Nancy Harris, Vice President, John Snow, Inc. (JSI)

By Evelyn Garland, Student Outreach Coordinator Christian Connections for International Health (CCIH)

Nancy's email: nharris@jsi.com

Getting started

Evelyn: How did you get your first job right after college?

Nancy: My actual first job was with Peace Corps. In those days, they posted generalist volunteers which they rarely do anymore. We were posted to Nicaragua. We were in a small town. I ended up working with a doctor in a local committee for a center for rehabilitation of malnourished children. I knew so little about public health, so little about clinical malnutrition. The first six months was a huge learning experience – we didn’t have the internet in those days. I realized that the lives of these small children, some of whom were very severely malnourished, depended on what I knew, which was very little. So that was my baptism by fire in public health.

When I finished Peace Corps. I went to UCLA to study public health to get some real qualifications in what I knew now as my chosen field and profession. I got a master’s in public health, in population, family and international health.

Evelyn: How about your first paid job?

Nancy: Well, I did a number of things. I did consulting work for Peace Corps and UNICEF. Then I worked for a family planning program in Nairobi – that was my first actual paid job.

Evelyn: How many years was that after you graduated from college?

Nancy: Fairly soon. I went to Kenya and got this first paid job. Nowadays it’s a little more difficult to get that first job in the field; in those days, it was a little bit easier. It’s not impossible, but it’s not as easy for people right out of a public health program to get a job – most people need to start either in Peace Corps, refugee work, or missionary work, in order to get a field-based job with a professional organization doing public health.

Evelyn: How many years have you been working in public health? And how many of those years were spent overseas?

Nancy: 30 years. About half of them were spent overseas. I spent 3 years in Nicaragua with Peace Corps, 9 years in Kenya, 4 years in Madagascar, and then 4 years in Republic of Georgia.

How did you become a good proposal writer?

Evelyn: I’ve seen how analytical and organized you are – you can put the ideas from a brainstorming session into a proposal in just half an hour. Were you born with such abilities?

Nancy: No, I don’t think so. This was a skill that I developed over the years. One of the advantages of having been posted in many places and traveled probably to 80 countries doing public health is that I’ve seen a lot of programs and I’ve written a lot of proposals. So, some of it is experience. I do think I’m pretty well organized. I studied French literature, history and philosophy as an undergraduate. I think those disciplines really helped me. When I look at a public health program, I look in terms of a natural history of how a program should evolve over time, so I don’t regret the social background as I think that was very helpful in learning to do that (writing proposals). These are learned skills.

Some people are better at project design than others. One of the fallacies in public health is that we think we can all design projects. It’s sort of like motherhood – people think that motherhood comes naturally but it doesn’t. Those who naturally become mothers have to learn the motherhood skills either formally or informally. The same is true with project design. It does help when you study how programs are designed and evaluated, and how good design relates to the outcome. I think this is extremely important because when you have a poor design you are starting off with two strikes against the program. It’s important that we have soundly designed programs. And, it’s important that people understand that this isn’t something you were born with – this is a skill you have to acquire. You have to look carefully to learn the skill, and then be mentored by people who know about program design.

Evelyn: So the best way to learn program design is through mentorship?

Nancy: That’s one way and a very important one. Most people in public health have, along the way, one or more mentors. I think finding good mentors is really important. The other thing is to see programs. The more programs you can see, through internship or volunteer work or non-volunteer work, the better. Someone who has seen ten different kinds of programs, say, in maternal health or maternal and child health, will have a better idea of how things are organized than someone who has seen only one or two.

Secrets in networking?

Evelyn: I heard that you were a great networker – you know a lot of people and you take the initiative to introduce yourself to people and get connected. What are your secrets?

Nancy: There’s no secret. You meet people and you connect with them on a personal level – that’s the important thing. I think networking is about getting to know as many people as you can, connecting with them, having them know you and you know them. For example, at the CCIH conference, a lot of people will find a few people they know and hang out with those people. That’s not the idea. The idea is to force yourself – sometimes this is not easy – to go over to a table of people you don’t know and say “Can I sit down and talk with you?”

It’s also about give and take: helping people. For example, helping young people find the first job, or if they’re going through a job crisis, talking them through it. It’s not about so much “Oh my career! I want my career!” If you are the kind of person who is only interested in your career, you won’t be a good networker, because a good networker looks for connections that help others and programs.

The other thing, of course, is to keep contacts – in my days it started out as a rolodex. Noow everything is on the computer. It’s important because years later people will come up to you and say “Do you remember in Bangladesh…?” It’s a small community in public health. It’s important that, maybe you don’t always remember the name, but you remember the meeting or the incident.

Interestingly, it’s not about only talking with people whom you perceive to be important or useful to you; it’s talking with and about other people. Twenty years down the line, your peers now are going to be the people you look to when you want to do a job change, or maybe they are working at a foundation and you want something funded, or maybe you are working with a foundation and you want a skill that they have. So networking is accepting each person as having value and having importance and looking for those connections.

Evelyn: Well, here’s a specific situation in networking. Suppose you go to a talk followed by a reception. Everybody seems to know everybody else, but you don’t know anybody there. I was once in such a situation. I found only one person available, so I went to talk to him. He kept talking on and on about the same thing, and he was so involved that I found it hard to excuse myself. What would you do in such a situation, especially when you don’t know any other person?

Nancy: It’s really tough. I won’t say that it’s easy. In fact, we are all a little bit shy when we go into a room where we don’t know people, especially when people seem to know each other. The hardest thing about networking is the “Hi, I’m ….” But you just have to do it, because that’s what receptions are for. So you stand in the group and then you try to wedge into a conversation from time to time.

If one person who wants to push himself/herself on you and take all of your time, I think you have to gently and politely say: “Take my card. Maybe we can email about this later. It’s important that I circulate.” It’s important to have lots of cards and give them out. The reason you go to receptions is to circulate. I used to joke with people I mentored: if there are a hundred people in the room and it’s a two-hour reception, you need to talk to ten people. It’s a skill. You’re not going to make, or rarely, a connection that will lead to a job. But you might make connections in giving and receiving business cards or hearing conversations.

The situation you mentioned is kind of the hardest way to network – this sort of gatherings. So you do the best you can but it’s not the best way to network. The best way to network is to find personal contacts either at meetings, or over lunch, or attending a class or seminar with someone, or you write a proposal together. For example, when we were working on CCIH things, I had a chance to get to know you, and you had a chance to get to know me. We laugh a little bit, we struggle a little bit, and we have some successes and failures together – that’s what builds a network. Or if you go to Global Health Council, go into booths and talk to people.

There are also ways to network, and they are much more suited for someone who is shy. But eventually you’ll figure out how to work what I call “work a room”. It’s a skill. You just have to say: I’m just going to listen. If there’s a group of five people talking and it’s a public reception, then you just stand there and listen. People who are not totally selfish will eventually bring you into the circle. People are kind, not always, but I think people try to be kind.

Evelyn: A lot of students must have networked with you. What are some of the good ways that a student without much experience can network with professionals?

Nancy: I always try to talk to people and to talk about their skills. Obviously, you can’t direct every person; you can’t find jobs for everyone. But I do try to talk particularly to young professionals. If they write to me, I write them back. I don’t have an enormous amount of time, but I have some time. I always try to remember how hard it is to get that first job. Sometimes I think people are aiming too high in terms of looking for jobs – they need to try entry-level, or they need to be more flexible geographically where they go.

Eventually you do find that first job, although you feel sometimes you never will. I hope that people never lose the sense of what it’s like to not have a job and to be on the outside trying to find that first job. I don’t think it’s always the case. I think some people once get a job, they’re part of the employed crowd, and they forget how tough it is. So I always try to remember that it’s tough to put yourself out there looking for a job.

Job, job, job!

Evelyn: I wonder, especially in this economy, are there really that many jobs in international public health for all the students who want to work in the field?

Nancy: I don’t have an answer to that question. I know that we (John Snow Inc., JSI) are always looking for bright young professionals. There are always jobs. There’s a lot of competition for jobs. I think, to tell you the truth, there are some people who approach job hunting as if it’s their right – they have a degree, and they come in and they say “Well, I want to work in DC, and I want to do X, and I want to get paid so much…” The less flexible and the more demanding a person is, the harder it’s going to be for them to find a job, even if they have the skills.

At JSI, we always say we have our own training program, which we do, and we hire young people, sometimes we hire people without advanced degrees because sometimes people with advanced degrees have so many expectations that they are going to come in and run a program right away. We find that the younger professionals are much more flexible because they are learning. A year or two in an entry level job at JSI – we give people a lot of experience – you learn a lot. I think you’ve found out, working with CCIH, that half of what everyone does is “scut” work. Everyone does administration, writes proposals, takes care of financial matters and does management.

Even as you go up on the ladder, it’s not all glory, it’s not all public health work. So I think it’s about finding the first employment, doing the best you can, having a learning mentality. If people want to work in public health, I think they have to be willing to go overseas, and possibly go overseas as a Peace Corps volunteer, or go overseas working in a lower-paid situation – that’s the way to enter in public health.

It’s about being persistent. It’s also about having a passion. Eventually, you will make it happen if that’s your passion and you are willing to make the sacrifices. What I see is that some people are willing and some people are just not. They would love to work in public health and their idea of working in public health is attending United Nations conferences, traveling four times a year to preferably nice places, like Nepal, but not Pakistan where it’s dangerous. I think that people with real passion for public health will find their ways to work in public health.

Evelyn: You mentioned that sometimes young people come to the interview with very specific ideas of what they want to do. Having been in that interviewee position for many times myself, sometimes I feel almost intimidated if I don’t say that I know or don’t pretend to know what exactly I want to do as a young professional.

Nancy: Well, it’s OK to know what you want and what your passion is. Your passion could be to work with programs that do maternal and child health, or to work with HIV/AIDS, or, if you love numbers you might want to do evaluation… There is a fine line between knowing your passion and a sense of “entitlement,” which is: you must to give me a job.

I find that under the age 30, we don’t tend to know what we want, but we can know what our skills are. For example, you know:
“Well, I’m rather good with numbers.” or
“I’m a detailed person.” or
“I tend to see the big picture.” or
“I work very well with groups.” or
“I like to train.”…
There are counseling services which can consider your skills and help you find what career you enjoy. So I look for what people enjoy, what they feel they are good at, and where their passions are. I don’t think anyone at 25 knows what they are going to be doing at 50. Some people do but most people don’t (laugh). I never thought I’d be doing what I’m doing now. When I was in high school and was asked “What are you going to do?” I said I’d be the Supreme Court justice. And look; I’m not even in law. There you go.

Evelyn: Were you ever asked this question in interviews: where do you think you want to be in ten years?

Nancy: I was asked, but not until I had already done some public health. So by then I knew I wanted to be in public health. I think that’s kind of a funny question. Sometimes I ask (job candidates) where you think you want to be in five years. I want to see whether people have a vision of where they could go, whether they see themselves as running a program in Zaire, or being a researcher. You want staff who are ambitious, but you want to know what direction people want to go, and you also want to know whether they have imagination.

For those kinds of questions, the actual answer is less important than finding out how people think. Sometimes in interviews I ask problem solving questions. For example, I’ll ask a question about a mistake someone made. That’s not to make the person embarrassed; it’s to know how people deal with mistakes. We’ve all made mistakes. One of the beauties of the organization I work with is that we understand that people make mistakes. The worst thing in the world at JSI is not making a mistake; it’s not taking risks, and not trying things.

Another question I frequently ask on interviews, which is fairly uncommon, is to describe a funny thing that ever happened to you. What do you think I look for in that?

Evelyn: Sense of humor?

Nancy: Sense of humor, definitely. But I’m also looking at people who can laugh at themselves. You have to be able to laugh at situations but you also have to be able to laugh at yourself and not to take yourself so seriously, because the work we do is so serious that if we don’t have a sense of humor, we’re never going to survive.

Evelyn: When you first started working overseas as a young woman, were you worried about security issues?

Nancy: I went overseas as a student to France with a group. Then when I went into the Peace Corps, I was married. Of course there were security issues, but it’s a little easier when you are a couple. I think that security is a big issue. I think that one of the problems is that young people don’t perceive risk at the same level as older people. On the one hand, you don’t want to go around being scared all the time; on the other hand, you have to be very smart about your personal safety. Safety and security is an important issue, and everyone needs to evaluate within himself how much risk he feels comfortable tolerating.

There are people who don’t get scared. I don’t tend to be easily scared, but young men with machine guns terrify me, especially when they are drunk. I’m very careful about my personal security. There have been situations where I have been made nervous. It’s part of the work we do. I just spent three weeks in Nigeria, which people say “Oh, it’s terrible and dangerous.” In my view, it depends on how you view things. New York can be a terrifying city as well. Security is an issue, of course. If you are going to go into public health, you have to evaluate your personal security and you have to decide how much risk you feel comfortable taking. That is definitely a consideration for people doing international work.

Evelyn: What are some of the alternatives to work in international health for people who are very concerned about security issues, or who want to stay in the United States close to family?

Nancy: There are. There is a lot of work domestically. For example, there are international communities living in the United States. So there’s a lot of work you can do in the United States that is really important work. There’s advocacy work. There are places that are less risky. Not everyone will spend their entire career overseas – some people do, some people don’t want to be in the United States – it varies. I think you are more limited if you want to stay in the United States. Some people have had fine careers doing either short-term work from time to time, or working on advocacy, or doing background research, or backing up people who are overseas – a lot of it is attitudinal.

You probably need to have some overseas experience simply because you need to know what it’s like for people in the field and have that sympathy and empathy. But there are a lot of jobs that need to be done in the United States and there are people who have had very good and productive careers staying in the United States.

More about Nancy: “Would you put my email out there with the interview article?”

Nancy asked, after the interview, then smiled and explained: “So students and young professionals know how to contact me if they want to talk to me.” This is so her – always takes the initiative trying to help and get connected with people. I was going to write a few more sentences about Nancy, but now think I’d better leave it to you to find out more about her, since you’ve got her contact information: nharris@jsi.com. :)