Tag Archives: international volunteer

Why Global Health Ethics Matter: A Personal Story

Image result for antigua guatemala

In the summer between my sophomore and junior year of college (undergraduate), I participated in a medical volunteering program for 2 weeks in Antigua, Guatemala. As a pre-med student, I knew I wanted to do something during my summer that involved medicine and figured volunteering in a hospital or clinic would be my best bet. Unfortunately because I had a mostly full time job, I was unable to secure any type of volunteering program locally since they all required a certain amount of hours that I would not be able to complete before returning to my university in the fall.

I then decided to look online at volunteering abroad, and found a myriad of programs that fit my time constraints perfectly. I honestly did not do too much research and just clicked on the first organization I found that had a solid amount of positive reviews and wasn’t too expensive. Looking at the cheapest options, I saw that in Latin America they offered an affordable medical program in Guatemala. While scrolling through the program description, the phrases “gain hands on experience” and “provide check-ups and basic medical care” piqued my interest as the idea of actually getting to perform medical procedures sounded incredibly appealing to myself as a student interested in a career in medicine. I imaged working in a hospital with doctors and nurses and getting the opportunity to experience medicine directly. The program description made it seem that these “poor” communities needed any help they could get, so I figured that I could kill two birds with one stone-help this underserved country while also gaining medical experience. Even though there were red flags consistently throughout the program description-the program oozed “voluntourism” and provided very brief and limited information on what actually would take place during participation- I wasn’t suspicious at all because I didn’t expect anything that involved volunteering to be problematic.

After signing up, there was a very brief pre-departure guide I had to complete before embarking on my trip. The guide was just a general guide and mostly focused on the logistics of getting there (ie. visas, packing list, etc.). There was a short list on my responsibilities, but it didn’t really mention anything about ethics. There were also 2 optional pre-departure training modules that were more informative on ethics, but were brief and took less than 30 minutes to complete. I didn’t really feel that prepared for my program, but figured I would get more instruction and guidance once I arrived.

Once I finally made it to Guatemala, I started to see problems and holes within the program. Before starting my rotation, I met with the medical coordinator for the program to have orientation. The orientation was pretty short and consisted of a powerpoint on the kind of care we could provide. After telling him I had had no prior experience in medicine, he told me that I would act somewhat like a nurse, taking weight, height, blood pressure, heart rate and temperature, making beds, cleaning, talking with patients, preparing materials and sterilizing equipment. Even though I told him I didn’t know how to take blood pressure or heart rate, he assured me the other visiting volunteers at the clinic would teach me. This orientation started to leave me a little hesitant about the program since he asked us to provide medical care, but expected other volunteers to teach us instead of himself as a doctor showing us.

After arriving to the clinic where I would be volunteering at, I was sent to work at the nurse’s station. At my rotation, there were 2 other volunteers placed there as well who had been there for about 4 weeks. One was applying to medical schools in the United States and the other was a 3rd year medical student at a university in Ireland. Luckily, one of them spoke spanish fairly well and was able to translate for us when we interacted with both the nurses and patients.

After the other volunteers briefly taught me how to perform the basic nurses duties (blood pressure, height, weight, and temperature), I was mostly on my own. It was definitely very nerve wracking having these duties when I’d never done them before and was even more difficult considering I spoke very little of the language. I was especially confused on taking blood pressure and while I immediately should have said that I wasn’t sure what I was doing, I was embarrassed to tell the other volunteers since they insisted it was an easy task and that I’d get the hang of it eventually. This is definitely something I wish I could’ve gone back to and done differently because there is a large possibility that patients’ information was recorded incorrectly due to my lack of experience. This was when I started to realize that gaining hands on experience wasn’t what I imagined at all. In my head I thought that everything would go smoothly and I would be ready to help the professionals in anyway possible. In reality though, my lack of experience became even more apparent to myself and I started to become suspicious that the “help” I was providing wasn’t all too helpful.

Image result for antigua guatemala crossWhile my lack of training may have led to incorrect patient information being taken down, there were other pre-med volunteers who were given duties that were even further beyond their scope of understanding and led to medical complications for patients. Since there were other volunteers working at my clinic, they cautioned me right away that I shouldn’t help with procedures such as giving stitches or injections since we didn’t have the training for that (I think they figured taking down patient information was harmless enough that my inexperience wouldn’t be an issue). I was very thankful for that advice since I was already feeling uncomfortable with the duties I had, I couldn’t even imagine how stressed I would have been if I had to perform anything more advanced. However, other volunteers weren’t as reserved. I remember this one other volunteer bragging to me about how the doctor had allowed him to give injections to a patient. He said that he didn’t really know what he was doing and he ended up piercing her 5 times because he kept doing it wrong. Another volunteer told me she helped stitch a patient up and said she was concerned that her stitches weren’t done right since she had never done it before. It was at this point that I really started to question the program we were on. Why weren’t there more regulations enforced by the program? Why were the duties of the volunteers so ambiguous? Why was I starting to feel so uncomfortable with what I was doing and why weren’t the other volunteers having the same questions I was?  

Besides just the volunteer aspect of the program, there were a lot of problems with the program as a whole, in particular when it came to safety. We were warned to never travel by ourselves at night. In keeping with those rules, two volunteers on my program walked home together one night after hanging out downtown. On their way home, someone pulled a knife on them and took all their belongings. The volunteers were traumatized and felt very unsafe about what had happened and contacted the program to let them know of the situation. The program responded incredibly insensitively and told them it was their fault for walking home late at night and didn’t provide any support for the two. Their response to an emergency situation such as this really made me concerned about the legitimacy of this program. They had told us it was okay to be out at night as long as we weren’t alone, yet blamed the volunteers for what happened instead of offering emotional support and/or more information on how we could stay safer while out at night.

I left my program feeling differently than I had expected. While I loved the country I was staying in, I felt disconnected from what I was actually doing. I felt uneasy about what myself and other volunteers had done without any medical experience and questioned my helpfulness. My experience showcases how easy it is for medical volunteering programs to be problematic and harmful for the communities they’re situated in when there is not an emphasis on global health ethics.

 

Note from CFHI: Many thanks to Zoe for sharing her story. If you have questions about ethical engagement in global health experiences please visit the publications page on the CFHI website (https://www.cfhi.org/publications) or listen to a recent webinar (https://www.cfhi.org/cfhi-webinars). We are also always available to answer questions about ethical global health engagement- contact us at students@cfhi.org.

Alumni Spotlight: Q&A with Alana D’Onofrio

Alana D’Onofrio participated in CFHI’s program Exploring HIV & Maternal/Child Health in Kabale, Uganda in September 2014. She is an aspiring physician assistant and recent graduate of Northern Arizona University, where she majored in Biomedical Sciences.

Q. How did you hear about CFHI? What attracted you to the Uganda program?

I heard about CFHI through the study abroad program at Northern Arizona University. CFHI was highly recommended to me. It had always been a passion of mine to volunteer in Africa and experience the culture there—that is what attracted me to the Uganda program.

Q. What were your goals going in to the program? How did CFHI help you in achieving those?

IMG_8705My goals going into the program were really to gain knowledge—whether that be medical or healthcare knowledge, or knowledge of a different culture and how people live, eat, dance, work, etc. in a country completely foreign to me. CFHI helped me accomplish these goals. Their partner organization in Kabale has some very special staff members who were willing to teach me so much. They allowed me to ask any question, explained everything about the people of Uganda and their culture, and made me feel very comfortable.

Q. How did the program impact you?

The program impacted me greatly. It solidified my goals of wanting to go into a healthcare career because I learned how much I love working with patients. I also feel more worldly. I now know so much about a country in Africa where very few Americans travel to. I know about the people, the food, the music, and the languages of Uganda. I saw how amazing the people that live there are, how simply they live, and how much they enjoy life no matter how hard it is. The people there inspired me to live my life like them and to never take anything you have for granted.

Q. What were the highlights of your experience?

I have so many highlights of my time in Uganda. One highlight would be heading down to the clinic everyday, excited to see the staff and looking forward to what I was going to learn or see that day. The relationships that I established with the staff are another highlight. We had amazing conversations and always had so much fun. Other highlights include traveling to villages for outreaches to treat people who could not make it to the main clinic in Kabale, hiking the Muhavura Volcano in Kisoro, and going on a safari in Queen Elizabeth National Park.

Q. How has the program changed your perception of health? 

IMG_9148I now understand the diversity of health. Health in Uganda is very different than health in America, yet there are many similarities. There are diseases unique to East Africa that I was able to see and study. There are also differences in the way people are treated and diagnosed for these conditions. The diagnostic tests in Uganda are much more limited, therefore many cases are not solved. Certain conditions and diseases that are treated easily in America are not easily treated in Uganda and are sometimes fatal because people do not have the money to pay for healthcare services or because they wait until that last minute to get checked out.

Q. Who was the most inspiring person you met on the program?

The most inspiring person I met was Allen. He is a medical officer who works under Dr. Anguyo at the KIHEFO clinic and he is the preceptor who I shadowed. He has such a passion to help and treat others. The clinic is very understaffed and Allen wants to go back to school to become more qualified in certain areas such as radiology, so that he can help the clinic even more. While he treated patients, he was so patient and always took the time to explain things to me. Overall, he was a great teacher and such a passionate healthcare worker.

Q. How has your worldview changed?

I knew so little of Uganda and even the continent of Africa before my trip. Africa is not at all like what is portrayed of it on the news. Obviously there are parts with war, disease, and extreme poverty, but there are also amazing things about Africa that I was able to see. I no longer associate one country of Africa with the whole continent. Each country is unique.

 

Special thanks to Alana D’Onofrio for allowing us to interview her for this post.

Truth in the Spoof: Medical Voluntourism in The Onion

Truth in the Spoof: An expose of voluntourism in The Onion.

By: Aditi Joshi, MD

Newsflash!  This week’s headlines report a new humanitarian organization ‘Doctors Without Licenses’ will start providing substandard care by putting together a group of “decertified physicians, pre-medical undergraduates, and ‘people just interested in the human body’.” The organization states it will be sending their staff to conflict zones and underserved areas to incorrectly provide medical care.

Image from The Onion satirical article

This news was reported in The Onion, a satirical weekly publication, so it is, of course, facetious. The sad truth is that it refers to a very real phenomenon.

Voluntourism and Medical Voluntourism – Repercussions

Searching ‘voluntourism’ on Google, one finds a number of hits for organizations that set up volunteer opportunities for well-meaning individuals to work in underserved communities. Medical voluntourism refers to doing medical care within these communities; these volunteers can be physicians, nurses, residents, medical students and a growing number of organizations offer hands-on opportunities for pre-medical students, as well. More and more research as well as anecdotal reports state that these short term volunteer trips do more harm than good to the local community.  (If you’re interested in a great contrast between voluntourism and global health—this article is a must read. The volunteers may be providing direct patient care, giving medications, and doing procedures. In cases where the volunteer has no formal training, and would not be allowed to do the same in their home countries, this type of care is unethical whether or not the results are disastrous.  Even for those who are trained and skilled, the lack of knowledge of local infrastructure, drug formularies, culture, language and historical frameworks can actually lead ‘good’ actions to having negative consequences.

Solutions and Social Responsibility

Proposed solutions vary as the scope of the problem is large and not fully realized. However, organizations such as Child Family Health International – CFHI, try to decrease harm by giving students the opportunity to immerse within the culture, focus on broad global health competencies, observe native health care providers who are dedicated to their communities long-term health. This prevents the student from being a short-term ‘band-aid’ health worker or trying to get patient care experience that they are not licensed to undertake. The students are able to understand health concerns in other countries while minimizing possible harmful outcomes.

Voluntourism is most likely here to stay, however the importance of finding ways to reduce harm while giving the local community the help it requires is an ongoing challenge.

 

Thanks to our guest blogger, Aditi Joshi MD, ER Physician and Former President IFMSA-USA for authoring this post.

CFHI Announces New Program in East Africa

CFHI’s Newest Programs in East Africa: Be Part of “An Activated Community” in Southwest Uganda

It is exciting when CFHI finds a partner so well aligned with its values of addressing broad determinants of health, engaging communities to help themselves, and strengthening local capacity for health care and community activation.  The Kigezi Healthcare Foundation (KIHEFO), a non-profit organization operating in Kabale, Uganda, is fighting disease, poverty, and ignorance by creating “An Activated Community.”  In partnership with KIHEFO, CFHI’s new Uganda programs HIV & Maternal/Child Health and Nutrition, Food Security & Sustainable Agriculture offer students from all academic backgrounds a firsthand learning experience addressing health, poverty, and education.CFHI Uganda Homepage Slide

Uganda is a country in Sub-Saharan East Africa facing many serious health problems and challenges, including high rates of maternal mortality (only 30% of women give birth in a health facility), HIV and child malnutrition. There is a shortage of medical professionals working in Uganda, along with equipment and medications. With the majority of the population living in rural villages and earning around less than $2 a day while subsistence farming, access to healthcare services is a severe challenge.

KIHEFO’s mission is to fight disease, poverty and ignorance in an integrated, sustainable manner. This means not only delivering healthcare, but helping communities deliver themselves out of poverty and reducing the problems causing sickness and disease. The team is large, “an activated community” made up of staff, former-patients and supporters worldwide mobilizing their communities for improved health and economic well-being.

CFHI Student’s Role in Uganda

Through CFHI, students from all academic backgrounds and levels have the opportunity to work closely to learn first-hand about child and maternal health, HIV, malnutrition prevention and rehabilitation, food security, sustainable agriculture, empowerment of women’s groups, micro-credit savings and community mobilization.

Students observe and learn from healthcare professionals working at the General Clinic, at the HIV/AIDS Clinic learn from counselors and former HIV positive patients about testing and counseling HIV+ patients, and participate in a monthly HIV outreach.

At the Nutrition & Rehabilitation Centre, students learn from social workers and nurses about preventing and rehabilitating malnourished children, and participate in nutrition assessments to measure patient’s growth and progress. Additionally, students learn about sustainable agriculture practices, including permaculture, and the importance of crop diversification and growing food closer to home.

KIHEFO believes there is no single cause of disease, much like there is no single solution.  Mirroring the CFHI approach they believe initiatives must be integrated, community-based and sustainable. Join CFHI’s Uganda Programs to learn from the people behind the “community activated” model for improving health and livelihoods.

Learn more.

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

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

A Visit with The Father of Palliative Care in India

Dr. Rajagopal Dispenses  Needed Medicines and a Healthy Dose of Respect.

Pallium India

Pallium India

 

After a meeting with CFHI’s Founder, Dr. Evaleen Jones at Stanford University, Dr. Rajagopal (Dr. Raj),  the Founder of Pallium India agreed to become one of CFHI’s newest partners in India.  CFHI India Coordinator, Ms. Hema Pandey, and I had the privilege of spending three days with him in Trivandrum, Southern India as we work to develop a CFHI Global Health Immersion Program exploring Palliative Care.

As the monsoon season takes its time to come to a close, the beautiful, lush countryside around Trivandrum in Kerala –Southern India is as calming as the Trivandrum, Indiapresence of Dr. Raj to his patients. We were given the great privilege of being allowed to shadow Dr. Raj during a day of home visits to various patients of Pallium India, the nonprofit he founded.

Who is Dr.  Rajagopal

Dr. Raj is responsible for beginning the palliative care movement in India.  He tells me that while the goal of palliative care might be the same in India as it is in England, where the modern hospice movement was started, the implementation is different.  Dr. Raj feels that to simply pick up and transplant palliative care as it has been developed in the West can inadvertently have consequences that cause more suffering –when the main goal of palliative care is to reduce suffering. Dr, Raj is indeed a unique individual; he is both a visionary and a worker in the trenches.  To follow him for a day doing home visits was inspiring.  It was also a primer in how to do this kind of patient care.

Dr. Raj pointed out to me the four domains of patient care that were outlined by Cicely Saunders, the founder of the modern hospice movement.  The four interlocking domains are Physical, Emotional, Social, and Spiritual.  It is certainly a tall order for anyone to provide such comprehensive care, and to do it in low resource settings is even more challenging.

A Day in the Life– Implementing Palliative Care in India

As we drove into some of the poorest communities in Southern India, Dr. Raj and his team, a nurse, a social worker, and a driver went about their routine.  Patient files are reviewed as we travel in the van.  The size of the patient files is notable.  After Dr. Raj read the file a bit, he begins to tell us the context of the family we are about to see.  We get a succinct yet

Ms. Hema and Dr. Raj on home visits Pallium India

Ms. Hema and Dr. Raj on home visits

thorough description of the family composition and history.  The level of detail is impressive and we even had a few questions about the family that Dr. Raj answered from the record.  I asked him when he last saw the family and he said that this was his first visit to them.  There are three other teams conducting home visits and so the family has been seen by the other teams in the past.  It is amazing to see the level of detail that is recorded from the home visit.  From these notes, other services from nutrition, to physical therapy, to social work are provided –all driven initially from the teams’ weekly or fortnightly visits.

As we arrive, Dr. Raj gives warm and respectful greetings.  He makes use of his reading of the chart right away to let the family know that he is up to speed on the situation even though this is his first time seeing them.  Telling and retelling the story can be a help, at times, for a family but to have to do it with every healthcare worker that shows up, can become a burden.

In the home visit, Dr. Raj is totally in his element.  Calm, positive, and respectful, he has a way of making the patient and the family feel that he has all the time in the world to spend with them –they have no idea that he has six more home visits to do.  His careful touch, his undivided attention, his deep listening, his affirming comments are all the epitome of what a home visit should be.  He listens and draws

Dr. Raj conducting a home visit, Trivandrum Southern India

Dr. Raj conducting a home visit, Trivandrum Southern India

out information to help him tweak the treatment plan based on what has happened since the previous home visit.  As he leaves, he has given not only some medicines and ordered some more physical therapy but he has also given the family and the patient dignity, respect, and acknowledgment through his manner, his interactions, and his presence.

And, of course, as we make it back to the van, it’s time for Dr. Raj to write page after page of notes so the follow-up treatments can be done and so the next home visitor can pick up right where he left off.

 

CFHI Featured in Everyday Ambassador Blog

Everyday Ambassador Blog

Everyday Ambassador Blog

We at Child Family Health International (CFHI) are deeply honored to be featured in the Everyday Ambassador blog post by Kate Otto.  Kate’s own accomplishments in global citizenship and smart diplomacy are considerable for anyone, especially for someone at such an early point in her career. She is a great example for students today who are interested in global service.

CFHI is equally proud to be a member of the International Volunteer Programs Association (IVPA), also featured in the blog post.

Many CFHI alumni are already doing their part in the Global Health field.  With over 6,000 alumni now, we have a wonderful, growing family of everyday ambassadors who advocate and educate through their everyday activities.  Through their first-hand accounts of shadowing local healthcare workers in underserved and low-resourced settings, they can speak with conviction and in compelling stories about the similarities and the differences of healthcare systems, and about important global health issues.  Whether they do it in a professional capacity as a lecturer or professor, or in the informal setting of a party or a dinner, they can be equally effective in telling the story and enlightening people about global realities, thereby each doing his or her own part to bring us all closer together as the human family and improve the health of the world community.

You don’t have to be abroad to be making a difference.  Visit our Facebook and LinkedIn pages and join in the conversations that are happening with people all around the globe.  Follow #GlobalHealth on Twitter and keep yourself current on issues and causes.  Share all of this with your own social networks and you will be surprised how much influence you can have as an individual.  Our world is, in so many ways, becoming a ‘smaller place’.  Be a part of it; participate!

New US Census Data Shows Diversity of US Population Increasing

We are approaching a new highpoint in the prevalence of US residents who were born outside the country.”  This is part of a message on the Director’s Blog of the US Census Bureau website that is aimed at the marketing industry, at advertisers of goods and services, but we at CFHI believe it is also important information for current and future health professionals.

While the Census Bureau is providing this new data, none of the basic trends of an increasingly diverse population for the United States should be a surprise to us.  Forward thinking health professionals and medical educators have seen the indications of these trends for many years.  Health science students (including medical students, nursing students, and public health students) have not waited for courses to be developed by the data that is now beginning to be analyzed, but have taken the initiative to seek out medical electives and rotations that would give them first-hand experience of different cultures and the different ways people view health around the world.

Source: US Census Bureau -Director's Blog

With some 6,000 alumni of CFHI Global Health Immersion Programs to date, we hear over and over again from them how their CFHI experience gave them insight into the role that culture plays in health and healthcare.  Tenny Lee, a 2010 CFHI Mexico alum, reports: “My experience in Mexico has given my medical career a foundation to help underserved communities and break though language and cultural barriers.”  You can read more about her CFHI experience  in her review posted on the website Great Nonprofits.  The ability to competently serve a more widely diverse patient population will clearly become the expectation for health professionals, as we can see from the wealth of information that the US Census Bureau is releasing.

One of the most important data points released so far is that the Hispanic population of the US now exceeds 50 Million, a 43% increase since the last census as reported by CNN.  And it is not just in border states in the south.  The CNN article quotes demographer Jeffrey Passel at the Pew Hispanic Center as saying, “Previously, the Hispanic population was concentrated in eight or nine states; it is now spread throughout the country.”

Medical schools, organizations, and institutions of higher learning have also recognized these trends, and CFHI has been happy to work with many of them to design specific programs.  The Patient Advocacy Program at the Stanford Medical School began a program abroad with CFHI in 2007.  The University of California at Davis has partnered with CHFI for over five years now to offer a Bi-National Health Quarter Abroad program for undergraduates in special arrangement with the Chicana/o Studies Department at UCD.  Both of these programs also make use of CFHI’s built-in Spanish Language and Medical Spanish Instruction.  Students are also living with host families so they are immersed into the culture during the program.  Guided journaling and weekly meetings help students reflect and integrate what they are learning from their daily interactions.  CFHI is also working with others, including Northwestern University, The Student National Medical Association (SNMA), -which you can read more about in an earlier posting–  and the Public Health Institute in association with the Global Health Fellows Program.  CFHI has been able to partner with each group and use our 20 years of experience working at the grassroots level in underserved communities abroad to design programs that meet specific learning objectives that are achieved in real life settings with the help of local health professionals who have the unique expertise of the local healthcare system and the best understanding of the local culture.

Jessica Brown, a 2010 CFHI Ecuador alum, pulls it all together in her reflection about her CFHI experience:

“… [I] learned a wealth of information about health that extended beyond the Reproductive realm.”  Jessica goes on to say, “I learned a lot about Ecuador’s healthcare system by discussing health care access, education, socioeconomic class and ethnic background with my mentors and preceptors. I learned about how religion, education and customary social/cultural schools of thought (i.e. machismo) weigh heavily on Ecuador’s society, and individual minds; I saw how the cultural “way” dictated the population’s attitude towards healthcare, especially in Women’s Reproductive Health.

The moments that caused me to question belief systems in place within myself really stretched me beyond limits I never knew possible.  And it is these reflections upon the state of health care in Quito that can broaden my understanding of client needs, beliefs and culture here in the states.”

Celebrate 50 Years of Peace Corps –Sign the Service World Declaration

Service WorldCFHI is happy to celebrate the 50th anniversary of the start of the Peace Corps on March 1, 1961.  As  a member organization of the Building Bridges Coalition and the International Volunteer Programs Association, CFHI joins with other member organizations in issuing the following letter inviting you to sign the Service World Declaration.  You can see previous postings on this Blog about service world here.

_____________________________

Dear Friends;

On March 1, 1961, President John F. Kennedy announced the creation of the United States Peace Corps.  This Tuesday, March 1, 2011 is the 50th Anniversary of that historic occasion.  We at Child Family Health International are asking you to honor that event by signing the ServiceWorld International Volunteer Service Declaration.  It is a simple pledge to encourage expansion of such efforts and that you stand ready to be of service.  We and our colleagues in other organizations hope to have 100,000 Americans or more make such a commitment.

The Peace Corps was the first national organization in the world dedicated to international volunteer service.  In the past 50 years, the Peace Corps has engaged millions of people from all cultures and nationalities in the search for common ground, and has inspired countless organizations of every type, foreign and domestic, all over the world.  We at CFHI are a part of this legacy and whether you have served or are thinking of doing so, you are as well.

You can make a difference today.  All you need to do is to join us in signing the International Volunteer Service Declaration.  For more information about ServiceWorld and to sign this Declaration on this important date, please visit the Service World Website.

President Kennedy and the first Peace Corps Director Sargent Shriver envisioned 100,000 Americans serving abroad every year.  Imagine the impact this would have had on the world if such an effort had been realized 50 years ago and replicated by other nations.   ServiceWorld is ambitious, as it seeks to make this vision come true today.

While the current budget crisis makes this moment a challenging time to promote new initiatives, please remember that it is often during such occasions that old paradigms are changed, when necessity and creativity generate needed innovation, and when a “quantum leap” forward is truly possible.  Now is such a time for citizen diplomacy and international volunteer service.  Help us all become part of those new solutions.  After you sign the Declaration, please forward this request to your friends and ask them to join you in this effort, as well.

Sincerely,

Child Family Health International

Familiarity That Melts Away Mistrust -Michelle Obama

First Lady Howard University Jan 2011

First Lady Howard University Jan 2011

As part of the official visit of President Hu to Washington, First Lady, Michelle Obama spoke to a captivated audience at Howard University saying that when you go abroad, “you are shaping the image of America projected to the rest of the world.”  While Mrs. Obama was trying to promote a campaign to increase the number of students going to China, many of her comments are applicable to any cross cultural learning experience:

“…studying abroad isn’t just an important part of a well-rounded educational experience. It’s also becoming increasingly important for success in the modern global economy. Getting ahead in today’s workplaces isn’t just about the skills you bring from the classroom. It’s also about the experience you have with the world beyond our borders — with people, and languages, and cultures that are very different from our own.”

Last Spring, her husband, President Barack Obama, spoke to students at the University of Michigan saying:  “As our world grows smaller, more connected.  You will live and work with more people who don’t look like you, or think like you, or come from where you come from.”  And almost in a response to these words by her husband, Mrs. Obama went on to say:

That’s why it is so important for more of our young people to live and study in each other’s countries.  That’s how, student by student, we develop that habit of cooperation, by immersing yourself in someone else’s culture, by sharing your stories and letting them share theirs, by taking the time to get past the stereotypes and misperceptions that too often divide us.

That’s how you build that familiarity that melts away mistrust.  That’s how you begin to see yourselves in one another and realize how much we all share, no matter where we live.

CFHI programs have always focused on immersion into a culture, into a different helathcare system.  Rather than staging impressive extraordinary displays for students, CHFI’s Global Health Immersion Programs give students a real slice of life, giving the participant and authentic experience of what it is like to be a health professional in that country.  Some days may be very low key, other days in a hospital may be overwhelming.   Regardless of the program, the bonds that students have made with professionals, with host families and with each other are very strong and lasting.

A Spark Was Struck Again in Ann Arbor -Celebrating 50 Years of Peace Corps and Launch of ServiceWorld

As people gathered from different parts of our country and our world last week at the University of Michigan to commemorate the fiftieth anniversary of the spark that started the Peace Corps, at least some of us experienced a new spark.

It is a rich and storied history of how presidential candidate John F. Kennedy , weary from the long day and the long campaign, reached the University of Michigan campus at about 2:00 AM on October 14, 1960. JFK at U of M October 14 1960Despite nothing being scheduled to mark his arrival, Kennedy was amazed to find a growing crowd of thousands of students who had gathered to show their support.  Moved by this spontaneous crowd, Kennedy went to the front steps of the student union to address them extemporaneously. The young senator was in a very tight race against then Vice President Richard Nixon, and with only three weeks until the election, no plan had been made for speaking to the students perhaps because the vast majority of them were under 21, the voting age in 1960. But there they were. In a cold drizzle, there they were in the wee hours of the morning; there they were.  . The press had gone to bed; none of these kids could influence the election. It should have been a throw away moment -a simple expression of kindness and cordiality, but it was not.

We were so fortunate last week that many of those who stood in that drizzle fifty years ago came back. They remember it as a special moment, a moment when they felt a challenge, an invitation, a call …a spark!  The history is now recorded, thanks in large part to the University of Michigan, and a wonderful recounting of it is now available in a documentary called A Passing of the Torch. Do yourself a favor and find a way to see it. (It will air on public television in the coming months.)

It was cold and wet in the wee hours this past Thursday, much as it reportedly was at that moment fifty years earlier.  While this was anything but a spontaneous gathering, it was a purposeful gathering. Crowd at UofM 2AM 14 October2010 There was a sense of anticipation which felt strange because we were merely commemorating a historical event.  I’m not sure what we were expecting to see …a ghost… I don’t know, but we were drawn there for something.  Thomas Hayden, the editor of the student newspaper in 1960, and now 70 years old, said later at a speaking event on Thursday night that he had not planned on attending the 2 AM commemoration because he had an early meeting that morning.  As the night approached, however, he said he could not help but go, even if only to see if one can really relive a moment of their life –he said he was not disappointed.  He also asked rhetorically and jokingly, “Where is that damn torch any way? Can someone find me that torch?”

As I sat listening to Tom Hayden in a hall filled to overflowing, I realized that was it –the torch.  That is what we were looking for last week.  Whatever the torch is, it has inspired many over the years, and I think we saw it many times last week in Ann Arbor.  And as I listened to Tom Hayden that night, I realized that his words, his memories, his passion for service and fairness, dedication to participatory government and global understanding, -these are the torch.  They are the torch that Kennedy took up and ran with, inviting all to join him.  They are the torch that was passed to that crowd of students fifty years ago by an impromptu speech.  A torch taken up by Al and Judy Guskin (part of the audience for Kennedy’s speech who responded by starting a student movement that led to the Peace Corps –again, wonderful history that you will love) and by every Peace Corps volunteer who has walked in their steps since.  A torch taken up by many of us who have volunteered internationally through a myriad of other organizations.

I think that is what we were drawn to see last week in the early hours of October 14th –the torch.  And see it we did, in the nostalgic eyes of hundreds of returned Peace Corps Volunteers, in the wide eyes of U of M Students eager to make a difference, in the stories of fifty years ago that felt like they could happen again.  And indeed they were happening. Michigan Daily October 14 2010 We were given a renewed challenge and invitation.  We were invited to join a new initiative called Service World (www.ourserviceworld.org) with the aim of achieving JFK’s goal of having 100,000 U. S. citizens doing international service annually.  Just as a petition was drawn up by Al and Judy Guskin in 1960, signed by over a thousand U of M students, and led to the establishment of the Peace Corps, Service World has a declaration that is now being circulated globally.  Fifty years later, international service has become a global ideal. Thanks in large part to the model and the success of the Peace Corps.

It only makes sense in today’s world that a call to globalize Kennedy’s great challenge would arise.  Those of us who were in Ann Arbor this time felt a quiver deep inside us that was something other than just a reaction to the damp and cold around us.  Was it a spark?  Was there a torch that was being offered to be taken up?  I know that no torch can be seen in any of the photos or video that everyone recorded, but I also know that it will be seen in  all the renewed efforts for international service, and in the hearts of all those who go to the Service World website to virtually sign the scroll in support of the ideals that have spanned many years and lives and are still alive inside us today.  Anyone can participate.  Here is the text of the Service World Delcaration:

We envision a world in which volunteer service is a common strategy by people of all nations in meeting pressing challenges in education, health, the environment, agriculture, and more. We seek to foster an international culture of service and a heightened sense of compassion across borders that will bring volunteers of different countries, cultures, races, ethnicities and religious beliefs together for common purpose. We encourage individuals and organizations to engage in volunteer service in order to increase prosperity, strengthen economies, implement more informed foreign policies in all nations, and lay a foundation on which governments and civil society can build a more peaceful, healthy and secure world.

We stand ready to serve and support Service World’s bold agenda to expand volunteer opportunities for individuals internationally — at every age and among all socio-economic groups — to learn about global problems and help find more effective ways to solve them.

If these words resonate deep inside you, then please add your name to the scroll and pledge your support for a renewed call to international service that can transform all who are touched by it. If you know others who share this vision, invite them to add their name.  Every supporter we can get will help us convince policy makers that international service is important, needs to be nurtured, and will pay dividends for us all.

CFHI Joins in Support of Service World

ServiceWorldCFHI is very excited to support the launch of OurServiceWorld.org and the ServiceWorld International Service Declaration. Those of us involved in Global Health are deeply committed to international service.  The ServiceWorld Initiative is an effort to commemorate the 50th anniversary of the Peace Corps by realizing President Kennedy’s original vision of sending 100,000 volunteers to serve abroad each year. Please join us in supporting the future of international service by signing the ServiceWorld International Service Declaration and endorsing ServiceWorld.

As a proud member of the Building Bridges Coalition and the International Volunteer Programs Association, CFHI is happy to join a groundswell of international  organizations in support of this effort.  Please join with us.

CFHI Board Member Appointed by White House to Bi-National Board

POTUS SealThe Chair of the Board of Directors of Child Family Health International (CFHI), Mr. Gunjan Sinha, was appointed this summer to the US Endowment Board on Science and Technology during the US-India joint commission meeting of the White House Office of Science and Technology.

The Volunteer Board of Directors of CFHI functions far from the limelight but plays an essential role in the success of CFHI.  We congratulate Gunjan on this accomplishment!  Gunjan’s expertise as an entrepreneur has been indispensable to CFHI over the years, and we are sure he will be viewed the same way in his new role.

The Governments of the United States and India held the meeting of the Joint Commission on Science and Technology cooperation in Washington, D.C. on June 24-25 at the Smithsonian Institution’s National Museum of Natural History. CFHI’s Board Chair, Gunjan Sinha joined the meeting as part of the U.S. delegation lead by Dr. John Holdren, Assistant to the President Barak Obama for Science and Technology and Director of the White House Office of Science and Technology Policy. The Indian delegation was lead by Sri Prithviraj Chavan, Minister of State for Science and Technology and Earth Sciences. As part of the overall focus on science and technology policy, Mr. Sinha was appointed on the US Endowment Board, set forth between US and India to foster Science and Technology cooperation between the two largest democracies in the world.

The meeting follows the June 3rd discussion between US Secretary of State Hilary Clinton and India’s External Affairs Minister Shri Krishna that focused on the importance of facilitating cooperation in strategic and high technology sectors as a key instrument to achieve the full potential of the strategic partnership between the two largest democracies in the world.

Mr. Sinha is also Chairman of MetricStream, a market leader in Enterprise-wide Governance, Risk, Compliance (GRC) and Quality Solutions for global corporations, based in Palo Alto, California.

The delegates at the commission include senior officials from various US federal agencies and departments including the Office of the Chief Technical Officer, Office of International and Tribal Affairs, US Environmental Protection Agency (EPA), US National Institutes of Health (NIH), US Department of Energy (DoE), National Science Foundation and Bureau of Oceans, Environment and Science.

The joint commission between the two countries and the US-India Endowment Board will look to inspire public good and economic prosperity in US and India, through science and technology cooperation, greater public-private partnerships, promoting innovations and entrepreneurship and creating appropriate policy environment for greater bilateral co-operation. Areas of focus of the Endowment Board will include such significant areas like Food Security, Climate Change, Energy Policy and Healthcare among others.

In line with the mission of the White House Office of Science and Technology Policy, the commission’s aims to ensure that Federal investments make the greatest possible contribution to economic prosperity, public health, environmental quality and national security, and to foster professional and scientific relationships with government officials, academics and industry representatives for providing policy-relevant advice, analysis and judgment for the President on major policies, plans and programs of the Federal government

CFHI Students make Local Press in Ecuador

CFHI students made the local press in Ecuador this summer.  La Prensa, a local publication in the town of Puyo in the Pastaza Province of Southern Ecuador, carried a full page story of CFHI Students on the Amazon Indigenous Health Program, one of CFHI’s Global Health Immersion Programs.

CFHI Students Make New in Ecuador Summer 2010

CFHI Students Make New in Ecuador Summer 2010

Puyo, a city of about 25,000 people, with its close proximity to the Amazon Jungle, functions as the base for this program that allows students to see the interplay between the government Ministry of Health and the traditional medicine of indigenous populations living in the jungle much as they have for many hundreds of years.  Dr. Wilfrido Torres, a local physician and the Medical Director of several CFHI programs, reports that international students coming to Puyo and to the Jungle Region, “help the local population see that local doctors and community health workers have important knowledge to share with the world.”  CFHI is honored to have local experts like Dr. Torres who are eager to interact with international students.

This summer, the CFHI students were able to participate in a medical conference that CFHI helped support.  The conference, a multidisciplinary conference on the latest treatments and testing for diabetes and hypertension, was part of a series of conferences to educate health professionals and paraprofessionals on these chronic diseases that are relatively new to the local population.

Compassion Across Borders -Letter to Huffington Post

John Bridgeland, CEO of Civic Enterprises, sent a letter that has been published in the Huffington Post  about the benefits of the Service World Initiative –an effort to increase the international volunteering on all levels.  John explains, “Volunteer service by people of all nations should become a common strategy in meeting pressing challenges in education, health, the environment, agriculture and more.”  You can read John’s article at this link.  See also the June 30th  post on this Blog about Service World.  CFHI is part of a broader coalition of over 300 NGOs and Universities, and other organizations supporting Service World.  More information about Service World will be coming soon.

Global Health Down Under -A students’ Conference- Hobart, Tasmania

Map of Austraila and Tasmania

Australia site of Global Health Conference

CFHI is very happy to be at the Global Health Conference in Hobart, Tasmania that is being put on by the Australian Medical Students’ Association (AMSA).   The conference running 1-4 July has a full academic program with impressive topics and excellent speakers. The entire conference is organized by and for students and the level of professionalism is truly outstanding.  CFHI is very happy to be an NGO sponsor here and we find the interest and engagement of the students to be at a very high level.   A CFHI alum from Perth, Samantha Mulholland (2009, Pediatric Health, La Paz), has been present and giving her first-hand descriptions of her CFHI experience.

UTAS

UTAS Site of Global Health Conference Tasmania

The University of Tasmania in Hobart is the site for the conference as some 500 students gather from across Australia and New Zealand, and even from Asia and Africa.

Indeed students all over the world have a growing interest in Global Health.  What is refreshing here is that so many of them are deeply informed on world issues, social determinants of health and many other areas.  Panels of leading experts, student questions and discussions have all been engaging and enlightening.

GH Conference Hobart

Panel discussion at the Global Health Conference Hobart Tasmania July 2010

Expectations –When Helping is Complicated

Kim McLennan, an accomplished physical therapist, and long-time CFHI volunteer, is now in Haiti and has been communicating to us some of the complexities of just trying to help.  A veteran of many humanitarian missions, Kim knows that to lend a helping hand is not always as easy as it looks on the surface.  The crisis in Haiti, and the

Some of the many peopel who have volunteered their time going to Haiti in the aftermath of the 7.1 earthquake

This is a U.S. Navy photo of some of the many vounteers who have gone to Haiti to help after the great earthquake

outpouring of volunteers to give assistance has amplified the Grey Areas of coordinating and managing international aid.  The questions of culture,  ethics, passion, compassion, and the realities of unexpected complexities are raised in her moving, first-hand account.  Dr. Evaleen Jones, CFHI’s Founder and President, asked Kim if we could share her writings through this Blog.  Kim gives us her experience alongside her on-the-spot reflections which are informed by her years of cross-cultural work in some very challenging situations.

We are grateful to Kim for her permission to present her observations and thoughts here.  Unfinished and raw, they give us an unvarnished view of reality with no easy answers –much as the real situations in Haiti, and elsewhere in the world.  You are welcome to click on the “Read More” button to leave a comment.

Expectations

Here in Haiti, 5 months after the devastation of a 7.1 earthquake, volunteers are coming in droves.  I am one of them.  By the end of my stay, I will have been here 7 weeks.  Most of my fellow volunteers come for one week or two if they’re lucky.  Professionally, the greatest number are doctors, nurses, emergency room specialists, pediatric and wound care specialists, prosthetists and physical therapists. The majority have never been to a developing country or to Haiti before they arrive.

They come with the expectation of being welcomed for their concern and service, everyone paying their own expenses and hoping their week of selflessness will do some lasting good.  Most leave, probably feeling that their mission was accomplished, even if in some small isolated way.  This morning, at the hospital I’m working in, there are 20 American doctors, nurses and other hopeful people wanting to do something useful.  They’re surprised when they realize how different the system is here, how charts and notes and procedures that are standard in the US are hardly used here. They are surprised that the Haitian nurses don’t speak English or seem happy to share their small desk or coveted stash of medical supplies.  Many come with their own supplies of state of the art medical technology and toys and blankets and shoes.  Most of it is very useful and appreciated by the patients.  The Haitian staff seems to disappear when the volunteers arrive to see the rare and unusual patient injuries that have occurred here.

There have been many surgeries and interventions that would have never occurred without the volunteers being here.  External fixators and wound vacs are found throughout the hospital, and the meticulous care given to the patient’s wounds is without parallel.  But this is precisely the problem. The nurses here do not have the training to change the dressings or change the wound vacs and no one is training them. There will be no physical therapy or discharge planning when the NGOs pull out for good.  For all their good intentions, the volunteers seem to ‘take over’ when they arrive and then complain that the Haitian staff doesn’t seem interested.  Cultural differences aside, who likes it when someone new arrives on the scene, walks in,  starts to do your job and then leaves, making you feel less than adequate after witnessing such expertise.

As you know, this is a touchy subject.  Everyone who comes here has the best intentions, simply wanting to help.  The problem is when they come, they come in groups with their own comfortable systems in place, just in a new setting.  Most of the Haitian hospitals are not equipped to house or feed these additional visitors and the plumbing in Haiti already is barely serviceable.  They often don’t seem to try to learn a few words of Creole, or go outside the compound to meet the Haitians and share a local meal.  It probably feels like a vacation except that the food is scarce and the air-conditioning doesn’t work.

The first time I went overseas to volunteer 12 years ago in South Africa, I stayed for one month and it took me almost three weeks to feel I was accepted a little by the local staff and they still did not seem keen to have me in their midst.  I have been looking ever since for better ways to interact and contribute to poor people in need of basic healthcare.  I believe the answer is recognizing the potential of the local people….

It truly does no good to ‘do your thing” as a volunteer, no matter how much it is needed if you don’t teach someone else how to do it also.  Volunteering in Haiti can contribute to the Haitian infrastructure only if we volunteers think about the consequences of us being here.  Are we willing to be patient and work alongside someone whose future may improve from our training?  Are we willing to trust that they may know a better way than the way we’ve been taught?   We are influencing an entire system by our presence and we should be including them every step of the way…..”

Service World -A Bold New Initiative in International Volunteering and Service

On June 23, 2010, the Brookings Institute hosted a forum on international volunteering and service and the launch of Service World: Strategies for the Future of International Volunteer Service.

Ambassador Elizabeth Frawley Bagley at Brookings 23 June 2010

Ambassador Bagley at Launch of Service World Effort

CFHI is proud to be one of the organizations endorsing this effort that is a call for increased international cooperation at all levels.  We know that as the world effectively grows smaller, the health of the world’s population will depend more and more on our ability to share knowledge, understanding and efforts across boarders and continents.  Improved understanding of how culture impacts health and the global sharing of current best practices along with traditional proven interventions will benefit all of our efforts at improved health for all populations.  This is the intersection of modern medicine, that builds on science and technology, and the cumulative wisdom of ancient cultures that builds on a deeper knowledge of the earth and  the human mind, body, and spirit.  CFHI students experience this today in the Amazon jungle and the foothills of Himalayas.  To increase the ability of future health professionals to to have these transformational experiences in a manner that is socially responsible to the host communities, can only improve the health of the world community, and our progress as people toward global citizenship.

Ambassador Elizabeth Frawley Bagley, Special Representative for Global Partnerships in the Office of the Secretary of State, gave the keynote, inspiring those present to work collectively toward the goal of increased opportunities for people of all ages and walks of life to volunteer service internationally.  2010 marks the 50th anniversary of the birth of the idea of the Peace Corps.  As the celebratory events for this anniversary happen this coming October, our nation will have the opportunity to reflect on this great idea and the great accomplishments that have come from it.  Service World recognizes that the positive impacts have come not only from the government sponsored Peace Corps but also from the many private and nonprofit organizations that have taken up this global vision and provided opportunities for so many people from the United States and many other countries.

CFHI’s Founder and President, Dr. Evaleen Jones, has often recounted that the Peace Corps was an inspiration for her as a young medical student at Stanford University,when she began the creation of CFHI .  More information on Service World will be posted on the Blog over the coming months.

University of Oregon Students Receive Awards for CFHI Programs in Bolivia and South Africa

Ann Oluloro and Stella Chiu, both students at the University of Oregon have received scholarships awarded by the IE3 Global Internships Program.   Many other students from participating IE3 Schools will attend CFHI programs this year and will receive credit from their home institutions.  Oluloro and Chiu, “…stood out among their peers…” according to the IE3 Field Blog Website.

Ann Oluloro Bound for Bolivia

Ann Oluloro will be participating in CFHI programs in Bolivia starting in July 2010.   In her CFHI application she identified several reasons for seeking entrance to a CFHI program in Bolivia.  Becoming a fluent Spanish speaker is important for her professional goals.  “Being fluent in Spanish is an important part of my future career because I plan on working in public clinics.   Currently, as a volunteer at White Bird Community Clinic, I often see the doctor communicate with patients in Spanish. By being able to speak another language, the doctor is able to break down a communication barrier that would have otherwise existed and is therefore able to provide the patient with the best care she possible can.”  She dreams one day of working with Doctors Without Borders and she believes that her CFHI experience, “…will give me a deeper insight into international medicine…” and help her “…learn about a culture and a way of life that books and textbooks cannot provide.”  She hopes that her time in Bolivia, “…will give me a glimpse and understanding of a culture that I may otherwise not have a chance to learn about first hand. In addition, the internship will teach me about the structure of public health systems and how such systems are implemented in under developed nations both in rural and urban settings.  Ann has done her homework, reading about the challenges faced by many countries to provide healthcare to their populations.  “I am highly interested in how some under developed nations are still able to find ways and means in which to implement effective public health systems.”

Stella Chiu will be participating in CFHI programs in South Africa.  Stella’s goal is to become a doctor and also to have an impact on underserved populations.   She sees being part of a CFHI program as, “…a perfect match for what I want to do with my future. I want to become a physician and gain clinical experience, but I also want to help underdeveloped countries with public health efforts.”   For Stella, it is important to be immersed in another culture, “I hope to gain clinical experience in a setting that is different from that of the United States. I believe this would make me a better physician in the future because it will help me see beyond the privileged population and be more competent in serving the less privileged. I hope CFHI will provide me with opportunities to learn and experience things first-hand.”

Both Ann and Stella will be reporting on their experiences so we look forward to more in their own words.  We wish these students well as they embark on a summer that they will surely remember forever, and good luck with the tremendous potential of career opportunities that await them in the future.