From Colombia to Houston: How International Experience Shapes Leadership and Innovation in Healthcare (ft Dr. Andrea Ramirez Varela)

Welcome to Digital Voices, where healthcare and life science leaders explore the real work behind transformation. This podcast is about people, leadership, and the conversations that move healthcare forward. Now your host, Ed Marx.

Welcome to another edition of Digital Voices. Super excited because my guest is a pretty awesome person I've gotten to know, Dr. Andrea Ramirez Varela. Andrea, welcome to Digital Voices.

Hello, Ed. Thank you so much for inviting me today. Really excited to be here.

And we got to meet up last, a few months ago. I was going to say last year, but not quite last year, a few months ago. And I was just mesmerized by your story, about your leadership, about your personality, just who you are. And I was like, oh man, I have to have Andrea on Digital Voices and share a bit about what she's doing today, but as well as what you did a few years ago. So thanks for, thanks for being our guest. But Andrea, as you know, the most important question we ask the entire podcast is what songs are on your playlist? Like what kind of music do you like to listen to?

Well, as you know, I'm Colombian, but I'm also an adoptive Brazilian. So my, my list of music has lots of Latin flavor. And I listen to music in Spanish, music in Portuguese, and I I live here in Houston now, so I'm also incorporating some, some songs in English. My favorite groups are Bombay Stereo, Adriana Calcanioto, and Tool. And I'm a, I'm an opera fan, so I do listen to a lot of opera too.

Awesome. I, I'm definitely gonna listen to some of this music. So before we jump like too far in, are there words that you live by or words that sort of guide you, like how you, how you live or operate?

Yeah. So, um, one, one of my mantras, and it's the one I use every day, is like, everything is already resolved. So sometimes I do not know how things are going to turn out, but I have like a deep trust that in God and the universe that things are going to turn out well. So I repeat that to myself all the time. And also when things don't go well, I remind myself that rejection is protection and redirection. So you have to turn and look for alternatives, but you will end up where you have to be.

Yeah, I love that. And you already shared, Andrea, a little bit about yourself in terms of being from Colombia, but also adopted Brazil and obviously in Houston now. Tell us all about yourself, like including like where were you born and just how you made your whole way over to the United States?

Thanks, Ed. Yes, so I'm from Colombia, South America. I was born in Bogotá and I come from a small but loving family. I lived, um, all my life with my mom and my sister. My parents are divorced and I do have 2 younger half-sisters on my dad's side. So we're 4 girls. I'm the oldest and I love all my sisters very much. In Colombia, as you can imagine, we do love dancing, music. art, Colombian culture. So I grew up with that and I finished high school in Cali, you know, the salsa capital in the world. So we enjoy lots of music in my family and I returned to medical, to do medical school at Universidad de los Andes in Bogotá. So I really had a wonderful childhood. My mom did encourage us a lot to study and to be excellent. So I guess that reflects on how much I love to study nowadays. And yeah, I'm a constant learner because of all those experiences.

Yeah, that's awesome. And so eventually make your way down to Houston. How did that transpire?

Yeah, so I did medical school in Colombia. I did also my master's in public health. Since my, I think it was in the second year of medical school that I fell in love with epidemiology. So epidemiology is, um, the study of the distribution of health and disease conditions in the population. So that took me to being a research assistant very early in my career, and I got involved in an international network of physical activity epidemiologists and colleagues. So that exposed me to international colleagues. And after medical school, I did my PhD in epidemiology in Brazil. So that was my first big move. I did also live in Canada, in Vancouver for my public health internship. And after the pandemic, I got an opportunity to work here in Houston because of one of my biggest mentors and best mentors in life, Bill Cole, who sadly passed away 2 years ago. And he actually helped me get this job and I'm really excited. I've been here for 2 years now.

Yeah, no, that's awesome. It's our gain here in the United States to have you. Here. So how did you decide to become a clinician? So at what age did that, did you have this thought like, hmm, I'd like to be a doctor?

It has been all my life story. I don't think I have ever considered a different profession since I was a little girl. I was always playing to be the doctor of the dolls, my sister, my mom, all my family. Everyone contributed to my practice during med school as well. So I have always loved to, to help people, but also like, I'm fascinated with the human body. I think it's a perfect machine. So I'm just fascinated by medicine and how, how health is so critical for people's lives. So I love medicine. And now that I work as a physician scientist, I'm like a trailblazer between uh, the clinical world and the science world and advancing research to help people in real life.

Yeah, I know. I love that. I mean, your educational background and your experience is just amazing and you accomplished so much at such a young age. So you also pediatrics, right?

So I have a double appointment here at UT with the School of Public Health and the School of Medicine and Pediatrics. And I'm not a pediatrician, but all my research portfolio and agenda has involved studies with children. So that population, children and adolescents. I didn't tell you this, but in Brazil, when I was doing my PhD, I was in Pelotas, which is known for the birth cohort. So it's a very special place in Brazil, very tiny town, less than 300,000 inhabitants. And they have, they have had for 30 years now birth cohorts, meaning that they recruit people since when they are born and they follow them over time. to understand what makes them sick or healthy. So I had the fortune to study there and my research agenda includes children and adolescents.

Wow. Yes, it's pretty amazing. So yeah, let's talk about the pandemic. So I know part of your story, but obviously our audience, most of our audience doesn't. It's, it's so fascinating. So the pandemic happens, you're in Colombia at the time.

Yes.

So tell us what happens and the role it played in Colombia, the miniature you know, through the pandemic as safely as possible.

Of course. Yeah. Well, I remember that very well because I graduated from my PhD in 2019. I moved back to Bogotá and, um, I started a position as an assistant professor at Universidad de los Andes in the School of Medicine. And, um, the pandemic hit in 2020. I was just, I just started my position there and I was recruited by the vice chancellor of research at the university to be part of the team that would lead the university's response to the pandemic. And the reason is that Colombia, as many other low and middle income countries, was falling short on PCR tests and in general national capacity to deal with the pandemic. So the national government and the National Institute of Health called the universities to help out and to work together in order to make a stronger response and to really be able to provide PCR testing and care for everyone in Colombia. I'm not sure if you know this, but Colombia was one of the countries that did best in the pandemic.

Mm-hmm.

So in terms of deaths and in terms of people who received access and care if they needed it, in Colombia, everyone that needed an ICU was able to get it. because of how coordinated we were to treat people. So no one died in their house or just waiting in the emergency room for an ICU or a ventilator. So we're really proud of that. So I was fortunate to be part of the response from Universidad de los Andes. And the reason is that it is one of the best universities in the country. It's a private university, but also the university has one of the most advanced laboratories of genomics and molecular biology. So we started our own PCR testing site at the university, and I was in charge with a couple of other colleagues to develop the public health response. In that time, in 2020, we didn't have vaccines and we were just starting the PCR testing. So Colombia went into a strict lockdown. I'm not sure if you remember, but Uh, we were one of the countries that pretty much closed the borders for at least 7 months. So, we were trying to protect our population. And at that moment, everyone was in their house, but there were essential workers because we needed the cities to, to be able to function, right? So, the healthcare workers, the transportation workers, the essential workers, let's say in groceries and food services. Those people were going out in order to keep us alive and fed. So we were working with those groups to make sure they had PCR testing to know if they had COVID or not, and to get them access to healthcare in case they needed it. There was no treatment at that time. So pretty much if you get COVID or if you got COVID, you had a good risk of being severely sick or die because there was no treatment or vaccination. So I started working on that. Incredible amount of work, but a wonderful team. And we ended up being able to build drive-through walkthrough. That was, that is very frequent here in the US, but in Colombia it didn't exist. So we came up with that solution and we tested more than 1,000 people, essential workers. And we, and I remember I created my own call center to do contact tracing. So I was able to train my MPH students in order to be able to call and provide all the recommendations. And we followed those people. It was incredibly fulfilling and wonderful to have that team. We got a big funding from the Inter-American Bank to run that project because it logistically, it was extremely expensive to do that. And we were able to help the country and the city with the public health response to the pandemic. Subsequently, We got more funding from private companies in Colombia. So private companies were very concerned because their workers couldn't work. So they invested a lot of money in purchasing vaccines. At that time, we had direct contracts to purchase vaccines or the purchase through the international agreement. So in Colombia, the people from businesses and private companies decided to purchase vaccines to vaccinate their workers. So we went into a partnership with them and some of those vaccines were directed to very low-income populations and very vulnerable groups in the southernmost areas in Bogotá. So we ended up putting in place vaccination sites in 4 localities in Bogotá where transmission was very high, but because they were so poor and lived so far away from the vaccination sites that we had, we took the vaccines there and we were able to provide the vaccine to more than 100,000 people in record time. This was a matter of 4 months. So it ended up being 2% of the vaccination capacity in the city, but we were targeting really vulnerable groups and a lot of immigrants from Venezuela who didn't have access to healthcare. So the impact was massive. I remember going to those vaccination sites. I remember an activity we did on Halloween to vaccinate children and their families. So we put a gigantic theater, we were projecting a Halloween movie and we were vaccinating people as they were watching the movie because we wanted people to get vaccinated. We didn't want anyone to be left behind. So it was incredible. All of this with the team from the university and the private companies like Fundación Santo Domingo, who is a massive philanthropic in Colombia. And other private companies that were very generous to pay for those vaccines for people. So I think this is unprecedented just to see how generous people were in Colombia to do this for people without really any specific interests. So I did that work for 2.5 years. It was 24/7 work during the pandemic. I think I graduated as an epidemiologist. I did have my own field practice with the pandemic.

Yeah, that's amazing. Sorry. And I think in, in, uh, thereafter you were honored as, as one of 25 young researchers in Latin America by, by 3M, just because, you know, you helped save a bunch of lives.

Yeah. I'm really proud of that. And it was a major team effort, really. It was extremely complex to do all of that, but we were able to do it. So I think that shows the power of Collaborating together for a major purpose, which was helping the health of people and trying to save lives. We don't know exactly how many of those people would be sick or would have died because of COVID but that's the beauty of preventive care. When you save lives, you don't really know what exactly the, like the, the magnitude, because you're preventing awful things to happen to people. And that's, that's why, why we're here.

Yeah, no, it's amazing. Uh, I'm glad people like you, uh, out doing what you do. And speaking of which, who is there a person in your life, uh, it doesn't have to be related to the pandemic, it could have been before or after, that's helped see you as who you could be before you became who you are? You know, someone who really believed in you?

Well, I have had the fortunate to have so many mentors in my life and still I do. That's I'm really grateful for that because so many people struggle finding like their home and their network of collaborators, but I have always had someone holding my hand and helping me in those moments and really to see my potential. So my first mentor in life was Michael Pratt. I still work with him and he's like my father. I really love him very much and I'm grateful for, for his life. I think he's, he was the one who first saw my potential as a researcher. as a physician scientist. He was the one who got me in contact with my other mentor, Pedro, from Brazil, and that's how I got my scholarship to study my PhD. But during the pandemic, definitely the Vice Chancellor of Research, Silvia Restrepo, and Eduardo Behrens, and one of my dearest colleagues in the public health area in Bogotá, Luis Jorge Hernandez. He's very important there. He worked with the Secretary of Health. And obviously my biggest cheerleaders, my sister and my mom. They have always seen what, what I can do and they have always been there to celebrate and to, and to just cheer me up. Well, nowadays I have lots of mentors, really great friends that, that also helped me achieve, um, my successes. So yeah, I have been really like, I'm really grateful and fortunate to have so many people opening the doors for me. That's, that's what I think, like life shows you people to open doors and You just have to be grateful and take advantage of all of these opportunities.

Yeah, I love that. I agree with you. Yeah, let's talk a little bit about your day-to-day life today at UT. Like, you're also got appointment as a professor. I mean, what's daily life like? Like, what, what, what do you do?

Oh, it's busy and dynamic. And I have to tell you, my days are very different. Every day is a different, uh, a different story and I love it. So I'm very, I'm a very active person. So my agenda is full and I try to keep it like that because I just love to be able to do things and to help as much as I can. So I do have 3 major areas that I work in. It's research, teaching, and service. So I teach courses here at UT in relation to epidemiology. I have a very big research agenda about epidemiologic surveillance. I graduated last week. From my advanced field epidemiology training that I started after the pandemic. So it's, it's called the FETP program, which is an homologous, a sister program from the EIS officer here at CDC. So, uh, it's to be able to handle outbreaks and pandemics and epidemics. So I'm really proud of that. And I do research in that area. I do research in lifestyle medicine. So I do believe in prevention and healthy lifestyle as a way to prevent chronic illness, which is the leading killer nowadays. So I do work a lot on that. And in relation to service, I do service in my university. I'm a good university citizen, but I also love to do service in my community. Unfortunately, this year has been extremely busy, but I do try to be active and I'm part of the Latin American Medical Association of Houston. So I try to, to, to stay active and to help as much as possible. And of course, teaching and students are also One of the things I love the most.

Yeah. For those who aren't super familiar with UT Health, what is there one or two attributes about UT Health that the average person may not know about?

Oh yeah. So UT Health here in Houston, Health Science Center at Houston, I really love being here and I consider myself very fortunate because UT has a wonderful mentorship structure for immigrants like I am. I landed in a place that I really didn't know very well. So, the university has a wonderful structure to help you, like, locate yourself and really thrive. So, it's a very supportive environment, which I'm really grateful for. And also, UT is one of the most important public health schools in the country and in the world. And my office is right next to the MD Anderson Medical Center, which is one of the largest medical centers in the world. So, I find everything I need here and it's a wonderful place full of resources, more than I can take with my hand to, to really thrive and to really make a contribution to, to health.

Yeah, uh, you're right. And I don't know that everyone knows just how rich Houston is with all of the healthcare organizations, the universities, academic medical centers, research, science. And I think someone said, because we were at the same Latino Healthcare Leadership Conference, That, uh, maybe the most, the biggest Latino population in the United States is in the Houston area.

Yeah, it's true. Houston is the most diverse city in the country and it reflects like the trends for the future. So almost 40 or 50% of Latino population, bilingual with Spanish, very diverse city, full of action in relation to medical development, innovation, academics. Pharma, like really at the top of advancement. So, it's a wonderful city to live in. I really love it. And it has an opera theater, so I'm really excited too.

Yeah, yeah, yeah. Great arts for sure. So, the other involvement that you have sort of career-wise or service-wise is GOPA. I don't know if GOPA.

GOPA. Yes, yes, yes.

Tell us a little bit about GOPA.

So, GoPA is related to my lifestyle medicine and preventive medicine work. So, it's a global surveillance system for physical activity. It's one of my dearest projects because it started with my PhD. So, I've been working on it for 10 years now. I started as a student and now I am one of the co-chairs. So, I'm really excited about that.

Yeah.

And, we have been able to consolidate a network of at least 186 countries in the world with more than 300 members. And I love it because I can meet my purpose in life there, which is connecting people and helping people also find their purpose and find, um, what they need in order to do their work and to really promote healthy lifestyles, um, in other countries. So GoPA is fantastic. And I really love this network because I have found my best friends And like my best coworkers there, and I still have very strong relationships with them nowadays. So it's fantastic to, to be able to grow with these people. And as I say to them and to my students, life happens, but you still have, and you see people getting pregnant, having kids, retiring, publishing their first paper, getting their first grant, and all these things that are part of life and it's fantastic. It's amazing.

Yeah. I, you, you have a very full life in terms of all the different things that you're doing. It's, it's pretty cool. So let's talk about leadership because you've been so successful as we've been talking about here for the, for the last few minutes. What do you think are one or two key talents or skills that have helped you with success that others can learn from?

Well, I think. 2 major things that have worked for me are persistence. I'm a very persistent individual, so I don't give up easily. I will try and try and try until I find a way. And also a commitment to continuous learning. I love studying. I always study. I love studying. I'm a nerd. So I will continue doing that because I really love to learn and to keep my mind active and Definitely. It's, it's very difficult just to say, I finished my MD and my PhD, and now I'm not going to study anything else in my life. It's, that's really impossible for what I want to do. So those two are the, are the things that have helped me a lot in relation to skills to relate with other people. I think being coachable, uh, I listened from my mentors and I tried to see how to improve. So I tried to be flexible in my mind just to be coachable and to learn and to make adjustments because you're stubborn and, and really inflexible. It's going to be really difficult to adapt to different environments. And I have lived in 5 countries now and you need to, to learn to adapt because otherwise it's going to be really difficult for you. I think, I think that's, that's what has helped me a lot. In the last few years, I have, I have started to turn more inward, so really understand my inner world and how I can improve myself to really, like, also if I am in my best, I can also give the best to everyone else. So I have started to pay a lot of attention to that and really invest much more on my inner world and understanding and having more balance. Because as you may know, in this type of work that I do, it's really easy to just never stop working.

Yeah.

And that takes a toll on your mind and And your body and your emotions and everything. So I have tried to be more balanced and really enjoy more life as well, because you don't marry your papers.

Yeah, that's, that's really well, really well put. Yeah. Where, where do you, oh, maybe you already answered it, but where do you go when you feel like your creativity is drained or how do you refresh yourself? And maybe it's partially turning inward. Is there anything else that you do to just make sure you can care for yourself?

Yeah, I love physical activity. So I take my walks in the nature. I love hiking. And nowadays I meditate every day. I pay attention to my sleep. I love reading and studying. So that recharges me from, from the daily work that I do. So that helps me a lot with, with my creativity and allowing myself to rest. That, that also is important.

Yeah.

Really easy to don't stop. Yeah.

And you mentioned how you've lived in 5 different countries. Do you recommend sort of international experience for other people? Like how, how has it helped you and would you recommend it for others?

Yeah, absolutely. I think it's essential to, to learn other cultures and to see how other, how people live in other places, what are their struggles and where you can make an impact. And that's why I'm here also, because I am helping to expand the footprint and of beauty and everything we do here. And I think it's important to, to be open-minded in relation to what you do. It definitely helps with, um, with your work and how you address different challenges in life.

Yeah, I love that. Andrea, we'll have to have you back because there's, there's so much. You're such an interesting person. I was going to say good human, but But you've also taken these skills and talents that have been given to you and you've stewarded them in such a way to impact the world and helping a lot of different people. It's been fascinating. Everything from talking about some of the Colombian music and the Brazilian opera. I'm definitely going to listen to some of that today, later today. I'm super, super curious about that. And then we talked about just your growing up and your role during COVID and the different things that you did and And getting, uh, you didn't do it obviously for recognition, but you were recognized for the great work, uh, that you did to, to help your fellow country people and also your, some of your neighbors. And we talked about just your love for learning and being a scientist and a researcher and, and then a lot about UT Health and, and, and the different roles that you have. Oh, and that, that amazing study. I did look up that website and it was pretty amazing, all the different things. I think one of the common themes through all of this is connecting people. Finding purpose, living healthy. And then we, we ended up talking a lot about leadership and you really emphasize the self-care. And cause you know, the more you have to take care of yourself so you can take care of other people, uh, was really well put. There was other things to talk about as well, but we just ran out of time. What did I miss or anything you want to double down on? I'll give you the last words.

Well, uh, Eddie, no, you, you explained everything and summarized everything very well. I would just say that in my life, like I try to cultivate the motivation to help others and to really see how I am making a difference, if that makes sense. In this culture nowadays, it's really easy to be super selfish and only think about your own success. And, but I think it's, it's, it's like, it's amplified when you really think how your work impacts others and how you can put yourself to service in that sense. So I think that would be a, uh, like how, how I would close in relation to leadership and how.

Yeah, no, that's awesome. Andrea, thank you for sharing and being vulnerable and authentic with our audience. I think you really inspired a lot more people and your global reach has been magnified. So thank you for being our guest.

Thank you, Ed. I had a wonderful time today. Thank you so much.

Thank you for listening to Digital Voices. We hope today's conversation sparked ideas, reflection, and connection. Subscribe on YouTube, Apple, and Spotify Podcasts so you don't miss an episode.