First Memo Could Lead to Policy Change

During my practicum, I wrote so many policy recommendations, memos and reviews. My practicum was designed to give me a real-world experience into the world of health and human rights. Often, I would sit in the office and pore over mounds of documents for 8-10 hours each day. I discussed policy and current political climate with the advocates and often felt that what I learned and wrote about was common sense to those who would be reading my work. In other words, I felt my work would be a little futile in the fight to affect policy change.

Honestly, we as students see the practicums as another extension of the classroom. In many ways it can be, but it is truly a way for you to be present and “on-the-job.” An opportunity to create usable materials and demonstrate what you have learned. In two months, I wrote so often and so much that I was afraid my papers were simply going to be piled up on a desk, that someone would read and then dismiss them. Not that the advocates would dismiss it, but as I said before, I wasn’t saying anything that anyone did not already know concerning current health policy and human rights in Kenya.

Many of the advocates provided feedback concerning my work and I appreciated any advice or insight they provided. I was being told often “Thank you” and “This is going to really help,” but was unsure if they were simply being nice to a new person in the office. However, it wasn’t until Allan Maleche, our director, pulled me into his office and said that he had a final assignment for me to complete before I was to finish my practicum that I believed my work could be impactful.

At conference

From Memo to Impact

Allan told me that my work so far had been excellent and very helpful and that he needed me to write a memo concerning a new Isolation of TB policy being developed. I quickly dove in to researching the National Tuberculosis, Leprosy and Lung Disease Program of Kenya and realized that those affected by and living with TB often were victims of human rights violations. Only recently (2016) did the High Courts of Kenya annul the detention of patients who default on anti-TB medications. Although the current policy highlighted detention or involuntary isolation of those affected by TB should be avoided, it was not explicit enough in detail as to the actions that should be carried out.

I worked on the memo and recommended that the new policy should highlight ethical and human rights-based approaches to working and treating those living with and affected by TB. By the time I was finished, I was quite proud with what I had written, especially since it was the first memo that I had ever written. Of course, when I submitted it to the TB advocate team and to Allan I assumed they would review it and that would be the end of time in Kenya.

A few weeks after arriving back in the U.S. I received and email from Allan. I assumed it was a follow-up to my experience and time spent with KELIN. I read the email and he explained that KELIN had accepted an invitation to be a part of a “task force to spearhead a road map for policy formulation on isolation of TB patients” with the Ministry of Health. Imagine my surprise when I continued to read the part where Allan explained that KELIN was going to be using my memo as a part of their contribution to writing the new policy!!! I couldn’t believe it, I must have read it 3 times!

While my practicum experience, in my eyes, amazing and personally profound, I had no idea that I would have written something that may impact an entire country through policy. I had only spent two months in Kenya and never dreamed that anything I did would ever be that impactful. This tiny memo has now energized and motivated me to continue to work in the field of health and human rights. I have always believed that working in human rights is my path, but now I have a renewed spirit that I can be impactful and I’m knowledgeable and confident enough to challenge policy and affect change.

TB Memo


Lauren Jackson is a student in the Master of Public Health online program at the Keck School of Medicine of USC. Her project, “Intersecting Domains of Health and Human Rights in the Kenyan Context,” is funded by  the Anderson Family Global Health Immersion Fellowship

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