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This past week I had the privilege of travelling to Vancouver, British Columbia to attend the inaugural BC Forum of the Canadian Coalition for Global Health Research. Details about the conference can be found here: http://ngdi.ubc.ca/3296-2/ and I will not belabor the details, but we had a wonderful host in the Department of Global Health of Simon Fraser University (and especially from Drs. Craig Jones & Vic Neufield). It was a challenging and pivotal conference for me, in ways that I will elaborate on in the next few posts.
That is not what I want to share now. The conference started with an amazing keynote address, and then moved into a discussion of “Indigenous Health Research” which was an innocuous title that was hiding a discussion that really made me think about many of my assumptions about health care, the role of research, and how we “help” patients/communities in a new way.
Behind that title was a discussion of the interim First Nations Health Authority in British Columbia. If you have not heard of the development of this organization, you can read about it here: http://www.fnhc.ca/index.php/about/background/. However, it was more than the development of a health system to support a native people that struck me.
What struck me were the ways in it was developed, and the fact that there was a recognition of health as being an essential element of community. From the traditions and social structures that kept pre-contact peoples healthy, to the post-contact health problems that affected the diverse people of the First Nations of British Columbia, there was a basic recognition that the health of a community and the health of individual persons are inextricability linked. From that, I realized that the only solutions for healthy people are rooted in a respect for community and culture that comes through communication and a shared vision for health and community. That in a way, health IS community. Health is not something that gets shipped in on a truck, flown in on a plane, dispensed from a pharmacy, or provided from a clinic. Health is the attitude of the community towards food, water, children, families, work, and exercise…whether that is valued (or not). The mechanics of health care are just that, the tools that enable a community that desires to be healthy to make that happen.
Which lead me to an even bigger, more disruptive thought? What if the real point of health care was to truly support the community it serves? To do more than just trundle along as some behemoth that sucks up resources and dispenses “health.” That we should be learning from the patient and from the community what they need to be healthy, not constantly prescribing solutions and interventions. That instead of always having to be the “smartest” person in the room, we embrace the wisdom of being the most caring person in the room, coming to the person who needs us…not demanding they come to us. To me, this is the real promise of Global Health: Teaching us that health comes from community, not something that is given or provided.
The real promise of Global Health is not that "rich" nations can "provide" health care to the "poor" nations. The real promise of Global Health is that we can learn from building patient & community centered health systems how to provide better health care for all of us, regardless of where we live.