Category Archives: Academic Partnerships

Ethical Dilemmas in Global Internships: Lessons from the GIC 2016

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by Robin Young
Assistant Director, Africa and Asia

“The first year that the Northeastern Students came to the Tunaweza Children’s Centre in Uganda, it was wonderful!” shares Titi Pamela Kakonge, founder of the Centre, which offers a range of therapies for children with disabilities. “But then they left, and all the local parents withdrew their children from our school. They thought that since the Mzungus (white people) had gone, the program was over.”

The vacuum left by the departing students was gaping, despite the fact that the Centre was led and staffed by a robust local team. After that, Ms. Kakonge and Northeastern University worked together to find ways to ensure that the community saw the local staff as the leaders and the teachers, not vice versa. Today the Centre runs year-round, successfully receiving interns from Northeastern and other institutions, with clear local leadership and well-defined job descriptions for the physical and speech therapy interns.

I heard Ms. Kakonge speak at the Global Internship Conference in Boston earlier in June, at a session titled “Tunaweza Children’s Centre- We Can: An Interprofessional, International Partnership with Northeastern University’s Bouvé College of Health Sciences.”  Ms. Kakonge founded the Centre while searching for adequate care and services for her daughter who was born with disabilities. The challenge that she highlighted above has been well documented.

Pamela Roy, Farzana Karim-Haji, and Robert Gough call this the ‘revolving door’ nature of exchange between students and hosts, and propose several ideas for host communities to address this ethical dilemma, all of which Northeastern is now utilizing. They suggest making certain that students are sufficiently prepared for the experience, taking steps to ensure that host community needs are truly being met through the internship, and equipping students to listen, observe, and learn from the host community.

During their session at the GIC, Roy, Kaim-Haji, and Gough, drawing on their experiences at Aga Khan University, Western University, and the Consultancy for Global Higher Education, highlighted a new, open-access resource they have developed, titled “Building Ethical Global Engagement with Host Communities: North-South Collaborations for Mutual Learning and Benefit.” In it, they compile recent findings and summarize the ethical dilemmas that challenge all of us who engage in North-South Global Internships, including mobility inequality (in which students from the north have more access to the south in terms of professional development and career opportunities than vice versa); exploitation of the host community as research participants; and unethical marketingand advertisement to promote global internships, to name a few. The resource offers definitions of these dilemmas and offers a series of recommendations that can help all of us in the field to improve our global internship offerings.

At CFHI, we’re always thinking about how to offer internships that, to quote a recent publication on short-term global health experiences, “Optimize community benefit and learner experience.” From where we stand, an internship should only take place if we can ensure that it benefits, within an ethical framework, our partners around the world, as well as the intern.  We do this by engaging in fair trade learning practices, ensuring that our partners are fairly compensated for their work and have substantial leadership and input into all internships and programming; by requiring our participants and interns to complete the Global Ambassadors for Patient Safety modules, preparing them to engage in ethical medical practice that prioritizes patient safety at all times; and by inserting interns into existing healthcare and social service systems, with local leaders who focus on assets rather than deficits in their communities. I had the opportunity to share some of these resources during a session at the GIC alongside Moira Mannix Votel, Associate Co-op Coordinator & Director of Cooperative Education at Northeastern University’s Bouve College Cooperative Education.

At CFHI, we strive to close the ‘revolving door’ referred to earlier.  It is important to us to create leaders for the future who understand a larger view of the world beyond their own.  We are continuously pushed and encouraged by the input of our colleagues in this field and look forward to moving this conversation forward at any opportunity.


Rorobinyoungphotobin joined the CFHI team in 2015. As Assistant Director, Africa and Asia, she provides program management and support for CFHI’s programs, helping to ensure program safety and quality, best practices in international education, and strong institutional and global partnerships. Robin’s professional background includes extensive work in international education, global health, and asset-based development. Robin holds an MBA from Florida International University and a BA in Sociology/Anthropology with a minor in Ethnic Studies from Lewis and Clark College. She completed a course at the Summer Institute for Intercultural Communication, helping to inform her interest in increasing intercultural competency in global work and education, and subsequently co-authored the Cultural Detective Dominican Republic series. Robin received a Fulbright Fellowship grant in 2007 and spent a year researching gender-based violence in the Dominican Republic, where she ended up living for nearly 5 years. Robin is passionate about supporting thoughtful, ethical and asset-based strategies to address health disparities and support underserved communities. She lives in the Bay Area and loves backpacking, riding her bike, and spending time with family and friends.

 

CFHI Voices: One Northwestern Med Student’s Summer in the Himalayas

In July of this year five students from Northwestern University’s Feinberg School of Medicine traveled to rural India as part of a unique global health program organized by Child Family Health International – CFHI, the second trip organized through their unique partnership.  Funded by Northwestern’s  Center for Global Health we set out to learn about public health, increase our cultural competency, and develop clinical skills by participating in a four-week clinical shadowing experience across Northwest India. We rotated in different settings, from tiny villages like Patti tucked away in the foothills of the Himalayas to the bustling city of Dehradun, in both public and private healthcare sectors.  During our time in the clinics, on the wards, and in the field we witnessed healthcare disparities as they are manifested between rural and urban regions, between private and public sectors, and between different socioeconomic groups. We were able to see, for cultural and economic reasons, how differently medicine is delivered half a world away.DSC_0918

That month spent in India was an unforgettable and magnificent experience: the medicine we witnessed, the physicians and nurses we worked with, and the patients we got to interact with brought the kind of perspective to my medical education that only an actual, immersive experience that being abroad could bring. We didn’t stay in hostels or hotels – we lived with Indian families in their homes or in dormitories within the hospitals.

Nothing can beat that kind of immersion; nothing can beat waking up in a tiny mountain village everyday at 5:30AM with my fellow travelers to do yoga, or getting woken up in the hospital by a nurse to aid in a delivery or assist in the emergency department. We explored palaces and temples, hiked through jungles, and sampled the multitude of sights and smells, the cacophony of sounds, and the delicious and exotic foods.  India brought piece and calm to my mind and body, it gave me perspective on the doctor/patient relationship, and reminded me what medicine is really about – one component of the greater endeavor to help ameliorate human suffering in the world.

India left a lasting impression – one that no doubt will shape my medical career, but also my personal life. It left me wanting to return to the more disenfranchised parts of the world to practice medicine, it left me a with a firmer perspective and appreciation of my own upbringing, and it left me with fond memories of a country I would dearly love to visit and explore again in the future.

Jason Chodakowski

Northwestern University Feinberg School of Medicine

MD Candidate – Class of 2016

Turning Dark Profits into Enlightened Transformation

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I’ve been a doctor now for 13 (lucky) years but I recently had the opportunity to reflect on my path towards becoming a physician and my involvement in Continue reading