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Discovering Parallels in Healthcare Access Across Continents

Five Questions with Hamed Khachan on his unusual path to public health.

Hamed Khachan, MD, didn’t take the usual route to a Harvard education. Born in Libya to an Egyptian mother and Palestinian father, he pursued medical training in Bangladesh and practiced as a pediatric surgeon in his home country before coming to the U.S.

Khachan was on the fence between specializing in clinical medicine or public health when the Arab Spring of 2011 swept the Middle East, eventually igniting a revolution against the authoritarian rule of Libya’s repressive dictator Muammar Gaddafi. A watershed experience at a Harvard-affiliated hospital which was treating Libyan nationals who were injured in the civil war tipped the balance for Khachan to choose  public health. He was accepted to Harvard T.H. Chan School of Public Health just as COVID-19 hit.

Today, Khachan works as a clinical research associate at the health technology company ICON, where he oversees several clinical trials. We caught up with him at his home outside Boston not long after he welcomed his first child into the world.

How has your professional experience training and international work shaped your outlook as a clinician?

During my medical school training at an outpatient clinic in Bangladesh, a rickshaw driver who was cachectic walked in. My professor took one look and said, “This guy has tuberculosis. What do you do?” I would respond with all the standard diagnostic tests, and he’d say: “No, you cannot do all that. If you ask him to do all these tests, he will leave here and never come back, and he might die. He can’t afford to be sick or home. You have to find the most affordable diagnostic investigation that can confirm the diagnosis and go from there.”

“Everything is different when viewed through the public health perspective.”

We see a similar dynamic here, especially within the new immigrant community. They’re so busy with their lives and responsibilities in the U.S., they may forgo medical visits. Often, they don’t know the difference between visiting a primary care office and the emergency room. An ER is likely where they will go for any medical concern.

Through health fairs organized by Cambridge Health Alliance, I interact with community members to help educate them about the respective roles of primacy care, urgent care, and the emergency room, and why using the ER as primary care drives healthcare costs up. If they don’t have primary care or insurance, we connect them with a social worker who can provide resources for primary care and insurance.

What led you to study public health?

I had been thinking about public health since practicing medicine in Libya, and was trying to decide whether I should go back to do my residency or pursue public health. Then the Arab spring occurred and eventually spread to Libya, which cut off financial support my family was providing.

I became involved with an ad hoc organization, and we gathered weekly in Copley Square to raise awareness about what was happening in Libya. We advocated for international action against the Libyan regime for the repression of protesters in Libya, many of whom were my friends and acquaintances. We reached out to hospitals and organizations throughout Massachusetts and New England to secure donations of hospital-related materials, supplies, beds, and whatever else was needed, and sent it all to Libya. We raised around $38,000 at a fundraising event and sent three months’ worth of supplies there, specifically for treating war-related injuries, which require specific expertise, equipment, and materials.

As an ad hoc organization, we were not successful at bringing injured people from Libya for treatment, but later the interim government sent a number of injured Libyans, in coordination with the state department, for treatment at Spaulding Rehabilitation Hospital in Salem, which graciously devoted their entire top floor to their care.

What I discovered in this work is that public health trumps treating kidneys. In other words, changing policy and working on infrastructure to promote health in places like Libya for me trumped everything else. It sealed for me what I needed to do. So I came to Harvard to study public health.

“I recommend to all young investigator to take advantage of the rich resources that Harvard Catalyst offers.”

Then COVID-19 hit, and we saw firsthand how important it is to have a strong public health infrastructure. Everything is different when viewed through the public health perspective.

What are you most passionate about?

I’m passionate about helping others – those who need it most. There is no other way. There are many avenues for helping people out.

You are a postgraduate education ambassador for Harvard Catalyst, meaning you help spread the word about programs and courses – thank you! What advice do you have for other young investigators?

First, they should check out all the courses that Harvard Catalyst offers and apply to take one to reap the benefits. I myself took a few courses, each of which was amazing. These courses complemented some of those I took later during my MPH.

I recommend all young investigators take advantage of the rich resources that Harvard Catalyst offers. Recognize that there are many other elements that play a role in health. Learn about clinical research and clinical epidemiology. Learn about social determinants of health and social epidemiology. Learn how to communicate more effectively. Learn about food insecurity and safe housing and how these affect health outcomes. There is an array of courses you can take through the center. Have fun and grow! Who knows? It may offer you an opportunity to heal and better care for those you serve. That’s a good thing.

What do you do for fun?

I started a boxing workout, which relieves all my stress.

But my most recent adventure is having a daughter, who was born January 15 – a day before my own birthday. Her name is Shaden, which means “small gazelle” in Arabic. We are busy with her. My wife and I haven’t watched a full movie in two months!

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