Student profile: Crystal Cazier (Dallas Campus, MPH)

A global perspective to public health comes naturally to MPH student Crystal Cazier, who attended high school in Kenya, where her parents have been missionaries since 2003. Now living in Dallas, she’s working for the George W. Bush Institute coordinating a partnership focused on cervical cancer prevention and control in Sub-Saharan Africa. Last summer she went back to Africa for her practicum (akin to an internship) working with the Ministry of Health of the Republic of Zambia to plan for the introduction of better screening methods for cervical cancer — the leading cause of cancer deaths among the country’s women.

Cazier is enrolled in the customized MPH program at UTHealth School of Public Health in Dallas, concentrating in program implementation, monitoring and evaluation and global health. She plans to graduate this year.

Tell me about your practicum focusing on HPV in Zambia. What did you do?

Cazier and nurse in the field-square
Cazier and "Nurse Anne" at a cervical cancer screening in Zambia.

I worked with the Zambia Ministry of Health in Lusaka on the national cervical cancer program on a proposal for HPV self-testing. Most cases of cervical cancer are caused by HPV. If women can self-collect a sample, it takes out some of the barriers for cervical cancer screening. Then the sample is tested within one to three hours with machines, for an early instant diagnosis for HPV. Currently, the government in Zambia screens for cervical cancer by conducting a visual inspection with acetic acid to detect precancerous cervical lesions, together with same day treatment. We proposed adding HPV molecular testing in the front of the screening algorithm, to reach more women.

While there, I had the chance to go to a chiefs’ indaba – a gathering of nearly 300 traditional leaders in Zambia. It was two days of meetings to learn what the Ministry of Health is doing over the whole spectrum, and to get the chiefs’ buy in. Three of the chiefs gave examples of how they use their voice, authority and leadership to have positive health outcomes. To see the indaba firsthand was really incredible.

 Another impactful moment was when I saw a woman screened who had invasive cervical cancer. To see women present with cervical cancer at such a late stage—that would never (or rarely) happen in countries with greater resources such as the United States. But it is common for women in Zambia to present very late (40 percent of women who present with advanced stage cervical cancer are 35 or under).

What did you learn from the experience?

Listening and being willing to have an open mind and close my mouth taught me so much. Because local context is so important, and the wealth of knowledge in communities is so rich, if you come from the outside with an idea or a proposal, you have to be willing for that idea to be completely redone. That’s why it is important to involve the community from the beginning. 

What led you to public health and your current career?

Public health kind of chose me. I didn’t plan to be in this field, but now I can’t imagine being in anything else.

After graduating from high school, I went back to the United States, where I earned my bachelor’s in political science from The University of Illinois at Urbana-Champaign. My first job out of college was working as a receptionist and then a clinical research associate for Carle Cancer Center at Carle Foundation Hospital. Working with cancer patients, hearing their stories, seeing their tenacity and joy in the midst of pain and uncertainty, was very rewarding.

Then I moved to Dallas with my husband and joined the George W. Bush Institute, a nonpartisan not-for-profit organization focused on developing leaders, advancing policy, and taking action to solve today’s most pressing challenges, where I am an associate of global health and research and evaluation. I help coordinate the Bush Institute’s involvement in The Partnership to End AIDS and Cervical Cancer, an international collaboration with PEPFAR and UNAIDS that works in Sub-Saharan Africa to prioritize HIV-positive women in national cervical cancer prevention and control programs. Working at the Bush Institute, I was inspired by a couple of my colleagues who had master’s degrees in public health. To be more effective in public health, they encouraged me to get my MPH as well.

Why did you choose UTHealth School of Public Health for your MPH?

I was drawn to the program’s affordability, convenience and flexibility. As a working professional, I appreciate the flexibility of the customized MPH program as well as the flexibility to be a part-time student.

What are your future plans?

I would love to get more field experience, and I am looking at a few options through my current position, and even considering getting some clinical experience that would enable me to support women with cervical cancer. I would like to continue to focus on cervical cancer research, and work in the global health community to address the double burden in infectious disease and non-communicable disease. The overlap is interesting to me and somewhere where I can see my skill set being used.