There are many challenges to consider when completing a Global Health Elective, whether locally or abroad.  In our 3rd part to this series Catherine and Haley examine the challenges they expect to face during their time in Tanzania and Thailand.

Can you name some challenges you expect to face during your elective?

Catherine Brown (Tanzania)

I have only met a few people living with HIV/AIDS – a woman with remarkable inner strength who acquired HIV during the Rwandan genocide; a man who regretted his wild youth of injection drugs. To help prepare my mindset for the challenges of working in an HIV/AIDS agency, I have been reading as much as I can about the epidemic.  Randy Shilts’ And the Band Plays On describes why AIDS was allowed to spread unchecked during the early years of the epidemic; Elizabeth Pisani’s The Wisdom of Whores takes you from Jakarta to Geneva to explain why in the past three decades, despite spending billions of dollars, we have been unable to curb the epidemic; Stephanie Nolan’s 28 Stories of AIDS in Africa vividly narrates the individual experiences of hope, love, and courage from people living with AIDS and their loved ones.  Despite this immersion, I expect to be overwhelmed while at PASADA.

I am in my final year of a MSc in community health and epidemiology, where I am writing my thesis in the field of maternal and child health. I completed a BSc at the University of Toronto, specializing in global health.  I first discovered global health when I happened upon the Human Development Index as a preteen and wished to better understand disparities in population health.  I am delighted to be joining the interdisciplinary team of Dalhousie students travelling to Tanzania, and I look forward to learning first-hand about the challenges and opportunities related to the care and management of HIV/AIDS in Dar es Salaam.

We would also like to recognize all students participating in the 2012 Global Health Office Summer Program with Catherine:

• Joe Sadek (Medicine)
• Sarah Grant (Nursing)
• Jennifer Aucoin (Nursing)
• Jessica Gubernt (Nursing)
• James Hudson (Medicine)
• Dustin Conrad (Medicine)
• Alexandra Bishop (Medicine)
• Emma Reid (Pharmacy)

Haley Augustine (Thailand)

One personal challenge I commonly face with the idea of international electives is the use of local human resources. I worry that there is a lack of reciprocity between the students, like myself who are learning and the host site’s resources. While completing international electives there are competencies and objectives a student must fulfill. In meeting these requirements the student may require input and resources from the host site, such as training from their preceptors. This is a challenge, I know I will personally face.

Conversely, the student-preceptor relationship may also be a mutual exchange, as students tend to challenge their preceptors by bringing a fresh perspective and asking questions. In settings where there are limited resources, students can also assist in extending services by providing additional person power once they have developed the necessary skills. For these reasons I can help rationalize some of the resources I know I will use.

Another concern I have is the communication barriers and unfamiliarity with cultural practice. Communication is a key component in the foundation of medicine, which enables empathetic and productive interactions with patients. Different local customs and norms may limit a foreign student’s ability to communicate through body language and verbal communication. I am therefore very grateful for our language training and opportunities to meet with previous students to discuss some of the cultural practices.

Education and fieldwork are investments in human capital; therefore I will also find it challenging coming to terms with the sustainability for host countries once we have completed our placement. I am always aware and concerned that I may limit placements for local students who would eventually work as local physicians. I am therefore grateful of the longstanding relationship Dalhousie has with Khon Kaen University in Thailand. On previous electives I was fortunate to be placed in a setting where I could collaborate with local occupational therapy students for translation and knowledge sharing. I am hopeful I can once again link up with local students to collaborate and learn form each other.

Throughout these experiences I recognized that we don’t have to travel to experience and be an advocate for global health. I started to get involved in local global health programs such as the Aboriginal Health interest group, universities allied for essential medicines and local global health initiative programs. I gain a sense of energy and enthusiasm from these programs and am always learning from my peers, international partners, and experiences and therefore find them extremely rewarding experiences.

Thank you to Catherine and Haley for sharing these insights.  We wish them rewarding and collaborate experiences and look forward to hearing more when they return.

If you have any questions please review our website at http://gho.medicine.dal.ca/ or contact us at gho@dal.ca