The decision to pursue public health was not a haphazard one, but the result of a thoroughly thought out estimation of my interests, concerns and capabilities. When I was seventeen, I wrote an essay for college that described my motivation and commitment to learning a subject well for a purpose. Sitting under covers in a small, poorly lit room, listening to my father swear at the walls during a cocaine high, I wanted to understand substance abuse and addiction. The purpose then was to "grow up and learn why people become addicted to things that hurt them, their bodies. . . and their children," and my intent was to use that information in my work as a substance abuse rehabilitation counselor.

During my undergraduate years, I participated in numerous and rigorous courses related to my interest in substance abuse, one of which led to my involvement with a university-sponsored program called R2ISC (Risk Reduction of Intoxicants in the Stanford Community). R2ISC afforded me years of practical experience in public speaking, peer counseling, and community organization. Complementing my work with R2ISC, my work with heroin addicts at the Haight-Ashbury Free Drug Clinic taught me how to broach such sensitive topics as personal beliefs and practices. I learned that both individuals and groups are subject to formative experiences and subsequently subject to all of the clarity or perplexity that those experiences impart. It was also at the Free Drug Clinic that the women in early detox challenged me to apply what I had learned to my own life. They encouraged me to reevaluate my career choice and consider how my own dissatisfying experience with familial addiction had affected my decision. Coincidentally, it was that year, in my senior year, that I was offered the opportunity to study abroad with the structural and financial support of Stanford.

In Italy, challenged by a language, place, and a people that were strange and unfamiliar to me, I met every casual glance with the hope that it would provide a window or maybe even a door into the Italian culture. One month later, I met a young Italian woman who permitted a glimpse of a rich life filled with tradition, religion and family, a life very different from my own. Galvanized by her example, I reexamined many of the premises upon which I had based decisions and had acted thoughtlessly, particularly those attitudes implicated in my being born in a wealthy and industrialized nation. It was this experience in Italy, and throughout Europe where I later worked and lived for almost two years, that awakened me to the growing frequency of contact between individuals from different cultures and potential for mutual learning and collaboration, particularly between individuals representing nations that experience such gross disparities in wealth and opportunity.

When I returned to the U.S. still interested in health care, I decided to pursue further education in public health, yet with an emphasis on defining the needs of disadvantaged communities in the U.S. and abroad. I considered the Peace Corps, but desired first relevant coursework and experience. I enrolled in the Masters Internationalist Program at the Boston University School of Public Health, a program that coordinated a Masters in Public Health with field experience in a developing country. During this last year, my professors and peers--doctors nurses, and community health workers from over 50 countries--have clarified for me my role as a young citizen of a developed nation fortunate enough to have received a comprehensive education in public health, one that considers not only human health, health policy and health systems but also economic development, human rights, the role of culture and the environment. They in turn have taught me of the reality of health care delivery in severely resource constrained environments. A Catholic Sister and doctor from the Philippines impressed upon me the necessity of sustainable community-based health programs. A public health politician from Pakistan demonstrated to me the subtlety of cross-cultural relationships. A country doctor from Northern India heightened my awareness and appreciation of governmental and non-governmental organizations like the World Health Organization and US AID, who attempt to bridge the gap between developed and developing countries. These personal relationships have reinforced my interest in a career in public health in developing countries. The task before me is an ambitious one, considering the World Health Organization's revised definition of health: "...a state of complete physical, mental and social well-being, and not merely the absence of disease," and one that cannot be accomplished with too narrow a perspective.

Similar to when I was seventeen, I am still learning for a purpose, having recognized that I will always feel the obligation to do so. Yet it is now with the blessing and encouragement of an international community with whom I attempt to bridge the growing inequity between our countries, actualizing that obligation through the transfer of the knowledge and experience that I am fortunate enough to receive. Most importantly, I wish to apply, on their terms, the theory, methodology, and technology that I have been taught, thereby fulfilling the responsibility that I have to use this knowledge in the most beneficial manner.