Global Health Education Consortium Conference: Part 2
Tanyaporn (Tanya) Wansom who among many other things is the AMSA (American Medical Students Assocation) Chair of the Committee on Global Health now gives her take on the last two days (Thursday and Friday) of the GHEC Conference in Sacremento-Rhona
Hi everyone! This is my first post for The Lancet Student Blog, but I hope there will be many more. My name is Tanyaporn Wansom and I’m a Thai-American dual degree candidate at University of Michigan, where I’m getting both my MD and an MPP (Master in Public Policy). In 2008-2009, I’ll be serving as AMSA-IFMSA co-chair (with Hanni Stoklosa from Tufts Med) and also Chair of the Committee on Global Health. If you have any questions about how to get involved in either group, please contact me or visit www.amsa.org/global
On Thursday I gave a talk entitled, “Global Health Workforce Crisis: Potential Contributions for North American Universities, Faculties, and Students” highlighting the impact the Global North (with an emphasis on the US) was having on the global distribution of human resources for health (HRH) & talked about some ways institutions could work to address the global health workforce crisis. These included:
- Making sure that students and faculty going abroad were held accountable both before and after receiving financial support from their institutions. With the growing interest and trend of students wanting to go abroad, there is a danger that many may engage in “medical tourism” where one goes into a community without preparation (often for a short period of time) and has an overall net negative impact on said community. Some students may provide services that they are not qualified in any way to do. Even if medical missions are providing some direct services, what happens when the mission leaves? Is there follow-up care for the patients that were treated if necessary? How sustainable is the effort?
- Recognizing the burden that foreign health care workers (meaning us) place on the existing infrastructure in other countries, especially when we don’t have sufficient language skills. People must take time out of their lives to show you around, help you get acclimated, interpret for you in clinic, etc. – be aware of what you’re taking (and what you’re actually contributing) when you go abroad.
- Some long-term institutional commitments I highlighted included:
- Long-term collaborations with other universities in the Global South. These collaborations should be sustainable, bilateral, and involve twinning initiatives (or one for one exchanges so students & faculty can live and work in both places). Some examples of these outside institutional settings include the NIH/Fogarty Clinical Research Scholars Program and IFMSA clinical and research exchanges.
- Making a commitment to capacity-building to institutions in the Global South. Capacity can range from capital infrastructure investment to human capital through education, training, etc.
- Exploring making resources at your institution open access, or available to anyone on the internet. University of Michigan Medical School, for example, is making all its preclinical curricula (including streaming videos of lectures) available online. GHEC itself is also pioneering the development of modules on a variety of global health topics that will also be available on its website this coming year.
I closed my talk with some advocacy and activism. AMSA with many partners has been advocating for PEPFAR (President’s Emergency Plan for AIDS Relief) reauthorization and an expansion of US commitment to global health through the Global AIDS, TB, and Malaria Bill. The House version of the Bill narrowly passed when it came to a vote on Wednesday and now we are waiting for the bill to come to the Senate floor and voted on. This bill is pretty amazing and original efforts in the House were championed by Tom Lantos, D-CA, Chair of the House Committee on Foreign Affairs, who passed away from cancer in early February 2008. Lantos was an author to the House Bill, which dramatically expanded the scope of the Global AIDS Bill, gave $9 bn to TB and malaria efforts, included provisions to support microbicide research, and eliminated the abstinence-only earmark from prevention funding. In any case, this bill is HUGE (to the tune of $50 bn over the next 5 years).
To mobilize action around the issue of health care workers, my friend Dan Murphy (2007-2008 Legislative Affairs Director for AMSA) prepared a call-in script to Senators urging them to propose an amendment to the Senate Bill urging for the training and retention of 140,000 new health care PROFESSIONALS rather than just ‘paraprofessionals’ (which could include anyone such as maintenance staff). While paraprofessionals are definitely important, we need more health care professionals to make sure that the huge scale-up of antiretroviral treatment continues to be sustainable. At the end of the talk, I demonstrated a call-in to one of my Senators and we urged everyone to call-in to their Senators. About 250-300 took action and did call their Senators with our call-in script and it was exciting to see a wide range of people get together around an important cause that we’d just spent the whole morning talking about.
The call-in was exciting and many people approached us afterwards thanking us for connecting education with action. I think it’s always important to remember the power one has as an American citizen and constituent, and urge all of you readers to call your Congresspeople on issues that you care about – it really does make a difference! If you’ve never done it before, it’s easy to find action alerts or call-in scripts online as well.
In the afternoon, I listened to Dr. Steven Gloyd’s talk on the impact of structural adjustment programs on African countries, the role of debt and aid, and how much $ actually gets to people on-the-ground through our aid packages. I was interested to hear more about his work at Health Alliance International, based out of the University of Washington in Seattle.
Moving along to Friday. Some highlights of the day for me included:
- The morning keynote address by the recipient of the GHEC Distinguished Service Award, Dr. Julio Frenk. Dr. Julio Frenk just finished his six-year term as the Minister of Health in Mexico and discussed his role in galvanizing politicians in Mexico to come together around the issue of health as a human right and enact universal health care for all Mexicans. His lecture detailed important concepts around health care policymaking and implementation in a global setting and highlighted how ethics could underpin economic decisions around health care financing. The ethical foundation that the Mexican universal health care plan has five pillars: social inclusion, equality, financial justice, autonomy, and social responsibility. It was interesting to hear how ethics could inform health care reform efforts, and left a lot of us wondering how to translate that framework to the US context, where many people do not believe (or have negative views) around the concept of health as a human right.
- Lunchtime topic tables led by moderators on all different topics related to global health. I sat at the table on post-graduate training and heard a lot about new global health related residencies starting all over the country.
- Posters and exhibit hall. Hanni Stoklosa (AMSA-IFMSA co-chair) and I manned the AMSA-IFMSA table for awhile and had the chance to talk to many students from all over the US, Canada, and Cuba.
- The afternoon plenary panel discussing human rights and ethics in the field of philanthropy. Dr. Frenk spoke again (now wearing his foundation hat as a senior fellow at the Gates Foundation and also the head of the CARSO Foundation) and was joined by Dr. Robert Ross, president and CEO of the California Endowment. Dr. Ross’s talk was amazing and talked about advocacy, the lessons we’ve learned (and still need to learn) about how to frame universal health care, and the role of philanthropy in pushing for social change.
- Afternoon panels/workshops. These run concurrently and I attended two workshops titled “Global Health Education and Cross-Curriculum Courses” and “Global Migration and Health”. These workshops were cool in the fact that they were cross-disciplinary, and I heard talks from a nursing professor, an education professor, and ID physician, a medical anthropologist, and a public interest lawyer. It was also a good time to network and hear what other schools are doing around the country.
- Evening symposium on Global Warming and Health. We heard a lecture from Linda Adams, the Secretary for the California Environmental Protection Agency about how California was able to successfully pass the strictest laws regulating climate change (and decreasing greenhouse gas emissions, etc). As the first woman to head Cal EPA, she discussed negotiations, politics, and policymaking, and I definitely think there’s a lot to be learned from climate change to inform health care reform debates.
And there’s still a whole day left! Stay tuned for more updates and how to get involved, wherever you are! Tanyaporn Wansom: tanyaporn.wansom@gmail.com