A Day in the Life of a Global Health Physician


Rajesh Panjabi, MD, has a secret to balancing his work as a global health physician with his personal life as husband and father to a young son: the support and love of his wife, Amisha, a psychologist at the VA in Bedford, MA.

Dr. Panjabi, a native of Liberia, was profoundly impacted by his family’s experience fleeing the country during its civil war.  As a 9 year old boy, he and his family escaped in a cargo plane to resettle in North Carolina. The memory of all those left behind on the tarmac is what he calls the “clarifying moment” that inspired him to make the commitment to return one day.  He honored that commitment in 2005 when he returned as a medical student working with other survivors of Liberia’s civil war and American colleagues to form Tiyatien Health, now known in the United States as Last Mile Health.

Today, Dr. Panjabi is an Associate Physician with the Division of Global Health Equity (DGHE) and Executive Director and co-Founder of Last Mile Health (LMH). Last Mile Health, in partnership with the Liberian Ministry of Health and Social Welfare, is a partner project of PIH that is pioneering community-based health services for the most remote Liberian villages. The organization aims to save the lives of those patients in the hardest-to-reach areas—those “last mile” villages–by giving community health workers the training, equipment, clinical mentorship, and support they need to provide this critical care.  In 2012, LMH professionalized its community health worker model, what LMH calls frontline health workers, and delivered 22,715 home visits to care for the sick.  For the first time, women and children in Konobo district, one of the most remote areas in the West African rainforest with some of the country’s worst indicators for child and maternal health, received quality healthcare services from frontline health workers.  The organization aims to provide primary care to 100% of Konobo’s residents by 2014, a goal previously considered unimaginable in such a place.5109817070_5e859dcd8b_o

It is the kind of work that requires many sacrifices. Dr. Panjabi’s schedule is exhausting:  he splits his time between DGHE and LMH offices in Boston and travels frequently both to Liberia and domestically. He is away from home roughly 3-4 months out of the year, which is hardest on his spouse. To make his global health work possible, he works as a nocturnist at BWH several weeks a year, earning less than a third of what he could make in another specialty. He and his family live communal style, sharing their apartment with another young family as well.

“It is very difficult to balance it all and be a good husband and father,” says Dr. Panjabi, but he does it because of the personal connection he feels and the moral mission. “It’s hard to find more gratifying work.” He also feels grateful, he says, to be able to work at BWH because it allows him to focus on research and teaching, which is such a critical part of our mission of reducing health disparities. It is what sets us apart from other institutions, but it is also tough:

“I feel privileged and powerful working in the BWH community, but vulnerable at the same time trying to meet the needs of my own family and others—this is the untold story of the doctors doing this work. I can tell you that I don’t have it all figured out and it’s different for everyone.”

What he does know for certain is that treating patients is not enough. “We must work on changes at the systemic level and one way to do that is to build relationships with future partners and donors who want to maximize the return on their investments.  The Clinton Global Initiative, Big Bang Philanthropy, and the Draper Richards Kaplan Foundation, among others, are partnering with LMH, but more is still needed. BWH and other partner institutions like PIH and Last Mile Health have been incredibly successful at “scaling-up” to improve health outcomes for the poorest of the poor in large numbers, but more opportunities to showcase that impact and the magnitude of the work are needed, says Dr. Panjabi. The Division is widely respected and could use its gravitas, he suggests, to serve as a forum where faculty, practitioners and partners come together to advance their thinking and innovation around global health.  BWH is just the place to do that because of its unique culture, a culture that allows its doctors to focus on teaching, research, and service in parts of the world where there is such dire need.