Dr. Kirsten Johnson, M.D., MPH: Assistant Professor, Department of Family Medicine, McGill University; Director, Humanitarian Studies Initiative, McGill University; President, Humanitarian U (Part One)

Author(s): Scott Douglas Jacobsen

Publication (Outlet/Website): In-Sight: Independent Interview-Based Journal

Publication Date (yyyy/mm/dd): 2015/01/22

ABSTRACT

Part one of two, interview with Dr. Kirsten Johnson, M.D., MPH.  In it, she discusses: current positions at McGill University, McGill Affiliated University Hospital (MUHC), Humanitarian Studies Initiative, and President of Humanitarian U; growing up in Alberta and British Columbia in addition to Victoria; original dream of being Indiana Jones; major areas of research, Harvard University, Darfur, Chad, and gender-based violence; most recent quantitative research and $27 million dollar Congo research; money to bolster research, descriptive research, admirable trait in practical and applied research, and research project for unlimited funding and unrestricted freedom; the overarching phrase of “Empowerment of Women”; organizing principle for desire to do good in the world; controversial topics and examination of the controversial topics in areas of expertise; the argument against some humanitarian initiatives in opposition to her; and prior interview with Dr. Hawa Abdi.

Keywords: Dr. Kirsten Johnson, Humanitarian Studies Initiative, Humanitarian U, McGill University, United Nations.

1. What positions do you hold at present?

I am an assistant professor in the faculty of medicine at McGill University.  Also, I am an attending staff in the emergency department in the McGill Affiliated University Hospital (MUHC), a teaching hospital.

I am program director at McGill University called the Humanitarian Studies Initiative (HSI).  Last, I have a company that does a lot of the same kind of things.  It is called the Humanitarian U.  I am President of that company.

2. Where did you grow up? How did you find this influencing your career direction?

I grew up half in Alberta and half in British Columbia (BC), in Victoria, and I do not think growing up in BC necessarily influenced my career, but the travel I did at a young age more than anything, especially at such a young age.  I left high school early and travelled for about 3 years.

To me, the most influential decision was working with a Non-Governmental Organization (NGO) called Helping Hands based out of Colorado (at the time) and Kathmandu, Nepal.  I was working to bring medical teams in from North America to set up mobile clinics throughout the country of Nepal that we would staff on a regular basis.  As a combination of giving back and having the skill that became portable, which allowed me to do international work, I would say that gave me the desire to go into medicine.

3. What was your original dream?

My original dream? (Laughs) Truly, it was to be Indiana Jones.

4. What have been your major areas of research?

I fell into research.  I did not see myself doing it.  My research has a lot of applied and practical applications.  I like field work. Since I am not in a position – I have a son – to do long missions in this field, I needed to find a way to do field work to make a difference in another capacity.

My research focused on human rights issues around violations happening in the genocides of Darfur. I worked for positions in a human rights group.  In fact, one of the first groups to do an investigation along the border of Chad.  They found 30,000 people starving in the desert.  That was just the very beginning of the genocide, when they were forced out of their villages.

It was the consequence of a ‘scorch-and-burn’ policy of the government, which it was implementing.  The study was done in three parts, but I ended up presenting the data at the International Criminal Court.  I spoke at various organizations and the UN, which had a great impact on me.

My research came from a human rights angle.  For instance, looking at the populations effected by war, and then it took a slant to child soldiers.  Now, most of my research, my area, goes into gender-based violence.  Gender-based violence can be changed to conflict and emergencies.  My newest research study is based in the far north in Canada.

5. What is your most recent research?

It is interesting because I did a lot of quantitative research based on populations – population-based studies.  I used a lot of methods, which were quite unique to sampling population where you have a lot of demographic or population data.

It is a kind of unique way to look at the population as a whole and acquire data that is representative of the population as a whole.  However, the problem with quantitative research like that is the way it describes the population, it does nothing for the affected people.

In other words, it takes information from people, but does not do anything in practical terms for them.  You can help inform or direct policy, for sure.  My study in the Congo acquired $27 million dollars in funding through International Medical Corps, who was the partner for the study.

My new study is qualitative, not quantitative, which is new for me, but I feel this is the way it has to go – especially when talking about violence, sexual violence, against women.  People who are victimized.  It is difficult for them.  It is difficult in terms of perpetrators too.

I know many studies where the rates of sexual GBV in Canada’s North are as high as 80%.

We have a great team.  We have a guy from Johns Hopkins, who is really well-known, for his work in Africa – Paul Bolton.  He published in the New England Journal of Medicine on a randomized controlled trial in Uganda using this same method, which we will propose to use in the North too.

It involves a counselling method, a peer-counselling method, but we do it in remote locations.

6. When someone does have a lot of money to bolster their work, it can go into the research project, which – as you said – it can present the data and describe the situation, but it cannot necessarily implement solutions based on the information. It is admirable for you to conduct and head this practical and applied work.  Also, if you had unlimited funding and unrestricted freedom, what research would you conduct?

There is a lot of work needing doing, especially in terms of gender-based violence and violence in general.

7. Even looking at the health of nations through the standards set by United Nations organs to do with literacy, infant mortality rates, maternal mortality rates, access to education, quality of education, and so on, they present the item of most importance under our noses the whole time, namely: Empowerment of Women. If individuals, groups, and most of societies saw this information, had good intentions and wanted to improve their lot, they could do that following the models of various nations throughout the world. 

Exactly.

8. What is your organizing principle for doing good work in the world?

I am really organizing around this idea of professionalism in the humanitarian sector, and a standard of excellence.  I guess it is equality and humanism.

Everybody deserves the right to a good standard of care, service delivery, and health.  I am talking about humanitarian response.  We should all be striving to provide no less.

What I am doing as well is launching the first global humanitarian health association so that any practitioner in the world that’s involved in humanitarian response specific to health will have to have a certification from an accredited provider, and this association will be that body that credits and regulates practice – globally.

We should not be seeing what we have been seeing in Haiti, Rwanda, and Congo, and some of these other disasters that had significant humanitarian problems in terms of response and service delivery, which were people doing ethically and morally challenging practices..

I do not know about an organizing principle.  I think part of what I hope to leave as a legacy is this professionalism and a standard and excellence, and real community.

We also need to recognize that we need to be collaborative and work together and that this is much bigger than one person.

I know many things drive me.  It is excitement, commitment, and the love of working with other people.  It’s not just one principle.

All of these things I do speak for themselves.  I never thought of allying myself to a certain principle.  I think it is inspiring for a person like me living with people and seeing the luck in being born in North America, especially with all of the travel throughout the world.

I bought a motorcycle at 19 in New Delhi.  Living with these people, seeing their lives, and realizing they cry and laugh like us, and that there is a basic humanity and dignity that we all share.

However, not all people have access to that realization through circumstance.  I think what motivated me to get into medicine was the desire to give back.  You cannot enjoy the benefits of travelling and exploring the world without sharing and being a part of things, helping people and so on.

It is funny.  You work in medicine, but I never imagined how much work becoming a doctor could be.  After 14 years of post-secondary education, it can be difficult to not become a cynic sometimes and to lose it.  You can become sidetracked in academia and everyone arguing over authorship on a paper.  When, why are we doing this?  What matters here?  Is it humanitarianism or being first author?  It is important to go out in the field and get that feeling of humanity back, and to check in with the reasons for doing your work.

It is the reason for me doing this study up north, one of the reasons.  I consider it more important than quantitative research.

9. What do you consider the controversial topics in your field? How do you examine the controversial topics?

In the humanitarian field, the controversial topics are around professionalization, certainly, because people find that it’ll restrict making their practice.  And what constitutes a professional in a humanitarian context?  How do you measure that?  Who provides what certification?  I mean the whole discourse around certification and professionalization in humanitarian aid.  The way that we have to address that is consensus building.  You cannot push that across to people.  There has to be a lot of discussion and debate, continuing collaboration, and work in this way.

The controversial topics in my field of humanitarian action, which I am kind of at the lead of, is the push to professionalize and standardize the work because there has been so much bad humanitarianism as of recent.  I mean, Haiti was a disaster of epic proportions in terms of humanitarian support.

We saw the case happen in Goma after the Rwanda genocide, and so on.  Humanitarianism, the field is growing – about 250,000 people calling themselves humanitarians – many calling themselves professionals, but, what does that mean?  The training going into it, do we have the same attitudes and competency?

It is almost becoming a sexy, trendy thing.  When the earthquake in Haiti happened, you have nearly every faculty of medicine in North America sending planeloads of doctors, like resident doctors who were not trained, now all of a sudden they are doing field amputations – which they were not trained for – in environments that are not safe for the patient using no morphine or sedatives.

No coordination of the ground, people blocking the runway, and so on.  For example, the Canadian Government’s DART team could not land to get the supplies, and they needed to get in to provide the supplies for the hospital! And I think there is a push now for people in the humanitarian community is looking for a cut off.

People need to be licensed, credentialed, and certified.  The culture of humanitarianism and humanitarian work is about neutrality and ‘cowboy’, “We want to do what we want to do.”  That there is nothing we have to agree to within their organizational culture.  They strive along the culture of independence.  They do not want to be like another organization that would have them not adhere to other rules.  My partner in the military might be belligerent, for instance.

So the question becomes, “How do we do this?  How do we elevate the standard of care for these people?”  Of course, it is all well-meaning.  I do not mean to say that people going into this field mean to cause harm.  However, a lot of things that were no thought of happen, and they do not need to happen because we have a lot of evidenced-based research in all of this.  We have a special set of competencies before people are allowed to work in this area.  In this, it is a kind of humanitarian reform, which is the main area they are talking about here that will go forward in the next 5-10 years.

10. What do some in opposition to you argue? Although, from my angle, I consider the strong possibility of only a minority in opposition to humanitarian policies and practices. 

I argue for a professionalization, and this is coming from an academic background and a profession.  So I am coming from something that is properly defined, and I understand that construct, and I think that needs to be implemented in the humanitarian world.  Someone arguing against me might be a manager or country representative of Medicin Sans Frontieres (Doctors Without Borders).  And even though there are, and those examples are, medical organizations, they may not necessarily want to be held to our given structure.

They may not want to conform to the rigid structure.  They may ask, “Who will oversee it?  Who will work for it?”  In other words, they may not agree with the people organizing and running the program.  Therefore, there are two ways of looking at it.  And I am definitely on one side of it.  There are many debates in my community of humanitarian action because it is so multi-disciplinary.

Now, this is very research focused.  We do interviews and scoping reports, and that kind of thing.  And I think acquire funding from Canadian Institutes of Health Research (CIHR) for funding based on this work and to conduct more of this work.  However, I do not know if this sits in your paradigm.

11. It does, especially in terms of the framework here. For instance, some of the interviews conducted. I conduct an interview with Dr. Hawa Abdi, MD.

Yes, I know her.  She runs a medical clinic out of Somalia.

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