London School of Hygiene & Tropical Medicine

Can you tell us a little bit about you?

I am Maria Ritter, but everybody calls me Mati. I am a medical doctor from Paraguay, a country in the heart of South America. I do not work in patient care, even though I studied medicine to help people feel better about their health. But what does health entail?

Throughout my career, I sought a comprehensive concept of health that could explain the physical, social and emotional aspects of one’s being. After some time, I realised that even though, as physicians, we can do our best to connect, contain, accompany, and facilitate a person’s wellbeing, health encompasses much more…

For instance, I have been witnessing the poor management and organisation of the Paraguayan health system. A lack of coordination with other sectors like education, urban development and housing, water and sanitation made me understand health's social and political aspects. Without addressing these social determinants, health is not complete. And those were the missing parts of the health concept I have been looking for throughout my career.

Paraguay has many excellent physicians working on patient care, but few are working on health systems or public health. Therefore, I decided to leave that behind and started my path to public health by working in non-governmental organisations with which I shared a similar vision of health, especially in the social and political aspects.

Why did you choose to study at LSHTM, and what did you study?

As I moved into health promotion, primary healthcare and immunisation programmes within public health, I recognised the need to broaden my knowledge. Therefore, I decided to go for a master's degree. To get there, I applied to the Chevening Awards from the UK Foreign and Commonwealth Development Office to fund my studies. I did not win the first time in 2020. However, I did not give up and applied again in 2021 and won the award in 2022.

I chose to study MSc Public Health – Health Promotion stream at LSHTM because it is the best public health school in the world. Studying at LSHTM was a dream come true. I could not believe it when I got into the programme because it was so far away from me when I started picturing it. 

Being part of a cutting-edge institution that contributes to public health worldwide with research and innovation makes me profoundly proud and gives me the responsibility to maintain the same quality in my roles. 

As far as I know, I am the only Paraguayan who completed this full-time programme. The other two did blended learning programmes.

The other reason to study in the UK is the NHS, which is the best example of an effective and efficient public health system. It combines technology, research and quality, providing universal health coverage. As I said before, the Paraguayan health system lacks the coordination and strength of this kind of system, so I wanted to learn everything I could about it to contribute to its improvement because that is how I see that health can improve for the Paraguayan people.

What have you enjoyed most about your time here?

During my time at LSHTM, I really enjoyed the lectures in the John Snow lecture theatre; that room is fantastic! But besides that, I enjoyed the diversity of topics the programme offered within each module. I highly appreciated my peers. They came from many parts of the world and contributed to my knowledge-building in ways I couldn’t have imagined. They helped me open my mind, break down prejudices and discover new cultures, ways of thinking, living and being. I am deeply thankful for that!

Has there been anyone you’ve enjoyed working with at our School?

I have also enjoyed meeting the programme directors, lecturers, seminar leaders and a few fellows. They have fascinating backgrounds and research approaches. They have all challenged my thinking and learning in such a stimulating way that, even though it was much to read and process, it was rather satisfying to understand different views about the same issue and build mine. I had eye-opening seminars with Meenakshi Gautham on Health Policy, Process and Power. I remember our talks about the dimensions of power when making a policy, health inequities, and policy implementation.

Another remarkable module was the one on Health Promotion Approaches and Methods, in which Wendy Macdowall invited major health promoters from the different approaches to share their worldwide experiences and knowledge with us. Wendy herself shared her expertise and facilitated the opportunity for us to share our health promotion experiences with our peers.

My favourite class was the one on Community Mobilisation with Joanna Busza, where she shared her expertise on participatory approaches for research and the importance of community involvement for research results and the community’s empowerment in more healthy behaviours tailored to their contexts.

The best module I have taken is the Health Promotion Integrating Module. Having Peter Weatherburn and Will Nutland as facilitators and mentors was a great honour. They are passionate and experienced health promoters who shared their life and work experience without hesitation. Besides learning concrete tools for designing and implementing a health promotion programme, I learned how to be genuinely aware of inequities, including the affected population when conceiving the idea of a health promotion programme and the importance of evaluating a programme for sustainability and scale-up. Most importantly, I have come to understand that the concept of health is different for each of us, that it depends on many factors contained in our contexts and that we can first build a joint idea of health before starting to promote it.

What are you planning to do now that you’ve finished your MSc?

With all this new knowledge, I would love to work in public health policy. Apply everything I learned on health promotion programmes and combine it with a research approach to generate evidence that informs public policy in Paraguay.

But, before coming to London, I worked as a Health Specialist at the country office of UNICEF Paraguay in the Health and Nutrition Section. I already got that job back, but as a Public Health Specialist. In this role, I oversee the implementation of a safe, family-centred motherhood programme; I am the focal point for risk communication and community engagement (RCCE) on immunisation, and I am developing an RCCE strategy for pandemic preparedness and response with the Ministry of Health.

However, my passion for community mobilisation is still there, and I may do volunteer work in the field, facilitating participatory processes involving communities for health and social empowerment.

What advice would you give someone who is considering studying at LSHTM?

As I had a unique and mind-blowing experience, I can advise people considering or studying an MSc at LSHTM to keep their minds open to learning, changing views, re-building new concepts, finding new passions, and, if necessary, re-starting their careers. Public health is such a broad field that needs the work and commitment of passionate and knowledgeable people to re-think, re-design and innovate the concept of health worldwide.

Is there anything else you’d like to add about your time at LSHTM?

I have never felt more positively challenged and stimulated to learn and grow academically and personally. I profoundly appreciate my time at LSHTM and in London because it exceeded my limitations and showed me what more I can achieve. And I am grateful and honoured to have encountered amazing people throughout the way.

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