Read Dr Xaviour Walker's Story

PROFILE Doctor at large Alumnus Dr Xaviour Walker is looking at the big picture, taking a “macro” view of public health and policy. ince graduating from the Otago in geriatrics and says this latest white paper to the Office of Global S Medical School in 2006, Dr Xaviour appointment fits with his medical career’s Research at the National Institutes Walker has spent much of his career trajectory. of Allergy and Infectious Diseases gaining broad medical and public health After graduating from Otago he (NIAID), National Institutes of Health training to understand more about how worked at Dunedin Public Hospital, (NIH), on infectious diseases’ research he can “contribute to improving health before practising rural emergency opportunities in the Pacific Islands, care and reducing health disparities”. medicine in Australia. In 2009, he moved which included looking at the work New He gives a “real-world” example from to Boston for an internal medicine Zealand, Australian and United States Baltimore – gained while he studied residency and served as chief resident researchers have done in the Pacific for his Master of Public Health at the and a medical education fellow at Mount region. Johns Hopkins Bloomberg School of Auburn Hospital, Harvard Medical He was also involved in testifying Public Health last year – to show the School. He then stayed on as an attending to the Maryland State Senate on public role knowledge plays in reducing these internal medicine physician and a health issues such as carbon monoxide disparities. clinical instructor at Harvard Medical poisoning and on having paid sick days “In that city there’s a real issue with School. During this time he also gained for workers. structural inequalities. From suburb to a Diploma in Tropical Medicine and But compiling a list of impressive suburb the life expectancy varies greatly Hygiene – a Gorgas course – in Peru. credentials has been incidental; due to social deprivation. I was able to This led to Baltimore and the Johns inspiration for his career in internal work in the needle exchange services and Hopkins Bloomberg School of Public medicine and studies first came at Otago provide training on overdose prevention Health. A bonus of his career has been through his mentor Brigadier Dr Brian using intranasal naloxone, which is part of working at local, state and federal levels McMahon, a retired army surgeon, the Baltimore Health Commissioner’s work – including the Baltimore City Health and (later) Dr Leo Celi, a US-trained on reducing drug overdose deaths. Going Department, Maryland Department infectious diseases and ICU specialist out with a needle exchange van in the city of Health and Mental Hygiene, and who encouraged Walker to look at to see the challenges some people face on a National Institutes of Health (NIH) further postgraduate training in Boston. daily basis was a humbling experience.” – and with private sector health-care Reading about pioneering Otago His time in the city yielded a “brief” providers, and occupational and travel medical graduates such as plastic surgeon that has been adopted by the Mayor’s medicine at GlaxoSmithKline global Dr Archibald McIndoe, who trained at office, and which informs funding for headquarters in Philadelphia. the Mayo Clinic in Minnesota, and Sir community health-workers and case His medical career has featured Thomas Davis – the first Cook Islands managers to improve the continuity of service on numerous medical advisory doctor to graduate from Otago, and a care for women leaving prison. bodies and contributions to various recipient of a fellowship to the Harvard He is now doing a fellowship at international health publications. Earlier School of Public Health – provided the University of California (Irvine) this year he was pleased to present a inspiration. 39 “In the Islands I realised the importance of being a good doctor, but I also wanted to understand other dimensions of public health – such as preventative measures, systems improvement and infrastructure.” Even before graduating from Otago, on historically strong links in the Pacific enrolments in health-care programmes. Walker found clinical work personally as “more than symbolic”. “It is a full credit to those involved, rewarding, but his experiences – “People’s health will improve in the especially under the leadership of especially Otago Medical School electives region if there’s an integrated approach Faumuina Associate Professor Faafetai in Fiji, Samoa and Tonga – led to a and universities build relationships (Tai) Sopoaga, who has been a role model belief in the need to also understand the with governments and medical bodies. to myself and many young Pacific Islands “macro” of public health systems. Through various MOUs, the leadership health professionals.” “In the Islands I realised the at Otago is doing some great work in During his time at Otago, Walker importance of being a good doctor, building these long-term relationships.” enjoyed presidency of the Otago but I also wanted to understand other Such initiatives might reconcile the University Medical Students’ Association dimensions of public health – such Pacific’s “two worlds”; one is inhabited by and, later, the New Zealand Medical as preventative measures, systems tourists at five-star resorts while many Students’ Association. improvement and infrastructure. local people live on under $US1.25 per These “unique opportunities” helped There are, for example, some very good day. form his belief in contributing to clinicians in the Pacific, but in many In many low-income villages the medicine at various levels, and he links places they do not have the labs and impact of skin disease, pneumonia, them with recent involvement with the support resources. It really drove home infectious diseases and illness caused by World Medical Association (WMA), the need to look at grassroots clinical fresh water shortages and rising diabetes where he helped found the Junior work and the bigger picture of public rates is all too apparent. Doctors Network and was the inaugural health.” “There’s a lot of work that needs to chair in 2011. He was recognised for Working in the region, and be done but, in a way, because of the his contribution with the International subsequently attending conferences fall-out from natural disasters and poor Resident Leadership award from the on health in the Pacific, has added to infrastructure, there is much that’s Royal College of Physicians and Surgeons his appreciation of its cultures and accepted by Pacific communities who of Canada in 2014. He is still working communities, and his own Tongan have different materialistic values. with the WMA as a policy adviser and heritage. “I think formal relationships show a encouraging the involvement of junior “I was initially able to be involved respect for [the community’s] ideas and physicians worldwide. with Pacific Islands medical students mean the initiatives are collaborative “My Otago medical training was first during my time at Otago, but I found my and empower people, rather than make class. I am extremely grateful for all the calling was going back to the Islands to aid or assistance seem like a hand-out. clinicians and lecturers who taught us practise medicine. This really helped me It’s great the University is becoming over the years. During medical school I connect in lots of ways, and working in more active in this role. Along with was also able to work rurally on rotations the hospitals and communities there is that, we need laboratory and other in Invercargill, on the West Coast and something I could do long term.” clinical infrastructure that will help local also in the Pacific Islands. One of the Earlier this year, whilst in Dunedin clinicians do excellent clinical work, main reasons I looked to the US to add attending the Division of Health Sciences which is a win-win.” to my New Zealand training was to offer Pacific Welcome, Walker described the Walker is encouraged by the increased a set of skills that could be of use in New University of Otago’s moves to capitalise number of Pacific Islands student Zealand and the Pacific region. 40 Dr Xaviour Walker: “One of the main reasons I looked to the US to add to my New Zealand training was to offer a set of skills that could be of use in New Zealand and the Pacific region.” Photo: Sharron Bennett “Long term, I would like to come back to New Zealand to work clinically and in the medical school while continuing my interests in public health and policy. I have family in Dunedin and love working with students.” His future work may be among a growing group of doctors and researchers who are working to connect links between the US, Australia and the Pacific area. “I’ve been working with many of the New Zealanders who are based in the United States and there is a strong desire to leverage existing resources and efforts, and link US-based medical alumni back to New Zealand. “I’ve benefitted from so many opportunities during my career, so a lot of what I do now is about opening the door for others coming through.” Away from medicine, Walker enjoys spending time with his wife and two young children, and competing in long-distance running events, including the New York City Marathon, which he has completed five times (with a best placing of 89th overall), and the Boston Marathon, which he has run six times. SAM STEVENS 41.

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