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Moving from silos to systems - My journey as a medical doctor transitioning to Planetary Health

Updated: Mar 2, 2023

By Dr. Cyan Brown

Do you know the feeling of building a puzzle that has very different pictures as the parts?

There’s a certain level of frustration and challenge at not being able to have a macrolevel color scheme help you figure out what goes where and not seeing how the smaller sections join into the whole, but when it finally comes together there is an “Aha!” moment at seeing all the smaller parts contributing towards the big picture synergistically.

This has been my experience as a clinician transitioning into the area of planetary health. I studied medicine in Johannesburg, South Africa, and loved the intensity and complexity of clinical practice. During this time, my learning outside of medicine taught me on a theoretical and practical level how central the empowerment of women is to better health outcomes for women and their whole communities, and thus I was inspired to start the TuksRes women in leadership academy. It focuses on teaching and equipping young women with life, business, and leadership skills and helping them reach their full potential during their time at university and beyond. It is now seven years old the biggest student-led women in leadership academy in South Africa and has seen over 1600 young women graduate.

The process of understanding how central the upliftment of women is to better educational and health outcomes started me thinking about the social determinants of health and how we make an impact at a preventative level in the healthcare system. However, the institutional norms in clinical medicine always made me feel like this was a parallel part of my life to my studies, despite what I had learned about advocacy, gender, and collaboration becoming so central in how I thought about health and the patients I worked with.

I had two puzzle pieces that overlapped but didn’t build a whole picture, which eventually led me into the path of doing my master’s in public health.

I suddenly found a whole group of people who thought about health from a multidimensional and multi-disciplinary paradigm. It finally clicked how the social determinants fitted in so centrally to the clinical work I had been doing, I just didn’t have the vocabulary to name what had always been so intuitive. This stage has required so much unlearning about the world and health as I knew it, and openness to being a part of a collective group of public health practitioners who have very different ways of working in this vast field.

This step solidified my medical knowledge, work in gender advocacy and public health into one connected piece of the puzzle, but also added so many more blank puzzle pieces onto the canvas. One of those pieces turned out to be a fellowship in health equity with Tekano Atlantic Fellows, another, a social innovation program, Young Sustainable Impact, focused on creating sustainable solutions for the sustainable development goal number three good health and wellbeing and yet another making my first documentary in the health advocacy space. I have found that I don’t know where the path is leading, but the right doors have luckily and intuitively opened. This has been an intimidating process in a world where the rise of the silo and expert have dominated, to take leaps that neither advance congruent expertise nor lead to an expert path, but everything about what I chose to color the blank puzzle pieces with has felt right and has been decided with personal conviction.

So, there I sat in my late twenties with some fascinating but mostly disjoint puzzle pieces before me. I could see the links, but I didn’t know how to translate them practically. Then I was introduced to the concept of planetary health through the Women Leaders Planetary Health Mentorship Program, which focuses on the intersections of public health, gender advocacy, and the environment in a holistic and collaborative model. That was the moment I realized all the mismatched puzzle pieces were so central to the bigger whole. It made me realize we cannot advance public health at the expense of the environment, we cannot advance all of society if leave the marginalized behind, we cannot be a voice for justice in only a single issue, and still, hope for sustainable progress. All the pieces had a part to play.

My journey at the Women Leaders for Planetary Health

During one of my first sessions with my mentor Teddie Potter, a phenomenal woman who is the Director of Planetary Health & Clinical Professor at the University of Minnesota School of Nursing, explained the concept of systems thinking and in a few magical sentences was able to make sense of the diverse skill set and multiple puzzle pieces I had before me. I came to understand my role in being part of a movement and discipline of planetary health which requires bringing everyone along to create a just, healthier, and sustainable world.

Researcher and storyteller Brené Brown captures the stage I am in now with her quote:

‘Vulnerability is the birthplace of innovation, creativity, and change.’ Medicine often has pre-

determined ideas of what a doctor should be, and society often has strong ideas about the value of becoming an expert. However, my path this far has led me to deeply value holding all these puzzle pieces as they slowly knit together in the vast field of planetary health and being able to accept the tension of not having a linear and predefined path in using my skills, knowledge, and energy in one silo but rather working in emerging and evolving spaces in planetary and public health in multi-disciplinary teams. It’s required of me a level of vulnerability to be in and the willingness to be on a ship that’s is being built whilst sailing. But this has also allowed a great deal of creative freedom for our generation to create the type of planetary health movement that we believe necessary and inclusive of all.

My knowledge of clinical medicine, public health, and gender advocacy has been given a new lens and I have been encouraged as a leader to be more self-aware, empathetic, and collaborative during my time in the 2020 Women Leaders for Planetary Health mentorship program.

It’s created the framework implementing planetary health concepts in all areas instead of seeing it as an isolated domain. This next season holds the opportunity to apply these learnings and a planetary health lens to the work I will be doing in designing healthcare solutions using artificial intelligence through the Forbes Ignite Fellowship as well as applying the planetary health principles to my research in frugal innovation in surgical care in low and middle-income countries and the documentary internship in advocacy I will be undertaking later in the year in California with Brave New Films.

Planetary health has made me look up and see that my own puzzle cannot be complete without pieces from others puzzles and that when we work together in this way, the picture becomes one that is good for the planet, everyone’s health, and a sustainable way of life. I’m grateful for this journey and I am continuing to trust that the process is becoming more embedded in planetary health.

About the Author : Cyan Brown is a South African medical doctor with a passion for health, leadership and sustainability. In 2020, she joined the first class of mentees at Women Leaders for Planetary Health. She is a systems thinker who enjoys finding creative solutions to building healthier communities. She is the founder of South Africa's largest student led women in leadership academy, The TuksRes women in leadership academy, which is 7 years old and has seen over 1600 women graduate in the program. She is a senior Atlantic fellow for health equity and is currently pursuing a master's in public health from King's College London. She was named as one of the top 200 young South African leaders in 2020 by the Mail and Guardian and is an alumnus of the Young Sustainable Impact program. She has also been named as a McKinsey and Company next generation women leader. In her spare time she enjoys travelling, podcasts, good coffee and spending time outdoors.

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