As a doctor he met up to 100 patients daily, with a stethoscope as the only equipment. The experience boosted his interest in public health and how to help more people at a higher level. After a long journey from Yogyakarta in Indonesia to Umeå in northern Sweden, he has now arrived in Gothenburg. Meet Nawi Ng, the Institute of Medicine’s new professor of global health.
Nawi Ng’s first job as a newly qualified doctor in Indonesia was something of a challenge. He worked at a health center on the outskirts of Yogyakarta, a densely populated region on the island of Java with some 3.5 million inhabitants. The premises were shabby and the medical equipment inadequate.
“I saw up to a hundred patients every day, and all I had in my examination room was a stethoscope — nothing else. What’s more, medicines were in short supply. If I met a patient with high blood pressure, for example, I could only prescribe drugs for seven days,” Nawi Ng says.
The idea was that the patients should return for a follow-up consultation and another prescription after a week, but hardly anyone came back.
“Many of them were poor, and couldn’t afford the costly journey and to take time off work. In unfavorable circumstances like that, treating patients is really hard.”
Journey to Sweden
During his medical studies, Nawi Ng had already become interested in public health. His experience at the health center strengthened his motivation to work at a higher level, with a view to helping more people and working more on measures to promote health and prevent diseases.
His alma mater, Gadjah Mada University, had long collaborated with Umeå University. In the fall of 1999 he was interviewed by Professor Anna Winkvist, a Swedish researcher visiting Indonesia. In August 2000, he moved to Umeå to read for a Master’s in Public Health. His first impression of Sweden was its great emptiness and silence.
“In Yogyakarta, you always see people on the move — even at night. Umeå was completely empty, from the airport to the student block, even in the middle of the day. That was a bit of a shock,” he remembers.
In time, he began to like Umeå, and also noticed that his health improved thanks to the clean air. In 2003 he was admitted to Umeå University as a doctoral student, and although he spent the most of his time working on his PhD in Indonesia, the idea of moving to Sweden began to form in his mind. In 2007 he and his family moved to Umeå, and they have remained in Sweden since then.
Worldwide projects
During his years in Sweden, Nawi Ng has developed into both a successful and a productive researcher in public health and epidemiology. He runs several projects with major stakeholders, such as the World Health Organization(WHO) and the INDEPTH network in Asia and Africa. He has also taken part in the Västerbotten Intervention Program (VIP), and in many other projects in Swedish register research.
In VIP, risk factors for chronic illnesses, such as cardiovascular diseases and diabetes, are investigated. Respondents fill out forms about their health, provide blood samples, and so on. VIP has generated knowledge on a wide range of topics, including how risk factors like smoking, overweight and high blood pressure are connected.
“Every respondent gets a follow-up ‘health talk’ in which the nurse summarizes the results in the form of a star profile. The points of the star all represent factors like physical activity and cholesterol level. If a person has a lot of risk factors, the area is considerably smaller,” he explains.
Head of major research program
Nawi Ng leads STAR-C, a large research program funded by the
Swedish Research Council for Health, Working Life and Welfare (Forte) an app for creating the star profiles used in VIP is being made. The purpose is to explore how digital technology, social networks and social media can help people to achieve more healthful behaviors.
Initially, the program will implement qualitative studies, using questionnaires to find out which factors affect behavioral changes. How can social networks be used, both in reality and in social media? How can an app be adapted to different people’s needs and circumstances?
“Our hypothesis is that social networks are extremely important. When we talk to our families or neighbors, we both get influenced and also ourselves influence others. Behaviors are infectious. If a lot of your friends smoke, there’s a high risk of you being a smoker. The question is how various networks are, and can be, used to foster positive behavioral changes and how they can be combined with digital technology,” Nawi Ng says.
The project has adopted an interdisciplinary approach. A group of researchers from four faculties at Umeå University are to work on the project, in collaboration with Region Västerbotten. Nawi Ng has retained his visiting professorship at Umeå University in order to lead the work.
Aging in low- and medium-income countries
Nawi Ng’s research focuses on three areas: aging and disabilities
among older people, and the emergence of chronic diseases, in low- and medium-income countries; and interventions and behavioral changes.
One of his larger projects in the field of aging is a development project in Myanmar, funded by the Swedish Research Council and conducted jointly with the WHO, Help Age International and the Myanmar Government. The objective is to explore factors that affect older people’s lives, care needs and utilization of health care, and how these factors interact, in Myanmar.
Nawi Ng has five PhD students on their way from China, Indonesia, Myanmar and Vietnam, and is heading a newly started research group in global public health at the School of Public Health and Community Medicine at Sahlgrenska Academy (Institute of Medicine). The plan is that it will become a collaboration platform to consolidate research in global public health at the University of Gothenburg.
Passion for teaching
Besides the research, Nawi Ng also has teaching commitments,
both in the International Master’s Programs in Global Health and Public Health Science and in the Programs in Medicine and Dietetics. His teaching mainly relates to global public health and various epidemiological methods.
Teaching is something he has been passionate about ever since his own student days. As a small boy he wanted to be a teacher, but his father thought he should become a doctor. Today, he has an occupation that includes both roles. He finds teaching on the International Master’s Programs and being a mentor to young researchers from all over the world especially rewarding.
“The discussions are often exciting, since they have such differing backgrounds and experience. Global public health isn’t just medicine; it’s interdisciplinary. It’s a strength, but also a challenge, to get the interdisciplinary collaborations going. If you’re going to solve global problems of public health, such as giving good care to an aging population, you have to collaborate across subject boundaries,” he says.
Talent for pattern recognition
As an epidemiologist, Nawi Ng bases his research largely on surveying the prevalence of various diseases and risk factors, but he has also begun to find interventions more interesting. At the same time, the two clearly belong together. His very first doctoral student explored the association between outbreaks of dengue fever in Singapore and fluctuations in temperature and precipitation. Analyzing the data enabled her to predict, 16 weeks in advance, when an outbreak would take place. This knowledge came in useful, making improved management of epidemics possible.
“You might say that epidemiological data are what I get my enthusiasm from. My way of thinking is extremely quantitative and data-driven, and identifying patterns comes easily. In Umeå, my colleagues used to say it was easy to see when it was my week to clear up the coffee room: The crockery was neatly arranged according to size and color. It’s almost an interest of mine, finding patterns in large volumes of data,” he says, laughing.
TEXT: KARIN ALLANDER
PHOTOGRAPH: KARIN ALLANDER
