NAPA Career Profiles: Ted (Edward C.) Green
Ted (Edward C.) Green is perhaps most well known for his open critiques of the Western biomedical policies and practices of the AIDS establishment in its approach to Africa. Taking a more anthropological approach, Green has argued that effective solutions to decreasing HIV infection should be rooted in the cultural practices and indigenous knowledge of the peoples that public health organizations intend to help (skim to page 28 here for more on this topic).
Controversy aside, Green has had a long and successful career in medical anthropology, with a professional skill set that includes project design and implementation, evaluation, policy, operations research, social marketing, behavior change, health education and indigenous medicine.
“My research and project experience, from the 1970s to the present, fall primarily into 5 categories: African-American Studies, development anthropology, African indigenous healing systems, AIDS prevention, and AIDS policy reform. I have written 9 books and over 450 peer-reviewed journal articles or book chapters, conference papers, and commissioned technical reports. For most of my career, I had no university affiliation, so I guess all this writing came from a ‘publish or perish’ mindset formed very early in my career.
I concluded my long post-academic applied anthropology career back in academia for 9 years, at the Harvard School of Public Health, mostly as a ‘Senior Research Scientist’ and as Director of the AIDS Prevention Project. During my Harvard years, I served on a presidential and an NIH advisory board, among several board affiliations, and I have been profiled in, for example, Forbes Magazine and in The Lancet, among other publications. I have testified in Congress four times. At the urging of the John Templeton Foundation in 2010, I started my own non-profit, called the New Paradigm Fund, based in Washington, DC.”
Like many anthropologists, Green’s initial attraction to anthropology was rooted in his experiences abroad as a youth.
“I found anthropology to be intrinsically interesting. Both my father and grandfather were career foreign service officers and ambassadors, so I grew up in a few foreign countries, including two high school years in Seoul, Korea. I also found psychology and sociology very interesting, but they seemed too narrowly Western.
I majored in anthropology at George Washington University because it was the late 1960s and it seemed that all the coolest, hippest people on campus were into anthropology. I did my masters at Northwestern and then got drafted. I managed to convince my draft board I was a Conscientious Objector so I did 2 years of ‘alternative service,’ mostly working at a psychiatric ward of the former D.C. General Hospital.
I was able to resume graduate studies at Catholic University during this time, and for my dissertation I went to Suriname to conduct a first-ever ethnographic study of the Matawai Maroons, descendants of escaped African slaves from the plantations of former Dutch Guiana in the 18th and 19th Centuries.”
Although Green ended up teaching anthropology at the university level for about 5 years, he was particularly interested in working in Africa and was able to tap into his network to locate opportunities.
“My dad got me a 2-week gig as a consultant for what is now Population Action International, and while we were in Nairobi in 1980, my friend from grad school, Ned Greeley (who worked for the regional East and Southern Africa USAID office) asked me if I would like to be a consultant on a USAID project in Sudan, starting, like, next week! I thereby got my first taste of USAID consulting in Africa and I loved it. On the other hand, I almost ended my inchoate career in international development by publishing a satiric diary account of my first consulting job, in Human Organization. (‘Have Degree, Will Travel: An AID Consulting Job in Africa.’) I was critical of a certain USAID director and that almost got me in trouble.
Later that same year (1980) I acted on a tip and got myself involved in writing a proposal for Westinghouse Health Systems, for a schistosomiasis and cholera project in Swaziland. I found that this organization, and many others since then, really appreciate the holistic anthropological perspective. I, in effect, critiqued the stated USAID plan of simply doing a standard ‘KAP’ survey and I proposed adding substantial qualitative research in order to get the full picture that would be needed by project implementers. To make a long story short, I ended up going to Swaziland on this very project, although it was for the Academy for Educational Development. I ended up staying in Swaziland for 4 years, the last of those years consulting directly for the US Mission there, which was very open to standard anthropological ideas I proposed, such as building programs of collaboration with indigenous healers (thanks to the ideas from, and collaboration with, the late anthropologist D.M. Warren) and empowering rural women’s self-help organizations.
By this time I had published a few academic articles from my dissertation research with the Maroons and now was publishing on African health including indigenous healers. In fact, the USAID health officer in Swaziland came back from a global meeting of USAID health officers in Washington in the mid-1980s and told me that I was ‘putting Swaziland on the map’ from my publications.”
Although Green was building a strong professional reputation and was successful in promoting an anthropological approach to public health projects, he did encounter skepticism.
“When I first started working for USAID-type organizations in the early 1980s, people in charge were quite suspicious of academic types—as they perceived me to be—and our proclivity for publications. But by the close of the 1980s, USAID and other major donors had come to realize the important value of peer-reviewed publications that document research and related activities funded by US taxpayers. By then, peer-reviewed publications had actually become formal criteria for promotions and cash bonuses, at least at some organizations.”
Despite the challenges, Green adds that he had acquired critical skills that prepared him for a lucrative career in international public health.
“Good writing and research skills are always in demand and I suppose we learn to be good writers through the painful, iterative process of appeasing peer reviewers, sending improved drafts back and forth to editors, over time.
One also needs social skills, especially the ability to work cheerfully and uncomplainingly with other professionals, often under intense pressure in faraway places. I have heard it commented of my profession, ‘just getting along with people is at least half the job.’
Also, I have always approached my applied work with a critical, skeptical mind. If I don’t fully agree with the way a project has been designed, I will argue for changes, and this can usually be done in a collegial, productive way.
I was so proud back in the mid-1980s when the leading socialist at the World Bank, Michael Cernea, used the experience of how I conducted my first applied research in Swaziland as an example of how anthropology and sociology could and should be used by major international organizations.”
To illustrate his anthropological approach to the short-term projects and evaluations that have typified his career since 1980, Green describes a recent project:
“I was about to return to Africa on separate matters just a couple of months ago when I got a call from a major USAID contractor, that I had consulted for many years ago. They wanted me to work on their proposal for an enormous global AIDS prevention project, one that focused on promotion of VMMC (voluntary medical male circumcision). I told them that I was too busy and was packing up for Africa but, in the end, I agreed to provide 3 or 4 days of writing, and I would send in paragraphs at the end of each day, so that we are all working together in concert.
Now, it happens that I stumbled upon a very interesting finding in South Africa in 1991, namely that traditional healers had figured out (before Western medicine) that male circumcision somehow lowers the chances of STD and even HIV infection in men. Some healers started advising men by 1991 to consider becoming circumcised as a way to reduce chances of HIV infection, more than a dozen years before this became Western biomedical policy!
That discovery got me involved in the male circumcision and HIV issue almost from the beginning. Also, by this time, I had become well known for criticizing the western biomedical approach to global AIDS prevention, which boils down to condoms, testing and drugs for every country pretty much regardless of culture and type of epidemic (concentrated or generalized), one size-fits-all. I argued that we should not completely overlook behavior, culture and basic public health principles.
As it was with that very first proposal writing in 1980 that ended up launching a 35-year career in applied medical anthropology, this latest client seemed delighted with my contribution to this latest proposal, and I was told that I brought a ‘fresh and quite unique perspective’ to the table. I was able to draw upon personal, applied anthropological experience working in diverse parts of the world, my knowledge of the male circumcision issue and the burgeoning literature on this topic. Now the VMMC has become public policy for USAID, PEPFAR, and other major donors. I had strong opinions on AIDS and circumcision and I knew all side of the debates. So I certainly brought a lot of anthropological perspective and experience to this assignment. But remember, when I contributed to that first proposal about Swaziland in 1980, I brought zero technical, project or regional experience to the table, and yet by simply arguing convincingly for the need to add qualitative research—which I figure any anthropologist would have done—I strengthened the proposal and this got me to Swaziland for my first applied anthro job.”
For those out there looking to get involved in multi-disciplinary work in international development or public health, Green offers a critical tip as well as some basic advice.
“People from other disciplines don’t often bother to familiarize themselves with ethnographic literature from parts of the world where they are about to work—or have been working for years. We anthropologists know that ‘existing literature’ is usually the first place to look for guidance.
Over the many years I’ve been in this field, I have helped younger colleagues in anthropology, public health and related disciplines find ways to get a foothold in one of the most exciting and rewarding careers that anyone can devote their lives to. I did this as a volunteer, to pay back the kindness of established anthropologists such as Russ Bernard, John Janzen, and D. Michael Warren, who were so the helpful to be when I was getting started, first in anthropology and then in Africa.
My advice boils down to: find a way to get your foot in the door and then do a good job and show people that you can work with colleagues from diverse disciplines. Living in or near Washington, DC is a plus. I’ve done a lot of both short- and longer-term term work and it almost always involves working with teams of 3-7 people from diverse disciplines. I can remember working with a fellow anthropologist only three times in my career: in Bangladesh in the ‘80s, in Cambodia in ‘90s, and in Ukraine in 2000.
Now, on overseas assignments, anthropologists have developed a reputation for running off by themselves and doing solo interviews with people in odd places at odd times of the day or night, to the point that there’s a stereotype of the ‘lone wolf’ anthropologist on the team. In my experience, it is often justified to follow one’s anthropological instincts and do interviews with people in a position to know what it is you (the team) are trying to find out, whether or not they appear on a pre-approved list.
Here is a quick example, although it heralded a major change in my career: during a single week in Uganda in 1993, I found out that Uganda was implementing a unique, endogenous type of AIDS prevention program by 1993 (and earlier); moreover the rate of HIV was already declining by 1993. No one else, except many Ugandans, agreed with me at that time. My Ugandan informants and I were proved right. This was the moment I became started to became an increasingly outspoken critic of ‘Global’ (Western) AIDS prevention.
Also, as I’ve mentioned more than once, good interpersonal skills are essential. It’s certainly true in academia. I know a couple of super-highly published anthropologists who were denied tenure for the sole reason that people could not imagine spending the rest of their professional lives with either person. On a typical short-term assignment in my applied field, we have to work long, hard hours, often 7 days a week, starting with breakfast team meetings, then going on bumpy jeep rides for hours to interview people and check out worksites, after which the team dines together and often works late into the evening.
The late Barbara Pillsbury was the first president of NAPA. She and I first met in Bangladesh while on separate assignments, and we hit it off from the start. Barbara was super-multilingual. At first, she would only speak to me in Swedish, since I had lived there for 5 years as a kid. But I had forgotten virtually all my Swedish by then! We were later (2000) thrown together on an intense 3-week assignment in Ukraine. She was the team leader and could go without sleep for days, it seemed. One time, we were on an overnight train from Kiev to Odessa and Barbara held a team meeting in her tiny roomette. It went on and on. I quietly slunk away at about 2 a.m. and got in a couple hours of sleep. The train pulled into Odessa and we were off to meetings at cancer hospitals all day. Barbara ran on pure adrenalin and enthusiasm.
By the way, one of those meetings proved to be one of the most memorable and rewarding experiences of my career. We were at a women’s cancer ward and all the patients there had been told they would be dying of cancer. In fact, USAID had chosen this particular Odessa hospital to receive the very latest breast cancer drugs from America, and all the women in the room were Stage One or Two and so would be treated and would be going home to their family soon. Barbara gave a passionate speech about how she herself was a breast cancer survivor and how this very drug had cured her years before.
You can imagine: the mood went from resignation and despair, to sudden hope and delight! These ladies had already said their goodbyes to the families. Now suddenly they were going to live! I felt very privileged to be the only male in the room to witness this. It was like a Solzhenitsyn novel but with a deus ex machina, a sudden and completely unexpected happy ending.”
Green’s experience is evidence that it pays to follow any leads that come your way and keep looking for opportunities to pursue what you feel passionate about.
“Very little in my career was planned, and pretty much everything happened by chance or fate. It was by very random chance that I made a trip to Suriname during a spring vacation from grad school in 1970. I found my way up a river into the rain forest and met an elderly Maroon who told me that the ancestral spirits had in fact guided me there so that I would come to understand their culture and explain to sombe foe baose, or Downriver People (i.e., the rest of the world) that ‘we Maroons are good people.’
Years later, after my post-doc at Vanderbilt, I realized that I very much wanted to go to Africa, although I was not yet a medical anthropologist. I spent months having interviews in diverse areas of international development, including agriculture, appropriate technology, education, potable water & sanitation, and mental health. It was the chance meeting of my grad student buddy Greeley that helped me get my foot in the door of international health with my 2-week consulting job in Sudan. Now, for the 4-year job that followed, the minimal requirement for the social science position was a PhD in a social or behavioral science, and a minimum of 2 years’ experience in Africa. I advanced the argument that ‘my’ Maroon tribe in Suriname descends from West Africans, so that should count as African experience! Improbably, that worked.
My experience was that once one gets started, assuming that one can write and do research and—very importantly—get along with people under sometimes intense, even life-threatening situations, then one thing leads to another and before you know it you’re having a most rewarding career.
My original plan in graduate school was to have a career in teaching anthropology. I think it was Russ Bernard who first suggested, to paraphrase him, ‘since no one has ever heard of Suriname, go do some consulting in Africa and your CV will become much stronger.’ Sure enough, after a few years, senior colleagues such as John Janzen were telling me about openings at universities and offering to give me a recommendation. But I realized by late-1980s that I was really enjoying my career as an applied anthropologist and I didn’t really need or want to return to academia. Also during the 1990s, I actually applied for, and was accepted to, PhD programs in public health at both Johns Hopkins and UC Berkeley. But when it came down to it, I didn’t want to interrupt what I was doing and I found I could actually get by on cultural anthropology, without technical knowledge of public health.
But it would have helped! In later years, I would find myself debating AIDS experts on national public radio, on TV, in front of audiences at places like Harvard and Johns Hopkins, or on the floor of the US Senate, and yet I had real vulnerabilities. There were basic medical things I didn’t know, and what if I were to be found out and publically disgraced?
If I were to do it all over again, I would earn an MPH if I planned to go into medical anthropology or anything else relating to international health.”
While there is always more to accomplish, it is clear Green’s extensive professional achievements have been very rewarding. In looking over his career, he adds, “I more or less stumbled into bliss.”