Global Health Nexus, Spring 2000

Women in Global Health

Over the past 25 years, women in dentistry and other health professions have emerged not just as leaders in their fields, but also as builders of bridges to professional colleagues, institution, and populations beyond our borders. Some of the women whose careers are highlighted in these pages have already made their mark in their professions and on the broader culture; others are just starting out. But they are all women whose accomplishments resonate well beyond traditional boundaries to impact the lives of people all across the globe.

Dr. Lidia Kiremidjian-Schumacher, professor of basic sciences (cell biology), has taught at NYU for nearly 34 years. Over the years, she has built an impressive record of grant support and has published scores of scholarly articles on cell biology, immunology, and oncology. But it is above all as a teacher and research-mentor to students that she has become a legend at NYU Dentistry. Under her guidance, NYU Dentistry students have repeatedly garnered the top national awards for cancer research projects, including first prize in the basic science and research category of the Greater New York Dental Meeting competition. In tribute to Dr. Kiremidjian-Schumacher's teaching, New York University presented her its highest teaching honor, the NYU Distinguished Teaching Award. She has also been selected for inclusion in Who's Who Among America's Teachers, 2000.

But the demands on Dr. Kiremidjian-Schumacher's time have not kept her from organizing an overseas venture in the Dominican Republic to assess that nation's dental health needs, assist the government and the local dental association in developing appropriate and practical strategies for oral health promotion and disease prevention, and provide volunteer NYU Dentistry students and faculty expanded opportunities for service to the global community. Working in collaboration with the NYU Minority Oral Health Research Center (MOHRC), Dr. Kiremidjian-Schumacher has been leading biannual expeditions to the Dominican Republic since 1997, with the goal of providing a full range of dental services to needy Dominicans living in rural areas.

Dr. Kiremidjian-Schumacher, who holds a Ph.D. degree in cell biology but is not a dentist, calls the oral health needs of the Dominican population severe beyond anything seen in even the most underserved areas in the United States. "Right now," she explains, "the only hope for improving these people's oral health status rests with NYU Dentistry's ability to continue to provide care and to work collaboratively with Dominican dentists to develop effective dental public health programs. On every visit, I feel so proud to be helping NYU Dentistry share its resources with the world."

Dr. Racquel Z. LeGeros, Leonard I. Linkow Professor of Implant Dentistry and director of the NYU Minority Oral Health Research Center (MOHRC), arrived in New York in 1956 from Manila, Philippines, to accept a teaching assistantship at NYU's Graduate School of Arts and Science and went on to earn both an M.S. degree in organic chemistry and a Ph.D. degree in biochemistry from NYU. She has taught at NYU Dentistry since 1976, at the same time garnering a host of awards for her research, which is the most highly funded of any NYU Dentistry faculty member to date.

Dr. LeGeros is one of only a handful of women to attain international stature in the field of calcium phosphate minerals, an area that involves studies on bone graft materials and has special relevance for oral health in general and for implant dentistry in particular. In 1998, as the first woman to serve as president of the International Society for Ceramics in Medicine (ICM), Dr. LeGeros arranged a symposium held at NYU Dentistry that drew more than 250 scientists from 22 countries. Entitled "Bioceramics: Present and Future," the meeting focused on advances in the use of ceramic materials for medical and dental applications, including bone grafts and coatings for dental and orthopedic metal implants to make them more biocompatible.

As the first Leonard I. Linkow Professor of Implant Dentistry, Dr. LeGeros is responsible for formulating and implementing a comprehensive research agenda for implant dentistry and related biomaterials in collaboration with clinical and basic science researchers both within the United States and internationally. The Linkow Professorship is the world's only endowed chair in implant dentistry.

In addition, Dr. LeGeros is the founding director of the MOHRC, a collaborative program with the Forsyth Dental Center of Boston, sponsored by the National Institute for Dental and Craniofacial Research (NIDCR) of the National Institutes of Health (NIH). The center's goals are to improve the oral health status of minorities and to promote inclusion and diversity among oral health researchers.

Several years ago, Dr. LeGeros achieved yet another landmark distinction when she became the first Asian-American woman to receive the Basic Research in Biomineralization Award presented by the International Association for Dental Research (IADR).

The Honorable Donna E. Shalala, U.S. secretary of health and human services, has since 1993 led the Clinton administration's efforts to reform the nation's welfare system and improve health care while containing costs.

In her seven years as secretary, the Department of Health and Human Services (HHS) has guided the approval of the Children's Health Insurance Plan, raised child immunization rates to the highest levels in history, led the fight against the use of tobacco by youths, and crusaded for streamlined processes for approving new drugs to treat AIDS and other diseases.

Secretary Shalala has also redefined the role of HHS secretary, partnering with businesses and other private sector organizations to extend the department's public health and education missions.

Three years ago, Secretary Shalala again broke new ground by commissioning the first Surgeon General's Report on Oral Health. Dedicated to oral, dental, and craniofacial diseases, conditions, and health, the report is expected to be an enduring resource for the general public, health professionals, social service professionals, educators, researchers, and policymakers. The goal of the report is "to define, describe, and evaluate the interaction between oral health and general health and well-being (quality of life) throughout the life span, in the context of changes in society." The report is expected to make recommendations about how all Americans in the 21st century can live healthier lives through preventive dental care.

Last year, Secretary Shalala delivered the keynote address at NYU Dentistry's graduation ceremony at Carnegie Hall, taking the occasion to applaud NYU Dentistry for providing leadership in dental education and community care, including spearheading a regional oral cancer screening initiative. Said Shalala, "The screenings should serve as a long overdue wake-up call about the dangers of oral cancer. Lives will be saved because of the NYU College of Dentistry's extraordinary effort."

Secretary Shalala appearing in a "Milk Mustache" advertisement to help promote the drinking of milk in osteoporosis prevention.

Diana Galvis, Class of 2002, began her journey as an oral health professional in Puerto Rico when she was selected to participate in the Health Careers Opportunity Program (HCOP), a federally funded program for economically disadvantaged students. Through HCOP, Diana applied for a highly competitive, two-year program designed to train 40 expanded-functions dental assistants during the first year, with a group of six students selected for a second year of training to become certified dental hygienists. Not only did Diana successfully complete both phases of the program, but she also went on to earn both a B.S. degree and an M.S. degree in dental hygiene and to teach full-time in the Dental Hygiene Program at NYU Dentistry.

Diana also became involved in NYU Dentistry's international outreach initiative in the Dominican Republic and served as a principal investigator on a project sponsored by the NYU Minority Oral Health Research Center. She published a number of papers and contributed a chapter in a textbook on understanding the role of cultural diversity in oral health. With all these activities, she still found time to serve as president of the Hispanic Dental Association (HDA), where she worked to recruit Hispanics into the oral health professions; developed a national outreach campaign, which provided oral health screenings to Hispanic communities across the United States; and served as an HDA spokesperson for improving the oral health of Hispanics.

Then, at age 38, Diana took the next step and applied for admission to the D.D.S. program at NYU. Today she is completing her second year as an NYU dental student on full academic scholarship.

Diana considers her oral health career a "calling," and she attributes her ability to proceed up the dental education ladder to her good fortune in having wonderful female mentors. "Never underestimate the power of a mentor" she says. But her mentors would probably say, "Never underestimate the power of Diana Galvis."

At age 38, Diana applied for admission to the D.D.S. program at NYU

Dr. Dushanka V. Kleinman, a specialist in dental public health and a rear admiral in the U.S. Public Health Service, is the deputy director of the National Institute of Dental and Craniofacial Research (NIDCR). She has overseen national research planning and evaluation projects and has been involved in epidemiological studies related to oral mucosal diseases and oral cancer. As deputy director of the NIDCR, she participates in the management of the institute's dental, oral, and craniofacial research and research training activities, and most recently has been working on the Surgeon General's Report on Oral Health. She is president of the American Association of Public Health Dentistry and a past president of the American Board of Dental Public Health and the American Association of Women Dentists.

A key mission of the NIDCR is to develop international networks to foster research collaboration and training worldwide so that countries will have opportunities to work together and benefit from one another's experiences in health promotion and disease prevention. At the same time, the NIDCR serves as a direct contributor to global health by providing research funding and training and by acting as a catalyst with others to address common risk factors, such as tobacco use.

"From my perspective as a public health dentist," says Dr. Kleinman, "the value of collaborative education, research, and service efforts among nations and organizations cannot be overestimated. The global environment provides a wealth of natural variations in geographic, sociodemographic, political, and health and disease states. Collaborative efforts allow us to study different 'models' of health care delivery systems and different approaches to prevention, thereby increasing exponentially our ability to improve global health."

Dr. Lois Cohen, associate director for international health at the National Institute of Dental and Craniofacial Research (NIDCR), is the director of the Office of International Health (OIH).

The goal of the OIH is to enhance worldwide collaboration in research, research training, and health promotion by coordinating the NIDCR's international outreach efforts and targets to advance dental, oral, and craniofacial health around the world.

As head of the OIH, Dr. Cohen's challenge is in globalizing the NIDCR's investment in both intramural and extramural research. "There are many unique scientific questions that can only be answered through international collaboration," she explains. "By working with partners around the world, we may be able to prevent devastating infectious diseases such as noma and tackle the baffling tragedies of craniofacial birth defects and head and neck cancer that affect millions of people worldwide."

Known both nationally and globally as an advocate for biopsychosocial research -- which studies the influence of social and behavioral factors on health and disease -- Dr. Cohen, who holds a Ph.D. degree in sociology, has been called the "creator" of a sociology of dentistry.

Prior to her appointment as OIH director, Dr. Cohen held numerous positions at the NIDCR that have helped her to encourage the adoption of this research into the long-range planning of the NIDCR, the International Association for Dental Research, the World Health Organization, the Fédération Dentaire Internationale, and the American Dental Association.

Su-yan L. Barrow, born in Barbados, West Indies, is a clinical assistant professor of dental hygiene at NYU Dentistry and former assistant to the director of the NYU Minority Oral Health Research Center (MOHRC). Professor Barrow holds an A.A.S. degree in dental hygiene, a B.S. degree in dental health education, and an M.A. degree in health education in schools and colleges -- the latter two degrees earned at NYU.

Through her activities with the MOHRC, Professor Barrow has been able to pursue long-held interests by immersing herself in making dentistry more proactive in seeking out populations that need dental services but are not getting them, and in setting an example for minorities to pursue careers in dental research. She is a frequent participant in the outreach program in the Dominican Republic, where she provides care and also conducts research for the project, and she was the principal investigator for an epidemiological study funded by the MOHRC entitled "Oral Health Status of Asian-American School Children in New York City." In 1996, Professor Barrow led a team of NYU dental faculty and students to Jamaica, where they conducted an epidemiological study of the prevalence of caries in the Kingston area. Since 1997, Professor Barrow has been invited annually to the Jamaican Dental Auxiliary Conference to speak on the latest dental materials and technology. In 1999, she received a fellowship to attend a University of Washington Summer Institute, where she earned a certificate in clinical research methods. "I believe in taking dental care and prevention to the community by reaching out across cultures both at home and abroad," she says.

Laura Fuentes, Class of 2001, vice president of the Hispanic Student Dental Association, will always remember the summer of 1999 as one of the most exciting and gratifying experiences of her life. That summer, Laura entered a U.S. Public Health Service-sponsored, competitive program known as COSTEP (Commissioned Officer Student Training and Extern Program) and became one of only six students in the United States -- and the first NYU Dentistry student -- to be commissioned an ensign in the U.S. Public Health Service.

Laura's tour of duty was with the Indian Health Service -- the federal agency that provides health care to the Native-American populations of the United States. Stationed at the Uintah-Ouray Service Unit at Fort Duchesne, Utah, Laura spent six weeks in July and August 1999 providing a broad range of care for eight to ten patients a day.

"If I had to tell someone the single most defining experience of my dental education to date," Laura says, "it would be the realization of the vastness of the need for oral health care in our nation, across the open plains just as much as in crowded cities. In fact, I think that all dental students should be exposed to the wonderful feeling of providing dental services in a rural setting. This experience has brought me face-to-face with the gaping disparities in oral health status that exist in our population. I am proud of being at a dental school that exposes students to a vast diversity of peoples and cultures and is at the forefront of training a workforce that will be competent to address these disparities. I know that the background I acquired at NYU Dentistry enabled me to do both the College and myself proud. I hope that other students will take advantage of U.S. Public Health Service programs such as COSTEP and take a fantastic voyage of discovery just as I did."

Dr. Linda R. Rosenberg, acting head of the Division of Growth and Developmental Sciences and associate professor and acting chair of the Department of Pediatric Dentistry at NYU Dentistry, was following a family tradition when she enrolled in dental school at NYU in 1972. Both her maternal grandmother, Dr. Celia Feinberg, and her father, Dr. Sidney Rosenberg, Class of 1934, were dentists. Seven years later, she was followed in the family business by her sister Dara, Class of 1982.

Like her grandmother, a 1900 graduate of Temple University School of Dentistry, Dr. Rosenberg is a pioneer. The first woman to head a clinical department at the NYU College of Dentistry, Dr. Rosenberg is responsible for the largest pediatric community outreach program in the nation, delivering essential oral health services to nearly 10,000 school children annually at the NYU College of Dentistry and providing instruction in proper hygiene and nutrition to another 5,000 youngsters in their neighborhood schools. In addition, Dr. Rosenberg oversees the College's new "Smiling Faces, Going Places" dental facility on wheels and the current Ask Your Dentist program, which promises kids a cavity-free childhood if they and their parents follow a few simple rules.

Dr. Rosenberg is committed to a strong international faculty training and exchange program as a way of responding to complex global health challenges. "It's a win-win situation," she points out. "NYU Dentistry provides postgraduate training in pediatric dentistry and visiting faculty appointments for international dentists; NYU Dentistry faculty and students gain an enhanced appreciation of the global community of dentistry; and international postgraduate students return to their homes equipped with knowledge and skills in the most up-to-date pediatric dentistry techniques. It is an added point of pride that many of them go on to become leading academics, health policymakers, and community health dentists in their own countries."

Like her grandmother, a 1900 graduate of Temple University School of Dentistry, Dr. Rosenberg is a pioneer.

Meet Dr. Denise Murphy, another woman who is making an impact on global health, in the article International Partners in Health: The Universities of Thailand.