Global Ophthalmology Interview Series - Part 2

We recently caught up with Jeremy Keenan, MD, MPH, Associate Professor of Ophthalmology at the University of California, San Francisco.  He is a clinician-scientist who studies ocular infectious and inflammatory disease in the developing world as a part of UCSF’s Francis I. Proctor Foundation for Research in Ophthalmology.

 

  1. How did you initially become interested in global health?  My first exposure to global health was in medical school.  My med school was in New York City’s Washington Heights neighborhood, which has a large population from the Dominican Republic.  I helped a friend start a club called “Cultura,” which tried to expose medical students to Latin American culture so that we could better serve the patients in our neighborhood.  It was a really fun group.  We sponsored medical Spanish classes, had guest speakers, conducted a “big brother” type mentoring program, and started an exchange program that allowed club members to be “adopted” by a host family in the neighborhood, kind of like they were studying abroad.  Through that program I realized how much I enjoyed working with immigrant populations.  Over time, that interest evolved into working in other countries, and things progressed from there.  After getting an MPH between my 3rd and 4th years of medical school, I spent time with ophthalmologist Jonathan Pons in Swaziland and worked in a pediatric AIDS clinic in South Africa.  As a resident I spent a week at an ophthalmologist’s office in Peru and did a public health elective at the LV Prasad Eye Institute in India.  My interest in global health eventually led me to UCSF’s Proctor Foundation, where I did my fellowship and still work today.
  2. Can you tell me a bit about the Proctor Foundation?  The Proctor Foundation was founded in 1947 using money from the estate of Francis Proctor, an ophthalmologist from Boston who retired to Santa Fe, New Mexico.  He developed an interest in Native American eye health upon arrival to Santa Fe, eventually becoming an expert on trachoma, which was widespread among Native Americans of the Southwest.  After his death he willed a portion of his estate to support research on trachoma and eye disease.  This gift eventually became the Proctor Foundation, which is dedicated to research, patient care, and training in infectious and inflammatory ocular disease. The Proctor Foundation is now a referral center for infectious and inflammatory eye diseases, conducts basic science, and has an active international programs group with faculty involved in projects around the world.
  3. Why did you decide to go into academics?  When I started medical school I wanted to become a clinician.  As I progressed through training, I began to enjoy research more and more.  By the time I reached fellowship I found myself engrossed in asking questions and designing systematic ways to answer them.  Today, I spend 80% of my time performing research and 20% of my time in the clinic.  International travel is a big part of my job. I spend about 3 months out of the year abroad, working on projects in various countries.  It’s really interesting and a lot of fun.  I can’t really ever imagine becoming bored with my job.  I get to problem solve, teach, treat patients, and participate in a broader intellectual community.  It’s great.
  4. What projects are you working on right now?  We’re working on a number of things.  We are continuing efforts to eliminate trachoma, and we are gearing up to evaluate how building latrines and improving access to clean water affects the prevalence of trachoma in rural Ethiopian communities.  In Chiang Mai, Thailand, we are testing whether an HIV clinic can use telemedicine to identify CMV retinitis.  In Nepal, we are studying whether corneal ulcers can be prevented through the work of trained community health volunteers providing antimicrobial ointment after corneal abrasions.  We are also conducting a study in Bangalore, India, where we are evaluating various screening tests for glaucoma with the hopes of improving screening efforts.  We’re hoping to figure out how to get the right test to the right people, what to do with those results, and what treatment is most effective in that setting.
  5. What is your favorite part of working in developing countries?  Without a doubt my favorite part of all of this is the relationships I’ve built.  I’ve gotten to meet and work with a lot of great people, and that’s not limited to just the doctors.  I’ve become good friends with a number of our study coordinators, and I really love helping develop research capacity in new places.  Enabling people to tackle problems is really rewarding.
  6. What’s the biggest challenge?  I just wish there were more hours in the day!  I think that’s probably the same for most people.  Sometimes the solution to one problem leads to more questions than you started with.  There are a lot more problems to be solved. 
  7. Is there anything else that you’d like to share?  I’d just encourage anybody who is interested in global health to get involved in one way or the other.  It’s an interest that I initially thought might be fleeting but has ended up as a driving force in my career.  There are a lot of ways to be involved in global health.  Academics has been a great way for me, but it’s certainly not the only way.  Whatever your interest, pursue it.

 


Keenan