Insights from the Fourth Annual Midwest Universities for Global Health Meeting

December 7, 2017

By Rachel Bick, MPH ’18, Brown School and Philip Budge, MD, PhD, Assistant Professor, Department of Medicine, Division of Infectious Diseases, Washington University

Assistant Professor, Department of Infectious Disease, School of Medicine

Over 100 medical, pharmacy, and public health students and faculty gathered at St. Louis College of Pharmacy on December 1, 2017, to discuss the ever-changing landscape of global health study and service.

The day began with a presentation by Dr. Keith Martin, Director of the Consortium for Universities in Global Health (CUGH), in which he challenged the audience to think about global health from social, economic and political context. He emphasized that achieving the Sustainable Development Goals in developing countries requires a base of fair electoral systems, free media, and independent justice systems, and suggested that the new role of global health practitioners, both clinical and nonclinical, is to advocate for and support those goals. Dr. Martin concluded by reminding us that “The minister doesn’t read the Lancet!” and we will all need to “get political” before development goals can be achieved. This theme ran throughout the many discussions of the day.

Besides political involvement, event panelists discussed the rising need for ethical awareness in  global health, particularly for universities who send students to study and work internationally. Lise Saffran, MPH, Director of the Master of Public Health Program at the University of Missouri, called upon students and professionals to avoid “the narcissism of global health experiences.” Telling a story about global partnership and learning requires more than just a selfie. In an era of increasing technological connections, we would all do well to remember that international patients and partners can find us—and what we post about them—on social media. Additionally, our own standards for patient privacy and consent should apply wherever we practice. Would we take a photo of an ailing patient at a hospital in the U.S. and post it to social media? In power imbalances like those in much of global health work, it is important that we extend the same ethical treatment that is required in the U.S. to our partners and patients overseas. Students and faculty alike should ensure that the integrity of our partners’ stories are retained whether we’re taking pictures or writing blogs.

Dr. Janis Tupesis of The University of Wisconsin Global Health Institute, spoke about his own experience preparing medical residents for international work. Residents affiliated with UW were travelling and working overseas without formal applications or evaluation. To better support and hold accountable all researchers and clinicians, the university centralized their international applications and developed a framework for incorporating GH education into U.S. residency programs in an ethically sound and sustainable way. Dr. Ashti Doobay-Persaud of Northwestern University echoed these sentiments for ethical international work, reminding students to focus on cultural humility in their experiences, and to keep in mind the history of colonialism.

A panel of experts in international collaborative building carried on with the theme of capacity building through relationships and ethical practice. Often, global health work and partnerships are a way to get a quick publication or to quickly alleviate medical needs. Relationships that develop into institutional change take time and require reciprocal learning. Dr. Lora Iannotti, of the Brown School at WashU, spoke about the need to work within, and not around, existing healthcare systems. She introduced the idea of collaborative learning, where we learn new methods and strategies through engagement with partners, and innovating solutions together. Dr. Iannotti attributes the success of her work in Haiti in developing the first public health undergraduate program to personal relationships built on the conscious soliciting of feedback and integration of ideas from key stakeholders and community members.

Associate Professor and Associate Dean for Public Health, Brown School

The meeting also offered excellent panel discussions for students, trainees, and junior faculty on developing and sustaining global health careers.” Repeated themes of these sessions were the importance of establishing sustainable, equitable partnerships, having measurable objectives, and documenting the impact of your work.

In response to a rising concern that the needs of international partners should come first in research and work, CUGH has built a pilot web based portal to connect partners. This tool prioritizes the research and work needs of international partners while also providing opportunities for institutions to engage. CUGH hopes that the portal will function as a place where partners can post HR needs and where organizations can make offers of partnership to meet those needs.

Dr. Joseph Kolars, Senior Associate Dean for Education and Global Initiatives of the University of Michigan, left the group contemplating the role and scope of global health medicine and public health work. He challenged practitioners of global health to break out of our echo chamber and learn how to articulate the importance of what we do.  He emphasized the need to communicate 1) how global health affects local health and 2) how lessons from global industries can be applied at home. Global Health Universities are in a unique position to bring disciplines together and to bridge knowledge gaps in ways that business and government cannot.

To make sustainable changes in infrastructure, medicine, and health, institutions must be willing to invest long-term in meaningful partner relationships and to advocate for our global community. With a significant amount of global health funding originating from the U.S., it is imperative that we speak up against tax cuts, and “get political,” about global health.

Eighteen attendees presented posters on their training programs or research. Click here for a list of posters.

View the event’s Facebook photo album.