'I don't believe that something is better than nothing'

Here, third-year Harvard medical student Chitra Akileswaran, 26, discusses how she came to win the prestigious grant and what she intends to do with the money.

Whenever she gets ready to work as a volunteer far away from America, Chitra Akileswaran's Seattle-based mother starts Googling about the country and the town her daughter will be going to.

"Sometimes, she finds out more about the place than I have," says Akileswaran, who has studied sexual violence as a Fulbright grantee in rural South Africa; volunteered in a clinic for disenfranchised Haitian sugarcane workers in the Dominican Republic; and initiated an annual photography auction to advocate for foreign language study in medical education. Most recently, she returned to the family's native Chennai to explore financial mechanisms that improve access to healthcare for the poor.

"The amount of money poor people have to spend on child birth in India is staggering," she says. "Many have no faith in government hospitals, and at times they borrow at high interest rates, to see a private doctor. Now, think of this: if a pregnant mother opens a bank account when she is three months pregnant and saves money specifically for delivering her baby, she would have not only peace of mind but an opportunity to have a safe birth."

A third-year student at the Harvard Medical School, Akileswaran will begin her first year in a combined programme with the Harvard Business School for her MBA in September this year. She was an undergraduate at Brown University, where she earned a BA in Community Health, magna cum laude, and was awarded the Jin Prize for academic performance and commitment to service.

"I want to merge my medical practice with a career in social entrepreneurship," Akileswaran says, "fulfilling my passion to create novel health financing systems for poor populations."

"I am one of those people who does not believe that something is better than nothing," she says, adding that her mission is to work ceaselessly to improve the health facilities for the poorest, starting in America."

Her parents -- father Akileswaran, an engineer who works in medical IT at the University of Washington, and Lakshmi Akileswaran, a research scientist at the University of Washington -- had similar dreams of being involved in the larger community, but were hindered by the typical concerns most immigrants have: finding a secure haven for themselves and their children

Their hard work, however, has enabled the daughter to fulfill that joint dream, and today Chitra recalls how her social consciousness has been maturing.

"During the age-old tradition of morning rounds, my general surgery team referred to Anne (a patient) only as the identification in her chart -- '44-year-old female with a history of intravenous heroin use presents with infected ulcers of the right heel,'" she writes in her essay.

She, however, began seeing Anne as a human being, and in time learnt of Anne's abusive mother, an incarcerated husband, and the heavy hand of addiction. "Beneath turbulent social circumstances, her story resounded with me as strikingly American: a middle-aged, adversity-stricken woman intent on pursuing a new beginning."

The American promise of 'infinite new beginnings' reminded her of her parents' immigrant story as well, which began in Indiana more than three decades ago. "I am proud of them for taking advantage of the possibility for new beginnings unique to this country," she writes. "Nevertheless, I do not blame them for their initial reluctance to adopt this highly American approach. To pursue a new beginning is to take a risk, one impossible to justify in nations where economic and political stability is not guaranteed. In offering second, third, and fourth chances, the American experience truly affords its citizens the privilege to discover what drives them without compromising the lives they have worked to build."

Her own journey 'to fully internalise this notion' began during her undergraduate studies at Brown University. "Brown, I would soon discover, prides itself on shaping scholars unafraid to question their beliefs and choices," she reflects. "Initially, I tread lightly in my path of study: the basic sciences, I decided, would yield a secure career. But Brown's culture did not support such 'safe' choices, at least not without some experimentation first. Experiment I did, studying subjects as far afield as Civil War history, comparative Japanese literature, and the anthropology of HIV/AIDS."

In Chennai she encountered several young HIV patients and couldn't help thinking that if circumstances had been different, her own story could have mirrored one of theirs.

"Our current positions were a matter of pure luck, and thus constituted an unpalatable injustice," she wrote in the essay. "This realisation would drive the remainder of my study of Community Health at Brown. My senior thesis, eventually published, addressed the withholding of life-prolonging antiretroviral treatment from those suffering from HIV in Sub-Saharan Africa. I argued that despite (often racist) notions that African clinical settings lack the sophistication to manage difficult regimens, the evidence of treatment trials proved it clinically indefensible to deny individuals of these medications."

Her experiences and studies while at Brown, she says, reinforced the liberty she has as a New American to take intellectual and personal risks. In doing so, she says, she gained "an ethical underpinning for the sense of justice that has since guided my actions."