London School of Hygiene & Tropical Medicine

Tell us about your current research

I am an epidemiologist, humanitarian worker, and PhD candidate (who just handed in his thesis) at LSHTM. My research focuses on targeted strategies (‘case-area targeted intervention’) for the control of cholera outbreaks in the Democratic Republic of the Congo. I am supervised by Prof. Francesco Checchi and Prof. John Edmunds and during the PhD, I worked on cholera with Epicentre-Médecins Sans Frontières in Cameroon.

How did you first become interested in infectious disease modelling?

I have always been humbled by how broad the field of infectious disease epidemiology has become, and how the training one received during a Master’s degree 10 years back may not allow you to keep pace with modern methods and analytical approaches. Somewhere in the latter few years working as a field epidemiologist and public health specialist, I realised that I wanted to use spatial and mathematical modelling in my current work to pre-emptively understand the impact of new interventions. The problem was I had zero training in the subject, or the time to integrate the training into my work.

Describe your career journey so far

Coming from Sri Lankan roots, and based in Canada, I have been working as an epidemiologist in humanitarian settings for the past 15 years. From 2011 to 2018, I was the International Rescue Committee’s (IRC) senior epidemiologist, where I had the opportunity to support public health and epidemiology in twenty-plus crisis-affected countries. While at the IRC, I worked in a hands-on way on disease outbreaks and health emergencies during acute crises (i.e. cholera in South Sudan, Ebola in West Africa, Syria regional crisis), preparedness and early warning surveillance, and operational research to evaluate the effects of our interventions. What I liked most about that post was working with colleagues from every corner of the globe across the health areas key to survival: communicable and noncommunicable disease, water, sanitation, and hygiene, nutrition, reproductive health, and health systems. I have also worked for the WHO and other humanitarian organizations like the Centre for Research on the Epidemiology of Disasters, International Organization for Migration, and War Child. I completed the two-year Canadian Field Epidemiology Program to ground me in the control of outbreaks.

From Democratic Republic of the Congo to Lebanon, regions affected by humanitarian crises often suffer from the same risk factors that give rise to cholera outbreaks (i.e., poor water and sanitation systems or ruptures within existing systems). I had been working on the acute control of large-scale cholera outbreaks in Haiti, South Sudan, and Sierra Leone and other countries for quite a while and wanted to study the feasibility of a new strategy called case-area targeted intervention that could potentially reduce the size of outbreaks before they enlarged in size and impact. So, in 2018, I decided to apply for the PhD programme at LSHTM in order to sharpen my skills in infectious disease modelling as applied to the tricky question of cholera control in crises. This has led to four years of intense study of spatial and mathematical modelling of scenarios for CATI, and applying these scenarios in real-time to evaluate CATI in the Democratic Republic of the Congo. This was made financially possible by an award from the Canadian Institutes of Health Research.

What are your goals for the future?

Having gotten the thesis under my belt, I hope to return to humanitarian public health. Not to be presumptuous, but I would like to help to mainstream some of these advanced methods which are used extensively to explore academic questions, for more mainstream use by fellow field epidemiologists.

What’s your favourite thing about working at LSHTM?

I think the supervision is second to none at LSHTM. My supervisors reinforce academic rigour, on top of the tenets of practical public health. My fellow modellers at the Centre for Mathematical Modelling of Infectious Diseases are an incredibly smart bunch, and a great sounding board for questions, feedback, and anything new and exciting in this field. LSHTM is well connected with the humanitarian world, from MSF, Save the Children, and the WHO Health Emergencies Programme to Ministries of Health and civil society organizations who make things work. Last but not least, the group at Health in Humanitarian Crises Centre has allowed me to integrate knowledge from other disciplines (i.e., qualitative research) and paradigms (i.e., social sciences), to really think more broadly and practically about disease control.

Do you have any advice or tips for other early career researchers?

Specifically for colleagues who are mid-career (or somewhere leading up to that!), pursuing a PhD while working in public health (and having a family) is indeed possible. The key would be to overlap the research questions as much as possible with your experience to date (and your burning, time-honoured questions), your current role (as there are limited hours in the day!), and to ensure some financial support.

How can people get in contact with you?

ruwan.ratnayake@lshtm.ac.uk