Carisse Hamlet was in her senior year of college at the University of Delaware majoring in biomedical engineering when she had to break some challenging news to her father.
Carisse’s father is a pediatrician in New York, and Carisse had worked in his office on weekends and in the summer as a teenager. Her mother is a nurse in upper Manhattan; her two older sisters are a nurse and a pediatrician. Carisse’s family was waiting for her to go on to medical school.
But while studying biomedical engineering as an undergraduate, she had become disenchanted with how inaccessible the technology could be, especially for people living outside of Europe and North America. This question of access would drive her for years to come. And, while she had savored witnessing how tenderly and respectfully her father treated each patient, she had also been surprised by how cold the medical financing system was, after working with medical billing and insurance companies in her father’s office.
“I broke my news that I would be applying for MPH programs rather than medical schools. I told my dad, ‘When people come to see you, they are already sick. I want to be addressing problems in a way so that they might not even have to come to you in the first place,’” she said. “Clearly clinicians and public health practitioners each have immensely important roles in society, but knowing the kind of problems that I like to solve and the approaches I like to take, public health is a better fit. I am still an engineer at heart; we are trained to think about processes, systems, boundaries and design parameters. This is woven into my personality and how I move through the world.”
Carisse went on to Columbia University’s Mailman School of Public Health. Her family supported her decision, and in the years since, especially during the pandemic, Carisse enjoys comparing notes with her sisters and parents based on their clinical experience and her own training.
Carisse’s parents both grew up in Dominica and met and married there. They immigrated from Dominica to New York in the 1980s.
Both of Carisse’s grandfathers had worked in agriculture on the island, but each had insisted that their children study rather than work on the farm. Carisse’s parents passed this work ethic on to their children.
“I can’t remember a time growing up when academics and working hard were not important,” Carisse said.
Before kindergarten, when Carisse wanted to read like her sisters, her father paid her cousin and sister to teach her. At the start of the summer before third grade, Carisse’s father handed her a stack of flash cards, and she learned the multiplication tables by the end of the summer. Carisseoften played “school” with her two older sisters, and her eldest sister, who was seven years older than Carisse, would teach what she was learning. Carisse and her middle sister were both so advanced they eventually skipped a grade in school.
Carisse grew up in several areas in New York and New Jersey, but she feels most tied to Rockland County, New York, where her parents still live, where she attended high school and where she returned to live after college to attend graduate school.
In between graduating from the University of Delaware and attending graduate school, Carisse lived in Rwanda to try out working in global health. She participated in a program called Engineering World Health which pairs engineering graduates or early professionals with hospitals and clinics in different countries. She worked as a biomedical technician as a part of a team at a hospital diagnosing and fixing medical technology.
“I was searching for real-life confirmation that my suspicions about what’s holding us back are true, that it is infrastructural problems, access problems,” she said.
During graduate school, she worked as a Knowledge Management and WASH (water, sanitation and hygiene) Fellow at Project Concern International in Malawi. There, she conducted impact evaluations for programs relating to water access, water supply maintenance and hygiene behavior, among other areas.
When it came time to look for her first long-term job after graduate school, she was concerned about finding an organization whose priorities aligned with hers.
“I then had substantial experience with working with nonprofits in the global health and development space, and I was skeptical of how some of the politics, competing priorities and funding schemes routinely distracted from the intended impacts,” she said.
Carisse joined Vital Strategies in 2017 because the organization seemed to take a different approach to global health work.
“Many people at Vital Strategies have profound experience in government. I knew this was a critical piece, so that was really exciting to me,” she said. “While holding the technical pieces of public health near and dear, the organization pays attention to structures within governments at the city and national levels, and some of these nontechnical obstacles. I am still a fan of the approach we take, especially when we center the needs of partners in program design and build in exit strategies. This is very important to me.”
One of the first times when Carisse felt really proud of her work was after she helped run a training for Southeast Asian journalists in Bangkok to equip them to better use data to tell foundational stories about air pollution and health.
“Afterward, I was blown away by how much of the curriculum was immediately applied and staring back at me in journalists’ publications. They had taken the tools we offered and made them useful for their own work,” Carisse said. “It felt instrumental in a way that wasn’t imposing or self-involved. That was the feeling that I was chasing.”
At Vital Strategies, Carisse manages INSPIRE, a global coalition of clinicians advocating for clean air. Its main objective is to activate clinicians to raise the profile of air pollution and its harms to health.
She also plays a major role in the Health Policy Accelerator, a program that works with country and regional offices of the World Health Organization to help them play a more tangible role promoting and shaping health policies in countries. Current Policy Accelerator initiatives are primarily focused on sexual and reproductive health and rights.
“WHO country office staff have profound technical and contextual knowledge of sexual and health rights issues, but they may lack political or policy promotional know-how to package policies that are accessible and meaningful to decision-makers,” she said. “It is important to me that we are not taking up space that is not ours to take up in an institutional way. We are sharing the expertise we have, so partners are not reinventing the wheel, and cementing ways for them to access that expertise internally in the future. I think this is how it should work.”
She hopes she has a long career ahead of her, and while she doesn’t know exactly what positions she will seek, she knows she wants to apply the thinking of an engineer to her work.
“We need to innovate around a number of global health and accessibility issues, but that innovation often isn’t around the biomedical technology as I once thought. We don’t need to reinvent the toilet or air purifiers. Instead, we should be interrogating the underlying circumstances that create these problems and boldly designing approaches around that. I see this as a theme in global health—the need to excavate history and understand how its legacies manifest as the obstacles that we see now. My goal is to be a part of the work that is bringing this new and comprehensive lens to global health. One that does not ignore historical and systemic context.”