There were some who viewed my childhood and believed I wouldn’t amount to much. From their limited viewpoint, I might see why they felt that way. They saw a poor Chicano boy from an East Los Angeles barrio being raised by a single mother in the absence of successful role models, and erroneously concluded these challenges would break me. Instead, they formed me. The lessons I learned from overcoming those challenges have directly influenced my success as a community-based pediatrician and Director of the FACES for the Future Coalition. Young people like me who have been marginalized by mainstream society and overcome similar challenges should be recruited to the health professions, including the global health field. Their unique experiences are needed to inform and improve the healthcare practice that directly addresses many of the negative health outcomes related to poverty, limited resources and disparity.
I faced multiple challenges growing up – limited financial resources, few positive role models, family problems – all of which could have prevented me from achieving success. Like so many other young men of color with similar histories, I had relatively little understanding of what opportunities existed, and only a vague awareness of what skills I possessed. But, there were key adults in my life, including my family and others, who believed in my talents and potential. It was these people who connected me to important opportunities to develop emotionally and intellectually. Without them, my life trajectory certainly could have taken a very different course.
Many individuals who come from marginalized environments where there are high concentrations of poverty, community violence and health disparities gain valuable skills by successfully coping with adversity. Raised in challenging environments, we learn to be resilient and adaptable not only from our family role models, but also because there is an expectation and necessity to do so. For many of us, the experience of working diligently to develop and sustain a long-term sense of vision and purpose in the face of multiple barriers requires flexibility, perseverance, empathy and a commitment to breaking the negative cycle. It also requires people to support and believe in us. Finally, it requires patience and an unwavering faith in something possible outside of one’s “norm.”
In 2000, I co-founded FACES for the Future to provide youth interested in a career in healthcare access to the required skills and experience. FACES was founded in direct response to two important imperatives: to build a healthcare workforce reflective of our community’s diversity, and to improve adolescent outcomes for at-risk youth through career training and professional development. FACES programs work with underserved, minority high school youth, providing them with comprehensive services that ensure entrance into post-secondary training and college.
In partnership with the Global Health Fellows Program (GHFP) II, FACES is working to take a systems strengthening approach to building a diverse global health workforce. Through the FACES curriculum, our at-risk high school students directly impact the health workforce by increasing the pool of skilled minority students entering college, as well as capitalizing on the inherent skills they have mastered through their lived experiences in overcoming challenges. Leveraging these lived experiences, the FACES programs offer concrete, work-based learning through internships, academic support, case management and counseling, and youth leadership development.
Effective global heath practice requires skills such as cultural acumen, adaptability, innovation, and resourcefulness. Global health workers often must navigate barriers that involve language and cultural discordances. Thus, there is an imperative to build a diverse global health workforce skilled in these competencies, and that requires that global health academics and employers invest in more expansive and inclusive efforts to broaden their outreach. The potential value these young people can bring to the profession via the skills obtained through lived experience is tremendous. However, we cannot ignore the barriers that disadvantaged minorities face regarding educational advancement and entry into the global health profession.
A career in medicine was as far from my norm as I could envision. Given my background, the profession was basically foreign to me. Yet, in retrospect it made sense that I should become a community-based physician. I believe that the skills I acquired as a direct result of my childhood experiences provided me not only with a personal view of health and socioeconomic inequities, but also instilled a deep desire to improve those inequities for others. Moreover, I acquired certain skills that I believe enable me to work effectively with patients from culturally diverse backgrounds. Now, as a pediatrician who has committed my life to the service and well-being of underserved communities and at-risk children, I find that my ability to build trust and therapeutic alliances with at-risk disadvantaged adolescents is deeply informed by my own life experiences.
It is important that efforts to expose and train students to global health start before the college years, and that they address the myriad of barriers that prevent at-risk youth from being successful. Early recruitment and preparation of youth who possess resiliency, cognitive skills, social competencies, prosocial behaviors and other skills gained through lived experience is essential. There are many youth in marginalized communities whose bilingual and bicultural identities prepare them well for work in global communities. There are many youth whose foundation of strong work ethic and ambition, developed through confronting adversity, promotes innovation and resourcefulness – qualities that are important for the global health worker. We must ensure that these youth do not continue to be excluded from the profession. Our experiences with FACES graduates tell us that this is more than just a return on investment; it is critical to building a strong future for global health.
– Dr. Tomás Magaña, Founding Director of FACES for the Future Coalition
Reproduced with permission from Global Health Fellows Program-II blog. 
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