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Muriel Mac-Seing's International Journey in Global Health


by: Sylvia Lorico
 
Muriel Mac-Seing has spent nearly 15 years of her life working abroad in the field of global health. She been to numerous countries: India, Kenya, Cambodia, Kenya, Nairobi, Nepal to name just a few.  Yet, Mac-Seing admits that when her work abroad began in 2001, she thought she would be abroad for only a little over a year. “It was only supposed to be an 18-month mission,” she said, “But that 18 months turned into another 2 months in Cambodia, then back to India and then Nepal. That 18 months turned into 15 years.”
Mac-Seing began her international career in October 2001 in Gujarat, India after an earthquake hit the region the same year. She was an international volunteer with the Centre for International Studies and Cooperation.  Life in Gujarat could not have been more different for her. Because of the damage the earthquake caused, Mac-Seing lived in a camp with other project staff in the village, helping rebuild after the disaster. “Even so, I was in a position of privilege [in Gujarat],” she said, “I was the only woman with a small space the size of my bathroom and my 20-litre bucket of water. All these things shaped my thinking, especially about my own privilege and the disparities in the world.”
Muriel Mac-Seing has spent nearly 15 years of her life working abroad in the field of global health. She been to numerous countries: India, Kenya, Cambodia, Kenya, Nairobi, Nepal to name just a few.  Yet, Mac-Seing admits that when her work abroad began in 2001, she thought she would be abroad for only a little over a year. “It was only supposed to be an 18-month mission,” she said, “But that 18 months turned into another 2 months in Cambodia, then back to India and then Nepal. That 18 months turned into 15 years.”

Another big difference was, naturally, the language. In this distant village, the inhabitants only spoke Gujarati. To survive, she had to learn Gujarati by conversing with the locals and buying books. “All the train station names were in Gujarati,” she said, “I had to learn the Gujarati alphabet!” Mac-Seing described her time in Gujarat as “her first love,” admitting that it was difficult, but she learned so much about the importance of community. She remembers vividly one of the negotiations she witnessed was between the project coordinator and the community leaders about the placement of water pumps throughout the village. She was awoken at 12 AM to start the negotiations. “And so, we go back to the village at midnight to start the negotiations and we did it at 12 AM because this was the time when they were finished with all their business and took the time to reflect and discuss community matters,” she said.

After her time in Gujarat, Mac-Seing moved to Cambodia in 2003, where she worked with women in rural areas vulnerable to HIV/AIDS and then to Nepal two years later. Although technically based in Nepal’s capital, Kathmandu, Mac-Seing would travel frequently to the mountains to work with women living there from different castes and ethnic backgrounds. This posed its own challenges. “These villages were at the top of the mountain, so we had to trek for a day to reach them,” she said, “Every time I came back, I’d lose 1 or 2 kilos.”

Mac-Seing did not know right away that her work in these countries could be considered work in global health. Mac-Seing understood her work to be part of international development cooperation. “When you’re in academia doing research all these definitions become important: you know what’s global health versus international health versus colonial medicine etc. In a way, I was doing a bit of global health without really knowing it was global health.”

Combining research and advocacy

Mac-Seing specializes in working with, advocating, and researching issues impacting vulnerable populations especially people with disabilities. Her time in Kenya after her work in South and East Asia helped her discover her passion to support those with disabilities through research and community work. “In international development, when we have a project that’s been funded, we seek to ‘copy and paste’ and replicate that in another country,” she said, “And I was trying to push for the inclusion of people with disabilities into national health plans and HIV/AIDS plans.”

Her work required her to do a lot of advocacy work for people with disabilities. She would often meet with high-level officials in various capitals like representatives of ministries of health,  and even teams from the UN and find gaps in their policies. “And always, [these officials] would say ‘Yes, of course we don’t discriminate against those with disabilities, we include everybody,’” she said. “But when you asked them things like ‘How many people with disabilities are you reaching?’ they can’t say anything. So, they don’t exclude but they also don’t include.”

Mac-Seing spent another 7 years in several African countries, pushing for the rights of those with disabilities in various countries and seeking to fill those gaps in national policies and programmes. “When you don’t collect information or don’t plan the project or even just plan the activities with people with disabilities in mind, you won’t reach them,” she stressed.

Mac- Seing’s work in the African region eventually led to her coming home to Canada to pursue a PhD in public health (global health option) at the University of Montreal. Her research focused on the relationships among legislation, health policy and the utilization of sexual reproductive health services among people with disabilities in the context of post-conflict in Uganda. While working on her PhD, Mac-Seing saw another opportunity to be an advocate. Uganda is one of the few countries that collects disability-related data in three consecutive waves of demographic and health surveys. Both quantitative data, and her own interviews provided an opportunity to highlight the reality of the situation for people with disabilities in Uganda.

As Mac-Seing acknowledges, the numbers often do not match what is happening on the ground. One woman with disabilities she interviewed was forced to give birth to her child on the floor of hospital because the hospital did not have adaptive maternity beds for those with disabilities. “Numbers only say half the picture and interviews speak for the other half,” she said, “So yes the [data] was saying that over a 10-year period, the [healthcare] service utilization increased, but what the numbers weren’t saying was that the provision of services was quite poor.”

Another gap she discovered as a researcher was that oftentimes, the results of the research did not reach those in the local communities. “[Many of these local health and administrative chief officers] would say ‘Oh you white people, you come and do your research then you never come back and tell us,’” she said, “So in the last month of my [projects] I went back to see them to share the results of my research. They were really surprised.”

Present day work and advice

Currently, Mac-Seing is working on a 2 year CIHR and Centre for Global Health funded postdoctoral research with Centre Director, Prof. Erica Di Ruggiero on how global health governance during the COVID-19 pandemic is influencing population research health agendas in Canada.

“I was quite preoccupied and affected by the fact that many marginalized populations were really affected during the pandemic,” she said. “One of the important tenants of public health is health equity, and at the end of the day, why we do public health research is to reach for social justice.”

Mac-Seing sees her post-doctoral research as an “expansion” of her earlier work in Uganda. She wanted to “come closer” to national public health in Canada, a pivot from the international context. A veteran of more than 15 years in global health-related work, Mac-Seing also shared some advice for students interested in pursuing a career in it. Her advice? Don’t go straight from the bachelor’s to the master’s and then straight into the PhD.

“Go explore the world before you decide what you want to research,” she advised, “Many of us don’t really know our research topic until we get out into the field.” Mac-Seing explained that lived experience “bridges” with the theoretical aspects learned in university, making people more understanding of the reality of the topics they are researching. “I found my topic anchored in the field and the need that came from my work on the ground,” she said, “I’m really not sure if I had done everything from a linear path that I would have the same maturity in thinking.”

Mac-Seing emphasized that getting on the ground experience also helps a person determine what kind of researcher they might want to be after their studies “Do you want to do global health as an elite expert that publishes lots of things, go to some international conferences for one week and then fly home or do you want to be there for years, learn the language, eat with people there and go buy food from the market?”

Mac-Seing is adamant that the key to good research, especially in global health means interacting with the people and the community. "To me it's impossible to do good research flying in and out. We need to develop trust with people."
It is with heavy hearts that we are sharing the news of the passing of Professor Will Mitchell. He joined the Rotman School of Management in 2011 and served as a Professor of Strategic Management where he held the Anthony S. Fell Chair in New Technologies and Commercialization and Co-Director, Global Executive MBA for Healthcare and the Life Sciences. He was a friend, collaborator and mentor to many in our global health community over the years. He was the Collaborative Specialization in Global Health program representative on behalf of the Rotman School of Management, reviewed applications of incoming students and regularly gave his time to support co-curricular activities such as the Global Health & AI Challenge and the Toronto Thinks Case Competitions. To read more about his life and work please refer to this announcement from Susan Christoffersen, Dean, Rotman School of Management.

Black History 365 Calendar - ARCDO compiles a list of all the events, campaigns, and initiatives planned across U of T’s three campuses that recognize and honour Black History in the month of February.  Students, staff, faculty, librarians and chaplains are invited to submit any event/campaign/initiative for the Black History Month 365 Calendar.  
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December 13, 2021 
Networks & Partnership: Building Reciprocal Global Health Partnerships
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December 13, 2021 
Health Inc. Series - Seminar #2
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December 13, 2021 
The Canadian Launch of the GlobalChild Platform
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December 17, 2021 
SLPS - Championing equity and diversity for health systems change
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December 19, 2021 (registration deadline)
Planetary Health for Primary Care Course 
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May 15-19, 2022
24th IUHPE World Conference on Health Promotion
Location: Montreal, Canada
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October 31- November 4, 2022 (abstracts due Apr. 15)
7th Global Symposium on Health Systems Research
Location: Colombia
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DLSPH Upcoming Events
Register for the Commercial Determinants of Health Seminar Series!
 
The Centre for Global Health in partnership with the Lawrence S. Bloomberg Faculty of Nursing at the University of Toronto are hosting a seminar series entitled Health Inc: Corporations, capitalism, and the commercial determinants of health. The series seeks to promote conversations, research training and collaboration across disciplines regarding the impact of corporations on health. Themes that will be explored include the industry’s role in harm reduction, public-private partnerships, conflicts of interests, sustainable health care and more!

The second is titled "Part of the problem or part of the solution? Industry and harm reduction", scheduled for Monday, December 13th Noon-1pm EST and will feature the following speakers:
  • Abhimanyu Sud, Assistant Professor Dept of Family and Community Medicine, PhD candidate IHPME, University of Toronto
  • Daniel Buchman, Bioethicist and Independent Scientist, CAMH, Assistant Professor, Dalla Lana School of Public Health, Member, Joint Centre for Bioethics, University of Toronto.

To register for the second seminar or find out more information about the series please visit this link
The Healthy Cities in the SDG Era podcast was recently selected as part of a list featuring the Top 20 Public Health School Podcasts!
 
We hope you check out the many important conversations across all the podcasts but continue to listen and share our own podcast with your colleagues and friends. 
More Global Health Podcasts

Global Health Matters Podcast Episode 8: Discoveries from vaccine implementation 

Hosted by Dr. Garry Aslanyan and featuring Margaret Gyapong and Lee Hampton

DLSPH Professional Opportunities

 

PAHO Signs Cooperation Agreement with the Dalla Lana School of Public Health at the University of Toronto to Advance Knowledge Generation on Health and Migration in the Americas [PAHO] 

Frequency and patterns of exposure to live poultry and the potential risk of avian influenza transmission to humans in urban Bangladesh [Scientific Reports] - by Isha Berry (CSGH PhD Student), Mahbubur Rahman, Meerjady Sabrina Flora, Amy L. Greer, Shaun K. Morris, Iqbal Ansary Khan, Sudipta Sarkar, Tanzila Naureen, David N. Fisman & Punam Mangtan


Population Health Surveillance Using Mobile Phone Surveys in Low- and Middle-Income Countries: Methodology and Sample Representativeness of a Cross-sectional Survey of Live Poultry Exposure in Bangladesh [JMIR Publications] - by Isha Berry (CSGH PhD Student), Punam Mangtani, Mahbubur Rahman, Iqbal Ansary Khan, Sudipta Sarkar,  Tanzila Naureen,  Amy L Greer, Shaun K Morris, David N Fisman, Meerjady Sabrina Flora

Vaccines for all? A rapid scoping review of COVID-19 vaccine access for Venezuelan migrants in Latin America [ScienceDirect] - by Amaya Perez-Brumer, Zafiro Andrade-Romoa, Karla Solari, Ellithia Adams, Carmen Logie, Alfonso Silva-Santisteban

Recommendations for improving access to healthcare for street-connected children and youth in Kenya: A qualitative study. [ScienceDirect] - by L. Embleton (Post-doc, Centre for Global Health), P. Shah, A.Gayapersada, R.Kiptuid, D.Ayuku, J. Wachira, E. Apondi, P. Braitstein (Global Health Faculty affiliate)

Strengthening the basics: public health responses to prevent the next pandemic. [The BMJ] - by Victoria Haldane (CSGH PhD Student), Anne-Sophie Jung, Chuan De Foo,  Mathias Bonk,  Margaret Jamieson,  Shishi Wu,  Monica Verma, Salma M Abdalla,  Sudhvir Singh, Anders Nordström, Helena Legido-Quigley

 

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Launch of the Centre for Graduate Mentorship and Supervision
The School of Graduate Studies is excited to announce the launch of its new Centre for Graduate Mentorship and Supervision (CGMS).  CGMS supports successful mentorship and supervisory relationships using a unique person-centred, solution-oriented approach. CGMS offers personalized support to students, supervisors, and mentors to assist them in effectively navigating their supervisory and mentorships relationships. That means they can call or email our team for confidential support regarding their mentorship or supervisory relationships. That’s it. No forms and paperwork. No need to send multiple emails or coordinate between departments. Just call or email and CGMS will be there to provide direct assistance and coordinate other supports. 

Graduate Student Wellness Portal - Looking for mental health services, resources, or academic supports? Need to talk with someone about your experiences of supervision? This portal, developed in collaboration with the University of Toronto Graduate Students' Union (UTGSU), can help point you in the right direction.

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