Adriana
Hello. Welcome to our podcast, Who We Are Inside. We are so honored to be talking today to an incredible human being who serves as Dean of the Pitt School of Public Health, Dr. Maureen Lickveld. Dr. Lickveld was born in Suriname, and she attended the Anton de Koon University of Suriname and the Leiden University Netherlands for her medical degree. She then moved to the United States and enrolled at the Johns Hopkins Bloomberg School of Public Health. At the age of 23, she became the youngest and first female physician to work directly in the Amazon rainforest. Wow. Upon completing her medical degree, she spent 18 years with the Centers for Disease Control and Prevention and the Agency for Toxic Substance and Disease Registry. During her CDC career, she was involved in discussions to create a strategic national stockpile, a repository of drugs, vaccines, and medical supplies following the September 11 attacks. In recognition of her work, she received a Special Service Award, Public Health Service Special Recognition Award, and CDC Environmental Health Scientist of the Year. Dr. Lickveld studies environmental public health, focusing on environmentally induced disease, health disparities, environmental health policy, disaster preparedness, public health systems, and community resilience. Her research examines the cumulative impact of chemical and non-chemical stressors on communities facing environmental health threats, disasters, and health disparities. Welcome. I can go on and on and describe your great personal accomplishments, Dr. Lichtveld, but instead, I would love to hear directly from you. So I was listening to your Cupid interview as preparation for this podcast, and one part that really warmed my heart was when you talked about your decision to not stay sheltered in academia and your desire to be with people who are most vulnerable on the front line. You also highlighted that part of your identity is your commitment to work with communities to resolve their problems. Can you please tell our listeners about how your love for communities became part of your identity and who you are inside?

Maureen
And so life takes you in many different ways. I actually should back up a bit and say, now, if you look at me, and if you listen to me, you'll get culturally and ethnically very confused. I don't have a Latin American accent. I look Asian, and I have a Dutch last name. And so I am so proud of our country and of the world to become increasingly multicultural, because that's where the richness is, and that's what's in me. And so as I enjoy Indian food and I enjoy Cantonese food, I also enjoy hamburgers. And so it is that kind of value that brings you to wanting to be in surface to communities.

Karthik
Coming from a multicultural background, coming from different aspects where you all share a culture and you also share the culture that you live in, what are some things that you would say that you have assimilated in your multicultural family?

Maureen
You know, a lot of answers you might understand, but answers are best understood when you tell stories. So here's a story. So we have all the cultures in our kitchen, particularly all of my kids cook well. One is specialized in desserts, the other in main courses, the other in, you know, kind of salad. So here is the story. In the Netherlands, children eat bread with sprinkles, chocolate sprinkles. Now, in the US, chocolate sprinkles are things for cupcakes and big birthday cakes, right? And so my oldest one, who is now almost 41, when she went to kindergarten, we gave her a sandwich to school with chocolate sprinkles because that's how she was brought up. But every time the sandwich came back home. And so we were worried that she wasn't a great eater to start with. And so we were worried. And so it turned out that she was being teased because, of course, you don't eat bread with chocolate sprinkles in the US. And so my husband resolved it very simply. And working with the teacher was great. He brought two loaves of bread, two boxes of Dutch chocolate sprinkles, which are very different than the US chocolate sprinkles, I might say, and made little teeny tiny sandwiches for the class. And not only was it over, but we had the opposite complaint. My American colleagues, as women, said, well, no, all the kids want chocolate sprinkles to school, and that's not what we do. And so this is the story. But we, for example, against some opinions, we started our kids in English, and that's what they speak. They are Americans first. Some of them speak some Dutch, but that's the way we did it. The other thing we did, and that was different in the US, we always invited the entire class to birthday parties. It didn't matter whether they were all colors of, you know, black and white and poor and rich, and Asian and Hispanic, always all kids, because we wanted to demonstrate that that's how we celebrate. Fast forward. In our family, we have several children that we, not formally, but that we adopted, that we guided through college, through high school, that where we saw that there was an opportunity to make a difference. And my children followed in that footstep. So acculturation for us, it's a issue that is not one and done, it's your entire life. And I, you know, I always tell my colleagues that I couldn't be a prouder American, I had to study to become one.

Karthik
Yeah, no, it creates so much awareness. Thank you for that, for sharing that.

John
I love this discussion, because I think this is one of those things that, it's hard to find that, that, I don't know what to call it, like that threshold. Like, how much do you try to be like society? Or the society you're in, versus how much do you keep your own culture, you know?

Maureen
You become that, you enrich the culture where you live in, and open your own culture up to others. And so, for example, I take students with me, and I will in a couple of weeks, Pitt students, and I did before another university, with me to Suriname, where I come from. And so we go into the Amazon rainforest, and we plant mangrove little seedlings to counter coastal erosion, and they look at the habitat of dolphins, and they feed baby sloths who were rescued from the rainforest because of deforestation. So I do all that, and the things that they most remember is the different food cultures. And so they're introduced to fried rice, the Cantonese style, they're introduced to Indonesian soup called soto, they're introduced to roti, the Indian. So I open their eyes to a culture that they otherwise would not have seen, while in turn, they connect with Surinamese students. to learn for the Surinamese students to be able to see what US students go through and what US students bring in a culture. Because there are different cultures in the US as well, of course, a student from the South is very different than a student from Pittsburgh. But it makes it culturally so rich while they're actually learning as well. So it makes learning fun that way.

John
Do you ever see somebody who's like, wow, I didn't realize the world was so different, or I didn't realize.

Maureen
Oh, absolutely. So much so that from the years I've went, students grew up and got married, one took a dog from Suriname with him, but all of them to the student, they want to go back and spend more time. And so that makes me so proud and so humbled that I've opened their eyes to cultures that they otherwise would not have seen.

Adriana
I think it's really interesting too, as an immigrant sometimes, when you're talking to somebody that was interested in learning about your culture, you feel so satisfied, so seen. And I think this is something that people don't realize, you don't need to know everything about the other culture, about the other country, but if you know a little bit to start a conversation, this is so, so lovely. So how do you think you make people aware of your culture if they are not interested? How do you motivate them to come and experience?

Maureen
The first thing you do is be respectful of their culture. There is no superior culture, no one culture is superior. And so you're demonstrating your interest in learning about their culture will open up doors reciprocally to learn about your culture, that's one. But there are also always things that are the same, but expressed differently. And so for example, in the Latin American culture, you celebrate quinceanera, right? So in the board of the Surinamese culture, you celebrate when a child grows up and when a woman becomes more of a woman, you celebrate that. And so there are different reasons why you celebrate some of the same major milestones in life.

Karthik
In your interview, I remember, again, I was listening to the Cupid interview earlier, and you had mentioned something a little bit about gender roles and how perception was in terms of being a woman who is a leader in the field. Can you talk a little bit about how you overcame some of those challenges being in a leadership position as a woman in a field where probably at that point, it was not probably dominated by women?

Maureen
Actually, those challenges exist today, exist right here in Pittsburgh, too. And in a way that makes me sad, because we should have advanced the decades off, but it still exists for women leaders. But back to the Amazon rainforest, I had a patient one day that was a man who had gonorrhea and he had five wives. So in that time, there were for both social reasons and other reasons, men was tolerated that they had more wives. And so what you do classically, of course, in a clinical setting is to treat all the contacts, to treat all the wives. Clearly, what I found out later, he was a captain in a village and I was being tested, not only as a younger person, but also as a female. And so I decided, I can't share the gory details with your audience right now, but I decided rather than a nurse treating the gonorrhea, to treat it myself. And so I injected them myself, I asked them for all the contacts to come in and I treated them all myself. Next, most of my... Outdoor visits, my clinical visits were done either by dugout or by a Cherokee Jeep that I converted, they converted for me in an ambulance. And so this was my dugout visit, hours away from where the little clinic was. And at coming to his village, I was surrounded by other dugouts and I truly was scared. And so, well, what's going to happen now? And so his officers demanded that I come on shore. And so I did. And we went in, and here's the story. There was a man who had a fracture, a leg fracture, and he was treating, he was being treated by this man who I previously treated for his gonorrhea. And he said, well, I'm treating this person. And it was clearly a challenge of, will I allow or will I believe in non-Western medicine? And I said, so here's the deal. Let me take an X-ray of this person and you can treat him. And then we'll see what happens when you declare that the fracture is healed. And so we did that. Ultimately, indeed, the fracture was healed. So the deal we then had from then on is, if there is a fracture, I will take an X-ray. If it was a simple fracture, he can treat it. And I will do a re-X-ray after he decides that it was healed. If it is a compound fracture, then I will treat it. And so there is where not only I overcame that female challenge, being a female, but I also created a long-lasting bond where we integrated herbal medicine with traditional Western medicine. So in a way, it was a win-win-win effort.

John
How does that experience transfer to your life here?

Maureen
It makes you humble. It makes you be very comfortable with people of different culture. It makes me feel so happy when I can be with communities. Yes, I like to be in the DeSoto Street on floor seven, but that's where my heart is. That's where the respect is, but particularly the opportunity to learn from communities. Every time I'm with communities, I learn from them. A couple of weeks ago, I was with the East Palestine community where we have a grant to look at the impact of the train derailment, as you know, happened a year ago. And I felt most comfortable and most humble to be invited in the kitchen of one of the community members, because there is where I learned what people went through and still are going through, but there also is where we're invited to come to a community cookout that's happening in a couple of weeks. So it takes that. It takes not a Zoom call. It takes going to where communities are. It's just going to learn from communities. And so I can't imagine any position, including the deanship, without that connection with communities.

Adriana
You mentioned that the female situation as a leader still exists, and I completely agree. So if you had to give some advice to our audience about how to develop mental toughness and be a little confident in being a leader, even if the environment doesn't allow you to expand and to grow.

Maureen
The first thing that I do, and I committed to that when my mother died, is that I grow women leaders. I grow leaders, emerging leaders in general, but I particularly grow women leaders so that they don't have to rediscover what is currently happening now, so that they have the confidence. to move ahead despite the challenges that there are, so that they don't want to make the mistake that some leaders in my age group, I have gray hair now, believe that if you're as close as what males are, if you have those characteristics, that's the door that will open opportunities for you. In fact, it's not. It is growing your own, it's being your own, it's finding your own voice and acting on it. It's about not being intimidated the first time somebody challenges you. And unfortunately, the challenge doesn't necessarily come from only males. The challenge comes from women as well. And so it's that working through that and guiding and being that leader for others that come behind you, creating that level of succession in a much more bold way, and not shy away from it, in my daughters, my own daughters, but also particularly in women leaders, whether they're in academia or are community leaders, that's my number one priority currently. When women interview for a position in general, not all women, but in general, they typically make sure, because of this challenge to be absolutely right before and be protecting themselves in a sense, they make sure that if there are 10 boxes to check, that not only are the 10 boxes, all the 10 boxes checked, they're checked with a big black mark, with a big black marker, or a red marker, or a green marker, or a blue marker. In general, again, in general, men have less of a trepidation to not have all the 10 boxes checked. And so we need to get ourselves to build that self-confidence, to celebrate what we have. And go to the edge, just go to the edge. You'll be amazed what comes, what the self-confidence and your potential that comes out that we don't celebrate because we think it's not a great deal. We don't have to talk about it. When I coach younger women and emerging leaders, I say, it's really critical that you were a leader of your Girl Scouts group. It's key that you are leading a volunteer organization to pick up trash. That's key. That you were a president of your society when you were in high school. That's important. And so bringing back those things that we should celebrate, actually not bringing back, elevating and making visible the things that we should celebrate is part, a critical part of my coaching and my mentoring.

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♪ In the light of dawn, try to carry on ♪ ♪ Cause I still got far to go ♪

Maureen
When I graduated med school, there's nothing in me that wanted to be in academia. I thought that's only for the elite and where my life should be and where my service should be, would be in communities. And so I started that medical degree. Indeed, as you mentioned, in the Amazon rainforest, taking care of 26,000 inhabitants. But, and from many different cultures, including descendants from runaway slaves. But it is there in that Amazon rainforest that I had that aha public health moment. Because when I took over the childhood immunization rate of vaccines like polio, of course, you know, it was discovered in our school of public health right here in Pittsburgh. And measles and rubella, that coverage in the children with that I had to take care of was about 5%. And, you know, we need to get to about 96% to get what's called herd immunity so that the whole community is protected. And so there was no way, no matter how smart I was, that I was going to get from 5% to 95%. And so while we didn't know that that term was community health workers, I really worked with leaders in the villages, captains of communities and nuns who were working in the villages to train them how to give the vaccine, where I would take care of making sure the vaccines kept the cold chain.

John
What do you think are important steps for our audience or, you know, people listening to take to create that awareness about public and environmental health, you know, in order to improve access with the cold?

Maureen
I chuckle as you see, I smile because I have another story for you. It is easy when my oldest one is about five or six. And, you know, if you have kids, kids are always asked, what does your mom do and what does your dad do? And so it came to my oldest one. And she said, well, my dad is an engineer and he built big things. That's easy enough, right? And so now it came to her mom. My mom is a doctor, but she doesn't work in a hospital. I was at CDC then. She works in an office. Unfortunately, I did bring her to the office often to work. She works in an office and she has a big computer. Remember those computers from the late 80s? Has a big computer on her desk and lots of paper. And they all say draft on them. And so that's what's the definition of public health. Yes, in the federal government, we go through many drafts. So for public health, it is critically important that we do a couple of things. One, we explain better what it is we do. I mean, the onus is a lot on us. When the COVID pandemic happened, public health should have been in the lead because we know how to deal with pandemics. We know how to deal with food outbreaks. We know how to do that. We were not initially in the lead. And the consequences were there to show. Secondly, we know how to work together to address an emerging health threat. We have never, however, within public health, faced the degree of anti-science and the degree of misinformation that we're currently facing. Climate, not COVID, climate change, the impact of climate on health is the single most public health threat currently. There is no other one, and there will not be another one for some time to come, even if there is another pandemic. And so we need to be responsible for our actions. What we create, 90% of the negative impact of climate on health is created by us, by people. That's why I'm so proud that the health sciences and actually the whole university is focusing on sustainability, and we're taking that responsibility, and we're holding the mirror in front of our shelves. And so how can we do different? How can we do better? But whether it's heat or flooding, when I left Louisiana, I thought I was done with flooding and hurricanes, and I come to Pittsburgh and there's flooding. Heat, and not protecting the people who are most vulnerable because of heat. Issues of air pollution, we have polluted air all over the place here in the city, but particularly in our rural area. So taking responsibility to address that and working together to address that with the communities who are most vulnerable is what public health is about. So that's one, explain better what public health is about. Two, take action, which is what I just shared. And three, measure the impact. We are really good in doing and acting. We're not so good at measuring. We're not so good at sharing. In fact, we should really learn from industry because they're fantastic if you look at advertisement. So we're not so good at communicating our successes. And that's why I've invested a lot in our communication office in our school. I mean, they will make a big deal out of a little success. And for us, there is this old saying that on a good day in public health, nothing happens. Nothing happens because everyone is healthy. We haven't had a good day in public health in a long time because not everyone is healthy.

Adriana
I have a question. When you talked about we need to measure, we need to show the results. So I have been learning a lot about micro goals and micro celebrations. So trying to be on the positive side, where are we with acknowledgements and celebrations in public health? What can we say that we did, that it was positive and we are proud of? We just celebrated last year, our 75th anniversary, and I made a big deal out of it. Because Jonas Salk, how many people? I'd like you to stop somebody on the street after I leave, and then say, did you know that the polio vaccine was discovered in the School of Public Health 75 years ago? You might not get 100%. Yes, I knew that. And so I made a big deal out of it. Together with all the faculty, the staff, and the students, we celebrated the legacy of Jonas Salk. And in fact, we're working very hard on, we have an exhibit, we're expanding that exhibit, and we're working on a whole legacy foundation around Jonas Salk. So we're not touting our own horn, it's one. Second, we are just one, you know, I'm just one person, but if we expand the visibility and we celebrate our students, we celebrate our community. We celebrate our staff and we celebrate our faculty and we celebrate our communities, then public health speaks.

Karthik
I have a question going back to creating that awareness. And you mentioned the onus falls on, you know, public health to make that known and make it aware. So I have a question in terms of a lot of people that I've spoken to when I talk about climate change, the end of the conversation is typically when someone says, oh, you know, I am one person, what can I do? Which I know is a big misconception because, you know, everybody can create that change. So for folks that are lost, that don't know how as one person they can contribute towards climate change, what would be your advice to them in terms of changing that perspective a little bit?

Maureen
One person makes a tremendous difference. One person can be the leader, one person can motivate their own family, their schools. You know, when I work with communities, I very much, we have a public health science academy in our school of public health where we bring juniors and seniors from high school and to spend six weeks with us. We have an undergraduate program, not our new undergraduate program, which goes fantastically well, but we also have a national undergraduate program funded by CDC to bring in students who are less fortunate to see and learn about public health and climate and health is one of the areas that they work on. We already, and they're young programs, we already see successes. Some of the high school programs are joining in our new bachelor's of science and public health program. We just graduated our first nine and so proud of that. And some of the juniors and seniors in college that come to spend two months with us are going into the master's programs, are going into the masters of public health. So it is deliberately doing what it every day. So you can't, it's not a one and done deal. It is what you do together, but what you do deliberately in everything you do. And so whether it is being conscious what you buy in the grocery store, or whether it is being conscious of where you drive and how far you drive, what you do with plastics, whether you recycle or not. It is, each one of us can make a difference.

Karthik
Yeah, and celebrating those small victories are important as well, right?

Maureen
Yes, absolutely. Because you feel like you don't make that change, but you actually do. When we go to Suriname, we have, the students who go with me to Suriname have probably never had a garbage bag, and together we picked up bottles and things that wash on shore. They probably never have done that in their community because somebody picks it up, right? Someone comes and empties your trash can, and there we are, those trash persons to pick that up. Trash collectors.

John
In listening to all this, I feel like there are, I feel like our country is divided. And there are people who don't really think climate change is a big deal, and people who think women should be in, I'm putting quotes up, traditional roles. And all this stuff we're talking about, I feel like there's that opposite perspective where people just have different beliefs, and it's a really big belief system in our country. I feel like a lot of people think that way. How do you deal with that challenge?

Maureen
It's a challenge, but you deal with it by example. You also deal with it by demystifying it, making it personal, making it real. Not too long ago, I was asked, well, you're a dean, do you really go grocery shopping? I said, yes, I go to Giant Eagle and Aldi, and I wash clothes, and I mop, and I iron, and I'm just a normal woman. Normal in a sense, well, just normal, right? But I do both, to your point, the traditional things that we do in the household. I also do the other things, right? Do the leadership things. It is not a good strategy to try to go counter somebody's belief. I'll give you another example in a story. When a mayor in a southern city was interviewed and asked about climate change, that mayor said, oh, no, climate change doesn't exist, it's not, people make that up. And as the conversation went on, it was a conversation with a reporter, he said, well, the reporter asking how his city was doing and how proud he was about his city, he said, but my farmers tell me that their crop yield is less for the last couple of years because there's a lot of flooding. So if that's the translation of the impact of climate change on food security, so not having enough food, and food safety, because often in those instances, and this goes back to your environmental health question, even in Suriname, where I come from, people use more pesticides to be able to increase the crop yield. And so in a way, you have a double whammy, right? So you have more pesticides, you have less, yes, safety is in danger, and food security is in danger. So if flooding and decreased crop yield is the translation about the impact of climate on health, then that's okay with me. Then I don't have to argue about whether climate change exists or not. It does exist because those are the consequences, but we don't have to argue about where it goes. And to make sure that that person is on our sides. No, you have to be respectful of what people believe, but never lose the focus of what we need to address. So then how to get closer to that, may I just talk about ways to address the flooding so that the- The farmers have a better yield next year.

Karthik
Very cool. Yeah, it's sort of like trying to relate to what they relate most to and sort of approaching it that way. That's really cool. Dr. Lichtveld, you talked about last time about a grant program where you're bringing in students from high school, from the community to sort of create that awareness. Going into public health and just sort of general awareness, how important is it for you to communicate to or connect with the community at grassroots level? I know you said that that's probably your favorite thing. How important is that?

Maureen
So I'm glad you mentioned that program. So it is now in its third year and we are very pleased to get support for that, financial support, both for that program and the CDC program where we bring undergrads from all over the country, actually, as well as our own Bachelor of Science in Public Health program that I'm so proud of, has one significant aspect. In addition to, of course, high quality classroom learning that they get at the University of Pittsburgh. That aspect is that they are placed in the community to learn. So on the front line, our Bachelor of Science in Public Health program requires 120 hours of surface learning before they graduate. Some of that is happening with me when I go to Suriname, but other ways, they are right in their communities. For the high school programs, it was a remarkable occurrence where one of the students said, when we place and replace the students with community organizations, whether those are food organizations or organizations who are involved in middle school and lower school, or organizations who are involved with planting. So when we... We placed her, we had not looked at the very details. She said, oh, that's my community. And so she's placed in her own community while learning with us. I think that's what is making a difference because then not only do we have a more engaged and a more aware student, but now we automatically or maybe synergistically have a more engaged and aware community.

Adriana
We have had the pleasure to speak with you today. So for our listeners, what would be something that we could tell them to be sure to do to help the planet, to help the United States, to help the world?

Maureen
And so when the world hit 8 billion people a couple of years ago, I was asked, what keeps me up at night? And I said, there are four things that keep me up at night. One, food security and food safety, heat, thirdly, infectious disease, and fourth, air pollution. So if we think about those four things and ask ourselves, what is it that I can do about air pollution? What is it that I can do to make sure when I plant my own vegetables that they are safe to eat? What is it that I can do to address infectious disease? And so, for example, we are very pleased or very proud that the School of Public Health will be representing all of Pennsylvania's institutions under a One Health Consortium. It's supported by the state health office, supported particularly by the Department of Agriculture, but we together will address issues of One Health. Now, what is One Health? One Health is where animal health, human health, plant health come together to impact the planet. And so increasingly, it's not the ticks fault, it's our actions going further into the areas where ticks are that we have one of the highest rates of Lyme disease in our state. And so because the climate is warmer, the temperature increases, the ticks have a better environment to grow and we go towards their environment. They don't necessarily come so far into ours. And so by doing that, we have an increase in infectious, particularly in Lyme disease and other tick-borne diseases. But we also have an increase in mosquito-borne diseases, infector-borne diseases. So protect yourself, wear, not only wear protective clothing, I know it's tough to wear long sleeve shirts in the summer when it's hot, but think about that, repellent. But what we do in the environment to impact these four areas, each one of us individually and in our community can make a difference. And I am so proud of what you're doing here to spread that word. Thank you.

Adriana
Thank you so much for being here today. It's an honor for us.

Maureen
Well, I'll be available anytime you think I could be helpful and contribute to your audience. Thank you.

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♪ I still have stories to tell ♪ ♪ I feel ♪ ♪ I still have stories to tell ♪