Sustainable Student Initiatives in Global Health

Trying to repair medical equipment in an area without a guaranteed power source can get frustrating. McCormick junior Aaron Shoemaker knows a lot about dealing with power and infrastructure issues after spending last summer in Tanzania volunteering as a medical technician.

“At the end of the day you could try your hardest to fix a heart monitor and still not have enough electrodes to run it,” he said.

The experience gave Shoemaker the chance to see firsthand the difficulties that clinics in developing countries face. While many Americans might think that the biggest obstacle these clinics encounter is the lack of medical equipment, Shoemaker said that frequently there are two problems: a lack of disposable pieces needed for large equipment and a lack of qualified personnel to run and service the machines. That, and a strong infrastructure to support many types of service, he said.

Shoemaker shared his experience last week as part of a sustainability panel hosted by AIESEC, Engineering World Health and Project RISHI. More than 30 Northwestern undergraduate student groups volunteer in health settings and work with health initiatives, many of which they implement abroad. The panel discussed the best ways for student groups to support health missions around the world.

Northwestern Engineering Global Brigades students assist with in-home infrastructure projects as well as provide health education and engage community members during their trips to Panama, Nicaragua and Honduras. (Photo by Northwestern Global Brigades)

Student representatives from four organizations, including Shoemaker, McCormick junior Ian Su, Weinberg junior Kyle Chan and Weinberg junior Rohit Allada, each spoke about their time working with Engineering World Health, AIESEC, Global Brigades and Project RISHI, respectively. Professor Peter Locke, current director of Northwestern’s undergraduate studies in global health, and Professor Mark Fisher, a clinical associate professor in Northwestern’s biomedical engineering program, provided their insight into solving global health issues as well.

All of the panelists agreed that sustainability in terms of longevity was essential to providing meaningful results.

“Having a great solution alone is not enough,” said Fisher. “With Northwestern Global Health, a big focus of ours is: how do we make it profitable for somebody in the country to maintain this going forward…[that] somebody is invested in making sure that this continues over time.” 

For Fisher, making a lasting impact requires that global health groups pay attention to details such as the supplies, training, personnel and services necessary to maintain health programs after they implement the projects.

Allada, a member of Project RISHI, knows how difficult it can be to keep a program running. He spoke about some of the initiatives that Project RISHI undertook in the Indian community of Charnia.

“One of the problems we run into a lot is the sustainability issue. For example, we found that a lot of the villagers in the area had anemia, so the initiative that we came up with was giving them iron tablets to help supplement them,” Allada said. “We found it was really hard to get them to continue to take the iron tablets when someone wasn’t there telling them to do it or why it was important. The information wasn’t disseminated as well as it could have been and once the iron tablets ran out [we didn’t know] how we were going to get more for them. That initiative didn’t really work out the way we had planned and we learned from that. So now going forward…we have in mind that we need to work within the limitations of the area.”

While Allada focused on working within limitations, Locke promoted the idea of analyzing limitations to create programs targeting the sources of health problems. In the case of Project RISHI’s anemia initiative, Locke noted that the widespread anemia was likely due to dietary deficiency. To truly fix the problem in a sustainable way, it would be necessary to help the village gain food security.

Image from Charnia, located in Haryana, India. Northwestern’s Project RISHI works with Charnia’s community to solve health challenges facing the rural area. (Photo by Sathwik Nandamuri.)

“What we say in all of our teaching in the global health studies program is that we need to take a much more systemic approach,” Locke said. “We need not just changes in policy structures and paradigms of intervention, we need a cultural change in ideology in how we relate to the rest of the world. We need to stop looking for quick fixes to individual issues and realize that all of these issues are linked.”

Of course, providing support to fix entire systems of health care left in disrepair from political struggles and lack of resources is an enormous challenge. Student groups are unlikely to be able to solve systemic issues on their own. However, many have found ways to benefit health systems on a wider level.

Global Brigades, for example, not only sends students on medical brigades, their national organization also helps fund training opportunities, according to Kyle Chan. By increasing the number of certified workers in these regions they fight chronic problems due to lack of personnel.

In addition to focusing on the longevity of projects, the panel also discussed how to minimize the environmental impact their projects carry. Shoemaker said student groups should consider the carbon footprint of flying students to project sites and determine how well their projects can be adapted to the local area without requiring regular international shipments of supplies.

“Is [the project] repeatable?” Shoemaker asked, “Is it something that can be maintained onsite?”

Fisher advised students to keep the environment in mind, but avoid trying to focus on too many causes at once.

“You can’t do everything, you have to choose your mission,” he said. “Environmental sustainability is one portion of thinking about global health…it’s an important thing but you have to think about it as part of design process as a whole.”

Although global health groups face major challenges in creating and implementing truly sustainable projects, both Locke and Fisher remain optimistic about the positive impact students and professionals can bring when they work with communities. Fisher said it all starts with becoming “aware.” He advised students to focus on understanding systems and the people who work within them. From there, according to Fisher, a strong relationship can grow, delivering lasting solutions.

“Until you’re aware you can’t have empathy,” Fisher said. “You can’t have a solution without empathy.”

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