"When I discovered epidemiology I thought I had died and gone to heaven,"
says Linda Cowan. She is an epidemiologist and a professor at the University
of Oklahoma.
She loves to solve mysteries, collect evidence and study biology. She does
all these things as an epidemiologist. When she first started her career over
30 years ago, she dreamed of making an important discovery about what causes
disease. She has realized just how difficult it is to make such a breakthrough.
"Prevention is always the goal, so any steps in that direction is a reward,"
she says.
These days she is rewarded by preparing students for the field and moving
the research forward. She says the field is very exciting because it offers
many opportunities for international work and travel. She has done a lot of
work in Africa.
Cowan and her colleague Helene Carabin have a pilot study in Burkina Faso,
a landlocked country in western Africa. It is one of the poorest countries
in the world. They are studying epilepsy and a parasitic disease called neurocysticercosis
that can cause epilepsy.
Due to issues involving poverty, hygiene, food preparation and sanitation,
the human brain may become infected with the larval worm of this parasitic
disease. This can cause seizures and epilepsy.
"People with epilepsy are marginalized, cannot marry and are thought to
be contagious. So when one has a fit, they are left alone and people run away,"
says Carabin. She is also an epidemiologist and a professor at the University
of Oklahoma.
Carabin and Cowan visited an isolated village west of the capital city
Ouagadougou. They met with a nurse and found that no one with epilepsy was
being treated.
The local team of researchers interviewed people and sent those with epilepsy
to a CT scanner to get images of their brains. The researchers were looking
for people with worm larvae in their brains. They found that 50 percent of
people with epilepsy in that part of the world indeed have the larvae
in their brains.
"But the most inspiring result was that, when I went back to the village
last January to thank the villagers for their participation, we were told
by the nurse that he was now treating 30 people for epilepsy! The chief of
the village also mentioned during the meeting (which took place at the village
center under a mango tree) that people with epilepsy should go to the nurse
and get treated because the 'modern' treatment (in contrast to treatment provided
by traditional healers) does work.
"So it seems that simply talking about the issue improved the health of
at least 30 people in that village. These are the sorts of experiences that
make us happy. We hope to continue this research by testing an intervention
to reduce the infection with the worm and ultimately prevent several cases
of epilepsy in that region," says Carabin.
The logic behind designing a study is Carabin's favorite part of the job.
Like Cowan, she also likes to solve mysteries.
"You have a disease (or infection) that will happen in some people and
not in others. Why? I am a veterinarian by training and decided to become
an epidemiologist because I hated treating animals without knowing what had
caused the disease. Prevention is so much more rewarding, in my view, anyway.
And in order to prevent, you need to know the causes."
Getting funding for research is the greatest challenge for epidemiologists,
says Carabin.
Cowan agrees that a lot of good project ideas go unfunded. The studies
are expensive. For example, a lot of workers are required to follow 1,000
research subjects for years, and collect and analyze their medical data, which
can be costly.
Colin L. Soskolne specializes in environmental epidemiology. He graduated
in applied mathematics and computer science. Then he worked as a biostatistician
for seven years. Next he earned his PhD in epidemiology.
"I like the fact that my research can influence public policy at the highest
levels. This impact makes what I do seem all the more important for keeping
communities healthy," he says.
As with most health researchers, Soskolne's workday is typically longer
than eight hours. He is usually in his office whittling down a long list of
responsibilities. The list includes writing papers on completed research,
sending research reports to agencies, filling in grant applications for new
research that he would like to see undertaken, preparing lectures and helping
students.
"All in all, the days are exciting and challenging. I like to work long
hours because the work of the epidemiologist is so important," says Soskolne.
He says anyone with an analytical mind who is determined to work in public
health could be an epidemiologist.
"Physical and also personality peculiarities will define the scope of the
job best suited to the individual. For instance, not all epidemiologists are
good (or needed) in public speaking. Some people are best placed to work behind
the scenes. Others do well being in the trenches. Both are needed," says Soskolne.
He explains that some epidemiologists specialize in infectious diseases.
This type of disease is caused by bugs of some sort. Other epidemiologists
focus on diseases that take a longer time to develop. This specialization
might focus on exposure to pollution, or diseases caused by lifestyle choices
such as smoking.
"The challenge often is to disentangle genetic from environmental causes
of disease. Whether one works, for instance, in universities doing research
and teaching, or in public health units responding to disease emergencies
and health inspection monitoring services, the aim is always to prevent disease
or injuries from occurring," says Soskolne.
He says the maxim of epidemiologists is "an ounce of prevention is worth
a pound of cure."