The Emerging Themes of Ebola: One Health

By: Benjamin Capps, Department of Bioethics, Faculty of Medicine, Dalhousie University
December 2014

 

I was invited to give a talk for an event on ‘Ebola: Perspectives on the Epidemic ̴ Where to Begin’ taking place on 20th November 2014.[1] The immediate ethical concerns of the outbreak were raised: the dire conditions of the people the disease is affecting, and the consequent response from the international community. However, an additional point to reflect upon was that Ebola, just one of many zoonotic diseases, raises questions that can be rendered with the broadest brush – the makros kósmos – the idea of a global health response.

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Benjamin Capps Image courtesy of the Department of Bioethics

Zoonotic viruses, diseases that transmit between humans and non-human animals, are intimately linked to ecological niches; each virus can be stirred from its environment through different connections,  and each has a different potential for illness, endemic and pandemic. Questions like ‘Why now?’ and ‘What next?’ are significant, then, not only in the local devastation that these diseases cause, but also in respect to their effect on the global community. For Ebola, at this point we are dealing in the unknowns and knowns of the ‘ecology of the virus’. This is because until now it has been found only in remote areas of Africa (but nevertheless decimating those communities it comes into contact with), and little was known about its potential for, and behaviour during an epidemic. We know little about the natural history of the virus – we still don’t know the reservoirs,[2] or why so rarely it emerges in human populations. However, I suspect that many – those studying the nature of the virus in its natural environment – thought that not only an outbreak of this magnitude was possible, but also likely; and filling these gaps will affect our ability to formulate clinical and ethical responses.

The emergence of zoonotic diseases is becoming ever more common; and they are cropping up in far more diverse places and often not always those that are remote, wilderness fringed communities (recently: bird flu in Canada, Germany, Netherlands and the UK; this year in South Korea, Japan and Malaysia). New kinds of zoonotic virus, such as Marburg, Hanta, Hendra, Nipah, and MERS viruses, are threatening humanity, our closest relatives (the great apes), and other animals at unprecedented levels;[3] and their effects on the wider ecologies (including how we respond to them) is devastating.

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Ebola virus Image courtesy of the CDC

We therefore need to appreciate how and why the environment only spits them out when challenged or stressed; why the viruses spill over and emerge in human populations only sometimes; and thereby understand how we might better avoid them altogether?[4]

In this respect, an emerging area of study, called One Health, is demonstrating that not only will a healthy ecology be less likely to send these viruses our way, but it can also protect us by buffering and ‘soaking up’ zoonoses.[5] So, we need to look to other solutions of prevention, not just the ‘pandemic plans’ that tend to decimate local animal populations (culling of domestic animals and local wildlife), threaten ecological diversity and socio-economic sustainability (the impacts on agricultural and cultural ecological co-dependence), and then tend only to be useful after the event and once human-to-human transmission is sustained.

Event poster courtesy of Dal Med GHI

Event poster courtesy of Dal Med GHI

Overall, we ought to be looking to better ways to minimise the emergence of these diseases through an ecological perspective; understanding not only the human effects and solutions that presences (vaccines, public health measures), but also the reservoirs, connections and drivers of disease emergence. It is clear that land use (mining, oil refining), deforestation, and urbanisation are having an unprecedented effect on these ecological niches; so, we need to start accounting for local needs – including land management, like farming and husbandry; economic and political priorities in these countries that are most at risk; and the global interactions that are conditional on disease emergence.

These debates need to start off on better footing, by engaging with a much broader expert base and expanding traditional and often too narrow public health concerns.[6] This dialog must include veterinarians, biologists, ecologists and anthropologists; and as diverse as economists and historians. The risks are known, if not well understood, and we need to develop ideas about how human beings can better and more effectively live within the ecology that potentially harbours these diseases.

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[1] My thanks to the organiser of the event, Suzanne Clarke, a MED2 Student from the Faculty of Medicine, Dalhousie University. Suzanne also assisted with the drafting of this blog. The event was presented by Dal Med Global Health Initiative, Dalhousie University Global Health Office, Capital Health, Dalhousie Medical Students Society, Health Association of African Canadians & The Tropical Medicine Student Interest Group, and broadcast in multiple locations across The Maritimes, Canada. The opinions expressed here are my own.

[2] Probably bats; but we still don’t know how it gets into them, how it resides there, or how it then emerges in susceptible populations like human beings and other primates; Plowright, R. et al. 2015. Ecological Dynamics of Emerging Bat Virus Spillover. Proceedings of the Royal Society B 282: 20142124; Pignott, D. et al. 2014. Mapping the Zoonotic Niches of Ebola Virus Disease in Africa. eLife 3: e04395.

[3] See: Genton, C. et al. 2014. How Ebola Impacts Social Dynamics in Gorillas: A multistate Modeling Approach. Journal of Animal Ecology doi: 10.1111/1365-2656.12268; Walsh, P. et al. 2007. Natural History Miscellany: Potential for Ebola Transmission between Gorilla and Chimpanzee Social Groups. The American Naturalist 169: 684-689.

[4] Capps, B., Bailey, M., Bickford, D., Coker, R., Lederman, Z., Lover, A., Lysaght, T., and Tambyah, P. (In press; 2014). Introducing One Health to the Ethical Debate about Zoonotic Diseases in South East Asia. Bioethics.

[5] See: N. Harris & R. Dunn. Species Loss on Spatial Patterns and Composition of Zoonotic Parasites. Proc R Soc B 2013; 280: 20131847; F. Keesing, et al. Impacts of Biodiversity on the Emergence and Transmission of Infectious Diseases. Nature 2010; 468: 647–652.

[6] Capps, B. and Lederman, Z. 2014. One Health and Paradigms of Public Biobanking. Journal of Medical Ethics.Online first doi:10.1136/medethics-2013-101828.

Profound Learning @ Global Health Rounds

By Sarah Boucard, Outreach Assistant, Global Health Office

 

Some of my favorite learning experiences, whether inside or outside the classroom, have been those lead by passionate individuals. When someone loves their work, it reads in their face, in the way they lecture, and in their willingness to share their experiences and mentor others. This is why I would like to invite you to join me in attending Global Health Rounds, on the 3rd Wednesday of each month, held by your very own Global Health Office. Each of these sessions highlights a different global health activity at Dalhousie or a contemporary global health challenge through presentations and talks by leaders in the field. The rounds are a forum for discussion, questions, and interaction. Each has left me with more than just increased knowledge on the topic at hand.

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The intimate setting has given me an opportunity to meet like-minded people, network, and pursue different opportunities. So far, two sessions have been held. The first, was on social accountability within medical schools and was led by Ms. Shawna O’Hearn, Director of the Global Health Office, and Dr. Jeff Kirby at the Department of Bioethics. The second, lead by Dr. Des Leddin at the Faculty of Medicine, was titled “Health Education; Can the Net Level the Playing Field?”. He spoke of international partnerships in the establishment of specialty care centres in other countries. The facets of global health explored by these leaders are relevant to health professionals, researchers, and the public alike. As an emerging health care administrator, my own values and understanding have been tested through these rounds when I learned the value of establishing specialty facilities in developing countries, even when some of the most basic health care needs still have to be met.

I have to say, I felt as though I was being exposed to “inside information” throughout these discussions, candid and unpublished truths from the mouths of the experts themselves.

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Jeff Kirby, Courtesy of Dalhousie Faculty of Medicine

The next upcoming Global Health Round is with Bob Huish, Assistant Professor, Department of International Development Studies. He will explore the topic of “Why does Cuba care so much about Ebola? Understanding the Solidarity Approach to Global Health”. I hope to see you all there!  November 19, 2014 @ 5-6pm Tupper G-36, DMNB Saint John Rm 218.

For more information: Global Health Rounds

Youth PhotoVoice Exhibit: Healthy Communities

All were welcome last Thursday to browse a very important collection of photos at the North Memorial Public Library. This collection was the result of the dedication and hard work of youth from St George’s YouthNet and the Needham Community Centre. They came together to engage in a community based participatory action project, facilitated by a group of medical students at Dalhousie University. Although this team of 8 medical students reached out to initiate the project, George’s YouthNet and the Needham Community Centre were the key drivers and youth leaders were involved in each project session.

Community members who came to see the exhibit

Community members who came to see the exhibit

The project ran from Spring to Fall of 2014. The objective was to provide youth with a creative and safe means of self expression in order to explore what a healthy community meant to them. Dalhousie’s medical students were eager to take their education outside the classroom and engage with and learn from youth in the community. As the team put it, “We felt that the youth perspective is often unheard especially with regards to issues that affect them.”

We felt that the youth perspective is often unheard especially with regards to issues that affect them.

Dr. Ingrid Waldron speaking with an attendee

Dr. Ingrid Waldron speaking with an attendee

This is how the PhotoVoice team of medical students described their role in the project:

Our role as facilitators was to ask the youth important questions about their lived experiences within the context of the community they reside. After engaging youth with some critical questions, we then asked the youth to take pictures of elements in their community that affected their lived experience. The youth then explained why they took certain photos and what some of the issues they were trying to convey through the photos were. At this time, youth also discussed how the photos meant different things to them and how their perspectives about issues affecting their community paralleled or differed. It was an opportunity for some of the participants to also share aspects of the history and events that occurred in their community, linking past municipal and provincial choices to their current situation.   

Community members were invited to write their responses to the images

Community members were invited to write their responses to the images

The goal of photoVoice is to promote action. It is hoped that the youths’ ideas and thoughtful work, once made available for the community to see in this way, will spark interesting discussion among community members about what actions the community would like to take based on some of the narratives and photographs from the youth.

Dalhousie PhotoVoice team

Dalhousie PhotoVoice team

To learn more about PhotoVoice please visit their website.

Courtesy of Youth Photovoice Exhibit

Courtesy of Youth Photovoice Exhibit

Global Health Day 2014

By Sarah Boucaud, Outreach Assistant, Global Health Office

 

This past Tuesday the Tupper Link was lined with posters and busy with faculty, residents and students; September 23rd marked this year’s Global Health Day. The event, hosted by the Global Health Office, provided an opportunity for students, residents, faculty and the community to share their experiences in global health research and education, and engage with others who share their passion. Thank you to all those who attended and made this year’s event a success!

Welcome to Global Health Day 2014

Welcome to Global Health Day 2014

You could see and hear the enthusiasm in the room, with the excited chatter, eager gesturing, and cheerful smiles. Many of Dalhousie’s global health community and partners attended. Students from Occupational Therapy, Nursing, Medicine, Dentistry and Health Administration made their way around and in between the posters. Also in attendance was Dean of Medicine Dr. Tom Marrie and a special guest from Tanzania, Thecla Kohi.

Occupational Therapy students Dalhousie

Occupational Therapy students Dalhousie

 

Shawna O'Hearn, Global Health Office, Cher Smith and Dr. Lee Kirby, Wheelchair Skills Program, Division of Physical Medicine & Rehabilitation.

Shawna O’Hearn, Global Health Office, Cher Smith and Dr. Lee Kirby, Wheelchair Skills Program, Division of Physical Medicine & Rehabilitation.

 

Dr. Noni MacDonald, Dalhousie University/IWK Health Centre. MicroResearch in East Africa

Dr. Noni MacDonald, Dalhousie University/IWK Health Centre. MicroResearch in East Africa

The presented posters demonstrated the broad range of global health initiatives undertaken at Dalhousie. A group of Dalhousie students representing the Dalhousie Student-led Clinic Steering Committee presented their poster on Building a student-led, interprofessional community health initiative in Halifax, in which they highlighted their work on developing a student run clinic in our community. Research in Medicine students shared their work as well. For example, Emma Sumner’s poster was based on her work in the Evaluation of outcomes of a specialized seating program for children in a low resources setting.

Emma Sumner, Dalhousie Medicine New Brunswick (DMNB)

Emma Sumner, Dalhousie Medicine New Brunswick (DMNB)

When it comes to the international facet of global health, international surgery and international anesthesia also presented. And of course, Dalhousie’s Global Health Office offered posters detailing a variety of student programs, including the Local Global Health Elective and Summer Programs with partners in The Ghambia and Tanzania, to name name a few. In addition, there was a poster for the Global Health Advocates Certificate, with a reminder that the application deadline is October 3rd. 2014!

Allan Kember, Dalhousie Medical student

Allan Kember, Dalhousie Medical student

A steady stream of visitors wove in and out of posters, lingered to network, and participated in the Global Health Day draw. This year’s winners were Chad Klassen and Megha Vatsya, each taking home a global health book (When People Come First: Critical Studies in Global Health). Participants and visitors were so engrossed in coversation, individuals stayed until the last poster board was taken down at the end of the session.

 

 

Collaborating to improve health worldwide

Dalhousie departments, schools and faculties are involved with global health projects around the world. The reach of these initiatives and the network of partnerships formed along the way reflects the deep rooted passion for global health found at Dalhousie.  As the Global Health Office, we work at every level to enhance and promote these efforts.  One such collaboration is our work with the Department of Psychiatry and their Global Psychiatry group who foster partnerships for healthier minds across the globe. Two of these partnerships were recently featured in September’s issue of Headlines, the Department of Psychiatry’s newsletter. The first, is with Trinidad, and the second, while in Canada, is an example of a local global health initiative.

Training in Trinidad

Recently, Global Psychiatry began training in Prevention and Management of Aggression and Violence in Trinidad. Similar training was being provided in Tobago when the Ministry of Health Mental Health Planning Unit in Trinidad approached Global Psychiatry with the request. The project has grown since its inception and now includes training for staff in ministries outside the direct realm of mental health, including, Education, People and Social Development, Justice, Emergency Response, and Maintenance and Training Services. This growth was largely spurred from the drive of Ms. Trudy Rouse who saw a need for cross-government agency training. The next phase of the project will involve delivering a train-the trainer model to 10 of the participants, scheduled for September and November.

Update from NWT

Within Canadian borders, we find Global Psychiatry’s Dr. Arlene MacDougall, who was the 2013 recipient of our Dr. Jock Murray Global Health Award for Resident Leadership, and Dr. Bianca Horner who is well established in global health. With the support of a variety of stakeholders, they facilitated the development of an integrated collaborative step care model for mental health in primary care in the Northwest Territories. This collaboration included senior leaders, service providers, researchers and the Government. They are now working with these stakeholders to help oversee the establishment and evaluation of a pilot site in Yellowknife. The longer-term vision is to eventually adapt and expand the model to smaller communities across the territories.

Please see the September issue of Headlines for more details on these stories and more!

The network of reciprocal relationships, with the intent of benefitting our partners, truly enriches the learning experience of students and faculty members at Dalhousie. With the new academic year ahead, take the opportunity to get involved in global health. The Global Health Office is a great place to start. Check out our website at http://gho.medicine.dal.ca

How Working at the System Level Improves Quality Care and Patient Safety

by Sarah Boucaud, Outreach Assistant, Global Health Office
 

Sarah Boucaud is our outreach assistant and is spending the summer at Accreditation Canada as part of her residency for the Masters of Health Administration program at Dalhousie.

I believe this organization and the role of accreditation are extremely important in ensuring quality care and patient safety in always changing and complex health care systems.

Working at the Global Health Office (GHO) this past academic year, I’ve heard about and been in awe of the many unique opportunities Dalhousie, and the GHO in particular, offers its health professional students. These experiences allow us to gain valuable hands-on experience in a variety of settings, both at home and abroad. I am no exception this summer, since I am doing a residency at Accreditation Canada as part of my Masters of Health Administration. While I am not working within a limited resource setting or in a new environment far from home, I find it absolutely remarkable what Accreditation Canada does in terms of promoting patient safety and quality care both nationally and internationally. Not to mention that my first three weeks here have certainly been an adventure in their own right! I would like to share a bit more about this organization with the global health community and future health care professionals like yourselves, because I believe this organization and the role of accreditation are extremely important in ensuring quality care and patient safety in always changing and complex health care systems.

Accreditation Canada Offices, Ottawa, Ontario

Accreditation Canada Offices, Ottawa, Ontario

Independent and not-for-profit, Accreditation Canada (http://accreditation.ca/) has been promoting health quality through accreditation since 1958. How is this done? Accreditation Canada supports health care organizations in a continuous quality improvement process. Organizations are evaluated on a four-year cycle using standards developed based on research, best practices, and consultation. Peer reviewers, called surveyors, conduct these on-site evaluations. The results are evaluated by Accreditation Canada, who renders a decision as to whether or not the organization becomes accredited, and which level of accreditation it receives. What’s more important is that the results identify strengths and areas for improvement. These are provided to the organization to inform action plans and quality improvement initiatives. Accreditation Canada International (ACI) provides similar services abroad (http://www.internationalaccreditation.ca/en/home.aspx).

This type of process puts Accreditation Canada in a unique position to work on the standardization of care throughout the health care system. Accreditation Canada promotes the attainment of high quality standards in all health care organizations with which it works. This organization also takes continual improvement and knowledge translation to heart, keeping up with emerging evidence, and educating its clients and training its surveyors.

Accreditation Canada works with all types of health care organizations: hospitals, clinics, community health centres, emergency health services, and long-term care homes, to name a few. Over 5,700 sites and services have been accredited by Accreditation Canada. Accreditation can be seen as a systematic approach that looks at improving quality of care and patient safety within complex and continually changing health care systems.

We look forward to having Sarah back in September to share more of her experiences with us.

Awarding Faculty Leadership in Global Health at Dalhousie: Dr. Bob Bortolussi

Post 3 in our series recognizing the many global health achievements at Dalhousie

 

Every year the global health office recognizes and awards global health leadership at Dalhousie through our global health awards: the Dr Ronald Stewart Student Award, the Dr John Savage Memorial Faculty Award, and the Dr Jock Murray Resident Award. These awards recognize an outstanding contribution to the global health community at Dalhousie through:

  • demonstrated leadership in global health
  • work experience with marginalized communities
  • engagement in global health research
  • mentorship in global health
  • promotion, development and enhancement of global health at Dalhousie

We have so many members of our community (Faculty, Residents and Students) doing inspiring work and making global health a part of their personal and professional lives it is wonderful to have this opportunity to celebrate these achievements.

For 2014 we are thrilled to recognize a member of the Faculty of Medicine at Dalhousie who is doing important and inspiring work in global health through his involvement in the microresearch program.

Dr. Bob Bortolussi

Recipient of the 2014 Dr. John Savage Memorial Award for Faculty Leadership in Global Health

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Shawna O’Hearn, Dr. Noni MacDonald, Dr. Bob Bortolussi, Dr. John LeBlanc

 

The Dr. John Savage Memorial Award for Faculty Leadership in Global Health recognizes an outstanding humanitarian contribution to global health by a Dalhousie Medical School faculty member.  It is named for Dr. Savage who was a former mayor of Dartmouth, premier of Nova Scotia and a family physician. Dr. Savage was also a champion of the need to promote healthy communities worldwide and had a long-standing commitment to global health projects in Africa with the Nova Scotia Gambia Association (NSGA). Dr. Savage also served on the advisory committee to the Global Health Office at Dalhousie University.

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Shawna O’Hearn recounting the many achievements of Dr. Bortolussi

 

This award honours Dr. Bortolussi’s long and notable career as a paediatric clinical scientist and professor. He is described as a man who

has given unstintingly of his time both in Canada and in East Africa and has made this the major focus of his career…his contributions and collaborations with Canadian and African colleagues will have a lasting impact on global health research.

Dr. Bortolussi has been a mentor to countless clinicians and researchers and has developed resources to advance health research at Dalhousie and beyond.  He spent a 3 month sabbatical at Makerere University in Uganda where he facilitated workshops on research methods. In collaboration with Dr. Noni MacDonald, he worked with faculty and students to develop innovate approaches to research for health care professionals at district and village levels.  From this the concept of “micro research” was born.

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Dr. Bortolussi addressing the crowd and discussing the origins or the Microresearch Program

 

Its aim is to mentor young researchers, especially those who might otherwise have no chance for research training, to investigate the questions that are locally relevant to their practice.  This work has been well received and has resulted in dozens of graduates of the program.  The partnerships have expanded to Kenya and Tanzania strengthening Dalhousie’s international presence in East Africa.

Bob is also one of the leaders working to grow a collective vision of global health at the IWK.  His collaborative approach to working with residents, staff, faculty and researchers will help global health grow at the IWK and Dalhousie.

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Dr. Ron Stewart congratulating Dr. Bob Bortolussi

 

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Dr. Ron Stewart presenting Dr. Bob Bortolussi with the Dr. John Savage Memorial Award for Faculty Leadership in Global Health

 

Congratulations to Dr. Bortolussi!  Look for the 2015 Call for Nominations coming again in January.

To read more about this award please visit our Dr. John Savage Memorial Award page.

To read more about Microresearch please visit their website.

Next up, our student award winner!

 

Dalhousie’s Global Health Voice: Annual Symposium

2014 promises to be an exciting year for global health. The Millennium Development Goal’s (MDGs) target date is only a year away and  strong leadership, accountability, and collaboration are needed to continue to build on the momentum they have started. Dalhousie’s Global Health Office is also in the midst of reflecting on the year’s past accomplishments and successes, while looking forward to new adventures in global health.

This is why we are more than pleased to invite you to our annual symposium on April 1st, 2014. This year’s theme, Dalhousie’s Global Health Voice, recognizes some of the unique opportunities the year  2014 will provide us. We are offering 3 main events to encourage global health expansion, as well as collaboration in this field, and a chance to celebrate and honour Dalhousie’s leadership in global health.

First, our workshop (2:30-4:30pm, Tupper Room 14B2) will explore Dalhousie’s global health voice in a post-2015 agenda. Please join this discussion with key faculty so that we can identify common themes moving forward, areas for additional collaborations, and opportunities for funding in global health.

Following the workshop, a reception and poster presentation (4:30-5:30pm, Tupper Link) will be held to satisfy your afternoon coffee craving and highlight some of the exciting programs at the Global Health Office.

Last, but not least, we will celebrate the recent achievements of Dalhousie’s students and faculty in global health with an award and graduation ceremony (5:30-7:30pm, Tupper Theater A). This will include:

  • Global Health Advocate’s Graduation: We will honour this year’s graduating class of Global Health Advocate’s. These students have worked extremely hard to accomplish knowledge, professional development, and public engagement criteria in order to be graduating the program.
  • Certificate in Health Systems Graduation: In addition, we are also pleased to recognize our first graduating class form the new Certificate in Health Systems!
  • Global Health Awards: The opportunity will also be taken to announce our global health award winners!  The Dr. Ronald Stewart Student Award recognizes a student who has demonstrated leadership in global health and commitment to the health of marginalized communities during their time at Dalhousie. The Dr. John Savage Memorial Faculty Award recognizes an outstanding humanitarian contribution to global health by a Dalhousie Medical School Faculty member.
  • Photo Contest Winner: You will also have the chance to find out who will take home 1st and 2nd prize from our photo contest; where candidates’ submissions reflected the theme Global Health through my eyes.

Please be sure to join us with an eagerness to learn, willingness to participate, and of course, the spirit to celebrate! We look forward to seeing you there!  Join the discussion on twitter with #DalGHImpact.

Ottawa in October: An Important Month for Global Health in Canada

by Shawna O’Hearn, Director of Dalhousie’s Global Health Office
 

October is an exciting month for the Global Health Office.  It is the time for us to meet with colleagues from across the globe to learn about new initiatives and start planning for the next year.  This year, Brie Rehbein and I were in Ottawa where we attended the annual global health conference as well as some additional events that heightened the intensity of the trip to our nation’s capital.  Aside from the successful annual global health conference, there were multiple meetings and training workshops organized throughout the visit that took place before and after the conference.

One of these workshops was a five day intensive certificate course offered through the Centre for Global Health (Unvieristy of Ottawa), Carleton and the Swiss Tropical and Public Health Institute of Basel.  Participants came from all over the world and gained practical foundational skills in health systems strengthening.  For more information on the course please visit: http://www.ccgh-csih.ca/csih2013/healthsystemscourse.php.

 

Gathering Perspectives Dialogue, Image courtesy of CCGHR

Gathering Perspectives Dialogue, Image courtesy of CCGHR

 

As a member of the Canadian Coalition for Global Health Research (CCGHR), I participated in the University Advisory Council as well as one of the fall dialogues for the Gathering Perspectives project.  In May 2013 CCGHR launched a study to gather perspectives from the global health research community about the role of research in the pan-Canadian vision for global health.  Adopting an appreciative inquiry approach, four distinct dialogue processes have been used to engage perspectives from students, faculty, university administrators, partner countries, funding agencies, government agencies, non-government organizations and private sector stakeholders.  More detail, including the research framework, can be found in the Call for Dialogue available on the CCGHR website.  The discussions and findings were diverse with recommendations to have an annual event on global health research and to develop an ethical code of conduct.  A report is being drafted and will be posted through this blog and the CCGHR website.

There are 23 universities who are members of CCGHR’s University Advisory Council.  We had an intensive one day meeting in Ottawa and identified three key areas for future collaboration.  First, there is a recognized need to influence university internationalization strategies by identifying opportunities to align with global health research principles.  Second, a working group will be established to explore best practices of trans-disciplinary global health research to address the challenge of discipline specific silos that take place within and among universities.  Finally, the University of Calgary conducted a self-assessment on global health research within their institution.  The self-assessment tool was reviewed and considered as a potential tool to guide the work of other universities wanting to strengthen the visibility of global health research.

All of these sessions left us feeling energized and inspired to return to Dalhousie where we will apply our new knowledge to our programs and partners.

Collaborative learning in Tanzania: Clinical and Cultural opportunities Part 2

By: Luke Wiseman, Dalhousie Pharmacy Class of 2014
Blog Series Part 2 of 2
 

In this blog series Luke Wiseman, a Dalhousie Pharmacy student, is sharing his experience during the Tanzania Summer Program 2013 at PASADA in Dar es Salaam.

Luke observing Kaposi Sarcoma biopsies

Luke observing Kaposi Sarcoma biopsies

Some of the clinical skills and knowledge that I gained during this elective included interprofessionalism, how to improve medication adherence, how culture and socio-economic factors can influence someone’s health and the care they receive, patient counseling, and knowledge on HIV/AIDS and opportunistic infections.

Luke and Alex doing HIV testing

Luke and Alex doing HIV testing

I learned that the people are the experience; they help shape your thoughts and feelings about everything in this world.

My personal learning objectives included gaining independence as a traveller, and expanding my understanding of the global world.  It was a huge learning curve to learn the ropes as a global traveller. I quickly learned how to book air travel and reserve accommodations abroad. Reading, Internet searches, and talking to previous travellers in Africa were paramount to understanding practical information such as money, and health and safety issues. The guidance from the Global Health Office ensured that we were on track with immunizations and Visas, and that we were not completing this medical experience in isolation, a great example of collaboration. My personal global world was previously limited to the North American East Coast, readings, discussions, and adventures with relatives and friends. My world was small, but soon opened wide through participating in the Tanzania 2013 program. Not only did I travel extensively throughout Tanzania, I also traveled to Zanzibar, Johannesburg, and Cape Town. My adventures included climbing Mount Kilimanjaro, going on a safari, visiting the Apartheid Museum in Africa and going Great White Shark diving. However, I must say that the highlight of my journey, including the numerous experiences at PASADA, was the people that I met. The people of Africa made the most profound impression on me – as evenings and weekends in Dar es Salaam allowed for personal interactions, helping me gain a greater understanding of their life situations.  I learned that the people are the experience; they help shape your thoughts and feelings about everything in this world.

Door to Paediatric room

Door to Paediatric room

 

The biggest challenge that I faced during my elective was communicating with the patients. I could only speak a limited amount of Swahili and had to depend a lot on non-verbal communication. Despite this challenge everyone at PASADA was very understanding and willing to help bridge any gaps. I appreciated working in the various clinics, such as PMTCT, TB, ARV, lab, and pediatric, with my limited language skills. It gave me the opportunity to counsel patients of all ages using non-verbal cues.

TB Awareness campaign at PASADA

TB Awareness campaign at PASADA

When I think about how this experience has impacted my educational/career path I have a sense of both comfort and determination; comfort in knowing that I have chosen to work in the health community, and determination to reach forward and become a physician.

Please click on Post 1 to read the previous post in this blog series.

For more information on this Summer Program please visit our Tanzania webpage.