Neo Tapela
Howard Hiatt Residency in Global
Health Equity and Internal Medicine
Harvard University,
Brigham and Women's Hospital, Boston, MA

Neo Tapela knew as a young teenager that she wanted to be a physician; a measure of serendipity, however, intervened in her disciplined career preparation and markedly affected her future. Now, when she returns to Botswana, she will have worked on developing, concurrently, skills for clinical practice, health care policy development, advocacy, and leadership in resource-limited settings.

A scholarship student at a private secondary school in her native Botswana, she was given the chance to come to Milton through Milton’s Korean War Memorial Scholarship, and she took the opportunity. “I had no idea where, or to what kind of a school I was going,” Neo says, “but not knowing anything was actually kind of comforting; I had to be open to whatever I found. All I knew was I was going to America, with the chance to train as a doctor there.”

A multidisciplinary approach and in-depth exposure to the humanities at Milton, it turned out, was what amplified and enriched Neo’s perception of the sciences she had studied, and of herself. “We studied literature of the human condition, contemporary writers and issues, in small, very interactive groups. It was my first encounter with Toni Morrison, for example. Discussion in class was thought-provoking, the analysis creative. Fresh, meaningful topics were explored and critiqued in class; that was a very different intellectual experience for me, and you end up taking away your own thoughts (a far cry from the near memorization of the Victorian classics that bore little relevance to my life today and were taught without much opportunity for intellectual critique). That exposure drove me to major in Africana studies, in addition to biological sciences, when I got to Wellesley.

“I was so far from home, boarding for the first time, with new faces and a completely different school environment. I found that I had so much support and mentorship: The faculty were actively interested in helping me become who I was and aspired to be. That kind of support helps one crystallize one’s own vision.”

Neo credits former Milton college counselor Susan Case with advocating Wellesley College as a great match, and that it was. She found excellent mentors and solid preparation in the sciences, with the same academic approach as Milton—small groups, problem-based, very interactive—as well as terrific, funded opportunities on and off campus. Wellesley also charged up a different set of capabilities. “Wellesley provided a politically active environment that was almost infectious, and being politically active develops a skill set that helps you introspect, sharpen your convictions and passions, and then put them to work effectively. That experience was crucial,
as well.”

Overall, the small-group interaction at Milton and Wellesley, Neo feels, helps build a critical combination of assertiveness, confidence and optimism along with a clarity of purpose (or if not yet identified, a yearning to figure out what that purpose is). It leads you to believe that “this is a cause I should pursue; I will find people to help; I will find resources I need to realize it.” Summers served as particular building blocks in Neo’s ever-expanding effort to understand the ethical, political and socioeconomic factors that affect medicine.

During one college summer, Neo explored traditional Chinese medicine practice in Beijing, China (and worked on learning the language as well). That experience helped her realize that, while she appreciated the wisdom of age-honored practices, traditional Chinese medicine was not readily applicable to some other parts of the world. Western medicine would be the most effective way to serve her home community.

During the summer of 2001, while a sophomore at Wellesley College, Neo worked as a lab assistant at the Botswana-Harvard HIV Reference Lab. This internship was a pivotal one; it affirmed her desire to work in HIV in southern Africa. It gave her grounding in reality—the power of this virus and its effect on the population. “I came back haunted by the realization that over 50 percent of the mothers tested were HIV positive, and I felt compelled to involve myself more actively in HIV work in Botswana. I returned to Botswana in the summer of 2003 to conduct research assessing the impact of the National Anti-retroviral Drug Program. This time I was reassured by treatment adherence rates that exceeded 90 percent. The study also helped define obstacles to care, such as lack of transportation cited by 25 percent of patients as the reason for missed appointments, and offered patient-generated recommendations for improvement of the program, such as hospital-based HIV support groups desired by 90 percent of patients.”

At Harvard Medical School, Neo took social medicine classes and did her primary care clerkship at a clinic with a large HIV immigrant patient population. She also held leadership positions with Physicians for Human Rights, HMS AIDS Action Initiative, and Harvard Africa Health Forum.

The end of medical school and beginning of her residency was another watershed moment for Neo. She missed home, missed her connections and roots there, and was eager to involve herself more actively in work at home as soon as possible. She wondered whether she should return before starting the next phase of her training. “I was getting superb medical training,” she said, “but it was hard because my heart was yearning to be working somewhere else. It’s difficult to maintain the right balance.” She decided, though, that if she left, it would be a disservice to the opportunities provided her for training, and ultimately to her patients at home, to return without being a fully trained doctor.

Neo was selected for the Global Health Equity Residency at the Brigham; she seems to fit the goals of the program perfectly, and this residency is appropriate preparation for her commitments. In each of her residency years, Neo spends increasing amounts of time in international clinics established by Partners in Health (Haiti, Rwanda, Lesotho); in addition, she earns a master’s degree in public health or policy. The Brigham/Harvard faculty are preceptors at the Partners’ sites, and they serve as mentors, as interested in Neo’s development as a person and a professional as her earlier mentors at Milton and Wellesley. “My mentors have invested time in me and my needs again and again,” Neo says, “helping me crystallize the issues, and gain insight into the developing challenges in health care in the developing world currently, and how I may play a role in addressing them.

“I hope to draw upon my experience to bring dedicated, inspired clinical work, teaching, research and advocacy for health and human rights in Botswana and beyond; that would be driven by personal relevance, as well as the intellectual and humanitarian influences of my education.”

CDE

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