Using Guiding Principles to Develop Sustainable International Collaborations Parmi Suchdev, MD, MPH Assistant Professor of...
Is Short-Term Work Abroad Justified? True or False:
Objectives <ul><li>Discuss ethical challenges of short-term global health work </li></ul><ul><li>Propose a model for susta...
Foot bridge project, El Salvador <ul><li>12 volunteers from Wisconsin travel to rural El Salvador for a 1 week “mission tr...
Ethical challenges of global health work <ul><li>Self-serving </li></ul><ul><li>Raise unmet expectations </li></ul><ul><li...
Why is there growing interest in global health? <ul><li>Sense of a “global community” </li></ul><ul><li>Changing demograph...
International volunteer work for clinicians <ul><li>No set guidelines or norms </li></ul><ul><li>Most are short-term volun...
Sphere Guidelines <ul><li>Minimum standards for humanitarian work </li></ul><ul><ul><li>Participation </li></ul></ul><ul><...
Principles to evaluate international trips <ul><li>Mission </li></ul><ul><li>Collaboration </li></ul><ul><li>Education </l...
Application of Model:  Emory  Medishare <ul><li>Organize annual one-week outreach trips to Haiti’s Central Plateau  </li><...
1. Review organization’s mission <ul><li>Defines core purpose and group’s collective beliefs </li></ul><ul><ul><li>Are the...
2. Collaboration = partnerships <ul><li>Project Medishare </li></ul><ul><li>Haiti Ministry of Health </li></ul><ul><li>Zan...
3. Education <ul><li>Educating ourselves </li></ul><ul><ul><li>Sociopolitical context  </li></ul></ul><ul><ul><li>Language...
4. Service = “Doing work that the community needs and wants” <ul><li>Clinical medical care </li></ul><ul><li>Public health...
5. Teamwork <ul><li>Medical education model: </li></ul>Interpreters Local  physicians Community  health workers Patients E...
6. Evaluation = Are goals being reached? <ul><li>Annual needs assessment </li></ul><ul><ul><li>Identify areas for interven...
7. Sustainability = building capacity <ul><li>Partnering with a quality NGO </li></ul><ul><li>Working in a single target r...
Is Short-Term Work Abroad Justified? True or False:
Conclusions <ul><li>Many of the challenges of doing international medical work can be overcome when efforts are guided by ...
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Ethics of Short-term Experiences Abroad and Sustainable Solutions: Parmi Suchdev

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Ethics of Short-term Experiences Abroad and Sustainable Solutions

Parmi Suchdev, Emory University

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  • Transcript of "Ethics of Short-term Experiences Abroad and Sustainable Solutions: Parmi Suchdev"

    1. 1. Using Guiding Principles to Develop Sustainable International Collaborations Parmi Suchdev, MD, MPH Assistant Professor of Pediatrics & Global Health, Emory University Medical Epidemiologist, Centers for Disease Control & Prevention GHEC Plenary April 5, 2009
    2. 2. Is Short-Term Work Abroad Justified? True or False:
    3. 3. Objectives <ul><li>Discuss ethical challenges of short-term global health work </li></ul><ul><li>Propose a model for sustainable international medical collaborations </li></ul><ul><li>Apply model </li></ul>
    4. 4. Foot bridge project, El Salvador <ul><li>12 volunteers from Wisconsin travel to rural El Salvador for a 1 week “mission trip.” </li></ul><ul><li>A local healthcare organization asks them to address an infrastructure problem (i.e. lack of safe water, no latrines). </li></ul><ul><li>The volunteers decide to construct a steel foot bridge over the stream that flows through the village. </li></ul>Total cost: $10,000
    5. 5. Ethical challenges of global health work <ul><li>Self-serving </li></ul><ul><li>Raise unmet expectations </li></ul><ul><li>Ineffective </li></ul><ul><li>Impose burdens on local health facilities </li></ul><ul><li>Inappropriate </li></ul>
    6. 6. Why is there growing interest in global health? <ul><li>Sense of a “global community” </li></ul><ul><li>Changing demographics of U.S. practices </li></ul><ul><ul><li>Increasing immigration, adoption </li></ul></ul><ul><li>Increasing travel to developing countries </li></ul><ul><li>Educational benefits </li></ul><ul><li>Commitment to social justice </li></ul>
    7. 7. International volunteer work for clinicians <ul><li>No set guidelines or norms </li></ul><ul><li>Most are short-term volunteer brigades or training electives </li></ul><ul><li>Huge variation in credentialing, clinical duties, language requirements, religious affiliations, costs, etc. </li></ul><ul><li>No standard of care for trainees, few formal curricula </li></ul>
    8. 8. Sphere Guidelines <ul><li>Minimum standards for humanitarian work </li></ul><ul><ul><li>Participation </li></ul></ul><ul><ul><li>Initial assessment </li></ul></ul><ul><ul><li>Response </li></ul></ul><ul><ul><li>Targeting </li></ul></ul><ul><ul><li>Monitoring </li></ul></ul><ul><ul><li>Evaluation </li></ul></ul><ul><ul><li>Aid worker competencies and responsibilities </li></ul></ul><ul><ul><li>Supervision, management and support of personnel </li></ul></ul>Sphereproject.org, 2004
    9. 9. Principles to evaluate international trips <ul><li>Mission </li></ul><ul><li>Collaboration </li></ul><ul><li>Education </li></ul><ul><li>Service </li></ul><ul><li>Teamwork </li></ul><ul><li>Evaluation </li></ul><ul><li>Sustainability </li></ul>Suchdev, et al. Ambulatory Pediatrics 2007
    10. 10. Application of Model: Emory Medishare <ul><li>Organize annual one-week outreach trips to Haiti’s Central Plateau </li></ul><ul><li>Focus on public health education & sustainable medical assistance </li></ul><ul><li>Partner with Project Medishare, a registered Haiti NGO and U.S. non-profit </li></ul><ul><ul><li>http://www.emorymedishare.org </li></ul></ul>
    11. 11. 1. Review organization’s mission <ul><li>Defines core purpose and group’s collective beliefs </li></ul><ul><ul><li>Are they compatible with your own goals? </li></ul></ul><ul><ul><ul><li>Religiously affiliated? </li></ul></ul></ul><ul><ul><ul><li>Government involvement? </li></ul></ul></ul><ul><ul><ul><li>Address public health needs of community? </li></ul></ul></ul>
    12. 12. 2. Collaboration = partnerships <ul><li>Project Medishare </li></ul><ul><li>Haiti Ministry of Health </li></ul><ul><li>Zanmi Lasante (Partners in Health) </li></ul><ul><li>MedShare International </li></ul><ul><li>Morehouse School of Medicine </li></ul>
    13. 13. 3. Education <ul><li>Educating ourselves </li></ul><ul><ul><li>Sociopolitical context </li></ul></ul><ul><ul><li>Language </li></ul></ul><ul><ul><li>Local medical problems </li></ul></ul><ul><li>Educating the community </li></ul><ul><ul><li>“Teaching the teachers” </li></ul></ul><ul><li>Educating our peers </li></ul>
    14. 14. 4. Service = “Doing work that the community needs and wants” <ul><li>Clinical medical care </li></ul><ul><li>Public health interventions </li></ul><ul><li>Linking the community with the local physician </li></ul>
    15. 15. 5. Teamwork <ul><li>Medical education model: </li></ul>Interpreters Local physicians Community health workers Patients Emory physicians Medical students
    16. 16. 6. Evaluation = Are goals being reached? <ul><li>Annual needs assessment </li></ul><ul><ul><li>Identify areas for intervention </li></ul></ul><ul><li>Clinical studies </li></ul><ul><ul><li>Monitor effectiveness of interventions </li></ul></ul><ul><li>Program feedback </li></ul><ul><ul><li>Local physician and NGO, program participants </li></ul></ul>
    17. 17. 7. Sustainability = building capacity <ul><li>Partnering with a quality NGO </li></ul><ul><li>Working in a single target region </li></ul><ul><li>Institutional support </li></ul><ul><li>Diverse partnerships </li></ul><ul><li>Global health education curriculum development </li></ul>
    18. 18. Is Short-Term Work Abroad Justified? True or False:
    19. 19. Conclusions <ul><li>Many of the challenges of doing international medical work can be overcome when efforts are guided by a few specific principles </li></ul><ul><li>This evaluation model can be applied by others in the development and evaluation of global health initiatives </li></ul>

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