global

7 Reasons Why Your Two Week Trip To Haiti Doesn’t Matter: Calling Bull on “Service Trips” and Voluntourism

    I’d like to add that this is not a new idea. The problems associated with voluntourism are well known among the professionals who work in international development. I have added many links at the end of this post to inspire further reading on the subject.   There have been many different articles written about the ineffectiveness of short-term voluntourism trips to developing nations, including here and here by our friends at in-Training. You know the kind of trips I’m talking about: a spring break spent painting an orphanage in Haiti as opposed to drinking all day in Panama City Beach; a 10-day excursion in exotic Peru, with the pics of Machu Picchu to prove it; or, for the overachieving do-gooders, a couple weeks spent parading around Nairobi, Kenya.    However, these types of trips often exploit the people and communities they pretend to help. Worse, these short-term service self-fulfillment trips can end up doing more harm than good.    I’m guilty of this myself. I spent a couple of weeks in a remote Ukrainian village in 2006, where I basically just hung out with a few orphans and occupied space. The following summer, immediately after graduating high school, I spent a few months in Uganda where I did slightly more work until I realized the true uselessness of my unskilled presence there. But the only people less helpful than me were...

I’m an International Public Health Social Worker…Seriously!

Say what now? No it really is a thing! I promise! It’s called international public health social work. It’s really important to know about. Well why? That’s a loaded question. It’s focused on prevention. But in a unique way and brings a set of skills which require thinking on a clinical and population level at the same time and being able to understand that empowerment is not simply a tag line you put into a grant application. It’s about understanding the importance of balancing process with outcomes. It’s focused on the social environment as a significant contributing factor to health statuses. After all, it is not an accident that African Americans tend to be at a higher risk of obesity, diabetes, violence, and lower birth weight. Mostly, it’s about being able to approach a problem from two different and valuable perspectives. Being an international public health social worker, or at least being in this field, requires me to have an elevator speech ready to go in order for someone to understand what I am doing and bringing to the table. A doctor is more or less universally understood, no matter if it is in a tent in a refugee camp in Kakuma, a health clinic in Lima, or the emergency room on Friday night at Boston Medical Center. We understand doctors and what they do – they diagnose and...

What’s the Difference Between Relief and Development Programs?

The simplest breakdown goes like this: Humanitarian relief programs are focused on rapid start-up, and rapid impact. Implementers of humanitarian programs need to gear up as fast as possible, and start providing necessary assistance as fast as possible. Their primary focus is not building local capacity, sustainability, or monitoring and evaluation. Their primary focus is getting help to people in need. They end when the emergency ends. Relief can come from the outside, and it is a response to some kind of breakdown or disaster. Development programs are focused on achieving long-term change of some kind, with the intent of improving people’s lives and the lives of their descendants. They involve rigorous planning and ongoing operational research. They are rooted in local capacity building, because they are aimed at change which continues after the project ends. Even if it has outside support, development in the end has to come from inside. In practice, however, it’s not that simple. (It never is, is it?) Sometimes the emergency doesn’t end. Situations that look like short-term humanitarian emergencies can go on for years, or even decades. Somalia, for example, Afghanistan, or Sudan. Programs designed to provide immediate assistance become a way of life for people in crisis. It would be nice if those programs could be converted into development programs, but it’s very hard to turn a relief program into a development...

30 Game-Changing Global Innovations

A recent report by PATH, a leader in global health, lists 30 remarkable innovations that are sure to transform global health by 2030. The report lists innovations for maternal, newborn and child health, innovations for combatting infectious diseases, innovations for reproductive health, and innovations addressing noncommunicable diseases. PATH describes the findings as “the result of a yearlong effort to identify, evaluate, and showcase game-changing health technologies and ideas. We sought innovations from across sectors, disciplines, and borders, crowdsourcing hundreds of ideas from developers, entrepreneurs, and experts. Dozens of independent health experts then evaluated and ranked them, selecting the 30 innovations featured here.” PATH produces this report so the global health community can better understand where their energy and efforts will yield the greatest impact. Included is a malaria-blocking drug that makes it impossible for people to transmit malaria to mosquitoes, therefore making it impossible for mosquitoes to carry it on to anyone else. The report also includes an automated chlorinator that can make up to 8,000 tons of water drinkable before needing to refill it. One of the best parts is that it doesn’t even use electricity and is nearly indestructible. Sayana Press, a contraceptive that provides protection for 3 months with just one shot, made the list as well. Contraceptives can be expensive, but this drugs costs just $1. The injection is also easy to administer, so women can...

Physicians: A History of Healing and Torture

“Primum Non Nocere” – Do No Harm Every year, just before the weather chills and the trees begin to brace themselves against the long nights ahead, loads of medical students around the country gather in auditoriums across the country to recite the immortal phrases set down by Hippocrates thousands of years ago. So famous are these words and so oft repeated that many outside the medical community could recognize the sentences if not even in their original Latin forms. We are sworn into the medical profession by promising to uphold these virtues. It is this promise that binds us in commonality, as Father Time slowly transforms us from the homogenous mass of wide-eyed, eager medical students into the commanding surgeons, inquisitive internists, or tech-savvy radiologists that we were born to become. More than that, it connects us to a rich history of service, dedication, and self-sacrifice that millions before us have undertaken. How is it then that the fabric of our undertaking can so easily be undone? It’s been over a week since the CIA released its “torture report” and in it the shaming admission that medical physicians themselves were at the forefront of such grotesque crimes against humanity. Atul Gawande, renowned surgeon and author of books like “The Checklist Manifesto” in which he provides guidance on how to reduce mental errors has much less patience for the physicians...

Mummified Fetus Discovered in Living 92 Year-Old Woman’s Abdomen

Doctors in Chile discovered a calcified and over fifty-year-old fetus inside the abdomen of 92-year-old patient, according to CBS News. Local reports speculated the cause to be related to a botched abortion or lies told to the woman regarding inoperable tumor. The woman, Estela Melendez, supported the claim that she was told she had a tumor in her stomach that couldn’t be removed. The condition, lithopedion translates in Ancient Greek to mean ‘stone baby’ and occurs when a fetus dies during abdominal pregnancy and is mummified outside of the uterus. The woman’s doctors said that removing the fetus would be too dangerous of a procedure given her age and will not attempt to remove it. There are only 300 known cases of this phenomenon, the earliest of which occurred in 1554 in France. The image featured below is a photograph of a preserved calcified fetus from the Otis Historical Archives National Museum of Health and Medicine.   Check out the complete article published by CBS...

Six Things I Know About Medical Training

1.   When you train a doctor, it doesn’t trickle down. It stops, right there, with her. That’s why you need to train nurses and the rest of the clinical team. 2.   If you teach new skills from a book and don’t include hands-on practice, it won’t stick. People will go right back to the old way of doing things. 3.   If you train clinicians and you don’t change the rules that govern their practice, it won’t change their behavior. 4.   Invest in good practice models. Better to break a mannequin than a newborn baby. 5.   Finding – or developing – good trainers isn’t easy, but it is essential. If you don’t make sure local trainers can continue the program after you leave, you are wasting a massive opportunity. 6.   Don’t develop your own training curriculum. Odds are overwhelming that there is already an evidence based curriculum out there that’s been developed by someone else. Spending your time finding, translating, and adapting the curriculum to your local...