On Wednesday, September 5th, Feinberg School of Medicine hosted its annual Global Health Day. Featuring a career panel and poster session, this event highlighted the international experience of doctors from all walks of life as well as the research of current medical students.
At the panel, seven doctors, all with international clinical, research, and/or volunteer experience discussed the great commitment required of physicians in global health. Robert Murphy, Director of the Center for Global Health at NU, thoughtfully reflected on his experiences in Nigeria and Mali. “Know your limitations, especially if you don’t speak the language. Learn from the people around you.” He pointed to the proliferation of international health programs for medical students to do research or undergo clinical rotations. Many of these programs are short, but anything less than four weeks is often a waste of time. If there is no follow up, there is no guarantee that one can properly serve a patient. He then referred to a kidney transplant patient in Kenya who had died after his visiting physician left; the patient couldn’t afford the follow up procedures necessary to maintain his health.
Michael Pitt, MD, a Pediatric Hospitalist and the Director for Global Health Education for Ann & Robert H. Lurie Children’s Hospital of Chicago, questioned how the services of doctors seeking to work in global health might be better utilized. Firstly, Dr. Pitt pointed to the many public health problems we have in America: “you don’t need a passport to do global health work!” If abroad, he suggested teaching skills instead of providing direct medical services that can only be provided for a short time to a select few patients. Also noteworthy, Dr. Pitt asked the audience to evaluate their motives for global health work. Is it about ego? Do they want to tell their families and post on Facebook about how they were being great humanitarians? Or, did they want to really commit to the cause and all it entails for the long haul? Global health is by no means an easy field to work in.
Speaking of social media, the panel also discussed an unusually important topic: the use of blogging, twitter, and Facebook while volunteering or working internationally. One panelist pointed to an American student that almost had all doctors, students, etc. affiliated with his institutions kicked out of an African country due to his negative Internet commentary on that country’s government. Clearly, proper training and understanding of all of these different aspects of medical work abroad—whether clinical, research, or organizational (e.g. public health)—is vital to success.
Near the end of the presentation, Dr. Pitt told a thought-provoking story that all healthcare students should ponder. He was informed of an English-speaking doctor giving medicine to a Spanish-speaking patient. The medicine’s instructions stated that the patient should take the pills once a day; however, the patient interpreted once to mean the Spanish word “once” which refers to the number eleven. This patient then thought he should take eleven pills each day! This frightening story yet again brings to light the importance of being cognizant of the impacts of your work as a foreigner as well as your lack of total cultural and linguistic understanding when abroad.
Global health work is not just about bleeding heart foreigners compassionately providing services to the needy for a week or two. Global health is about commitment both in time and in resources, listening and learning, and making oneself a student once again to the cultural and medical practices of a foreign country. Paul Farmer, upon visiting Northwestern at graduation 2012, likewise advised that anyone going abroad should not assume they know better than those they are trying to help. It is not unreasonable to think that one can do more harm than good in carrying out global health work without a long-term commitment and the dedication of a lifelong learner. I think that is a great lesson for all of us, as students or practitioners, when choosing our life paths.