Global health experiences are exciting, wonderful learning opportunities and preparation for your trip is important.
Helpful preparation includes travel and health logistics as well as understanding the cultural context of the host community and the ethics of these short-term experiences. Many well-intentioned students have inadvertently caused harm to communities during their global health engagements due to a lack of understanding and cultural humility.
The following modules provide an introduction and orientation to global health fieldwork.
- Understand basic travel safety and health precautions and emergency procedures.
- Critically review global health research and education.
- Travel handbook
- Vanderbilt International Travel Safety and Security Checklist
- CDC Guide to Safe and Healthy Travel
- Developing Ethical Awareness in Global Health: Four Cases for Medical Educators by M. White & J. Evert in Developing World Bioethics (2014)
- How COVID Reveals The Hypocrisy Of The Global Health ‘Experience’ by A. Karan in NPR: Goats and Soda (April 18, 2021)
- Perceptions and Expectations of Host Country Preceptors of Short-Term Learners at Four Clinical Sites in Sub-Saharan Africa by H. Lukolyo & colleagues in Academic Pediatrics (2016)
- Host community perspectives on trainees participating in short-term experiences in global health by T.H. Kung & colleagues in Medical Education (2016)
- African Friends and Money Matters by David E. Maranz
Questions to consider:
- Review questions at the end of the White, et al. article
- Regarding the Lukolyo, et al. (2016) and Kung, et al. (2016) articles, What critiques do you have of the articles (hint: consider the authorship)? Based on their recommendations and Karan’s commentary, how will you prepare for your global health experiences? How, if at all, has your perception of your experience changed?
- Demonstrate cultural humility in engaging with the host site and in describing the ISC experience with family/friends.
- Understand signs and phases of culture shock (and reverse culture shock) and ways to mitigate it.
- Go Overseas by M. Schmidtt in How to Deal with Culture Shock While Abroad (2021)
- A New Culture, chapter 4 in A Few Minor Adjustments (Peace Corps Volunteer handbook)
Gaining an understanding of the local area culture, history, language, and clinical practice should not be delayed until you are in country and is a crucial part of preparation.
- Consider following local news outlets on Twitter and using other online resources including CIA World Factbook, Everyculture, Frommer’s, Lonely Planet, and others.
- Research your host community and country. Learning about the various health, cultural, political, and historical aspects of your host country is vitally important to beginning to understand the context in which your patients and co-workers live. Gaining familiarity with the country’s health, political, and education systems as well as cultural and language nuances will help you adapt and adjust to your new environment and to connect in meaningful ways with your colleagues and patients. See the Country Specific Resources page for resources of commonly visited countries by Vanderbilt students.
- For medical students: Due to a lack of WiFi at many of the hospitals, you likely will not have easy access to UpToDate, so being familiar with common diseases will be helpful. Here are a few suggestions to start:
- Search for relevant clinical guidelines such as print copies of World Health Organization treatment manuals or U.S. guides relevant to the scope of work you will be doing.
- Turn off your WiFi (go into Airplane mode) and try to access some of your downloaded medical apps before you go. You may be able to access part of some apps (such as without photos or videos).
- Review the country’s ministry of health or department of health website for any country guidelines for common conditions such as HIV, tuberculosis, malaria, or maternal care. Download these references prior to travel if possible.
- Review burden of disease, especially tropical disease by region prior to travel to anticipate the conditions you will be treating. United Nations Children’s Fund (UNICEF) maintains country profiles where this information can easily be accessed.
*The suggestions above were found in “The Practitioner’s Guide to Global Health,” a edX course by Boston University. The course can be accessed through May 2022.
Questions for consideration:
- What actions will you take in face of the various stages of culture shock? How will you prepare for reverse culture shock?
- What helpful resources have you found about your country?
- Consider the impact of their power on interactions in the clinic and community.
- How (not) to write about global health by D. T. Jumbam in BMJ Global Health (2020)
- How to Write About Africa by B. Wainaina in Granta (May 2, 2019)
- Knowledge, moral claims and the exercise of power in global health by J. Shiffman in International Journal of Health Policy Management (2014)
- The World of Work, chapter 5 in A Few Minor Adjustments (Peace Corps Volunteer handbook)
- Volunteering Abroad? Read This Before You Post That Selfie by M. Gharib in NPR: Goats and Soda (November 26, 2017)
- Ethics and Photography in Developing Countries by Unite for Sight
- Power in International Politics by M. Barnett and R. Duvall
Questions for consideration:
- Describe power that you might (or might not) hold in your host clinic and community. How will you navigate power differentials?
A case study to consider: MSF’s intervention in Liberia in 2014
- The Politics of Fear: Medecins san Frontieres and the West African Ebola Epidemic by M. Hofman and S. Au
- Report: Ebola 2014-2015 Facts & Figures from MSF
- Nationals” and “expatriates”: challenges of fulfilling “sans frontières” (“without borders”) ideals in international humanitarian action by O. Shevchenko and R. C. Fox
In addition to these modules developed at Vanderbilt, there are many high-quality resources from other institutions that will help prepare you for your time abroad. We recommend these resources:
- Unite for Sight’s online courses: International Ethics & Professionalism and Photography Ethics
- John Hopkins’ Ethical Challenges in Short-term Global Health Training
- Consortium of Universities for Global Health’s Working & Visiting in Low-resource Communities