

(01:12):
Hi, thank you for inviting me, Salma.
I'm quite excited to be part of this podcast series because I do think it's so importantto bring in different sort of evidence and experiences and perspectives because context
matter, as you know.
No, I fully agree.
And I think this teased me up very well for my first question, which is about BRAC itwould be great to tell us a bit about the university, the history of the university, how

(01:37):
it started, but also what made you interested in creating a school that has a differentunderstanding of public health teaching and practice that just differs from our existing
paradigm.
Okay, you're asking me to say a lot in a little nutshell, but I'm going to try.
Well, BRAC University was founded by the founder of BRAC.
It's one of the largest Southern led NGOs in the world, late Sir Fazle Hasan Abed.

(02:04):
And it was his dream.
He actually gave up his private sector job during the liberation war to set up camps forpeople who were affected by the war.
And this led to, can we have an approach that's very community based around
food, health, microfinance, training.
So it was basically education and health with microfinance to help these families who arereally, really affected by not only poverty, but by the war.

(02:33):
This eventually evolved into BRAC, but then he set up the BRAC University, in like 2001.
And I joined,
in 2004.
So I've been there for 21 years
We do a lot of multi-country consortium partnerships.
So BRAC School of Public Health was set up in 2004.
We have an international master public health program.

(02:54):
We have a lot of research.
And while it's stressful to look for grants, at the same time, it really allowed us tobuild our own kind of teams and work
with partners around the world.
but also helped us kind of generate evidence from the global South, if we use terms likeglobal South, were kind of in the forefront of doing our own research
And I think because I'm a social scientist, I'm a medical anthropologist, interested inhealth disparities, I brought that element into the school.

(03:22):
I said, we cannot do public health and just do numbers.
but I felt it was critical to understand the how and why of health.
Okay, 50 % of the population have
antimicrobial resistance or are suffering from a certain virus why are they?
How do we understand better what communities are doing?

(03:43):
How do we better understand communities?
And I think that brought in the element of developing more social science component topublic health.
So some of it was I was driven by my own interests.
Secondly, I actually felt as I got older, that this is really critical for public health.
It's only now we talk a lot about multidisciplinary, interdisciplinary, bringing inanthropologists, bringing in historians.

(04:05):
But in 2004, it was very much about bio, epi, statistics, surveys.
I mean, there's some people looking at qualitative.
So some of that has been my own journey, but I think it's increasingly now in the world welive in
post COVID or even pre COVID, I mean, the world collapsed because of COVID, but I wouldargue we've had poverty and health and its interconnectedness for a long time.

(04:31):
COVID would just magnified the level of the problem.
And I think it just made everyone look at it a little bit more, you know, comprehensivelyand realize we have a huge problem.
Yeah.
I think I fully agree.
So first of all, the part about being in your 20s, maybe because I'm in my 30s now reallyresonates with me because I have my students who come in and I always talk about in your

(04:51):
20s, yes, you're very certain about a lot of things, but it's also time to explore andactually realize what you want to do.
So that resonates with me.
But I agree with you, it's interesting.
So I studied medicine in Sudan and practiced in Sudan.
And then I was always interested in any factor that is not healthcare, I've seen it inhealthcare settings that affects health outcomes.
And I know everyone who's studying now public health, they hear social science, they hearinterdisciplinarity and they think, oh, this must be foundational to the field.

(05:21):
That was not the case 20 years ago.
20 years ago, this was very, I even dare to say, it's just like,
not revolutionary in a sense that we're trying to dismantle anything, but it was more ofjust like, this is uncommon for public health to focus on social science issues.
So definitely agree with that.
Yeah.
when I first joined, it was almost like, yes, you're there.
And even when I took over as Dean, the founder, Fazle Hasan Abed, basically said, Sabina,I don't want a doctor to run the School of Public Health.

(05:48):
I want you.
You're a social science.
I feel public health needs to expand.
Because he'd set up BRAC,
and he knew that you need a holistic approach.
And then they would add a few quotes and it was almost like, here's a few quotes tosupplement key data.
And I really wanted to upend this hierarchy of evidence.
Who decides what evidence counts?

(06:10):
And now social science, much more in the West, we're still catching up a lot more in ourpart of the world.
We have to have anthropology and sociology and even history,
to come in to understand the nature of disease, the history of disease, but also how do wefind, it's not about let's just get stuck in abstract.
A lot of the work I do, we inform policy, programs, government.

(06:34):
So it's not like, we sit in theories and talk about problems.
Yes, we say it's messy, it's complicated, but this is also how we need to approach it.
Can we not have a simplistic solution and blame the poor for having disease?
Yeah, I agree.
So you came in and that was that was a different vision.
And as you said, again, in Sudan, it would be very hard to convince anyone in the Schoolof Medicine that we need to think about different types of evidence to inform our

(07:00):
practice.
So what were the biggest challenges that you or the changes you thought I need to make asa dean as soon as you started as a dean at BRAC School?
So I, when I took on the deanship, I think one thing when you set up, you work in a newschool that's not so entrenched like Harvard or Boston, which is 300 years old, but the

(07:21):
bureaucracy also matches some of those changes.
I think when I was dean, I was like, I'm going to bring in and set up a, know, socialscience research.
I'm going to apply for grants that look at public health from multidisciplinaryperspectives.
And I also met like-minded colleagues in universities and institutions in the UK, And Isaid, can we work together?

(07:43):
And some of it was like, you know, we won some grants, long-term grants.
I also was really interested in rights, human rights perspectives, but from a contextualperspective.
So when we talk about women, can we not have gender very much a north centric lens of allwomen are oppressed and all men are oppressors?
As again, we talk about class, race, caste, religion, privilege and power.

(08:08):
So, you know, the rights-based perspective looked at poverty of men and women.
I'm not saying women are not disproportionately affected.
In fact, even more so now
with the backlash on gender rights.
But on the whole, I think when you're working in a new institution, it was set up in 2004,there was a lot more leeway.
I had a lot more support from my colleagues.

(08:29):
I also went about recruiting colleagues who are interested in social science and health.
Because we already had the epi group and the statistician group and the health economicsgroups.
So I just felt like I needed to build that aspect and then how do we work together?
how do we make it much more interesting, the public health research we do?

(08:50):
the teaching we do.
In fact, I started working with others to rework our even our curriculum.
you
Now we're like 30 as a team just for the center and two thirds are social sciences, right?
So it's just, and that was like, what, 10, 11 years ago, but I'm just saying about keepingat it.
Of course there's challenges, but I would go and present at government and they'd be like,thank you very much.

(09:16):
That was very interesting.
But what's your percentage?
How many national level representative samples?
So I learned early on that, of course I'm gonna do national level surveys, but I'm gonnabring in rich ethnographies.
So it was about playing the game, but also bringing in the importance of sharingnarratives and stories.
Because I think you can't just be like, well, that's it, I'm not gonna do surveys and I'mjust gonna talk about the narratives.

(09:40):
Because I think to talk to government and policy and donors, you have to tell, it's liketelling a whole story.
And part of the whole story is bringing in those elements.
So it's not like I would say, okay, no more surveys, but like when we won this big grant,remember pre-COVID, we did a national level representative survey on men's SRHR.

(10:01):
And then we did ethnographies in about six parts, sites of the country, six districts ofthe country.
And we combined it and said, this is what the ethnographies are showing us.
This is what the quant and this is how the ethnographies are answering
some of these why and how and the differences between age groups and caste and class, inour case it's religion and age.

(10:24):
It's about also being passionate But I had to be smart about if I'm gonna talk togovernment, I need to tell them more.
And it's also important for their programs, for their policies, if that makes sense, youknow?
it does.
And just quickly, so for those who don't know the term, it's SRHR, sexual reproductivehealth for men.

(10:48):
I know there are people here who also listen who are not necessarily also public healthpeople, but I fully agree.
And I think, so it's interesting.
I don't know if the history of BRAC and I think you said this, like the history of BRACalso shaped what you did at BRAC University School of Public Health, because I don't know
if you can tell us a bit about
ORS is the story I always tell my students.
So, Oral Rehidration Solution that was started by BRAC.

(11:11):
so if you can tell us a bit about that history, because I do think also he shaped from atleast from my reading of the university, what the university ultimately ended up focusing
on.
I wonder if it made it easier for you as an environment.
I think that's a really good point, Salma.
There's a taken for grantedness of my environment, but the founder of BRAC was very muchcommunity based.
So public health, which I talk about, is not about disease.

(11:34):
He'd say, let's look at where people live.
Can we help them with education, with some finance so they can have some poultry or dosome farming?
Can we provide subsidized healthcare and make sure the kids who've dropped out go toschool?
So I wanted to give that picture because ORS, and I heard it from
You know, I was privileged to hear it from two people like Richard Cash, who passed away.

(11:57):
He was at Harvard and Abed Bhai, we called him Abed Bhai, Fazle Hasan Abed, the founder ofBRAC.
So when ORS was rolled out, they wanted, we had huge numbers of diarrheal deaths.
Okay.
And we wanted to address it.
And this is like in the eighties, you know, people, oh, the poor, they're not literate orhow, you know, we need
We always think top down.

(12:17):
Abed Bhai was like, I'm going to go to the communities.
We need to come up with a solution that women can manage.
And they came up with this solution of using a woman's palm to calculate the amount ofmolasses, you know, it's be gur labon water.
So it was salt, water, and a certain ingredient, right?

(12:38):
And they said, can we figure it out in the hand?
Because we don't want to say,
three fourths of an inch, this and that, and women picked it up very quickly.
Then Abed Bhai, I remember telling me, I realized soon that the women were not responding,even though like we had health workers in the field, they were talking to them in
discussions, and then we realized we weren't speaking to the men.

(13:00):
So again, they started the field work, started talking both the women and men because it'sa family.
Men and women, both parents care about their children.
So then they started talking to the men and women about this solution.
They said women are at home a lot.
This was in the 80s.
Men were going out.
This is what we're trying to do.
The men were like, great.
So Abed Bhai was like, you know, when we talk about communities, we want to talk to boththe women and men.

(13:25):
And then they went to talk to the local religious leaders, the local stakeholders, thelocal leaders who became the influencers.
And it took off.
And diarrheal deaths came down.
And another thing about moving beyond the disease approach, oh, you know, you havediabetes, you know, start eating this.
It's like you live in a world where you don't have options to eat.

(13:47):
You know, if you look at America, right, what do poor people have?
They have food vouchers for processed food that they get out of tin cans, which is high insodium, really bad for your health.
And then we blame them for being obese.
There's no parks.
I remember living in New York, sorry, just very quickly for six months.
I was at Columbia as a Fulbright.
and I got lost and I went in an area that was very, I would say not well maintained.

(14:13):
It was poorer
part of New York.
And I suddenly noticed there was no parks, no trees, lots of broken cars.
Starbucks had the toilets locked.
The streets were just, you know, everything about it was, it was like a parallel world.
And living in Bangladesh, it's the same thing.
You work in informal slum settlements.
It's like being in a parallel world.

(14:35):
You go down to Dhaka city and you have skyscrapers.
And then you go off to uh a periphery area and people don't have basic water sanitation.
You know, food is expensive.
Yeah.
Sorry.
I'm like going off on tangents, but like, you know, a lot of this, just feel is soimportant for students to understand and people in public health.

(14:56):
It's everyday lives that are affected, you know?
I fully agree.
so This is so interesting to me, and to be honest, coming here to the US in Boston, butespecially in St.
Louis, I see that delineation so much clearer about, in St.
Louis here, there's something called the Delmar divide, where it's like Delmar is onestreet.
I live in one area that is one of the better off oh areas in St.

(15:19):
Louis.
If you just cross that street, it changes
drastically.
It's because of laws, of course, here the US where like they divided the city based onthat during the Red Lining laws.
But it was, it's so fascinating to see like exactly what it said.
People live in a parallel world.
If I went there for, uh I was trying to work through that tornado, they had a tornado andI was trying to help.

(15:40):
But if it wasn't for that, I would never have, would have had gone to that area.
Like I could have just lived my entire life in St.
Louis,
in just in the nice area that I live in, which is I think exactly what you're talkingabout.
It's the parallel areas.
And if you don't go and talk to people in the communities about what they need and whatthey're working on and what they have that they can build on, it is much harder to
actually intervene.
The point is with public health is we blame the individual, right?

(16:03):
And the current rhetoric does it even more.
But public health itself, when it focuses on disease, take medicine, eat, diet, lifestyle.
I don't think I can use the word lifestyle for many people who live in America, in poorercountries all around the world.
Disparities not just between countries and developed and developing countries, disparitiesexist within countries.

(16:27):
And when we say lifestyle, we're assuming they have choices and options.
I mean, in Bangladesh, or even if you look in Nairobi, I've worked in Nairobi, but if youlook at even in New York, I saw so many homeless people.
Oh, they're just druggies.
We blame people for their lives.
We don't look at structural and social determinants, unfair policies, taxes, unjust sortof laws.

(16:53):
try to demonize and homogenize the poor without looking in as like they're human beings.
And how do we need to change the narrative of public health?
How do we need to change and have a paradigm shift of how we understand health of humanbeings?
And what is our responsibility and accountability?
And Salma, another point that, when you're talking about when there was a disaster and youhad to go.

(17:18):
You have to talk to communities.
They cannot be objects that we look at the other, that we look down at and feel pity for.
So there's two problems.
We demonize or we feel pity for.
So it's a holier than thou.
But these are communities that we need to learn from, work with, understand.
They're partners.
We have to understand and have conversations about their lives and their needs andpriorities.

(17:40):
Right?
And I think this is very relevant.
I think you've written about this and I've thought about this.
I also wrote written about this, especially during COVID is really like a foundationalquestion of public health.
Exactly what you said.
Who designs interventions and for whom?
I read your article um about COVID-19, especially in the informal settlements or slums inDhaka, where we had shelter in place laws, which was similar to the type of laws we had in

(18:04):
Sudan.
And it's just, it seems to me, and at least maybe I misread your article, it's similarissue to what we had in Sudan.
It was very hard to tell someone.
I grew up in a neighborhood that was not uh well off in Sudan.
In Khartoum.
It was very hard to tell people to shelter in place in a house that has 12 people in threerooms.
Like that doesn't help.
And I remember talking to my mother when I was telling her, you just, you need to stayinside of the house.

(18:29):
You shouldn't go anywhere.
Or say that to the family.
And they would say, this is...
It's great that you care about this whatever virus that you're talking about, but we had ashortage of bread and we need to send someone from the house.
They have to stand in line for like four hours to get bread.
This is the priority for us now.
So as much as we would like to listen to you telling us we need to stay at home with acrowded house, we have other priorities

(18:55):
You know, in Bangladesh, when we had the global lockdown, right?
It's a privileged view of what affects your life.
It's a privileged view of hierarchy of risks.
So I write in my book, you know, Poverty, Gender and Health, Children of Crows inBangladesh.
I write about this because I follow them for two years, families from 20 years ago and

(19:18):
and COVID and post-COVID.
I said, fundamentally, you may have phones and you may be more mobile, but endemic povertyand impoverishment has not changed.
So you know what the women were saying to me, young girls, they were like, you think I'mscared of COVID?
Of course I'm worried about COVID.
I'm more scared of having no food.
How am I going to feed my children?

(19:39):
Who's going to feed the elders?
How am I going to manage?
And they desperately tried to be inventive to get out of lockdown.
What did they get fined and penalized by police and the law?
And this whole notion of COVID is a disease is gonna kill me is a luxury you and me,Salma, can do sitting in you in Boston and me sitting in Dhaka.

(20:01):
I worked remotely for the first four months, got my salary.
The average person, you know, with 80 % are informal workers, which means they rely onlike labor, could be daily wage labor, it could be domestic work.
And that's how they survive.
And most of them lost their jobs.

(20:21):
How are they meant to eat?
And our government did roll out some stipends, but it wasn't prolonged, it wasn'tsustained.
And then you have politics.
We don't talk enough about politics and health.
You also have in every micro neighborhood, powerful leaders.
They pick and choose who gets relief.
We had long lines, we shut it down.
We also had them saying, if you report your symptoms, the police will take you to thehospital.

(20:45):
The police are people they're very scared of.
Police are constantly picking them up.
And so there's such a mismatch.
And in our country, there was a clinical task force, like in many countries.
And I write about this, but I wrote with other colleagues that we need to expand thenotion of risk.
We need to expand the notion of health.
Because if we're talking about context matter, if we're talking about global health, 80 %of global health problems are in developing countries.

(21:14):
Why do we still have a very disease oriented approach to global health?
Why are we dismissing most communities experiences of health where they say, I don't havewater, water comes for 20 minutes.
I just lost my job.
My mother just got injured.
um My food, the prices have gone up.
So we're living on water, chilies and potatoes for about a week.

(21:36):
Why do we dismiss that on health?
Because I was just thinking Salma, for me, if I come home and I've been evicted from myhome,
Imagine I come home and I have nothing.
I've lost my job and I need to eat.
Why would that not affect my health?
Because I'll have less nutrition.
Forget the wellbeing, less nutrition.
I can't afford stuff.
I'm on the streets.
Like why would not, why is that?

(21:58):
Why have we used health in such a siloed way?
Sandro writes about it.
I write, a lot of people write about it.
Will we still, and I think some of it's about, we don't want messiness.
We don't want complexities.
We want.
Hey, we'll deal with this.
We'll deal with disease and then set up more biotechnology to deal with it.

(22:19):
I'm not saying we don't need technology, but I'm saying we need to address some of theunderlying root causes of why people are sick, where they live, and why they're falling
sicker, why they're falling ill all the time.
And it's not about they don't understand.
Most people I've met in communities are smart, capable, resourceful, because they have tomanage with a lot less than you and I.

(22:42):
And I think so this is interesting to me because as I said, increasingly we're sayingpublic health shouldn't be siloed, should be interdisciplinary and we should include
social science, but at least I think in Sudan, but also I think from what you're saying inBangladesh, when they created the clinical task force, when it's time to act, all of these
buzzwords that we use about social science and interdisciplinarity

(23:04):
suddenly disappears to saying like, who are the five doctors we want to have in the room?
Instead of talking, exactly as you said like, should we have economists there?
Should we have sociologists?
We have anthropologists who would say they're trained out.
Yeah.
sorry, Salma to interrupt you, but like we have economists and we have doctors, but wedon't have people from different disciplines coming together.
We became part of a Southeast Asian, South Asia group that was funded by IDRC to look atsocial science and COVID.

(23:30):
And many governments started changing their policies by 2021, where they realized thelockdown had created more hunger, more unemployment, more insecurity.
I think...
violence.
Yeah.
Yeah.
Yeah.
Yeah.
Yeah.
the streets.
You had poor men who were, I knew girls who were maids who were offered, uh you know,like, if you have sex with us, we'll give you a lot of money.

(23:56):
And they were like, no, I can't.
But they started begging on the streets to survive.
And I think the reality is that this is an entangled web of
control and power.
I mean, I disciplines are territorial.
Funding have a certain kind of language of a magic bullet.
Vaccines are gonna do it all.

(24:18):
Vaccines are important, but it's not gonna do it all.
I can get a vaccine, but if I live in an extremely shitty place where waste is around me,where there's no roof, mean, water's dripping, I get diarrhea every other day, I can't
afford to eat.
So I'm saying vaccines need to come along with other components of health.

(24:39):
Yeah.
Yeah.
Yeah.
Yeah.
it's power, it's politics, it's privilege.
I think we continue to look at traditional public health and that seems to be the wayforward.
I'm not sure why, as you pointed out, whenever there's a crisis, we go back to veryconventional public health, very conventional biomedicine.

(25:05):
And I think we need to start challenging this.
I think academics need to start working together, but it's beyond academics.
It's about policymakers being pushed within to understand.
We know what the issues are in public health.
And so I want to pick up on something that you said, or you said power, but maybe goingeven on a more local level.

(25:25):
And this is a question I ask everyone.
You said local leaders have power, right?
They get to decide.
So sometimes when you say communities, they are included in the communities we thinkabout.
But then at least here, it seems to me that the conversation about communities disregardssome of the power dynamics within communities.
So it
In Sudan, I worked on female genital mutilation and I came here and I'll talk to peopleand they say we just need to lift it to communities.

(25:51):
And then communities are going to solve the problem without really recognizing the powerdynamics all through the community.
I don't know how to explain to people if we just had let a specific community with justthe leaders decide what is needed, I don't think FGM would never have ever become a
priority there.
So we need to think about also about those power dynamics within a community and how dowe.

(26:13):
So a lot of the work I've done, use not to use big words like intersectionality, but Ilike to work with people who are diverse, okay?
Because a community, just like you and me, we're not homogenous.
I don't represent every Bangladeshi woman or group or category or age or background,neither do you for Sudan, right?

(26:37):
So when I work in urban informal settlements with communities,
that doesn't mean just male leaders.
I talk to female headed households.
I talk to elderly people.
We talk to people with disabilities.
We talk to adolescent girls because I think it's very important in any kind of leadership.

(26:57):
There's always an absence of voices, right?
And I think when we look at public health also, a lot of our research is foundparticularly in the Rohingya camps, but in urban slums.
When it came during COVID or a crisis, it's those households without any male guardiansthat suffered more.
It was those households where they were elderly, couldn't actually line up for three hoursto get their food rations.

(27:21):
Those adolescent girls who were married early didn't have much of a say because it was themother-in-law, father-in-law deciding.
And I think it's very important.
And then leaders themselves, this is the paradox, right?
So you have these leaders who are powerful because they have political ties with othersbeyond the slum,
police and other politicians.
At the same time, these leaders then become exploit them, but also become theirprotectors, right?

(27:45):
Because the structural system and the lack of governance has created these systems toflourish.
At the same time, you've created these systems where you have leaders who then controltheir own populations, right?
Then you have larger level leaders and politicians who make sure that everyone else iskind of

(28:07):
affected because I mean, you know, at the end of the day, I feed when I work in slums,even when we draw a power and privilege and politics, I don't find it's a win-win.
I feel they're a product of the structural systems and the lack of governance andcorruption in many of our countries in developed and in developing countries.

(28:29):
What I see, right?
And what you happen is we've created these power inequities within slums, I agree, whichis very important to understand health and health experiences and lived experiences and
particularly gender and vulnerabilities, but by having a much more micro understanding.
And I think sometimes RCTs homogenize groups and qualitative and ethnographies and socialsciences bring out these different diversities and the complexities of even priorities and

(28:55):
needs.
I'll give you an example, young girls when they're talking about making latrines,
they were really worried about space at the bottom and they wanted more privacy and theywanted some space that allowed them to change their, either their menstrual cloth or their
sanitary napkins.
And if I just spoke to a bunch of guys, they'd be like, can we just fix the door?

(29:16):
Right?
So it was very important to understand that, and then whose voice speaks for whom.
And I always find with, even as an anthropologist doing field work, am I representingenough of the diversity of voices?
Have I shared some of this feedback and validated some of the, and am I willing to adaptand refine and change the course of what I'm doing if I'm being ethical, as opposed to

(29:40):
this is convenient, we've already figured this out, how do we make this work?
In fact, one of our projects, ARISE really did that.
We built water points in the slums where we found that certain people just didn't haveaccess to water.
They had to walk, particularly women, but some of the men walk like a good 20 minutes toget water.
So we then built water points, but we had to work with the local leaders and incentivizethem by saying, well, you're the leader and work with them to allow for water points to be

(30:08):
set up for the more marginalized communities who don't have access, right?
Same thing with looks needs.
So it's about working and being aware of these nuances that you point out, Salma.
I think it's very important.
Yeah.
So two threads here I actually want to pull on.
uh But I think I'll get back to the gender one because I actually really like that youframe that gender sometimes also is like men are affected a lot by that by how we think

(30:34):
about gender in a society, which I like that that's a thread throughout.
But I'll come back to it later.
I really want to push down more about your experiences and as an ethnographer, because Ithink your book, which I didn't get a
get to finish all of it.
I'm actually reading it right now.
I was reading it for preparation for this.
But yeah.
I'm starting a second one, but looking at young women who are going to college who live inslums to understand the experiences.

(30:59):
Yes.
I'd love to get your feedback.
Happy.
Happy to send it to you.
But I think, yeah, so it's I think you mentioned earlier, it's called poverty, gender andhealth in the slums of Bangladesh, children's of crows, in case people are interested in
buying it and we'll leave we'll put a link also in the notes.
I as someone who was trained in clinical medicine and then in epidemiology, I would loveto hear first why ethnography because that's what you pick the field that you pick.

(31:23):
And also what does it mean to immerse yourself?
I think you mentioned that for two years in a project and how do you usually think aboutthat method as you're writing?
You know, some of it is just, my training in, you know, medical anthropology, and alsoyou'd end up doing ethnographies, you end up spending time with communities.
Immersing oneself, I mean, if I simplify it for even students or people, you don't have tospend two years.

(31:48):
I mean, I had the luxury of doing another project for two years, but even can we spendthree months or six months?
Because when people start to trust you, residents, wherever they live,
they open up and start sharing.
It's beyond the nutrition standard, politics standard, like I have this disease, I'mmanaging, because you start having conversations with people and it's about how you

(32:15):
approach it.
So ethnography really is about narratives and trying to learn about individuals.
I call them some of them my friends because they became my friends over a long period oftime.
Of course, the power relations are different.
But at the end of the day, the power relations also shift.
I relied on them.
They started relying on me.
But immersion is really spending trying to understand their everyday lives.

(32:41):
my first training was when I was doing my PhD, which was a long time ago.
I had a set question around reproductive tract infections.
I wanted to understand vaginal discharge and terminologies around that.
And I kept going to the slum.
This slum I picked, uh
It's called Fulbari Slum.
And it's in the book because I talk about present and past.

(33:02):
And I kept asking these women, you know, tell me about did you go to this clinic and whatwas your symptoms?
And as I was spending time with them, they were like, you know, my husband just lost hisjob.
I am a tenant.
Oh, I have to go now because I need to get water.
Water is going to come for 20 minutes.
And I see them take this bucket, rush back and sit down.
And the child would cry and say, what's for lunch?

(33:23):
And she'd be like, be quiet.
You know, I'm waiting for
your father to come home.
He'd come home, he'd give her one egg and then have a bit of rice.
She'd start cooking it.
Then they start arguing because she'd be like, well, you know, I haven't eaten properly.
And he'd be like, do you think, you know, it's easy for me?
I've been also struggling and you know, they've shut off these roads and the police arefinding us.
And then I see all of this and I'd get really frustrated.

(33:44):
And I'd be like, yes, I studied anthropology, but like, I also want to understand a moremedical anthropology of like,
culture of language, and it was more, and then I shifted to actually critical medicalanthropology, which was, and I'll explain why, because I'll be like, I remember writing to
my supervisor going, you I'm not trying, I'm not getting enough on their health seekingbehavior and all of that.

(34:06):
I mean, I had larger questions, but I thought, let me start with health seeking and thengo into their lives and experiences.
And then it struck me one day, cause I was looking through my notes and I thought, they'retelling me about health.
Sabina, you're such an idiot.
She's telling me, I don't know if my husband's got a job.

(34:27):
I've got one egg to eat.
I haven't eaten in two days.
I have to rush off to get water.
All of this is impacting.
And then she started talking about, I feel weak all the time.
then, I have discharge and I don't know if the discharge comes from an infection, and thenI looked at their rooms.
There's one bed sheet.
There's barely a fan.
There's a, you know, there's a little
room with no ventilation.

(34:48):
I thought discharge is just one symptom of a larger problem, public health.
And I think that's when I realized I need to immerse and understand their everyday livesand spend time with them.
And it kind of changed my life.
It changed the way I understood public health, but anthropology, also critical medicalanthropology, but also communities.

(35:11):
And I just realized I cannot do public health the way it's being done.
And I cannot do medical anthropology the way it's done.
I'm not interested in the language and culture of discharge.
I'm really looking at gross health disparities, stark, stark health disparities and whatdoes health mean.
And that actually changed from my PhD onwards I started bit by bit trying to understandmore broadly what is health

(35:35):
When you meet people who say, and I think you've probably met a few of them who say, well,ethnographic work or anthropology is not rigorous enough as what we do in epi what do you
say back?
I mean, people don't say that because they're a scared, but if they do, I would say whenyou spend 10 months, 12 months trying to understand, because the depth and the detail of

(35:59):
the ethnographies, and there are anthropologists in public health, writing about publichealth, you know, some of them, there's a lot of famous people.
So I don't think people would say it's not rigorous enough.
think people, I think they would not understand it.
They're like, well, you looked at 10 case studies.
How is this like
representative?
And I'm like, well, 80 % of informal workers have these lives.

(36:22):
I've got, you know, 60, 70 case studies.
I'm just sharing three case studies.
And when you have that level of detail, I usually, I've not had anyone say it's notrigorous enough.
I've had people say qualitative, well, very interesting.
10 women said this.
And I understand qualitative like quantitative if it doesn't have methodological rigor,any of these disciplines,

(36:44):
be it quant or qual, it'll show through in the quality of the data, right?
It'll be very generic.
The deeper the depth and ethnographies tend to be very, very detailed.
And then you've got literature and enough data.
You know, if I say, you know, there was a queue of, you know, in my book, I talk about sixwomen.
There was a queue of like these six women wait for three hours.

(37:07):
There's enough 20 newspaper articles that talked about during COVID
that thousands of people were lining up for three to four hours just for food relief.
So it's not something that people can get away with.
I think what my, rather than get into, ethnographies are known for their methodological uhexcellence in its field.

(37:28):
What I really like is being brought into public health.
I think one of the criticisms around qualitative, and I would say the same for quant,depends on the variables and the levels of analysis.
If qualitative
is used just for a few quotes and it's not representative, it doesn't show diversity, itdoesn't show nuances, then you can challenge the rigor.

(37:48):
And I have worked with colleagues who have given me qualitative data and I've said, excuseme, you've just made some very generic statements and this can be misused and I'm not
clear about your methods and we need to strengthen it, right?
Same with quantitative, you you jump to certain kind of conclusions using certainvariables and if,
I work with colleagues who are epidemiologists and statisticians who will be like, no, Ithink we need much more analysis around intersectionality in this survey of younger men,

(38:17):
older men, Muslim, Hindus to understand risk behaviors.
So I think that criticism can be looked at by any discipline if you don't actually do themethodological rigor that's required.
I mean, I think you can get away with a lot of crap anywhere.
Yeah, yeah, yeah.

(38:37):
very careful and just say, you know, this is how.
And also for most people who doing public health, I mean, for us, we have to publish, wehave to present, we have to, you know, and more than that, we're presenting to government.
You've got people in government who are in research.
They ask very hard questions about which district, what and how, and what are yourecommending?

(39:01):
So you can't really, you know, just say, okay, it's an ethnography, so therefore,
lots of stories, which people liked.
Yeah.
I don't know if that's a enough answer, but I just feel like rigor itself needs to bechallenged.
And another point I wanted to say, and I've written about this in Lancet sorry, is thatone of the problems in this model of the North we've inherited here is the individual

(39:25):
research expert.
That's really flawed.
You need to have communities and practitioners in your research team.
There is no individual expert.
The data you collect is actually enriched by communities and practitioners, and you needthem as part of your research team.
Along with multidisciplinary, it's not just adding a bunch of researchers together fromdifferent disciplines.

(39:47):
You need to have community as part of your research.
If it's not too sensitive, I'm not looking at sexuality or SRH, you know, but you needcommunities and you need practitioners because people, practitioners and communities know
their context best.
You know your home best.
You know your lifestyle best.
This individual health expert is actually hugely flawed in the North and we've cut andpasted it because it works for us.

(40:15):
I'm an expert.
I'm the professor of poverty and health and you know, blah, blah, and I'm theanthropologist.
But really I'm learning from communities.
They're our teachers, right?
We're trying to understand and learn.
There's harmful practice.
There's a lot of stuff that we can learn from.
And there's practitioners who've been implementing programs for years.

(40:35):
I think, when we say rigor, everything can be rigorous or not rigorous.
We just have to be very clear what we mean about rigor.
And I actually, it's interesting.
I think I read the article in the Lancet.
I've been preparing for this for a few weeks.
So I read a lot of your articles.
I know, I learned a lot.

(40:56):
And I think I agree, especially when it comes to public health.
And that's the interesting part for me.
We pay lip service to all of this.
It's very hard for you to go to a place right now in public health who doesn't say, weneed to, of course, think about different perspectives and think about practitioners and
think about a sociologist being here or someone else.
But it's always interesting to me that we just somehow always then revert back in practiceto something very different from what we preach, which is that's a disconnect, I think,

(41:24):
I'm trying to understand But yeah, go ahead.
Yeah.
in charge.
And I think it's about even like, you know, there was a criticism that a lot of papers arewritten by, you know, I have a different take on decolonialism Yeah, there is a lot of the
colonial legacy.
There is a lot of the overtly differential, but I also think it's not so simple.

(41:46):
I think it's about elites, it's about privilege.
It's about how I use my privilege as a dean,
you know, educated and what I do with that in my own country as well.
We talk about parachute researchers from the West.
We don't talk about domestic helicopter research, which is I fly in and out of my owncountry in one field and I write about it.
But I think a lot of it's about power and privilege and we have to shake it up a littlebit.

(42:09):
People have to be, give, we have to give a little bit, give up their territory, give upthe silos and say, okay, how do we make this work better if our actual goal is improving
health
of the disadvantaged populations, right?
So that's interesting.
Maybe it's a different conversation for decolonization, because I feel the same.

(42:29):
It's so funny to me.
It's so interesting that we talk about power differentials between countries.
I am fascinated.
And maybe because I grew up in a low income area in Sudan, and then I got very lucky.
And I think now I am in a much better, I know, privileged position for sure.
you're lucky.
I think you worked hard and you achieved what you did.

(42:51):
It's not about luck.
Yes, there is, you know, good opportunities, but some people don't actually get this far.
You did well and you worked hard for it, Salma.
I want you to remind that because I think we often like kind of dismiss it as luck.
No, I worked really hard.
When I was Dean and now I'm working really hard on my research, right?
And we meet good people who support us along the way and mentors and other colleagues.

(43:14):
I appreciate that.
Thank you.
I think I think it's interesting because I think within countries, sometimes I have likeit feels like it's a weird conversation.
There are some people I know in my country who have never been to neighborhoods that andwho would lead the Ministry of Health in Sudan.
Right.
And would never have been in neighborhood like mine.
Yes.
was always mind-baffling to me to say this person has more authority than someone wholived in Delmar area that I was just talking about in St.

(43:39):
Louis who knows more about poverty I think and who might have a comparable life experienceto my mother than this person who leads the Ministry of Health in Sudan.
So I really appreciate that perspective.
Yeah.
we talk about that.
I think it becomes very convenient about us versus them.
But if you look at abortion, if you look at certain rights for sexual minorities, this wasacross borders, across countries, movements that came together.

(44:03):
Then to reduce it to you, us, versus, that doesn't take away from, yes, there was coloniallegacies.
That doesn't take away from.
But how are we reproducing certain things?
How are we just, I think, scapegoating and making one group all bad and us sort of likethese victims is not helpful.
Because I think if you look at public health, even in our lives of development, I've hadfantastic partners who are extremely supportive.

(44:30):
I work with people who've worked in areas, as you were saying, with a lot of poverty, havebetter ideas than some of the people
where I live and the people I meet that have never ever stepped into a informalsettlement.
I met Bangladeshi and even kids, because we have kids from all over the world in ourinternational MPH, who've never been to a poorer neighborhood.

(44:51):
Like they live in a bubble.
So, I mean, I think we need to have those discussions.
So otherwise we end up losing a lot in public health.
It's sort of like you versus us versus, you know, and then leave it at that.
How's that helpful?
I don't know.
I fully agree.
this is actually making me think hopefully I'll bring you back for a conversation aboutdecolonization because I agree with you.

(45:12):
I really think we there is so much nuance that needs to be added to that conversation.
It seems like we stopped at a certain place and then we never move forward or made theconversation more complex.
But just quickly, I want to go back to the thread who said about gender because I thoughtthat was interesting.
I see this here in the US uh I listen to some of the what you call like we have the genderbacklash,
the Manosphere, what they call them here, Manosphere podcasts.

(45:33):
And of course, a lot of it is over the top.
It's just very hostile against women and sexual minorities.
But at the same time, I think that sometimes it feels to me like in public health, yes,women, of course, curry the brunt of a lot of the difficulties we have that we need to
address in public health.
But it seems to me sometimes a conversation about gender, mostly just focused on women.

(45:55):
And sometimes we forget what you said.
Like we don't include class.
We don't include uh any other issues that people need to think about.
Like during COVID, I was part of writing up about the impact of COVID.
And we usually always all the time think about gender-based violence, which it did happen.
It increased during COVID.
No one can disagree with that.
But it was rare that when I'm writing a gender section that we also write about how it wasmostly men who were dying from COVID because they were exposed more.

(46:19):
And I don't know how in public health we can hold two things at mind.
It's just, yes, women are really vastly affected by all the inequities we address, but atthe same time, men in certain situations, because of how we think about gender, are
actually severely affected, especially like here in the US, we have younger...
Exactly, suicide.

(46:40):
men being locked up disproportionately in jail.
And then they blame.
Yeah, yeah.
Suicide among teenagers.
The numbers were fascinating to me when I read them.
It was really shocking.
Most of the teenage girls, the majority of uh suicide ideation is among teenage girls.
But in the US, the vast majority of teenage suicide is actually by, I think up to 80 %among teenage boys.

(47:04):
And that to me is like, we don't necessarily talk about that.
So yeah, I don't know if you have thoughts on how do we address gender in New York?
Yeah, yeah.
think we need to really push back.
Like, why do we have this one linear model from the seventies or eighties?
I'm a feminist.
I'm all for feminism, but like a very standard definition of gender for the whole world.

(47:28):
One.
Two is in many countries in your country, Sudan, Bangladesh, Nairobi, I've worked, Nepal,because we have partners.
multi-country for the very poor.
In some ways, we're crippling women as well, you know?
Because we're seeing men and women, of individuals who rubbing up against each other inopposition.

(47:50):
A lot of these families are together trying to survive.
So in Bangladesh, I'll give you an example.
Like I think we needed to work with women because they were having seven children.
Immunization was low.
They were not going to school.
So the government set up stipend programs for girls to go to school, immunization, garmentfactories.
But then I feel like we somehow along the way, like in many countries, men were just sortof forgotten.

(48:16):
So like men don't have jobs, but women are being hired in garment factories becausethey're cheaper to hire in terms of labor.
Well, know, things like that.
like we talk about family planning and contraceptives.
We'd give it to women, microfinance, give it to women.
We would take it for their husbands for these loans.
So why are we so reluctant in public health?
Like we took this North American lens of women because all women are victims, all men areoppressors.

(48:43):
And then in developing countries, it's even worse.
All brown men, black men are really horrible.
Yeah.
And all brown women and all black women are just miserable.
They're such victims.
America has its own weird kind of narrative around, you know, blacks.
I don't want to go there because I don't know it enough, but I'm just saying developingcountries you've got Middle East men, if you look at Arab men, if you look at Asian men,

(49:07):
they're either effeminate or they're demons, right?
The general language of the problematic.
You know, I remember when I was getting married, someone asked me,
What's your husband like?
And, know, I won't mention names.
was traveling and I said, he's great.
Was he Bangladeshi?
I said, yeah.
Oh, so he, you know, he gives you freedom.

(49:27):
You can work.
I'm like, yes.
So there are these stereotypes, right?
And I think the stereotypes are much more than we were Afghan man.
Everyone must be a Taliban.
Oh, Nepalese.
Everyone must be a Maoist.
Every Muslim man, Jihad, every, you know, we have these ideas, It's also affected, youknow,
men all over the world.
And particularly, we don't want to talk about poverty.

(49:50):
We don't want to talk about caste, class, racism.
Because one, public health in itself is so traditional and conventional, it doesn't wantto go there.
Two, women have been disproportionately affected, but at some point, poverty means thatmen and women are also being affected.
Men in my country, in many countries, worry about not being the rice winner, the breadwinner.

(50:14):
They get anxiety.
You can't get married if you don't have a job.
A lot of them are, you know, then they get into, you know, we talked about domesticviolence against women.
Huge problem.
Yes.
But there's a lot of gang violence in informal settlements.
We don't talk about that.
And I think some of it is, and I don't even want to, I think it's convenient rhetoric.

(50:35):
So we have convenience about being the poor because they're too stupid and we give themmore knowledge, education and programs.
You also have a lot of, um
very much divide and create, you know, immigrants against immigrants, create men are aproblem, women are this.
I think some of it's political, some of it has just stayed.
It's just the mindset and it's not just related to public health.

(50:58):
It's media, it's our kind of socialization.
It's the way we other, the othering of people from different countries and individuals.
And that kind of has seeped into the way we understand our world, what we value.
who we devalue and how we look at men and women.
like, you know, I'll be honest, I think my husband and I will go to an immigrationcounter.

(51:22):
He'd be given a harder time than I will in most cases, because he's a brown male comparedto me being a brown female.
I'm just kidding, I don't know.
I mean, I don't know if I'm going off too big, but some of this is much more about theworld we inhabit.
It's not just public health.
It's the media, it's language, it's literature.
It's about how we view, the stories, you know, not without my daughter, every.
I'm not saying

(51:42):
Yeah.
Yeah.
Yeah.
patriarchal systems.
It's everywhere.
In America, in my country, Sudan.
But I don't think we can say that's all and that represents all men.
And I think when we do that, particularly in public health, we are denying andinvisibilizing a huge percentage of very poor men who are struggling, who look after their

(52:07):
families, who have diseases, who don't take health, who don't seek care.
who don't want to be seen as weak, who are really living very precarious lives.
And we need to have those conversations.
Yeah.
Yeah.
Exactly.
we need social analysis to understand.
Why do we view the poor as this group that we always talk about?

(52:29):
We've already objectified them.
The poor in Sudan, the poor in urban slums.
I think we really need to take a step back, even us, in our fields and say, we have kindof homogenized a stereotype.
Yeah.
And I think that's part of what you're saying.
It's like, yeah, none of those is a complete story.
Decolonization or colonization is not a complete story.
Patriarchy is not a complete story.

(52:50):
It's true.
Yeah.
Yeah.
Yeah.
Yeah.
Yeah.
Yeah.
Yeah.
Yeah.
Yeah.
Yeah.
I agree.
I agree.
So before we end, I wanted to pick your brain very quickly.
I think I'm lucky to have you today so just want to pick your brain about a few topicsthat I've been thinking about.

(53:13):
But the last one is really about your perspective on what is global health?
What does it really mean today, just the world we're living in, where it just seems likethe world is, there are so many tensions happening, rising nationalism.
We have, I'm pretty sure this is not going to be the final pandemic, but we have, we havedue political tensions.
So I don't know how you envision what global health is right now.
So for me, I just look at, work at local health, you work at your local health, we cometogether and we need to understand and explain the world that we live in, okay?

(53:45):
I wanna say, if we're gonna talk about global health, then we need to acknowledge andunderstand that there isn't some standardized universal definition of health.
We really need to.
We need a whole kind of, not just, oh, reimagine.
push back, interrogate, break down, dismantle what health is.
And it's not just disease inside the body.

(54:07):
That's one.
Two, we need to also break down notions of gender, health, wellbeing, and why contextsmatter.
Why is it so important?
Two.
So language and power is very important.
So my other point about health and evidence is can we dismantle

(54:30):
the knowledge hierarchies that exist, which is epi and bio.
Can we say now there's enough evidence to say social science, anthropology and otherdisciplines are equally and part of and inform health, health conditions, whether it's
global health conditions or local health conditions.
So we really need to push that.
I also think we need to kind of talk about public health in a way that brings indiscussions around governance and accountability.

(55:00):
I don't know if that makes sense.
I don't think we have enough of those conversations.
For me, global health, I want to have conversations around governance.
I want to have conversations around accountability.
I mean, we're looking at climate change.
Bangladesh is, I think, one of the eighth most vulnerable countries in the world.
But the cause of climate crisis has not even changed.

(55:22):
For us, it's a crisis.
There's no future climate change.
It's happening right now.
Then we need to talk about accountability.
Who's responsible for the climate crisis?
right?
So I think health itself, we need to unpack and say, what does it look like in differentcontexts?
And then when we bring that together, how do we then dismantle existing understandings?

(55:44):
And it's not just understandings, standardized frameworks, definitions, push back and say,we need to redo health and global health.
If we want to make a change, if we really want to help those who most affected, be itBangladesh, be it Sudan, be it,
New Orleans, be it, you know, I mean, I just think it's very important.

(56:04):
And that means having some deep interrogation and reflection and working across not onlyjust academics, but, you know, policymakers, practitioners, funders, funding bodies that
still exist, you know?
And I still think with all the stuff that's happened with, you know, money and resourcesbeing pulled back, I still, I mean, I see a glass half full.

(56:25):
I don't like to see it half empty.
I think there's opportunities.
can create new allyships.
We can create new kinds of ways of working together.
But make sure that for me, it's very important to keep pushing that the people we workwith are human beings.
They're not a disease statistic or a number or just a narrative.

(56:46):
These are human beings and we have a certain ethical responsibility in our disciplines toshare as much as possible on the complexity of their lives.
Yeah.
So as we, as we come to close here, I think I really liked the glass half full partbecause part of what we wanted to do with this podcast and hopefully it will do more in
the future is yes, people, when they talk about public health, we talk about all thethings that need to be done.

(57:08):
think about disease, we think about like, no, no, but we have been like, we have all ofthose issues that still need to be addressed.
Like usually the conversation is very, there are so many issues that need to be tackled.
And I think it is helpful for younger people at least to hear about the progress we'vemade as well.
So I don't know there is one area that you think we've made, given all your work thatwe've done.
Yeah.

(57:28):
I I think I live in a country like Bangladesh where we had BRAC.
They had developed ORS, which was given door to door.
It was just sugar molasses and water.
And it brought down diarrheal ill diseases.
I live in a country where Grameen, who's now, you Yunus, who got the Nobel Prize, youknow, microfinance, got five women together and said, you become each other's bank
collateral.

(57:49):
And we set up microfinance throughout the country.
I live in a country where kids who drop out of school have a non-formal primary educationprogram that they can go and catch up.
I live in a country where it's not perfect, but I also think that it is up to us then tochange the conversations, to keep moving forward.
And I think we have enough resources and opportunities and enough allyship of people whothink the same way to start looking at.

(58:14):
I mean, there's so many things that are positive.
You've got people who are still going on about climate crisis and there's activism there.
You've got people still talking about food insecurity and
And how do we then align it to like health and make sure that people don't get evicted?
You've got people still talking about in your country, guess, Obama care is still there orI don't want to get political, but I just know that there's some kinds of care and

(58:39):
insurance.
I'm not into your politics, but I just feel like in your part of the world, there's stuffthat's still going on.
People are pushing back.
I think, but I do think that in health, whether we call it global health or local health,health in itself has to be interrogated and dismantled.
We cannot, and we need to start working outside.

(59:00):
Instead of preaching to the converted, I think we do need to have conversations withpeople in the private sector, people working in different oh organizations, bring them
together.
There's a lot of people who have a lot of interest in health and development, who arecommitted, who have a vision.
And some of them just want to get support.

(59:21):
But I think we need to start also uh looking outside the box.
Yeah, yeah, yeah, yeah.
Well, it does.
What would be your advice for someone who's starting today?
Like undergrads.
I just gave a lecture last week to undergrads who are really thinking about health andwhat they can do.
I think you can do so much.
I think, you know, just spend time in a community where you live, try and understand theirlives, their health, their everyday lives, their wellbeing, for you to just immerse

(59:51):
yourself in that community.
It could be your neighborhood, it could be an hour away , will teach you so much.
will be, you know, knowledge is what's important about knowledge is you're alwayslearning.
I'm 56.
I'm still every day.
I go to the field.
When I do go to the field, I feel like I've learned something new.
I actually think that if you're in public health, you are the future.

(01:00:13):
You are the one who's going to create change.
You are the one who I hope, listening to me and Salma, will say beyond numbers, I'minterested in statistics, I want to capture stories.
I want to spend some time with these communities.
I want to understand their everyday lives.
And one day, whether I'm a journalist or I'm a writer, or if I go into policy, or if I gointo government, I will create change.

(01:00:35):
It sounds corny, but I do think
you do have an influence in policy and in programs.
Some of the biggest changes in Bangladesh has been through our journalists.
They will write hard hitting articles in newspapers and you've had ministers come andimmediately change some of their programs because there's so much criticism.
So I mean, I think you can do a lot.

(01:00:56):
And the only way you can do a lot is through learning, through knowledge and throughwriting and through your own experiences.
I don't think there's any shortcuts to learning.
But if you're passionate, you can, you know, we have so many students coming from othercountries to our country, doing internships, learning from us.
Oxford University every year sends students and they love it.

(01:01:19):
Not that they, oh, I love, they love being in a completely different environment andlearning about communities in rural areas, women and their lives and livelihoods.
And I think there's so many opportunities to learn.
And I think.
I do have hope in the younger generation because I feel like they're the ones that are tobe the ones that are to push back against a lot of the shrinking civic spaces that's

(01:01:42):
happening right now.
we have.
I fully agree.
So the last question we have is, uh what should people take from this?
What is one narrative that needs to be complicated as we think about health?
Which I think you alluded to.
I think I might know the answer from you right now.
But what do you think should be the one narrative they really should think about as theythink about what they need to do in public?

(01:02:04):
I think every individual we meet is a human being.
They want to live a life of dignity.
And everyone has the same aspirations, hopes, and dreams.
So whether we do research or we work in programs or whether we write, whether we want tolearn about them, we need to realize we're working with people who have a lot to share and
we have a lot to learn from them.

(01:02:25):
Some humility, some respect, and some empathy
would go a long way in improving your own public health career.
But also it's very rewarding if you kind of shift why you're in this and what's your goal.
What do you want to do?
Why do you want to understand their lives?
Is it just to get a publication?
Is it just to be a teacher?
Is it just to be able to get a degree?

(01:02:46):
it because you actually, I think it's very, you get a rich, when you understand much morepeople's lives, you realize how much you have in common.
The color may be different.
The socioeconomic stages may be different.
People may live different lives, but actual, the needs and priorities and aspirationsremain the same.

(01:03:09):
And I think if you're in public health, it is critical and ethical to tell the story in away that's far more comprehensive, realizing there's multiple truths and you're always
leaving some stuff out.
I don't know if that's what...
uh
can be a one-liner.
I'm not good with one-liners, sorry, Salma, but maybe if you can come up with something.

(01:03:32):
But I just around with human beings and we know this business, some ethical moralresponsibility we all come with, whether you're a student or a faculty or, and, and, and,
and there are partners.
They're not objects.
They're not objects.
yeah.
No, I think this was great.
Thank you so much, Sabina.
Thank you so much.

(01:03:52):
Really enjoyed it.
I really appreciate it.