"It's not a disease in front of you, it's a person."
Dr. Jamaji Nwanaji-Enwerem joins the Agents of Change in Environmental Justice podcast to discuss his wide-ranging training in environmental research, medicine, and public policy, and how he plans to use all of it to make people and communities healthier.
Enwerem, postdoctoral fellow at UC Berkeley School of Public Health and a final-year MD/MPP candidate at Harvard Medical School and Harvard Kennedy School of Government, talks about growing up in North Carolina embracing his Nigerian roots, the lasting impact of attending a Historically Black college, and his prolific research on everything from epigenetics to air pollution to COVID-19.
The Agents of Change in Environmental Justice podcast is a biweekly podcast featuring the stories and big ideas from past and present fellows. You can see all of the past episodes here.
I'm really excited to be joined by Jamaji Nwanaji-Enwerem. Jamaji, how are you?
I'm doing well. How are you?
I am doing wonderful. We were talking beforehand. It is a little cold here. But other than that I'm doing okay. And where are you? Where are you talking to us from?
So right now I am in Cambridge, Massachusetts.
Cool. Very cool. So speaking of place, that's a good, that's a good spot for us to start. So you were born in southeastern Nigeria, but moved to North Carolina when you were young. But sounds like your parents really held on to native language, food and storytelling. And I'm wondering how this, how this shaped your childhood.
So I think that's a great place to start, because it's sort of where my own story starts as well. So I moved to the states with my mom and dad at the age of one and a half. And I think it's one thing to say that my mom and dad sort of shared our culture with me. But it's actually probably a little bit more accurate to say that they lived it with me. So from various foods like Fufu, to listening to songs like Casa de beers, or Sunday, a Wednesday. I think Ebo culture itself really permeated almost every aspect or facet of my life. In fact, I think my parents actually decided not to speak English at home, whenever we first moved to the States, they thought that I would be able to learn it from radio and news and school and things like that, but they really wanted me to be able to speak Ebo.
And as I sort of reflect on that, I feel like that decision really paid off a lot, and has definitely added a degree of richness to a number of my various interactions. And I think one other thing that I would add, as I sort of think about early life. And something that my mom and dad were very intentional about is that they took my siblings and I everywhere, right. So whether it was a cultural wedding or birthday, we were there, whether it was something that wasn't as happy. So someone being sick in the hospital or something like that we were there as well.
And I think my father's says it best to where, like, oftentimes people think oh, you know, we don't necessarily need to expose kids to all of these things. But for him, and for my mom, it was important for them to really, for them to really show us who they were in all spaces, not just at home, right? So ups and downs, sacrifices, frustration, his failures, we really got to see a lot of it. And I think that has really helped shape the man that I am now. And also the vision that I have for myself, both professionally and in my own personal life.
Oh, that's that's really cool. And I think when we think – so now we can look back at, at your experience. I didn't have this as much. But the it's really beautiful to think about having that cultural experience growing up to now look back and say, oh, that wasn't normal for a lot of other kids, even other immigrant families. That probably wasn't the norm, they probably tried to assimilate as much as possible.
But was there any confusion at the time? I mean, you're probably watching the same cartoons I am. But then you have this whole other side of life. I'm wondering if there was any confusion or if it was just kind of that that's how it was? You know,
I think when you're young like that, there's so many things that are happening that you don't really register, right, like sure you live those moments, but you don't necessarily feel the weight of them until you look back on them.
So yeah, I mean, like the food that I eat everyday was traditional food. It wasn't until later on in life and my parents started to make spaghetti and things like that. But at the same time when I went to school I was having just so yeah, I mean, like, the food that I eat everyday at home was traditional food. It wasn't until later on in life that my parents started to make spaghetti for us at home and things like that.
But at the same time, when I went off to school, I was having those things that lunch, it's just, I didn't realize that whenever others went home, you know, that's what their food probably looks like, as well, right? So I'm sure there are differences that I am basically more aware of now, but we're definitely still there when I was younger.
That's the beauty of these things happening when you're little is you're just a sponge, right? You're just absorbing these materials, and you're not giving the same intentional thought that we do as adults.
What a great time to be exposed to that.
So that kind of the next step – well, there's probably many steps in between – but you went to Morehouse College, which is a historically black college for men in Atlanta. I'm curious about this, because I went to a very large state school here in Michigan. And I'm curious to hear about why you chose an all male HBCU and what that experience was like and how it shaped you.
Yeah, so HBCUs were a new thing for my family as well, you know, we had just moved over to the States. And we personally, you know, whenever we look back now and think about the people who lived in our neighborhoods and things like that, we knew people who had gone to HPC those, but we just didn't know that they went there, right. So whenever it was time for me to apply to college. At that stage, I sort of decided that I wanted to go to med school. And being the overeager student that I was one of the things that I thought of was finding a place that wasn't too far from home, that was also associated or affiliated with a med school. And I thought that would be important for me, because it would help with possibly getting exposure, maybe getting some mentorship. So just having that available, because I knew that that was a path that I wanted.
So whenever I made my list of schools, it had all of your standards, places on it, but then it also had HBCU that was on it as well. And then it came time to sort of submit everything and we got letters and things back. And then my parents and I actually went to visit the, the various schools. And there was just something unique and something special. Whenever we got to Atlanta, it was, it's so vivid, in my mind now – literally one of the sunniest brightest days ever, the weather was perfect. We arrived. And I remember just looking around and seeing basically a sea of black students who looked just like me. And this wasn't just like four or five, literally hundreds, right.
And my parents were the type that they sort of sort of just did things. They didn't necessarily schedule meetings with departments and things like that. So we sort of arrived just at the school. But we eventually found our way to the Department of Biology, walked into the office there. And we were immediately able to meet with the head of it. And he sat down with us and talk to us about where I had been what I was aspiring to accomplish, and just who I was. And that interaction whenever I think back on it now it was one that was unique and that I didn't get at any other place that I went to. And whenever we left the campus, there was just really a sense of ease and a sense of feeling as though this is where I was supposed to basically end up. So whenever we got home, it was pretty much a very obvious thing that this is where I was going to spend my next few stages of education.
You know, what were maybe the good and the bad or how did that play out?
So I think whenever you read about this experience. That's what a number of people think right oh it's an all male school, it's definitely and one of the most diverse cities, one of the youngest places to live as well. But the thing that most people don't realize is that literally across the street is an all female school called Spelman and we interact, all the time all social events are combined. You can even enroll and take courses there they took courses with us. So, as far as getting that sort of that sort of interaction, it was definitely there, and wasn't lacking. However, when it came to sort of living and in most of your courses. Yeah, it wasn't all male experience. But I think that was important for us as well. I mean, you know, these days we talk about the unique sort of obstacles that people of color face living here in the States. And some of those are really specific for like males as well. Right, so being able to have a safe space to discuss those things and think about and learn about how others have sort of handled those obstacles was actually very meaningful for us as well.
Yeah, that makes that makes a lot of sense. I know I'm a sports fan and I know lately. Basketball has been putting a big spotlight on HBCUs and a lot of it was in, in the aftermath of George Floyd and a lot of these other heinous incidents, and the idea was talking to black, black men to black males at these universities, so I think that that's a really good point. So, you mentioned this interaction at at the at the college there, and maybe this this answers his question, but what is the defining moment that shaped your identity.
A moment or event?
So, let me see if I remember this the right way, we saw I found if I was accepted to Morehouse in December of 2000 And what year was that 2007 yet Wow, okay. I decided to enroll that spring so probably around March or April of 2008. And after sort of deciding that I was going to enroll I was sort of just ready to start school that following August.
But while still in high school, I remember one afternoon or one evening, must have been in May or so. May of 2008 Maybe. Or maybe even in April, but I got a phone call, And I got a phone call from the professor, Dr. Mel Thompson, and she said that they were going through the registry or the list of students who were starting in the fall and she saw that I was going are planning to major in biology and she was leading a new Department of Defense-funded initiative that was aimed at helping to increase the number of Black males who are getting PhDs in STEM.
And she said that, you know, from what she's read about me that she thought that I'd be a good fit, but that it would mean that I would have to come down to school in the summer I spent, I believe, four or five weeks there being exposed to like research and things like that. So, mind you, I told you very early on from like middle school I decided that I was going to go into med school, that's where my passion was, but this was a whole different avenue that I had really never thought about this whole idea of research and research being something that you could pursue for a living.
But I really had nothing else set up, besides like hey, you know, I'm going to be at home anyways, this sounds like it could be an enriching opportunity to learn something else. So why not. So I said, "Yeah for sure, you know, I'm free, I'll be there." And they signed me up and I ended up spending that month or so they're being exposed to research from all all areas so biology, physics, everything. And at the end of it and I didn't know this, on the front end. If you performed well throughout those four or five weeks, you'd be formally accepted into the HOPPS scholars, that's the name of it: H O P P S. And as a HOPPS scholar, you basically were matched with the research advisor, who you did research with during the fall in the spring for your whole time there, but then you're also helped to apply to pursue summer research elsewhere. So at some of these larger more research funded institutions.
So from HOPPS, I was able to do research at a number of other areas I did research at Merck. During the summer of 2011 I believe. And those experiences really helped to broaden I think what I wanted to do with my life. To be very honest with you I fell in love with research and thinking in that way. Up until the point that whenever it came time to apply to med school, I realized that I didn't want to just be a physician, I wanted to be a researcher as well. So, at the time I was still pretty young and you know I really love to both, so that's why I decided to apply to do the both the MD and the PhD.
That's excellent, and that's a common theme that when I've talked to people on this podcast is kind of not, not having the exposure to research at a young age. And it's same thing for me: I'm a science journalist by training, and I don't think I knew the structure of scientific papers and that they were published in these journals, until I was in my early 20s. I mean, I'm not afraid to admit it, it was this thing that just never, I thought of Bill Nye the Science Guy and that you know the kind of the real stereotype, but I think that points to a deficiency maybe public school systems.
But that's very cool and to get into your research now to kind of skip ahead a little bit so as part of your dissertation research you. I believe you identified a marker in people that could reflect exposure to air pollution, wonder if you could tell me a little bit about that what you found, and why it's important.
I think, a good setup for this as well is to let you know that while I was in undergrad, a lot of my research was basically wet lab work, so I was at a pinch with the pipette doing that type of work. But after I started med school and I'm not sure if the listeners know the way that the MD, PhD works but you do the first half of med school first and you go off and do your research, and then after you're done with all of that and you defend your dissertation that you come back and you do years three or four minutes ago.
So after I done the first half of med school and did a few rotations, I realized that I was really starting to fall in love with population health and public health. And you know, I had seen so many examples of people who are doing bench work and also you know seeing patients in the hospital space, but for me, I felt that I wanted to do something a little bit different that I wanted to do work that was sort of directly working with a population, but I also wanted to make the most of a lot of the molecular and cell bio skills that I had sort of worked on. And I found a great place to marry that and I think the School of Public Health and specifically and environmental health.
It was an area that sort of speaks a lot to me just because we know that environmental health issues are really big, especially in areas like Africa and West Africa specifically for me, but also in cities here in the States right? We've heard about Flint and we've heard about all these stories of marginalized areas being exposed to all of these harmful chemicals.
So in thinking about all these things that were sort of swirling around in my head that public health, environmental health, population space that seemed to be a wonderful area so I joined the lab at the School of Public Health. After the end of my second year of med school. And in his lab, I was primarily working on a DNA methylation based marker of aging. That was brand new at the time and no one had really shown any links between the marker and various environmental health exposures and we thought, you know, this would be very novel, because this marker is unique and it's evolved a bit.
But it's unique in the sense that it tells you about agent, you know, something that oftentimes happens and you don't necessarily have to be sick but it can help define you know your risk of becoming sick. And if we could show that various environmental exposures, actually, aged you or maybe even protected you. You know, we could possibly find ways to intervene before people actually got sick and showed up in a hospital.
So in my specific dissertation work, we looked at long term exposures to ambient particles in the air, and we were able to show that oftentimes those exposures would actually make you biologically older via these measures that we looked at. And then we also did a series of other studies showing that mitochondria micro RNAs and other molecular actors are also involved in the links that we saw.
So, so moving on to more your research, I think, you know, you mentioned your interest in Africa specifically, specifically West Africa. I think when most people think of air pollution, they think of massive power plants or traffic, especially here in the States.
But you've done research in Nigeria, looking at the health impacts of indoor air pollutants and wonder if you could talk about that and also kind of broadly if there's any other health or research issues in Africa that you're particularly interested in pursuing that you haven't had a chance to yet?
Yeah, there's, there's a lot to say there. So let me tell you about the study first and then I'll expand on that.
So the study: Thankfully, when I was a grad student, I was able to work with another student in a study that was focused on a region called Ogale – O G A L E – and Ogale is in the Niger Delta region. And it has been a region that has been really affected in a lot of horrible ways by oil spills, and there have been a few studies that I've looked at the air there the water there and just showing like how harmful the levels of a number of compounds, there are.
But one area that we really didn't see a lot of research was in the indoor space and given that many of the homes have a lot of good ventilation with the outdoor space and given the fact that people oftentimes see this indoor space as like the safe space, like, when I'm inside, nothing can really harm me I'm safe.
We thought that it would be important to also like measure what the air was like inside. And this was a pilot study of less than 30 or so homes but what we saw was that there were levels of various compounds in the air that were harmful hundreds of times higher than what we would expect to benzene is one of the ones that we found in that study. So I think there really remains a need to understand the holistic expose them or the whole mystic environmental exposure realm. In many areas. And that's one thing that I hope to work on in the West African space.
To expand on the latter part a little bit I mean, there are a host of issues, but whenever I think about it, I think it's best summarized by something that my mom and dad say often, which is: you shouldn't have to repeat the same mistakes as someone else to learn lessons from those actions, right?
So as Africa continues to evolve, I think we can really look at a lot of the lessons that we've seen from Asia, from here in the States, and use those to make sure that we're defining and developing in a way that's both environmentally and ethically sound.
Do you think that – maybe it's kind of a softball question – but do you think your upbringing helped having that cultural exposure growing up to, to, to research this community as opposed to, you know communities that maybe you didn't have as much knowledge about, or connection to?
Absolutely. So I think one thing that what you just stated makes me think about is in med school, oftentimes you know we're, we're there to help everyone. But there are these moments where the patient in front of you, either from the way that they look or from something that they say there's something that sort of hits home and you think, "Oh, this could be my own mother, this could be my neighbor that I used to live next to, this reminds me of this person."
And it makes those experiences really human right? It's not just like disease in front of you, it's a person, and that person has family and friends, they have a life. And I think whenever you're really able to consider the human aspect of that and I think the same thing applies to how we think about research and exposures when you're able to, like, really wrap your mind around the fact that you know, these are people's lives and aspirations and all these things that are involved here.
It makes it matter in a different way. So yeah, I'm not sure if I answered that.
That makes a lot of sense, and it reminds me a lot of. It reminds me a lot of the similarities between science and journalism because I COVID notwithstanding, I always encourage our reporters to be out in the field, because to write a write a story about blood lead levels in the city of Detroit is one thing to look at the report and write report the data to go into a mother's home and talk to a mother who has a child who has been led poisoned, or who has been exposed, it, it brings it to life, and it really hammers the point home, no so I think that's an excellent. That's an excellent point. And one of the areas you're interested in which I just find fascinating.
So I want to hear you talk about it, is epigenetics. I don't know if a lot of people know about this – we've written about it a little bit – but can you kind of just hold our hand, talk a little bit about what it is and how it further compounds a concern over some of these exposures?
Yeah. So, you know, I think one thing that comes to mind is that we've all heard the sort of the adage that you are what you eat, right? You are the sum of your exposures but, you know, those statements don't really tell us how, right?
And I think one thing that this field does is it helps people conceptualize and understand how so we're all born with DNA. It's like the roadmap that makes us it makes every aspect of us, and to some extent, It makes you at risk or protected against various diseases, right.
But the DNA itself is not set in stone, right, it can be modified. It can be modified by DNA methylation so of adding these little marks on it, which can affect whether or not a specific site gets expressed more expressed, less than there's other things as well, but that's the one that most people talk about, and guess what helps drive that our environment right so different exposures can lead to alterations in methylation, which means that your DNA is read differently, right.
So, it really is neat because it helps give a biological sort of explanation to what I think we all really know that you know, the things around us can affect us, but this helps to answer how.
And that's just one of the, so you publish on a large range of topics in just getting to know you and watching from afar and Twitter and so on and so forth. I'm just blown away at all you have going on. And so I mean COVID, air pollution, police brutality, and I'm wondering if you could influence the advancement of one policy change in the next few years, which one would you focus on?
Oh, that's a great question. And it's a hard one because you know there are a number of things to pick from.
The way that I'll answer that is, is, is one of the things that I've tried to do more of. So, whenever you first start off as a student, you're sort of working with your advisor and doing the things that you're like advisors funding has funding for and sort of helps guide you with, but as you become a more independent researcher and scholar and thinker, there's more sort of leeway for you to use those skills that you've sort of built up to really answer things that may be of more interest to you, right?
And what that has meant for me and this is the reason why I sort of, even with the MD and PhD decided to add on this extra Master's in Public Policy. The reason for that is because I really want to use sort of my life, both professionally and personally to really help the people who live in my environments and like can better actualize themselves, right? I don't know: We laugh a lot about, like, I've spent nine years now basically doing all this, but it's to be able to sort of help so whenever I talk about policy now I've studied it in a way that I think helps me to speak the language of the people who help legislators.
I think the research helps me speak the language of science, I think the medicine helps me speak another language as well and be able to move through all of those spaces. I think has helped me to sort of see where they really overlap, and then being also around and try to interact with people in the place where they live, helps me sort of bring those perspectives into the dialogue as well.
So to answer if there's one specific area that I plan, or that I'd want to make major advances in. I don't think that's up to me, right? I think what's really in front of me is just listening and hearing about what matters to others, and then trying to use my skills to, to make sure that they get the help and the assistance that they need. And whatever that is, if it's police brutality issues if it's air particles if it's aging, it'll be what it'll be.
But as long as it matters to them and as long as I can help, that's what's gonna be.
That's great and it's worth acknowledging that, of course you know this and I know that a lot of these are overlapping. You know the Venn diagram with these issues, there's a lot of overlap.
But you kind of answered my next question which was, you know, having all this training, how do you how do you want to push for change?
So I'm going to change that up a little bit and and ask about, obviously you're in this program because you at least find some importance in communication and outreach. So where do you see that playing a role, kind of very lay person communication when it comes to your kind of future career and research and help?
Yeah, I mean we, we live in a country where the people who I mean this is a nation that's really have four imbibe people right so you really need to be able to communicate at, at, at the simplest, most direct level right there are obviously these like nice realms of people who are super super specialized but then there's everyone else. And if you can't translate those that dialogue into the space of everyone else. It's kind of like they don't even hear it. Right. If they don't hear you. How can they sort of React or help.
So that's one of the reasons why I think the fellowship was really meaningful and is meaningful for me and not only does it help with sort of networking and meeting people who are working from or on environmental health from various aspects but it also helps make sure that, you know, you can maintain the skill set of being able to talk and speak in a way that most people can understand.
Yeah, as a, as a longtime journalist, I'm biased, but I just think the power of storytelling is, is just so key, and I was thinking about this during the election, you know, a lot of us pay a lot of attention, and you watch Twitter whatever, and it seems like the country is bubbling over and you know 60% of people don't vote.
Yeah that only so many people have, they don't know so and then you know and that election is hitting us over the head so to think about studies and research and health communication, how many people it's not reaching. I do think there's so much, so much importance, trying to find those people, and speak your language.
So Jamaji, this has been so much fun: I have one last question that I've been asking everybody, and that is what is the last book that you read for fun?
Oh, well, I'm not finished with it but I'm working through and I think I'm about halfway or so through but I've been reading, President Obama's memoir a promised land.
Yeah. And, wow, wow. There's actually, um, there's a part of it actually that has really struck me in these last few days or so. And it's the part where he sort of thinking about whether or not he's going to run for president, and he's talking to like friends advisors and all that type of stuff.
And he says something along the lines of, and this isn't exactly but I think it's something along the lines of, "You don't pick the moment, the moment picks you." And that line really is sort of hit home for me and I think it hits home for a lot of us because, as we think about our work, our advocacy our research using our lives to sort of serve others.
Sure we get to decide, some things right? But it's interesting in that it doesn't really let you decide everything. So you don't always get to pick the who, the what, the where, or the win. But you do know the why, right? You know that the why is that you want to help others, and I think I say this all to basically say that it's offered me the very important reflection of all we can personally do is to prepare, and to make sure that we're sort of ready so that whenever that moment for us to sort of serve in our unique way happens, that we're ready to make it matter.
Yes, yes, yes, well Jamaji, this has been, as it is always talking to you, inspiring and wonderful and I really appreciate you joining me today.
Thank you for having me.