NB This piece was written and first published as the feature article in the June 2013 inaugural publication of the health magazine Roses and Thorns. The Owner/Editor was Nurse Rosie Felix. We present it once again in memory of the fallen Dominican champion
“I am one who is always looking for excitement and a new challenge”. The words of Dr Carissa Etienne, newly appointed Director General of the Pan American Health Organization (PAHO), as she spoke to me in a telephone interview from her home in the US, a few weeks ago. Dr Etienne now heads the organization, in which she was second in command between 2003 and 2008. Subsequently, and immediately before taking up her new post, she served as Assistant Director General of Health Systems and Services of the World Health Organization (WHO).
There is genuine excitement from Dr Etienne as she speaks about her new appointment. She describes it as a major challenge and an awesome responsibility. But she is not daunted. She is of the firm view that her experiences, ranging from her clinical practice to the varied managerial positions that she has held over the years, have prepared her for an opportunity such as this one. And yet, notwithstanding her tremendous achievements, the high level of expectation and the potentially life changing position which she currently holds, she remains simple and humble, with feet firmly rooted to the ground. “I am still the same person that you knew back then,” she said with a laugh.
In the 1980’s, she and her husband Willie, were “ Mum” and “Dad” respectively, to several young people with whom they journeyed over a two year period. The Christ in Others Retreat (COR) was a watershed moment during which time, they listened to the issues and concerns of the youth, providing them with moral and spiritual guidance. The experience, according to Dr Etienne, shaped her understanding of the issues faced by youth and communities. She appreciates the need for support systems for this vulnerable group. “I firmly believe that if there were more persons who were willing to journey with more young persons, our society would be better,” she says with conviction.
Dr Etienne has fond memories of growing up under the watchful eyes of her parents. They were disciplinarians and exercised a high level of control. The teenage Carissa was not always pleased with the guidance provided. Today, however, she is grateful for the protection received and the lessons learnt.
The first of three daughters, Carissa never behaved like the first child. Housework was not foremost on her agenda; she was an avid reader, a quality which has served her well over the years, even during those wonderful and challenging times of child bearing and raising. Her three grown children were born to Willie Gregoire, her marital partner of thirty-six years – an achievement in itself. She credits the Marriage Encounter (ME) Weekend experience for deepening her appreciation of the dynamics of communication and for the skill of “listening to the whole person”. ME also contributed to the development of her public speaking skill.
The words of the Mighty Sparrow singing, “school days were happy happy days!”, seemed to come alive when Carissa spoke of her days in formal education. Her time at the University of the West Indies was “the most enjoyable time of my life”. It was a steep learning curve ranging from academia to organizational skills such as time management. Finances and course work demanded no less. The positive influence of selected professors, lecturers and teachers remain indelibly etched in her memory. Today she shares the philosophy of former Principal Mr S. L. Jolly, that children should be challenged according to their abilities and that the education system should exercise a certain degree of flexibility to cater for children of varying abilities. Dr Etienne was a beneficiary of that philosophy. She was allowed to ‘skip’ a few grades resulting in an early and successful attempt at the then Common Entrance Exam.
By age 16, Carissa was out of high school. One year later she entered the hallowed portals of the Mona Campus, University of the West Indies, Jamaica, to pursue her childhood dream – a dream that she had entertained, from as early as age seven (7). Her final year was completed at Cave Hill, Barbados and her internship was done at St Augustine, Trinidad. By the end of her medical program, she had in fact walked through the corridors of all three campuses of the University of the West Indies.
“It was not easy being a young doctor in Dominica” stated Dr Etienne. Her first engagement upon completion of her studies was at the Princess Margaret Hospital. She worked hard to overcome the stereotype in the medical field, that is, that all doctors were male. She solicited and secured the co-operation of her nurses. They bonded, developed solid relationships and worked as a team. Together they learnt from case studies and indeed they learnt from each other. “There are quite a few things that a young doctor can learn from nurses, if only he/she is prepared to listen,” she advises. Nurses Jennifer Doctrove, Hilary St Clair, Gerald Nibbs, Edith Felix and Peterson Sabaroche were among the stalwarts in these early days.
Dr Etienne counts herself blessed to have worked with Dr Gerald Grell during those formative years. His influence on her clinical career is not to be taken for granted. Dr Grell, the ward organizer, was big on quality, individual care of the patient and on the training of nurses. He was keen on getting the care right at all times. The young Dr Etienne repeatedly drank from his reservoir of knowledge and skill but then, all too soon, Dr Grell was required to move on, leaving numerous tasks to his young protégé. With no management training but only a natural flair for organizing, she navigated the choppy waters of managing two medical wards and a private practice. To use a common but applicable phrase, the rest is history.
Dr. Etienne is a devout Catholic Christian. She satisfactorily performed the balancing act of pursuing a career and raising a family; she built her clinical practice on sound medical knowledge on the one hand and faith and prayer on the other. It was not uncommon for her to pray with her patients and engage in active listening. She was empathetic and never rushed her consultancies. She believed then and still does now, in the holistic care of the patients.
The rise of Dr Etienne is the pride of Dominica. We wish her well in her continued quest to service and to do so with excellence. We also listen as she speaks directly to all of us: “The non communicable diseases are the leading causes of death, disability and morbidity in Dominica. You can make a few changes to your lifestyle, which can prolong your life … stop smoking, limit the drinking of alcohol, reduce fats, salt and sugars in your diet. Exercise and see your health care provider regularly.” These very words were probably said to Dominica when Dr Etiene directed Primary Health Care in the 1980’s. If we did not listen and act then let us listen and act now. We could not have heard it from a better source!