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Canadian Students Involvement in International Health

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1945 - 96% of US medical schools taught tropical medicine/international health ... Ottawa public health edu, English/Chitambukan medical dictionary, Child to Child ... – PowerPoint PPT presentation

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Title: Canadian Students Involvement in International Health


1
Canadian Students Involvement in International
Health
Alexandra Martiniuk MSc Community Health
Epidemiology PhD candidate Epidemiology and
Biostatistics University of Western Ontario,
Canada SUNSIH President 1999-2000 and 2000-2001
(www.csih.org) Contact alexmartiniuk_at_hotmail.com
1
2
WHAT TO EXPECT IN THIS PRESENTATION
  • Why topic important
  • Students involved in international health
    important for global community Canadian one
  • Students already involved
  • Students need to improve communication to each
    other, their universities/faculty overseas

2
3
BACKGROUND
A resurgence of interest and activity in
international health is strong but
unorganized(Stuck et al., 1995)
International health care/aid is provided through
multiple channels (both local and international)
resulting in duplication and waste, fragmentation
of care and poor coordination of services Most
believe that health faculties have an important
role in this struggle (Ulmer, D.D., 1995)
3
4
RATIONALE
  • HOW MANY STUDENTS ARE INVOLVED?
  • 1989 annual AAMC (American Association of
    Medical Colleges) graduating medical student
    survey - 15.3 had done an overseas elective
    (Imperato, 1996.)

4
5
  • BELIEF THAT INTERNATIONAL ROTATIONS/ELECTIVES ARE
    POSITIVE
  • confidence in knowledge, history and physical
    exam
  • skills in diagnosis
  • appreciation of economic (costs) and political
    policy effects on health
  • understanding of cultural factors in
    Dx/assessment and Tx (Bissonette, R.P. and
    Alvarez, C.A.,1991)

6
Benefits of International Work to Home Community
CANADIAN LACK OF RURAL HEALTH CARE
PROVIDERS Undergraduate international
experiences may preserve desire to work in
under-served communities (Chiller, et al.,
1995) Links seen between developing world and
under-served populations in North America
(Stuck, C. et al, 1995.)
CANADIAN HEALTH CARE SYSTEM IN FINANCIAL
CRISIS International health work can
de-emphasize the use of expensive technology.
Health care costs may be reduced. (Chiller et
al., 1995)
5
7
PUBLISHED LITERATURE ON THIS TOPIC
  • Canadian contribution (Head, I.L. Canadian
    Contributions to Health in the Developing World
    Canadian Journal of Public Health. Vol. 74,
    July/august 1983) (McGill paper, 1993)
  • 1945 - 96 of US medical schools taught
    tropical medicine/international health
  • 1954 - 7 were offering such courses while the
    number of students performing electives overseas
    has increased (Imperato et al., 1996.)

6
8
Literature Contd Do international health
rotations increase interest in resource-poor
areas back at home?
  • international health rotations increase the
    number of physicians entering careers in
    under-serviced areas and improve the health
    systems in resource-poor regions (Pust, R.E.,
    Moher, S.P., 1995.)
  • STUDY (Chiller, T.M. et al., 1995)
  • questionnaires to 142 graduates (1993)
  • 23.1 who attended international rotations
    intended to work in resource poor areas of the US
  • compared to 5.6 of those who did not do an
    international rotation
  • note follow-up poor (76 students) ALSO
    self-selected, no argument for causality)

7
9
Literature Contd Are international health
rotations meeting their objectives?
  • Current objectives include
  • develop professional linkages in international
    health work
  • increase training ( international health
    courses)
  • expand multi-disciplinary research in global
    health issues (Torjesen, H.,1995)
  • STUDY
  • questionnaires to 30 medical students
    (international rotations since 1984)
  • improvements in communication, role of religion
    and disease concepts on management of illness
    (Bissonette, R.P. Alvarez, C.A., 1991)

8
10
FUTURE DIRECTIONS
  • More research into international health
    rotations/electives
  • a paucity of articles on consequences of
    international rotations, studies into effects of
    student international experiences encouraged
    (Chiller, TM et al., 1995)
  • systematic survey of alumni who participated in
    overseas electives re their subsequent careers
    would be useful (Imperato, P.J., 1996.)
  • US medical schools have provided medical
    student experiences overseas for 40 years but no
    systematic documentation of educational
    consequences (Bissonette, R.P. Alvarez, C.A.,
    1991)

9
11
INTERNATIONAL HEALTH STUDENT GROUPS IN CANADA
Dalhousie University (DIMS) McGill University
(OMAF) (SAMA) McMaster University (SIHI) Queens
University (QMO) Universite de Leval (Sante
Universite de Montreal Tiers-Monde) (CINESIU
M), (CASI) University of Alberta
(SIHA) University of British Columbia
(GOSA) University of Calgary
(GHIG) University of Manitoba (MSAID) University
of Ottawa (OSHI) University of Saskatchewan
(Health Everywhere) University of Toronto
(UTIHP) University of Western Ontario
(MedOutreach, WIHN)
10
12
SCHOOL (year) LOCATION (last is current
location) 1. Dalhousie (99) Gambia, Cuba 2.
McGill (84) Cameroon, Kenya, Haiti, Croatia,
Armenia 3. McMaster (?) Malawi, Cambridge Bay
(Nunavut) 4. Queens (84) Guyana, Belize,
Northern ON., Kingston 5. U of Alberta
(90) Guyana, Tanzania, Edmonton 6. UBC
(93) Guatemala, Vancouver 7. U of Calgary
(?) developing project in Bangladesh 8. U of
Manitoba (96) Haiti, Northern Manitoba 9. U of
Ottawa (88) Zaire, Rwanda, Burundi, Guyana,
Malaysia, Vietnam, Malawi 10. U of T
(95?) Toronto, developing project in Ethiopia 11.
UWO (86 98) Nigeria, Tanzania
11
13
WHAT ARE THESE STUDENTS DOING OVERSEAS?
1. Dalhousie medical students observe Cuban
health care system 2. McGill work with disabled
children in orphanages, health education, refugee
supplies, mental health survey, photo
journalism, funds for wells in Haiti 3.
McMaster curriculum development Peace through
Health, fundraising, journal club 4.
Queens rehabilitation in Guyana, program
evaluation in Belize, immunization, health
education schools village workers, northern
ON continuing education, Camp Trillium, CNIB 5.
U of Alberta hypertension/diabetes study in
Guyana, primary health care education, hook
worm Dx/Tx in Tanzania, AIDS education, FAS edu
in Edmonton, Operation Eyesight, text
collection
12
14
6. UBC health/SES survey Guatemala, pediatric
safety, immunizations, Vancouver Boys and Girls
club nutrition classes, Health Safety Fair,
aboriginal health 7. U of Calgary international
health resource center 8. U of Manitoba malaria
program (bednets), TB/CHF clinics, physio at
orphanage (Haiti) 9. U of Ottawa public health
edu, English/Chitambukan medical dictionary,
Child to Child 10. U of T immigrant health in
Toronto, pen pal to health professionals in
Ethiopia 11. UWO speaker series (WIHN), protocol
dev in Tanzania (eg. Antibiotic use),
parasitology research, neonatal respiratory
physio, physical exam diagnosis with rural
health care workers
13
15
ISSUES AND INSIGHT
  • Growing student base, a need to collaborate and
    create (eg. U of Arizona offers an international
    health course for students from any university)
  • Need for Canadian knowledge base (better record
    keeping, sustainability communication)
  • Roles Responsibilities of the University need
    to be discussed such as supervision of student,
    protection of student from illness and injury
  • Risks to student university (20s
    developmental stage, risks worth gains?)

14
16
ISSUES AND INSIGHT CONTD
  • Ethics
  • working in another culture/country (clean up
    your own backyard first vs. our global
    community)
  • meeting our needs or theirs? (a fad in North
    America?)
  • provide valuable medical assistance (now and/or
    later)?
  • Equalizing the relationship (3rd world charging
    tuition)

15
17
CONCLUSIONS
  • Topic is important
  • Students in international health relevant to
    our global community our Canadian one
  • Students involved
  • Need to improve communication between students,
    universities/faculty overseas

16
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