'Baptism of fire': Tested Caribbean trailblazer leads COVID response in the Americas
Mar. 16—She navigated the chikungunya and Zika fever epidemics across
A medical doctor by training,
But it is COVID-19, the virus first recorded in multiple
"it's difficult to ever imagine a pandemic of this magnitude," said Etienne, whose day begins before dawn with a morning prayer that is followed by a long succession of back-to-back meetings.
For the past year, Etienne has been the public face of the regional response to the worst public health crisis in recent history in the
"Long days, late nights, early morning meetings with
Even before the pandemic, the
"We are home to more than half of all the global COVID-19 cases," said Etienne,
'Baptism of fire'
Week after week, Etienne sits in front of a video camera, sometimes from her home, other times from PAHO's
"The COVID pandemic is the worst public health crisis of our lifetime," she said during a recent press conference. "No country is out of the woods when it comes to the COVID-19 pandemic. We all remain vulnerable to getting infected."
Usually sporting a brightly colored blazer while relaying what is typically a grim outlook, Etienne exudes confidence while calmly sharing the latest infection and death numbers, urging governments and suppliers to speed up vaccine deliveries and warning that COVID-19 is not over.
"We need to bring this pandemic rapidly under control," she said in a
Etienne first caught the attention of regional and international public health experts 42 years ago when Hurricane David, one of the deadliest storms to hit the
David's 150 miles-per-hour winds and destructive rains wiped out banana crops, stripped trees from the island's lush mountaintops, disrupted health services and destroyed most of
Six weeks into her internal medicine postgraduate studies in
"I felt the necessity to return home, return to serve my people," she said.
That decision would propel her into a leadership position that had the world watching. A year before, governments from around the globe had gathered for a U.N. health conference in Alma-Ata,
"We were the story that was waiting to be told. We were the example for the rest of the world," said Etienne,
Etienne's humility is her trademark, said
"She chartered the course of primary health care in
The married mother of three's reputation as a primary health care crusader and her uncompromising belief that public health is a critical element to the development of countries around the globe has helped drive her success at PAHO, where she served as assistant director between 2003 and 2008, and later at the
When Etienne decided to mount a campaign for the top post at PAHO in 2012 with the backing of
Dr.
"For anybody
"She has led PAHO extremely well through this COVID period, and her ability to do that is rooted in her strong faith, and life experiences, above all, that baptism of fire in David, where she emerged as the leader of the health sector transformation," Hospedales added.
Describing Etienne as "a
If the coronavirus pandemic has laid bare the deficiencies in the region's health systems as countries wrestle with lockdowns, curfews, and surging hospitalizations, it has also reinforced something else, Etienne said: The policies she has long promoted, including reducing health inequities and universal health coverage, are needed now more than ever.
"Access to health remains really an overlooked right," she said.
'We have to work'
Seven years ago, as the threat of Ebola hung over the region, Etienne mobilized PAHO teams to assess the readiness of 28 countries and help them identify the gaps. Ebola didn't become a realistic threat, but the exercise provided insight into how unready the region was to deal with any deadly pandemic.
In November of 2019, Etienne said that for a still inexplicable reason, she convened PAHO's pandemic influenza planning committee. Soon word spread about about a mysterious pneumonia-like illness in
"That was
"When I called them, we were ready to go. I said, 'I need a team to go to every country to do the assessments on the ground, to help address health systems needs going forward, etc,'" she said. "They told me, 'Well, this will take us until April.' I said, 'Never. I need this done and completed by February.'"
But Etienne,
Since then, she has had to confront not just COVID-19's spread and the emergence of new variants, but political complications, like the Trump administration's decision to terminate the
There also has been criticism over the slow roll-out of vaccines in
Even still, she always makes certain to mention the
"We make it a point of duty of also reminding the world, reminding our region, that there are issues in the
Early on in the pandemic, the
"I think that took courage and leadership, because they depend on tourism, and they were virtually closing the doors to tourism," Etienne said. "But beyond all of this really, the
Under Etienne's guidance, PAHO has achieved a number of noteworthy milestones. Among them, the
Beyond COVID-19
Today, Etienne said, her biggest challenge is getting countries to plan beyond COVID-19.
"COVID-19 will end and we have to ensure that our region is well placed; one, to stop the pandemic, but at the same time, to plan ...for the future," she said.
The deficiencies in the region's health systems like inequity and the lack of investment still need to be addressed.
"You cannot grow your economy if you don't have a strong health system," she said. "If you can't ensure that, you can't lift people out of poverty."
As for the lessons learned during the pandemic, she has personally learned several.
"You have to be decisive," Etienne said. "You have to be timely in your decision-making. You need to engage across the organization, you need to engage member states early and to support them to get to where they need to be."
Thinking of the lives lost and forever changed by the pandemic, Etienne noted the pandemic has hit hard, especially in communities that were already vulnerable.
"It is really my hope that our governments, the national authorities, that they heed this warning, and pay attention to the lessons that have come out of the experience of the pandemic," she said. "That could help them fulfill a promise that they've made to their communities: that everyone has a right to health."
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