Public health consultant

Besides the well known medical professions such as physician, medical specialist or researcher, there are many other interesting career possibilities in (global) health care. With these short interviews we want to introduce different, interesting, sometimes unknown, professions to you. 

 

Jaap Koot lives in the Netherlands and is a medical doctor specialized in international public health. He is currently working as a public health consultant for the company Public Health Consultants in Action. He is specialized in health care management and works in the field of ‘evidence-based health care’ and quality assurance.

I studied medicine at the University of Amsterdam and I graduated as a medical doctor in 1981. I worked for two years as a house officer in surgical and obstetric wards in Dutch hospitals, preparing to work as a tropical doctor. From 1983 – 1995 I worked as a medical doctor in hospitals and health programmes in Angola, Tanzania and Zambia.

After working in Africa, I took a Master’s course in Business Administration and I have been working as an international public health consultant for fourteen years now. At the moment I am not working as a medical doctor, instead I fully concentrate on public health.

My work schedule is completely unpredictable. One week I work in Afghanistan and the next week maybe in Sierra Leone or in Croatia. My work is comprised of advising, training and coaching in public health and management matters. I help ministries of health to plan or strengthen their health programmes; I advise international organizations how to improve their development assistance; I train organizations abroad.

My job involves a lot of networking. Intensive e-mail contacts, communication and writing, frequent meetings and irregular work schedules. Definitely not a nine-to-five job and often very demanding.

I gained a lot of experience through working in hospitals and health care programmes in Africa. Working at the grass root level made me understand what is needed to deliver health care under challenging, often primitive, conditions. I understand what is required to create a better working environment for doctors and nurses.

After working so many years in the field I took a Master’s course in Business Administration to acquire more knowledge on the management part of health care.

My ambition is to improve the performance and quality of health services in developing countries. It may sound vague, but to give an example, as a result of a training programme that I coordinated, 1 000 doctors in Croatia started to prescribe antibiotics in a more rational way. As a consequence the country was able to reduce costs, to reduce antimicrobial resistance and to improve patients’ health outcome. Currently, I am helping a donor organization in Sierra Leone to improve their curriculum of nursing schools and to develop a training programme for midwives to reduce maternal mortality.

Sometimes, I miss the practical medical work and contacts with patients, which gives "instant" satisfaction. I see results of my job only after months or years.

I think my job is exceptional, and I do not expect medical students to understand what my job involves, but I think it is good, if medical students get a broader view of the medical profession than clinical care alone. Prevention, health promotion and improving performance of the health sector sometimes seem to be considered as irrelevant. I strongly disagree with that, I think that we (with our medical background) can make a difference in public health; we can call attention to those interventions which really contribute to better health.

The variation, conferring with a minister one day and with a traditional birth attendant under a tree the next, bringing worlds together. There is never a dull moment, or blind routine. I am very happy to see that health workers, when I come back after months, indeed have improved their practice and are grateful for what I have taught them.

For a career in international health, it is important to start learning more about health care systems, cultures and medical practices in other countries. For example by working as a doctor abroad. Be open and realize that you have to learn a lot. Work and learn, and find your fields of interest in international health.

After gaining some years of experience, you need further training in public health, to be able to return as advisor or trainer. And, as I said before, be prepared for lots of travel, for being away from home, working at odd hours and for meeting new people and situations all the time. It is no job for couch potatoes.