A Poetics of Public Health

Several times a year, Roy Jacobstein goes overseas. It’s part of his job as clinical director of EngenderHealth, an international nonprofit organization that works to make reproductive services safe, available, and sustainable for women and men worldwide. Most of the time Jacobstein finds himself in developing countries like Malawi, where in 2003 he was inspired to write “HIV Needs Assessment.”

As Jacobstein remembers it, he’d been in Malawi for about a month, doing an evaluation, and was sitting in a meeting when his mind began to wander. He began thinking about the fact that roughly one of every six adults he’d seen in the country was HIV-positive, and that “everybody’s going to funerals every weekend.” Driving around, he’d observed billboards advertising coffins as well as toothpaste, and he’d been struck “by the way that the mundane present and the ambition for the future go on at the same time.” After he drafted the poem, a Google search led him to the concept of a lightweight coffin that can be carried by one person.

Jacobstein, 56, began writing poems in his mid-40s, long after receiving his M.D. and M.P.H. degrees. He’s worked as a pediatrician and for the United States Agency for International Development, Save the Children, the Centers for Disease Control and Prevention, and the World Health Organization.

Jacobstein says writing enriches his public health work—particularly the work he does in other countries—and allows him to put a human face on an often abstract field. “In public health it’s a little hard to focus on the single individual,” he says, so he searches for “one small thing to stand for the whole. It’s the human encounter, the charge and the dynamic of the human encounter that make poetry powerful.”

When he’s not traveling overseas or commuting to New York for his EngenderHealth job, Jacobstein lives in Chapel Hill, North Carolina, with his wife and five-year-old daughter, whom he adopted from Cambodia on September 12, 2001. Jacobstein’s first poetry collection, Ripe (2002), won the Felix Pollak Prize.

"HIV Needs Assessment," reprinted at right, first appeared in the literary journal Prairie Schooner and won first prize in the Society for Humanistic Anthropology's annual poetry competition. It appears in Jacobstein's latest book of poetry, A Form of Optimism (University Press of New England, 2006).

Photo: Gideon Mendel, Corbis

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At left: HIV-AIDS patients in a Malawi hospital.

HIV Needs Assessment
By Roy Jacobstein, M.D., M.F.A., M.P.H. '86

Everywhere the faces, hair, limbs
are coal, obsidian, flawless black
sapphire, thus the rare mzungu*

like me stands out the way those
remaining white moths once did
on industrialized London’s trees.

A month fluttering The Warm Heart
of Africa’s long length on this Needs
Assessment. We’ve found the needs

many. But let us not talk of that,
as the people do not. Focus instead
on the vivid oleander & limpid sky

that domes the arid volcanic hills,
its lapis mirrored in the uniforms
of the file of schoolgirls who stride

the side of the road. And when the talk,
matter-of-fact, beyond resigned, bears
left at the roundabout, glances upon

a cousin’s funeral attended yesterday,
the two added children your colleague
from Lilongwe is now raising alone,

funeral venues for this weekend, just
sit there as the Project Vehicle propels
you onward to the next Site, past

the lone ads for toothpaste
& for study opportunity abroad,
& the many for caskets (“lightweight,

can be carried by one”), & say nothing.

*Swahili for white person,
literally “to travel around”