'Malnutrition kills more children in India than any other country'

Rishi Mediratta is one of the 40 people across the United States chosen recently as this year's Marshall Scholars. Funded by the British government, the scholarship, which covers university fees and living expenses, gives Mediratta the opportunity to study at any British university for two to three years.

One of the most-profiled Johns Hopkins students, Mediratta, 22, will study medical anthropology at the School of Oriental and African Studies and public health in developing countries at the London School of Hygiene and Tropical Medicine.

The last two years, Mediratta has studied diarrhoeal diseases in Ethiopia that are a leading cause of death in children. He is the founder and president of the Ethiopian Orphan Health Foundation, a non-profit organisation dedicated to improving the health of orphans in an Ethiopian region where -- in between his university studies -- he has spent months working. He talks to Arthur J Pais about his experiences in Ethiopia, his life lessons and career goals.

How did your childhood and school days nudge you in the direction of public health studies?
I was fortunate that my parents took me to visit my family in India several times as a child and teenager. I saw so many people on the streets living in dire poverty, and wanted to improve their condition. In high school, I helped organise a fundraising dinner at our temple for a boy in India with leukaemia. With other students in the community, we raised more than $1,000 that night to help the boy's family pay for chemotherapy. I was always interested in helping others, but my passion for public health was solidified after coming to Johns Hopkins University.

Tell us more about your family.
My dad Ravinder is a psychiatrist who has his own practice, and my mom Sangita is a research scientist at Pfizer Animal Health who formulates vaccines. I am extremely thankful that my parents worked hard to provide many opportunities for my sister and me -- opportunities that they did not have while growing up.

Many Indian parents decide for their children when it comes to careers. Growing up in a 'science' family, I was never pushed or even nudged to become a doctor. It was my decision. My sister Sonia is passionate about human resources and my parents are very supportive of her career. They raised both of us to be humble, hardworking, respectful, and passionate about our work.

What led you to Ethiopia?
In many ways, my work in Ethiopia started as an accident. During my freshman year in college, while waiting in the Detroit airport, my Johns Hopkins sweatshirt attracted the attention of a man waiting next to me. That man, Dr Richard Hodes, completed his residency at the Johns Hopkins Hospital and has since been treating poor patients and raising orphans in Ethiopia for 20 years.

Where did the airport encounter take you?
Intrigued by Dr Hodes, I scribbled his e-mail address on a napkin, and we began corresponding about health issues in Ethiopia. I wrote a proposal and received funding to conduct a maternal and child hygiene survey in Ethiopia.

How did you prepare to work there?
Before conducting the clinical study about the risk factors and the management of diarrhoeal disease, I wanted to learn about the Ethiopian health-care system, culture, and language, and familiarise myself with the diarrhoeal disease medical literature and the major aspects of public health. For one month, in January 2006, I volunteered with Dr Hodes at Mother Teresa's Missionaries of Charity as well as other clinics in Addis Ababa and Gondar, and learned how mothers cared for children suffering from diarrhoea. I also lived with Dr Hodes's 18 orphans, who taught me Amharic, the national language, and the culture.

What was your initial experience in Ethiopia?
While shadowing Dr Hodes, I saw children suffering from diarrhoea. In Gondar, I met Solomon, a naked 3-year-old boy who was visibly malnourished. He had experienced dysentery for two weeks, and his mother had failed to take him to a clinic. I felt Solomon would become another number, one of the 100,000 Ethiopian children who die every year from dehydration caused by diarrhoeal disease.

You have also talked about realising something very important.
The cure for this disease was not an expensive triple cocktail of medications, or a panacea still waiting to be found in a research laboratory; the cure was something as simple as washing hands and providing oral dehydration salts.

Would your work be of interest to India?
Absolutely. Sadly, more children in India die from pneumonia, diarrhoea, measles, malaria, and malnutrition than in any other country in the world. Deaths from these common childhood diseases are entirely preventable.

So how do you address it?
To reduce India's child mortality rate, progress is needed to improve the case-management skills of health workers, improve the health system, and improve child health education provided to families and communities at the household level. My experience in Ethiopia over the course of the last three years will be salient in helping India combat its child survival crisis.

Are there Indian physicians in America you admire?
I deeply admire Atul Gawande and Abraham Verghese. I have enjoyed their writings detailing their patient interactions and insights into medicine. Both have shown me how a patient's narrative can be used to improve medical care, and are inspirations for me to reform health care.

What books have influenced you the most?
I have always been intrigued by Mahatma Gandhi. As a teenager, I read his autobiography and was impressed by his dedication to a cause that he felt was important. Also, Dr Ben Carson's Healing Hands is a testament to how being hardworking can pay off. I hope to have instilled Gandhi's and Carson's commitment to fighting for others, as they motivate me to follow my dreams.

Gawande says his guilty pleasure is reading mystery and espionage novels. What are your guilty pleasures?
I love watching marathon episodes of Friends and beat boxing to different types of music.

What is the best life lesson you have got from anyone?
My friend at Hopkins told me that it's better to focus on being really good in a few things than to be the jack-of-all-trades and be average in a lot of things. I have taken that advice to heart and have returned to Ethiopia four times over the last three years to work on child health issues. Still, I have so much to learn and discover.

Ethiopians are crazy about Indian films. Did they get to discuss Hindi movies with you?
Many Ethiopians love Indian movies. In fact, the sole movie theatre in Gondar regularly plays Indian movies dubbed in Amharic. My Ethiopian colleagues tell me how they enjoy the songs and colourful clothes in the movies. Often, when walking on the street in Gondar, children will start singing Kuch Kuch Hota Hain to me. I join in!

What are your career goals?
As a future physician and public health practitioner, I hope to continue dedicating my life to designing, implementing, and evaluating sustainable child survival programmes that mobilise families to seek quality health care. Training in medical anthropology, public health, and medicine will be a critical step for me to address the root causes of social inequalities in health care and serve the world's most vulnerable citizens.