Deserving partners in the community’s success

In 1969, Geni Eng was a French major at the University of Wisconsin-Madison. With a stretch of student teaching under her belt, it seemed inevitable that she would begin her career in education by conjugating verbs with middle-schoolers.

However, as the decade turned and Eng faced commencement in 1970, her government was waging an unwinnable war and National Guard troops had fired guns at student protesters on an American college campus. It seemed to her a good time to be out of the U.S. for awhile.

She applied to the Peace Corps and after graduation was assigned to Togo, a slender strip of land wedged between Benin and Ghana. Eng would stay in West Africa for six years — two terms of service and an additional two years as a paid trainer and consultant — more because she’d found work she’d loved than a place of escape.

As part of a nationwide response to an advancing cholera epidemic, the Peace Corps leadership worked to coordinate the efforts of Togo’s Ministries of Health and Education, which until then had functioned as independent agencies.

The resulting coordination of services opened up a world of opportunities for Eng. Her volunteer group developed a health education curriculum and trained elementary school teachers to integrate health lessons into their curricula.

During her second two-year term, Eng served as a volunteer leader with the Ministries of Education and Health, collecting data from 100 pilot schools, where they observed teachers pretesting the curriculum. They convened a national task force to make revisions, and the U.S. Agency for International Development (USAID) produced enough copies for the government of Togo to distribute to every school.

In years 5 and 6, she was a paid consultant, conducting health education training in other countries in the region, including Mali, Benin, Burkina Faso and Niger.

Dr. Geni Eng, far left, during her Peace Corps service in Togo

Eng not only found her calling in Africa but also her lifelong partner, Daniel Goetz, a fellow Peace Corps volunteer in the wells program, now a senior public administration specialist with RTI International’s development group.

“When it came to improving water supply, Dan was the hardware, and I was the software,” she likes to say. “He was a well-digger and had the training to dig the well, install the pump and make the technology work.

“I worked with the women, who were the water bearers and the ones inconvenienced if the well didn’t work. I overheard them saying, ‘The pump handle is too long. The children will swing on it, and it will be broken in no time.’ I told Dan, and they changed the design. It’s a case of the technology being improved through community input.”

After six years abroad, Eng felt ready to fine-tune her skills through graduate study.

“I knew I wanted rural communities to be part of my work,” Eng said, “and UNC was the only one of my choices that was in a rural setting, with faculty members whose research and teaching were with rural populations.”

After earning the master’s degree at UNC in 1978, she joined a project in Cameroon, led by Dr. John Hatch, while completing her DrPH in 1983. The following year, she was invited to join the UNC faculty.

As a faculty member in the 1980s, she returned to West Africa to conduct child survival research and training, funded by the Centers for Disease Control and Prevention. One of those trips was to Togo, with her five-month-old son, Gabe. “It was so much easier to be a working mom there,” she says, “because a child is truly raised by a village.”

She also worked on several projects with Dr. John Briscoe, at that time a UNC faculty member in environmental sciences and engineering, later a director at the World Bank, now a professor at Harvard University.

In Tanzania, Togo and Indonesia, they studied community participation in water supply, comparing villages that had outsiders install wells with pumps for them with villages whose residents, including women, were themselves engaged in building wells and maintaining pumps.

Eng and Briscoe learned that when child vaccination programs were introduced after the water supply programs, communities that were engaged in improving their water supply had significantly better vaccination coverage for their children.

“Our study showed that when programs invest in building people’s capacity to make safe water available for their community, they were not only healthier but could use this same capacity to make decisions and mobilize their members for other health initiatives.”

In 2000, Eng’s daughter, Mira, was spending her junior year in college abroad, in Senegal. Eng met her there and took her to meet her Peace Corps village in Togo. “Everyone oohed and ahhed when they saw her,” Eng says. “‘She reminds us of you!’ they said. And it struck me that Mira was almost exactly my age when I first came to the village.”

Mira is married now to Loic Hudson, whose father was a Peace Corps volunteer in Niger. They served in Mauritania as “legacy” Peace Corps volunteers. In fact, the son and daughter-in-law of faculty member and Peace Corps volunteer John Paul now live in the same house Mira and Loic vacated at the end of their service.

At the UNC Gillings School of Global Public Health, Eng’s research and teaching address many of the same issues she first faced in the Peace Corps.

She teaches courses on health issues relevant to women, racial and ethnic minorities, rural populations and developing nations, as well as the community-based participatory research approach.

For 19 years, she directed the MPH program that sets a high bar for students to learn directly with communities the sophisticated skills of engagement. Each year, the Department of Health Behavior and Health Education receives requests from area community-based organizations and agencies for student teams to engage communities in assessing strengths, needs and priorities for action. Each student team spends two semesters with a community, using methods from anthropology, epidemiology, program planning and empowerment education to design, implement and evaluate an intervention.

Eng remembers that a favorite Peace Corps motto was “Work yourself out of a job”; in other words, give your communities the tools they need to do everything as successfully as you’re doing it. Eng has not yet felt her job to be finished; inequities in health and education are still too deep and widespread, and too many people are without the conditions necessary to be in good health.

What gives her hope, with so much left to do?

“Even the most isolated, marginalized community has a circle of helpers, resources and strengths,” she says. “The key is to look for that, build on it, document and act on it. Ask yourself how best to enter a community respectfully. How do you listen; how do you talk so that people will listen?

“I want to teach students to look for the strengths of those with whom they work in addition to recognizing their needs and shortcomings. I want them to be deserving partners in each community’s success.”

Carolina Public Health is a publication of the University of North Carolina at Chapel Hill Gillings School of Global Public Health. To view previous issues, please visit www.sph.unc.edu/cph.