Category Archives: Global Health Education

Social Justice: Embracing Global Health Complexities

Internationalizing Medical & Health Education

At the recent NAFSA Conference for international educators, the Colloquium on Internationalizing Medical Schools proved to be a forum marked by many thoughtful remarks, especially those of the opening speaker Edwin Trevethan, MD MPH.  Yet nothing struck me as much as the name of the school he heads–  Dr. Trevethan is dean of the St. Louis University College for Public Health & Social Justice.  The social justice part piqued my interest.  Social Justice is a term that did not receive enough exposure during my undergraduate and medical education, despite dedicated studies about global health, underserved care, and health equity. jessicanlauren nafsa 2013

Importance of Social Justice in Health Evolving

Why hasn’t this term gotten the play it deserves?  What does it mean anyways?  One of my favorite definitions of Social Justice is a “historically deep and geographically broad” understanding of gross inequities, power imbalances, and underlying causes of ill health.  Dr. Josh Freeman, the creator of the blog ‘Medicine & Social Justice’ offers further insight into definitions of justice, social justice, and how they relate to health and health care.  Social Justice has also been studied as one of the key ethical principles for students wanting to be involved in Global Health.  Increasingly there has been discussion on whether social justice should be a factor when selecting students for admission into medical school.

I think the reason Social Justice has not always made it into our medical and educational syntax is that it encompasses the utmost complexity.  Particularly in medicine we like things that we can boil down to cause and effect, test while controlling for variables, and fix with evidence-based antidotes.  Social justice doesn’t allow us to be logical and create such neat solutions.  Social justice demands we consider a host of influences on health, wellness, and disease.  It requires that we humble ourselves.  It requires we admit that problems causing health inequities worldwide defy the scope of one solitary discipline, or the involvement of just one prestigious university.

I want to commend St. Louis University and Dr. Trevethan’s leadership for their insight in going so far as to include social justice in name of their school of public health.  They, alongside other leaders such as CFHI partner association American Medical Student Association, demonstrate the fundamental ability to embrace the complexity of global health, and not unlike CFHI persevere with programming and partnerships that give social justice its due attention–both as a goal and as a lens through which to understand health.

At the annual NAFSA: Association of International Educators Conference CFHI was represented along with over 8,000 professionals who come together in late May each year to network and learn about today’s issues related to the fields of study and interning abroad.

Student Essays Reflect Realities and Impact of Global Health

Student Essay Contest Winners with CFHI Executive Director Jessica Evert, MD (far left)

Student Essay Contest Winners with CFHI Executive Director Jessica Evert, MD (far left)

At CUGH’s Annual Meeting last week in Washington, DC educators and students from over 60 countries met to discuss the global health landscape.  Perhaps one of the most powerful and emotional sessions was one that captured power of reflection in global Continue reading

The Power of IFMSA & The Global Health Placebo Effect

International Federation of Medical Students’ Associations (IFMSA) is not just another acronym in a field laden with catchy abbreviations- it is a groundbreaking organization that despite its 60+ years of existence is doing something that remains innovative- bringing together medical student colleagues from around the world to work together as peers.

IFMSA Meets in U.S. for the First Time in Decades

Dr. Jessica Evert, CFHI Executive Director & IFMSA Alumna, with other IFMSA Alumni

Dr. Jessica Evert, CFHI Executive Director & IFMSA Alumna, with other IFMSA Alumni

This year the setting for the IFMSA General Assembly is Baltimore.  Medical students from Sudan work alongside colleagues from the US, those from Panama collaborate with Poland, the interactions are endless.  As an alumna of IFMSA I got the privilege to join the meeting and reconnect with old friends from my days as IFMSA-USA Vice President.  IFMSA’s US affiliate is the American Medical Student Association (AMSA), who is also partnered with CFHI.  IFMSA is a great resource for AMSA members, especially those interested in global health.  Often the global health dialogue is dominated by Western voices.  IFMSA allows 1,000+ medical students from around the world to work face-to-face twice a year.  It democratizes global health and allows for crucial relationship development that is necessary for a unified global advocacy voice for health equity and justice.  It has the secondary effect of humanizing perceptions of the developing world- rather that breading pity; it engenders mutual respect between colleagues from both resource-rich and resource-limited countries.

CFHI Global Health Approach Shared & Praised at IFMSA

Child Family Health International (CFHI) was in great company during the IFMSA alumni meeting.   Attendees praised CFHI for its gold-standard model for global health education.  Colleagues from Ghana, Serbia, Philippines, Nigeria, and beyond approached me with gratitude for CFHIs important advocacy voice in the global health education field.

I was equally as impressed by the candid discussion about advocacy provided by Predrag Stojicic from LeadingChange.  Predrag distilled buzz words and espoused a platform for grassroots champion recruitment and leadership.  A thoughtful organization, The 53rd Week, took the stage to describe their pragmatic approach to evaluate and maximize short-term medical trips.  These trips are characterized by volunteers going to resource-limited communities, usually for 1-2 weeks to deliver medical care and related services.  While well intended, the global health community is increasingly leery of short-term volunteer experiences, as their impact has been questioned and downfalls revealed.

 The ‘Global Health Placebo Effect’

Lawrence Loh, co-founder of The 53rd Week, calls the appearance of impact enabled by short-term medical missions the “Global Health Placebo Effect.”  Under the strong leadership of Loh and co-founder Henry Lin, The 53rd Week is creating a platform for the multiple, disjointed teams who visit a community at different times during the year to coordinate their efforts to created continuity, sustainability, and an overarching orchestrated approach targeted towards upstream interventions. Concurrently, they are raising awareness of the risks of short-term medical missions and suggesting alternatives that may lead to more tangible and sustainable ‘help.’

The efforts of these great colleagues and the synergy with CFHI philosophical approach and model of running Global Health Education Programs has been inspirational!

International Women’s Day- A Story From CFHI India

alwar2Evaleen Jones, MD is the founder of Child Family Health International (CFHI) and Clinical Faculty at the Stanford University School of Medicine.  Today, on International Women’s Day we feature an experience from her recent visit to CFHI partner sites in India, and a story from a woman she met while there.  Her story  carries the message of community empowerment that CFHI embodies.

January 31.  Today we visited Continue reading

CFHI: Asset-Based Community Engagement

Child Family Health International (CFHI) at 20 years old continues to be the gold-standard in forward thinking and innovative frameworks in global health education.  CFHI provides community-basedsmall-logo2_png education alongside local professionals via clinical and public health experiences for students and those interested in learning more about medicine and health-related fields, with more than 20 programs in 6 countries.  Programs cover a variety of topics from maternal health to palliative care.

What Makes CFHI Different?

After all these years CFHI remains unique, continuing to challenge paradigms in global health and advocating for local communities. CFHI partners with communities that are considered low-resource and underserved by global financial standards.  Rather than focusing on what is lacking, however, CFHI helps to identify community strengths, ingenuity, and passion.  In close collaboration with local teams, CFHI creates programs and funds community health projects identified and carried out by local teams. This practice is based on the asset-based community development approach, formalized at Northwestern University.  The CFHI approach positions local health practitioners and patients as the ‘local experts’—presenting global health realities through authentic experiences that help shape and transform young people who are interested in global health, equity, and global citizenship.

CFHI Student with Dr. Paul, Rural Urban Himalayan Rotation

CFHI Student with Dr. Paul, Rural Urban Himalayan Rotation

Not Just Talking the Talk, But Walking the Walk

Importantly, CFHI is a staunch proponent of compensation for local community contributions and practicing financial justice.  Uniquely CFHI, 50% or more of student program fees go directly to the communities they will be visiting, benefiting the local economy at large and specifically undeserved health systems.  CFHI is an active affiliate of Consortium of Universities for Global Health, United Nations ECOSOC and has authored literature about global health educational curriculum development at undergraduate and graduate levels.   CFHI encourages students to “Let the World Change You” in preparation for being a part of socially responsible, sustainable change they wish to see in the world.

Turning Dark Profits into Enlightened Transformation

From Skepticism to Hope: Turning Dark Profits into Enlightened Transformation

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

CFHI & Northwestern University Students Impact Women’s Health in Mexico

A Global Team

Global Health Initiative (GHI) at Chicago Lake Shore Medical Associates is a nonprofit organization leading through philanthropic advocacy.  Funding from GHI provided medical students at Northwestern’s Feinberg School of Medicine (FSM) the opportunity to engage in a month-long global health experience in Oaxaca, Mexico with a lasting impact.  Beginning in 2011, Continue reading

CFHI Welcomes new Director of Research and Evaluation

In the rapidly growing field of global health education, looking at the effects and effectiveness of global health immersion on participants, host communities, and the larger health equity movement is essential.

Dr. Gieseker with CFHI Medical Director Dr. Jessica Evert

Karen Gieseker PhD, MS joins Child Family Health International (CFHI) with a passion for Continue reading

How Can We Think Globally & Act Locally?

Phrases like “Think Global, Act Local” and “Global Health is Local Health” are catchy, but it’s sometimes difficult to figure out what they really mean. Continue reading

CFHI Featured at AAFP Global Health Workshop

Child Family Health International’s  Quito, Ecuador Medical Director Dra. Susana Alvear and Global Medical Director Dr. Jessica Evert were featured in the closing keynote address of the 9th Annual AAFP Global Health Workshop.  Nearly 300 attendees from 25 countries attended to share ideas, evidence, and inspiration on topics ranging from global health education at US institutions to the proliferation of family medicine around the world to the ethical challenges of global engagements.

Drs. Alvear and Evert presented on the realization of ethical aspirations- breaking down ethical concepts into practical topics and tangible actions.  The presentation was warmly received.  Dr. Dan Ostergaard,  AAFP’s Vice President for Health of the Public and Interprofessional Activities emphasized the application of CFHI’s motto “Let the World Change You” for all trainees, faculty, and physicians active in global health.  He also emphasized the concept drilled home by Drs. Alvear and Evert that we should really speak of “Toward Equity” rather than “Equity” itself given the gross disparities around the world.  Drs. Evert and Alvear emphasized the ability of institutions and individuals from developed countries to highlight the value of assets in developing country contexts—for example, richness of culture, strong traditional medicine practices, resourcefulness, rather than emphasizing the disparities of financial resources in order to ‘level the playing field,’ a concept originating from CFHI’s former Executive Director, Steve Schmidbauer.

Great respect and admiration were expressed for CFHI’s leadership, program structure, and partnership model.

New MCAT Means Greater Need for Global Health Exposure

The New MCAT – Shaping Future Physicians for the Better

For pre-medical students their life choices are often defined by the MCAT—the often-dreaded U. S. medical school entrance exam that determines whether their professional dreams are dashed or realized.  Rarely do we consider that what we test and emphasize on such exams determines what is prioritized in undergraduate education and consequently Continue reading

Global Health Training Guidebook: 2nd Edition Out

Global Health Training in Graduate Medical Education: A Guidebook

Extra, Extra! Read all about it!  Just published, the second edition of the guidebook is edited by Jack Chase, MD and CFHI’s own Medical Director, Jessica Evert, MD.  The book builds upon the  first edition to provide an expanded, evidence-based perspective on curriculum and capacity-building in the global health workforce.

The guidebook contains relevant material for readers at many career levels, from college and professional students to medical educators and residency and fellowship training program directors.

The 2nd edition is now available in paperback and e-book from Amazon.com, and can be read from the GHEC website.

Congrats, Dr. Evert!

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Read more about CFHI’s Global Health Education Programs that provide global health training to 700 students per year.

 

Trends in Global Health Education: UT Health Science Center, San Antonio

UT Health Science Center, San Antonio Houses Global Health in the Center for Ethics

It’s interesting to consider where a university or medical school chooses to house their Global Health efforts and how this affects the focus and framework of global health activities.  Continue reading

Students Asking Difficult Questions on Global Health Engagement and Development

During the Western Regional International Health Conference I had the privilege of lunching with a group of inspirational and innovative undergraduate students from the University of Washington and University of British Columbia.  At University of Washington students have created the Critical Development Forum (CDF),  a think-tank creating Continue reading

CFHI Sexual Health in Ecuador Program Highlights Constitutional Priorities

In 1998 Ecuador was the first Latin American country to name reproductive and sexual health as constitutionally guaranteed human rights.  Continue reading

Celebrating 20 Years of CFHI

Happy Birthday, Child Family Health International!

2012 marks the 20th anniversary of CFHI’ s transformative Global Health Education Programs and Community Empowerment. This milestone gives us a chance to celebrate and to look back on the impact of CFHI. Continue reading

World AIDS Day 2011

On this 30th anniversary, World AIDS Day gives us a time to pause and take in the enormity of this disease that has ravaged so much of humanity.  There will be much written today about how we are turning a corner and that the epidemic is showing signs of coming to an end.  It is important to celebrate and salute the great accomplishments in the fight against AIDS but it is also important to note that we are a long way from taking a victory lap.  We do need to build momentum in the fight, so the accolades are helpful as long as they help generate enough buzz and enough energy to follow through by implementing and building on the advancements that have been made.

Unfair

The latest numbers show that there are about 34 Million people with HIV world-wide.  At CFHI, because of our international partnerships, we are acutely aware that among all the world’s AIDS statistics it is particulary sobering to note that 60% of all cases are in Southern Africa and that South Africa has the horrible distinction of being the country with the most cases.  Also it is important to note that statistics shoe that among all Asian countries, India has the most cases.  When we look at global health disparities in general, we see how unfair the realities of burden of disease and access to healthcare are but in the context o this particular disease, it is somehow even more shocking. Try to take some time this World AIDS Day to educate yourself.  The World Health organization has a wealth of information, you can start at this link.

One of the great privileges for me as part of CFHI, is the opportunity I get to visit doctors, nursers, and other healthcare workers in the field.  As you really cannot even begin to imagine, communities where the prelevance of HIV/AIDS is very high, are impacted in a variety of ways.  On World AIDS Day, I think back on the doctors and nurses in hospitals that are inundated with patients due to the epidemic yet they still push on, they still show up even when success is not a common part of their day.   Finding local health professionals who are dedicated to their own underserved communities and trying to support them in their work is at the heart of what we do.  We see them in hospital wards that are overflowing, we see them on strenuous trips to rural areas to test, educate, and treat -thus making treatment and  healthcare accessible to  more of the population.  We see them in hospitals where the staff room has become a small ward or infection control area thus leaving them spending long hours working with no place to go for a break.  We see them in clinics working tirelessly as as line of patients stretches out the door and down the street, more than a city block.  We see them morn the loss not only of patients but of so many of their colleagues, and yet they continue.  We see them in these situations every day, and we see them more dedicated and more earnest in their efforts each day.  These are real heroes in this global fight and we salute you on this World AIDS Day and we pledge our continued efforts to help support and champion your work.

On this World AIDS day, 2011, it is particularly wonderful to note that a new film is debuting in South Africa.  Inside Story: the Science of HIV/AIDS will be premiering across South Africa.  A wonderful attempt to target the exact population that the epidemic is targeting –young people.  Using live action, computer animation and, yes, football (soccer), the goal is to educate through entertainment.  Actors from different African countries are participating in hopes that the film will gain audiences across Africa.  In addition to a love story and a sports story, the film shows through animation what is happening inside the body as HIV and AIDS run their course.  The effort deserves a two thumbs up even though we have yet to actually see the whole film.  We hope that this film can be more effective than any drug at combating the disease.

CFHI’s Model for Global Health Electives Included in Oxford University Press Publication

Oxford Handbook on Neuroethics

Oxford Handbook on Neuroethics

“Global Health Ethics is once again in the forefront of discussion with the recently published Oxford Handbook of Neuroethics chapter emphasizing the relevance of biomedical, clinical and public health ethics within the global medical and academic community.  Child Family Health International’s (CFHI) Evaleen Jones M.D., Jessica Evert M.D., Scott Loeliger M.D., and Steven Schmidbauer co-authored the chapter on the importance of establishing and sustaining an ethical framework for educational global health programs.

With growing interest in Global Health Electives among the medical and academic community, there are genuine concerns regarding equity, justice, and sustainability within underserved communities.  CFHI’s chapter discusses global citizenship via a socially responsible framework to create positive global health educational experiences for students and host communities, connecting students with local health professionals and through direct investments in local community based projects.  ”

So reads the beginning of the Press Release for CFHI issued today.  Needless to say, we are all very proud and very happy to have this recognition especially from such a noted publisher as Oxford University Press.  The portion that CFHI contributed to this chapter on Global Health Ethics is an attempt to describe our model of working in underserved communities by identifying local experts and building on the inherent strengths of the communities.  We have seen over and over again low-resource settings where amazing things are being accomplished every day in patient care due to extremely dedicated local professionals.  We see their deep commitment to serving the people and we join together with the local health professionals to design Global Heath Education Programs that are open to international students and trainees.  You can read our submission here but I want to take this opportunity to thank all our international partners who have chosen to work with us to develop this model and make it successful for the last 20 years.  No partnership is one-sided and we are deeply indebted to all the local doctors and nurses, hospital and clinic staff, local coordinators, host families, language teachers, drivers and many others who make our international programs function so well, even in some very challenging circumstances.  Our hats are off to all members of the CFHI global family –you all share in this recognition!

Read the full CFHI Press Relase and Chapter.

World Food Day

United Nations World Food Day

World Food Day

Today is World Food Day.  The United Nations Food and Agriculture Organization has issued a report that should be on the ‘must read’ list of anyone interested in global health.  There is some good news but also some disturbing news that should act as a wakeup call for the world community.  Staple food prices are at or near all time highs.  One of the most alarming facts in the report entitled Food Prices From Crisis to Stability is that just since last year the increases in the cost of basic food has, “pushed nearly 70 million people into extreme poverty.” 

 

Past Successes Have Not Kept Pace

The report points out that while the world’s population doubled between 1960 and 2000, there were significant advances in agriculture that allowed food production to “meet and even exceed demand in many countries.”  Unfortunately, the investments in research that were made, by both rich and poor countries, to produce the much needed innovations have not been maintained in recent decades.  There has been a 43% decrease in government spending on research and development in the area of agriculture in the last 30 years.  Therefore while the population of the world continues to increase, food production has not kept pace.

The last time food prices were this high was in 2008, when the price of various staple foods shot up very quickly and there was rioting in over 20 countries as a result.  Certainly the global

FAO Food Price Index October 2011

FAO Food Price Index October 2011

economic situation is in even less shape to deal with record high food prices today.  What’s worse is that due to the inability of food production to keep pace, “The global market is tight, with supply struggling to keep pace with demand and stocks are at or near historical lows.”

 

Promising New Successes

While the report warns that food price volatility may become an unsettling fact of life for the foreseeable future, it also gives some success stories that offer great hope.  If we can prioritize research and development and scaling of existing successes, we may be able to prevent some of the volatility that now seems inevitable.  Some scientific advances in Africa and Asia are resulting in higher yields but much more needs to be done in this area.  Some countries have made increasing their food production a priority by encouraging agricultural land use and supporting research.  Other countries like Mexico have been proactive in targeting assistance to some of the 70 million globally who are the new poor.  Through carefully monitored programs tied to the education system, the Mexican government has been able to provide assistance to one in four families who have been hardest hit by rising food process.  Even in these difficult times, this effort has, “…been credited with improving the health of children and adults, and raising nutrition and school enrollment levels.”

As we advocate for improved basic healthcare, we must also advocate for smart basic development that learns from the past and is doing the necessary research to keep up with our current and future needs.  For the cornerstones of global public health continue to be water, food, sanitation, and education.