Packing ethics into medical students’ global health trips
Medical trainees want to help in less-resourced countries. But short-term programs can misread local needs, overburden hosts, and send students into situations they're not prepared to handle. Here’s how leaders are ensuring ethical, effective experiences. Programs that want to provide effective, ethical experiences should avoid veering toward "volun-tourism," experts say. Instead, they should build solid, respectful partnerships with local communities. Some call this “fair trade education,” borrowing from the “fair trade” concept that promotes equity between producers, who are often from lower-income places, and consumers in higher-income nations. To make sure it was achieving this and other goals, Wayne State University School of Medicine paused its student-run global health trips a few months ago. Until then, the school’s World Health Student Organization would raise funds, buy medicines, and travel to sites in less-resourced countries. “The students would create pop-up clinics” and organize trips with the help of U.S. nongovernmental organizations, explains Ijeoma Opara, MD, who codirects Wayne State’s new interdisciplinary Global Health Alliance (GHA). “It was students’ responsibility to arrange faculty to accompany them on travel as well as faculty in the host country to provide oversight.” Now, though, the school is working on extensive changes. “We want to focus on structured, competency-based learning experiences as well as on developing strong, long-term, bidirectional relationships with faculty leadership in host countries,” says Opara. “Hosts should be fully engaged in program design and defining intended outcomes. Only they really know their resources, their needs, and their capacity." At Wayne State, predeparture trainings include lessons in the history, language, and culture of destinations, combined with modules from the University of Minnesota’s Global Ambassadors for Patient Safety program. Students’ failure to understand local values can inadvertently cause problems for both patients and providers, notes Kristiana Kaufmann, M.D., who codirects the school’s GHA program with Opara.
February 11, 2020