Living in today's globalized world, we learn endless ways to describe our differences. This type of learning is critical to our survival since it allows us to understand which aspects of a situation are worth taking to heart. Having grown up in various places throughout the world, I find that the infinite degrees of difference which distinguish us from one another also give way to splotches of similarity. For example, even though people throughout the world have different culinary traditions, we all require the same basic nutrition. Similarly, even though different diseases and conditions claim the livelihoods of people throughout the world, we all require the same basic health services. While the need for basic nutrition for all garners agreement, many continue to disagree that a basic package of community-based health services is needed at all. Many experts find the differences between people too overwhelming to agree upon services that meet common needs. In the communities where I work, I have found that when groups of people share their diverse challenges, a common strength emerges. This is no truer than in the process of systematically bringing community-based health services to everyone in the world.

I grew up in Nairobi, Kenya, and when my family moved to the United States, my brother and I became first generation immigrants, just as my parents had been when they migrated from India to Kenya. One of the great advantages of moving around is that we keenly looked for similarities between communities to feel at home while carefully noting the subtle differences that made each place unique. One thing that I appreciated throughout my travels from Michigan to Pennsylvania to Indiana was my mother's work as a Montessori school teacher. Watching adults pushing themselves to learn more about the world around them and then convey that knowledge to their children had a profound influence on my interest in community health. After all, it is when communities teach and learn from each other that healthy relationships are formed. Everywhere we went, we were amazed by the diverse array of skills and talents that parents brought via their children to her classroom, which were shared between children and then passed along to other parents in the process.

These days, the communities I work in appear to look very different from those I grew up amongst. Working with the Millennium Villages Project (MVP) and Columbia University's Earth Institute, I travel across sub-Saharan Africa through 15 clusters of villages in 12 countries where we collaborate with communities to improve the education, nutrition, health and livelihoods of approximately 400,000 people using an integrated, evidence-based, cost-effective approach to development. These experiences, coupled with earlier work with the International Rescue Committee supporting refugees in conflict and post-conflict zones, has highlighted the diverse ways people find common ground to survive, even during difficult circumstances.

I started this work while I was a student in medical and graduate school. In graduate school, my PhD work on neural and genetic systems always seemed distant and separate from the issues of urban and rural poverty. Slowly, I realized that what I sought was a set of systematic approaches to delivering community based health services that could adapt to local environments. As I learned more about the role of Community Health Workers (CHW), commonly known as "barefoot doctors", in rural communities, it became clear that they were at the front line of health system development. This formed the basis of the Program for Health Systems, Development and Research, which I currently direct. The work of developing CHW programs in collaboration with communities and national governments in 12 countries has required a thoughtful approach to development that finds advantage and strengths in difference through an adaptive implementation process. Additionally, one of the most rewarding parts of this work has been learning from the contributions of students and professionals in other fields who have formed the rich community who continues to support the development of the CHW programs.