An Alumni Perspective on Public Health with Scott Herrod

Recent BYU alumnus Scott Herrod shares what inspired him to study public health at BYU and how he sought out research opportunities. He describes his global health research as an undergraduate student, including a recent trip to Ghana where he participated in cataract surgery initiatives. Specifically, he collaborated with providers in Africa affiliated with the Stop Infant Blindness in Africa Task Force, Daybreak Vision Project, and Himalayan Cataract Project.

 Guest Bio

 Inspired by his church mission to Ghana, Scott Herrod chose to study public health at BYU with a minor in international development. Herrod graduated in April and started Harvard medical school this fall. Passionate about global eye health, Herrod plans to earn a Master of Public Health after medical school and work with international colleagues as an academic ophthalmologist. In his free time, Herrod enjoys camping, hiking, and skiing with his wife, Madelaine. 

 Scott’s Research:

https://www.nature.com/articles/s41372-021-01040-7

https://www.tandfonline.com/doi/full/10.1080/09286586.2021.1910315

Global Eye Health Initiatives:

https://cureblindness.org/

https://www.daybreakvisionproject.org/

https://www.childrenseyefoundation.org/webdev/what-we-do/africa-rop

Recorded, Edited & Produced by Paige Sherwood, Isabella Loosle, and Tanya Gale

Transcript

Cougar Hall: 0:09

Welcome to Y Health, a podcast brought to you I'm Dr. Cougar Hall, a professor here at Brigham Young University. Whether you are a student, parent or BYU fan, this podcast will help you navigate the world of public health. Our podcast strives to help individuals receive accurate information regarding public health. So whether it's global or local, we will discuss how it pertains to you. Just kick back and relax as we talk about why health. Scott Herrod, thank you for joining us today on the Why Health podcast. How are you doing?

Scott Herrod: 0:45

Good. Thank you so much, Google. I appreciate you inviting me to be on this podcast.

Cougar Hall: 0:49

You are the first student, actually former Now, you just graduated about a month ago, so congratulations on that. But the first student we've had on the podcast and I think I'm more excited about this conversation than anyone we've had so far.

Scott Herrod: 1:02

Well, thank you. That's really nice.

Cougar Hall: 1:03

You've had a really busy summer and I want to But would you mind just introducing yourself first a little bit about who you are, where you're from, and why you're here, right?

Scott Herrod: 1:12

Yeah, great. So my name is Scott Herrod. I recently graduated in public health, health, science and International Development. I am very interested in global health, and that's I think one of the reasons why I'm here is to talk about my experiences in academic global medicine. I'm married. I've been married for three years, and I'm the oldest of seven kids. So I've got a blended family, my mom and then my stepdad and then a bunch of siblings. So at one point there are actually five of us here up at BYU. And that was that was definitely a good time.

Cougar Hall: 1:42

Wow, that's really cool. Okay. Where did the Herod's reign from? Where's home?

Scott Herrod: 1:45

So I'm from San Clemente, California. So that's South Orange County.

Cougar Hall: 1:50

Very cool. I love it. Tell me why you chose public health. Why you chose health science?

Scott Herrod: 1:56

Yeah. So originally when I first got to BYU, then I ended up shifting to exercise science. I was really interested in sports and then I served my mission in Ghana and that really opened my eyes to global health inequity. And I had people on my mission who I knew, who died in childbirth. I saw a lot of poverty and how that impacted health. And I knew when I came home that I didn't want my career to only be helping athletes get back to a sport, but to help people who are underprivileged or underserved access health care and ultimately become healthy, like people that are wealthy can be healthy. And that kind of sparked me to be interested in public health. And so I ended up switching my major switch to public health health science because I knew that that was a good route to medical school as well as to give me a population mindset to medicine, which I think is really important. So that's ultimately why I chose public health and then also international development.

Cougar Hall: 2:54

I don't know if all our listeners are Church of Jesus Christ of Latter day Saints. And I know that even those that are may or may not know where Gon is on a map. If you don't mind, you just tell us a little bit about a mission experience and about Ghana in particular. Is that.

Scott Herrod: 3:09

Okay? Yeah, definitely so. Ghana is in West Africa. It's actually one of the more wealthy and developed countries in West Africa. It's got a pretty good medical system or health care system. But I serve from 2016 to 2018 and I guess one experience I can share, you know, I alluded to, you know, a friend that I knew that died in childbirth. And when I first got to Ghana, I worked in this this area that, you know, is a little bit outside of the main city, Accra. And there was a friend that we had made as we were working within these communities, because as a missionary, you get to know, you know, most people in communities. And we made this friend who owned this baking shop and we passed by frequently and she wasn't expecting expecting mother. And every time we would walk past this shop, she would say, Welcome, my friends, welcome. It's good to see you. And we'd get this pastry from her. You know, my my companion and I, we enjoyed getting to know this. This woman. And she wasn't a member of the Church of Jesus Christ of Latter day Saints. But we still, you know, valued that friendship. And one day after several weeks of this, we stopped by and she wasn't there. And we didn't really think anything of it. You know, we knew she was expecting we knew she was probably due any day. And one of the workers at the at the bakery stopped us and said, Do you know where your friend is? And we knew she was alluding to this woman and we said, No, we don't. Where is she? And she said, Oh, she died last night. She died in childbirth. And I remember that was kind of the first time I realized, like, I'm not in the United States anymore and I'm in West Africa where know health is is not guaranteed for all and health care isn't guaranteed for all. And, you know, I started to question why, you know, she didn't have any choice to be born in Ghana. Why did she passed away in childbirth? Whereas I know many people in the US who are much more privileged than are able to get care when they have a complication. And I didn't know if she didn't go seek care or if it was inadequate care, but that really kind of sat with me throughout my two years as well as additional experiences that I had, and that's when I came home. I realized that I wanted to make a difference in some way, and I've learned a lot along my journey of what does it look like for me to have an impact in global health? And you know, what is sustainable, what is helpful, what isn't. But that's kind of was one of those pivotal experiences for me in being interested in global medicine.

Cougar Hall: 5:29

Yeah, I would think so. I can wonder what an impact that would have had on you. You and I met, I think, in an introduction to public health class and right before. For the SARS-CoV-2 pandemic. In fact, I think this will go down as one of the dumbest things I ever said. But I don't know if you remember this in class. I think I shared know Public Health in the news. And it was an article, I think, from Dr. Fauci or it had a lot of good quotes from him. And this is likely the first week in February, right, of that year. And I think I remember standing up and saying, well, if this ever came to the US, we'd take care of this in about two weeks because our public health infrastructure, we got this taken care of and that has haunted me so many times over the past couple of years. But I think that's when we met. And then we had just a brief conversation in my office about working together and in a project that you were really passionate about. And I really think it's something that came from an experience that you had in Ghana. So tell me about the project and then what led to what's called a Cura or a college undergraduate research award here in the College of Life Sciences. Do you mind talking about that?

Scott Herrod: 6:37

Sure. Yeah. So I had worked with Randy Page on going on a global health internship with Unite for Sight, which is an organization led by ophthalmologists in Ghana to perform cataract surgery for those that are in poverty in different villages around around Ghana.

Cougar Hall: 6:56

Okay. Time out, Scott. What are cataracts and why is it an issue in Ghana?

Scott Herrod: 7:01

So cataracts is when the lens of the eye able to see. And specifically in low income countries like Ghana, they don't have access to surgery. And so they can become blind and has a lot of detrimental impact on on their health and on their families economic status and their children's educational attainment. And so it's easily treatable with a quick surgery where it can take 10 minutes or less, where the lens is replaced with a synthetic lens so that they're able to see. And so the purpose of my time with United for Sight was going to be assisting these local physicians in providing care for these patients, but most importantly, also conducting a research project, which is when I first met you, we had talked about possibly doing a study where we interviewed patients and assess barriers to cataract surgery in Ghana so that you could innovate and customize their services to reach those that are hardest to reach. And so that was kind of the basis of our project. We worked on that for several months. We even completed an IRB application and got approval. And then, like you said, the pandemic came and that got shut down. So my wife and I were not able to travel to Ghana, unfortunately, but luckily I met a man named Dr. John Welling, who works at the Himalayan Cataract Project and was also starting up DAYBREAK Vision Project, which is in collaboration with with ophthalmologists in Ghana, to basically do the same thing that Unite for Sight is doing. And we were able to to develop a new study that was very similar. But instead of surveying patients, we surveyed ophthalmologists in Ghana and Ethiopia and Zambia. And so we got IRB approval and implemented the survey. And now we've done analysis and we're just writing of that paper.

Cougar Hall: 8:46

That's really exciting. And I'm really course, your recent trip to Ghana, because you've just gotten back, what, a week ago? Yeah. Before I go there, though, you know, research is much more challenging than most of us think. You know, oh, this will be nice and quick and smooth and we'll get through this. I think it's really impressive, Scott, that you have been the team lead on this research project. I've had many research assistants, but I don't know if I've ever had anyone that was as prepared and as focused and as driven as you. And yet you had a lot of help along the way as well. You've worked with some amazing people at really prestigious institutions. Maybe talk about some of the people that influenced you along the way. And then let's get to your data and your findings. Is that okay?

Scott Herrod: 9:36

Yeah, that'd be great. So I would say what really set me off on the career of wanting to do academic medicine is I had an internship with the Stop Infant Blindness in Africa Task Force. It's part of the International Pediatric Ophthalmology and Strabismus Council. It's this international network of ophthalmologists from all around the world. And I worked with a mentor from Stanford named Dr. Scott Lambert on this project with this task force to prevent this specific cause of infant blindness in Africa called retinopathy of prematurity. And as part of that project, I helped establish training centers in Africa. I networked with a lot of doctors in Africa, and we did two studies on what was contributing to this infant blindness, as well as how many infants are going blind in Africa because of this condition. And I received a lot of mentorship from Dr. Scott Lambert and also his colleague, Dr. Sherman Eisenberg at UCLA, where I learned a lot about how to conduct research, how to get. Approval. How to ensure that you do data analysis. I think I also really opened my eyes to the fact that not only as a doctor do I want to help provide care for patients, but that through research you can really impact thousands of other people by moving your field forward, by helping understand barriers to care. And I really it really said if I my interest in integrating public health and medicine as well as pursuing academics. So I'd say definitely Dr. Scott Lambert is one of my mentors that's really been helpful in preparing me to do research as well.

Cougar Hall: 11:13

That's really cool. It's possible that we'll have some public health students listening to this, Scott. That would be cool, wouldn't it? Do you have some advice? You've just rattled off three or four different organizations and some top academic physicians in the country. And you were an undergrad. How should undergrads proceed to have some of those experiences so that they can be where you are?

Scott Herrod: 11:36

So I'd say one of the biggest things is I tried for a lot of different opportunities and didn't get some and got some others, and I think that it's important to just put yourself out there once you've identified what you're passionate about, to look for opportunities along those lines and just apply to everything that you can. Anything that the Public Health Department offers, anything outside of BYU that is offered. I was fortunate with that internship that there were some recent physicians who who had just completed training, who were starting up some internships with some prestigious physicians at different universities. And that's kind of how I got connected to Dr. Lambert. But looking for those opportunities and then not being afraid just to put yourself out there and you've got to recognize that some opportunities you'll get and others you won't. But as you get more and more opportunities, it starts to snowball. Where you have one internship, you're able to get a good letter of recommendation from. Then it helps you get the next one and you're able to pivot through each opportunity to decide What are you really passionate about? What do you really want to pursue? So I guess if I could boil it down to one thing, it'd be put yourself out there and apply to everything.

Cougar Hall: 12:41

Yeah, you've done a great job with that. So tell us about what you found with your study. You've just returned from Ghana. You collected some data. Tell us about that.

Scott Herrod: 12:52

Yeah. So after my internship at Stanford, I John Welling, who started DAYBREAK Vision Project and works with the Himalayan Cataract Project. And so he helped Network, Courier and I to some ophthalmologists in Africa so that we could get their input on a study, on a survey to assess what impacts productivity of their surgical productivity, as well as what do they perceive as barriers to care in their respective countries for cataract surgery. And so Krueger and I, we designed this electronic survey through Qualtrics, which we sent out to hundreds of physicians, and they've responded over the last few months. And we just recently completed analysis with Dr. Ben Crookston. And I guess some of the most important findings that we found is that a lot of them start off their careers in the government hospitals. And the government hospitals are what provide care for the most impoverished within those countries. That's where many of them access, access, care. There's government insurance that many people in Ghana at least can use at government public hospitals. But interestingly, the surgeons responded that they weren't as incentivized in government hospitals to be as productive as possible, and they actually prefer to be in private practice. That was and actually all of the countries was hands down. The most preferred practice setting was private practice. And that's likely because very wealthy patients are able to seek care that they might have private insurance or they can pay out of pocket. And so it's more lucrative for these ophthalmologists, which is, you know, completely understandable that they have their own families. They want to make sure that they can provide for for their families. But at the same time, that means that you have this drift from ophthalmologists in Africa working in government hospitals to wanting to work in private settings, which bars many of the most poor patients from accessing care. And so I think that finding is really important to for government to look at and think about how can we change our services to better incentivize people to work for us so that we can provide care for the most impoverished? It also helps organizations like DAYBREAK Vision Project and Himalayan Cataract Project, as well as local providers know, you know, what can they be doing or what could they be advocating for to make sustainable change?

Cougar Hall: 15:04

You know, there's a lot of research that we And I'm I'm going to talk about my my experience. I think a lot of the papers I've written, I don't know if anyone ever read them, including me. Maybe my parents did. Right. But there's there's research like what you've just done that I think is really meaningful and has the ability to change the lives of individuals. I don't know if everyone quite understands just how impactful it is when in a in a family in the developing world, an adult in particular, a breadwinner, the individual who provides for the family loses. Says his or her site. I think you've experienced that. And maybe that's one of the things that has really been a motivator for you during this whole project.

Scott Herrod: 15:47

So while I was in Ghana, I often saw blind begging for money by children. And this was often during the school week where those children should be in school. They should be gaining an education that will not only help their family or their selves, but also their family. But instead, they're stuck caring for grandma or grandpa, you know, to try to get some sort of money or to care for them. And that definitely really impacted me while I was in Ghana. I saw that first hand and I didn't know that there was anything I could do about it at that point. But it definitely stuck with me and I realized that. You know, blindness does not only impact the individual who's blind, that elderly person, obviously, they have worse health outcomes. They can have mental health challenges because they're not able to see they're not able to interact with people how they used to. But at the same time, it also impacts families where these children aren't able to go to school. Their economic productivity will decrease ultimately in their life because they can't get a good job. And it it honestly can. There's this this perpetual cycle where blindness and poverty are interconnected, where one contributes to the other. Those who are poor can't access services to get care. But also, if you're blind, you become more poor as well. And so that really drew me to ophthalmology. And just a few weeks ago, I was in Ghana working with DAYBREAK Vision Project, and I got to see firsthand the impact that cataract surgery, a very simple procedure can have on the quality of life of the individual, but also their family and just a little bit of background. So cataract surgery can be done in 10 to 15 minutes by an experienced surgeon. There's very low risk of infection. And these high volume cataract outreaches are what is very commonplace in in global health, where this last week, 667 patients were screened in different villages by local clinical teams and brought to a hospital where surgeries were performed by experienced surgeons and the total cost, including food travel, to get to the hospital, the surgery, all of the equipment, the consumables that are used is around like $75 per patient. So it's very inexpensive for a surgery. It's just helping these people access care. And this last week, there was this woman named Aquilla, who was a single mom, wasn't married, had five children. Her oldest was 19 or 20, and her youngest was only just a few months old, if not maybe a year old. And she was bilaterally blind from cataracts. And she could she had very, very minimal vision. And so. We went to her home before surgery and saw what her life was like because she was blind and she showed how she's not able to wash her clothes because she can't see if the clothes are dirty or clean. She talked about how when she needs to change her baby's diaper, which by the fact she's she's actually never seen her baby before because she can't she can't see. But she talked about how when she changes her diaper, she can't see if it's dirty. She has to feel because she cannot tell. So something as simple as changing a diaper was really difficult for her. And she she just sobbed as we were there before she got surgery, just talking about how difficult it's been to be a mom of five children bilaterally blind from cataracts. And her 14 year old daughter was there as well. And her 14 year old daughter had to drop out of school to care for this baby, as well as to help her mom with household responsibilities, as well as helping provide a living for their family. And so, obviously, her educational attainment was was decreased. And again, this mother was just sobbing and it was really, really heartbreaking to see. Flash forward a few days later, she gets surgery. The surgeons didn't know if it would work. There were some other complications that may impact her vision beyond cataracts. But we all prayed for the best. And the next morning, when they removed the patches to see if she could see they did some eye exams, she as soon as the patches were removed, she just jumped up and just started yelling and was so excited and so happy. Her 14 year old daughter was just sobbing next to her. I think she knew what that meant, not only for her mom, but for her and her life as well. And then one of the first things that the mom did is just called for her baby because she wanted to see her baby for the first time. And so they brought her her baby. And she just was I can't even express how excited she was. It was really moving to see. And then we also went back to her her village, into her home a few days after to see what her life was like different. And she showed us how she could now wash her clothes, how her daughter was going to start school on Monday. And just to see that kind of impact in such a simple procedure that can be done by local clinical teams, I think was really impactful to me and really opened my eyes to the impact that that eyecare care in low income countries can can have on people.

Cougar Hall: 20:33

Scott. That is the most incredible story I've What? What an experience. I can't even fill my car with gas. In June of 2022 for $75. And the impact, that's a life changing. It's actually going to impact generations of that family.

Scott Herrod: 20:52

It's pretty it was pretty incredible to see. I'd read about it in textbooks. I learned about it in different things that I've done. But to see it firsthand was really, really moving.

Cougar Hall: 21:00

Yeah. Okay. So I think I have a little bit of a glimpse now of what motivates you and why you're so excited moving forward. So you just graduated in April from BYU. What are your what's next? What are your plans?

Scott Herrod: 21:15

Yeah. So I recently applied to medical school fortunate to get into Harvard Medical School. So I'll be attending that upcoming four years. I also plan to get my master's of public health as well, whether that's at the Chan School or the London School of Hygiene and Tropical Medicine. I definitely want to blend public health and medicine as much as possible, but what really drew me to Harvard Medical School is my interest in global health. They definitely are considered a frontrunner in sustainable global health. And one of the biggest things that I've learned in my public health classes and my international development classes is the importance of empowering providers and leaders in low income countries to really lead out in efforts to care. And really, my job coming from a place like the United States is to really just support them in how they want to be supported. And Harvard has not always had that mindset, but recently with the work of people like Dr. Paul Farmer and other people at Harvard. They really emphasize the importance of letting local providers and public health specialists lead out and that we're really just there for support and how they want it. And I really love that mindset about Harvard. They call it decolonizing global health. And that's kind of my my path is I want to get my medical degree and MPH and then become an academic ophthalmologist, helping support colleagues in low income countries like Ghana.

Cougar Hall: 22:36

I really appreciate you adding that. I think public health has a history of kind of parachuting in and being the saviors on the ground and providing all of the care that's needed. But that that shift and people like Paul Farmer really have led out in that shift. And let's build their capacity. Let's let's do it the way that they want to do it. But we'll we'll provide that technical assistance. And and really, when you leave, they're stronger, they're more prepared and they're better equipped to take care of their own challenges. And and I know that the foundations that you're working with, they absolutely have that mindset. And I will I will absolutely leave you in the description for this particular conversation, some context, you know, some links for the foundations you've been working with. I do have to say congratulations. Byu does a terrific job of preparing undergraduate students and our students. They do go forth to serve and they land in some of the most prestigious graduate programs, professional programs around the country. I've never had a research assistant at BYU that landed at Harvard Med. So, Scott, you're being humble. That's really cool. Really exciting. Have you been to Boston yet? Have you found an apartment? What are you doing here?

Scott Herrod: 23:47

Yep, we've found an apartment. We're going to be right by the Red Sox Stadium. It'll be a easy ten minute walk from me and a ten minute subway ride for my wife to her work as well. We head out in just two or three days, so we're excited for the adventure.

Cougar Hall: 24:01

So exciting. And your plan then with the MPH and the M.D., is it clinical practice? Is it a combination of academic medicine? What do you...I mean, obviously, things may may unfold as you as you go through this experience, but what are your plans now?

Scott Herrod: 24:16

Yeah, so I'll definitely have an open mind, 50% clinical work and 50% research and working with with colleagues around the world.

Cougar Hall: 24:28

Really cool. Really cool. Scott Herrod, thank you for joining us on why Health and I wish you all the best, my friend. I hope that we can keep in contact and stay friends and that when I travel to Boston you can give me a place to lay my head. Does that sound.

Scott Herrod: 24:41

Good? Of course. Thank you so much for having I appreciate it.

Cougar Hall: 24:43

All the best, my friend. Thank you for joining us today. Catch us on our next episode and don't forget to subscribe to Future Y Health episodes.