Dr. Kunchok Dorjee: Leading the Charge in the Fight Against Global TB
Dr. Kunchok Dorjee (he/him) is a physician and epidemiologist specializing in tuberculosis (TB). He serves as Assistant Professor of Medicine and International Health at the Johns Hopkins School of Medicine and Bloomberg School of Public Health. Dr. Dorjee sat down with RC Sadoff to discuss his personal and professional experiences with infectious diseases and refugee populations.
A lifelong mission of public health equity
It was not like I wanted to become a doctor overnight, it was a culmination of experiences over time. I grew up in a Tibetan refugee community – my parents came from Tibet – so in the refugee school that I went to, the facilities were not good, infectious diseases were rampant. We were seeing health conditions such as TB all the time. Children would often be taken out of class for months on end because they got sick. Sometimes we would have medical camps – doctors and volunteer groups that came from other countries trying to help – and I saw the value of that profession. Also my mother would often get hospitalized for various reasons, and I saw that when doctors would talk to her nicely, it would make me feel good, and I saw the value from that standpoint as well. When I came of age, I sat for the medical school entrance exam, which was pretty tough, and I’m glad I got selected. There was only one seat for all Tibetan graduates at the time. Six years there and I became a doctor.
A lot of my current work – including Zero TB Kids and HIV programs – has been informed by my past work in South Asia. For example, I was director of the Tibetan TB program in India for a number of years, and I saw the TB ward was overrun with patients – we sometimes had to put two in each bed in the hallway to accommodate them – you can imagine the state of the problem.
“I also saw that every time you treated a person with TB, that person would get better, but another person would come in the next day with TB, so the disease was not addressed from a public health standpoint. Treatment was on a one-by-one basis.”
From a disease standpoint, TB is the leading infectious disease killer – it has again overtaken COVID and HIV/AIDS – and it is affecting people globally. Every year, there are almost 10 million new cases and over a million deaths. The World Health Organization and UN have come up with ambitious targets to end TB by 2030-2035, so a lot needs to be done. There’s a huge unmet need there.
We got a UNOPS grant to do active case-finding among thousands of people in the community. We found a very high rate of TB in the Tibetan community, and that it was driven by diseases in young populations and diseases in congregate settings such as boarding schools and monasteries. We were also seeing other conditions such as HIV and Hepatitis B. So those early experiences are informing the work that I'm doing right now, including helping kids not just with their health, but also educational resources so that they become overall better-equipped to get jobs, to go to universities, and to become digitally smart and financially prosperous citizens.
Human rights in the fight against TB
Speaking from a global health equity perspective, there are parts of the world, parts of communities, populations such as refugees, migrants, poor children, women... there are a lot of disadvantages. There are a lot of resources going into addressing health conditions in high-income countries, but commensurate resources are not going into addressing health conditions where the majority of the burden is being carried. I knew firsthand from living in these schools, living in the refugee camps, what kind of health needs there are. It seems natural that I would dedicate myself to addressing some of them, and because if I don't do it, there are not many other people who will. I see health as a matter of human rights. We all deserve health, all humans. It should be a basic human right. But it’s something that a lot of people in the world – especially in low- and lower-middle income countries – are deprived of.
“One of my mentors told me, ‘Kunchok, in life, usually things don’t go as you plan them.’ Your life is driven more by something – maybe not by Black Swans, but by unexpected things – and they direct your career path and direction. So it is important to plan, and out of those plans, something will grow, something will come out and then fly off into a direction that might totally amaze and satisfy you.”
Learning to find meaning and peace
Right now, I’m in a battle against time. We all have just one life and want to make the most of it, that’s how I look at it. And there is so little time. If it’s Monday today, tomorrow is basically already Friday. You cannot do everything, but I think you can make some contribution to this world in your own capacity, to make the world a better place and to leave the world in better shape for our children and for future generations.
I think it is important, especially when you're working in demanding environments – when there are deadlines and lots of projects or people that are depending on you – then it is important to stay calm and stay focused at the same time.
One thing I learned from Tibetan Buddhism is trying to stay aware of surroundings, time, and existence; trying to just be aware of what’s going on, that anything can change at any time, and that nothing is permanent. And in those moments, try to make a contribution. I also love spending time with my kids, they are also drivers for me.
“I always try to remind myself that I will use my day in a meaningful way, and I try to stay aware of the time. I also try to tell my children that time is their most precious resource, because that’s the only thing that you can’t get back if it goes by.”
Right now we are facing a lot of problems. We have conflicts, climate crises, pandemics, a lot of things going on. It's not easy to stay focused. It is important to stay calm, keep working at it, and keep persevering. In one way or another, you will find your way. In this time particularly, it is important to be aware of oneself, be aware of others, the surroundings, the shared environment, shared causes – the pandemic reminded us perfectly of that – and then try to be a good person and to not cause any harm if you cannot help (of course, you will not, but I just remind myself). I think it is important to imbibe compassion and some of these values in our routine lives. It is for our own sake, also, because it makes us happier. Especially if you are driven by competition, it is important to have these other values that keep you grounded and make you happy.