Practicing Meaningful Healthcare Abroad

Contributor
School of Nursing

Last month, I visited Los Pinos del Eden, a tiny, beautiful town in a rural, mountainous region of the Dominican Republic, near the border with Haiti. I was leading a group of eight women on a public health service-learning trip for Una Vida, a local non-profit I’ve spent years collaborating with to cultivate meaningful short-term service work. 

During our trip, under the supervision of the local Ministry of Public Health, our volunteers were able to shadow a Dominican family physician as she performed screening for cervical cancer. 

After watching the physician complete a pap smear, the provider offered the volunteer the chance to perform the exam herself on the following patient.

Our volunteer was torn by this opportunity — as a future health professional she yearned for the chance to gain clinical experience, yet ultimately decided to yield the opportunity.

As a nursing student and coordinator of short-term medical service work, these are ethical questions I face as I work with local partners to produce an experience that is mutually beneficial for both foreign students and the local community.

Last month, the Consortium of Universities for Global Health (CUGH) converged at the downtown SF’s Hilton Hotel for an annual conference bringing some of the most innovative and experienced minds in the field of global health.

As a student ambassador representing the UC Global Health Institute, an organization that represents all 10 of the University of California campuses and their global health initiatives, I had the privilege of meeting and founders of organizations I admire, like Haiti Cardiac Alliance and connecting with faculty, residents, and other students deeply engaged in projects around the world.

Throughout various sessions and presentations, one common question emerged: How much of a positive impact do short-term medical trips have? And less subtly, are we doing more damage with short-term initiatives than good?

These are questions that are deeply personal to me, as I have seen both the positive and negative effects that short-term service work, often involving students, can have. I’ve worked as a translator in the Dominican Republic for short term trips, where the goal is to see as many patients as possible in a single day, handing out donated medications, without regard to a patient’s current medication regime, access to future meds once the donated supply runs out, or coordination with local providers.

In attending CUGH, I found a community of like-minded individuals who are dedicated to asking these difficult questions as they design and implement programs in global health.

As students looking to participate in global health programs, I believe we have a responsibility to research and understand the impact of the trips we will take.

By taking the time to keep ourselves accountable to the work we hope to engage in, we can learn deeper lessons through our experiences abroad.

Interested in understanding the complexities of short-term service work? The following are 10 useful tips I gathered while at the CUGH.

  1. Join the community engaged in “fair-trade service learning” at GlobalSL.org. Join their mailing list to learn about evidence-based initiatives in global health.

  2. Choose programs with a proven track record of sustainable global health education, approved by UCSF faculty, such as Child Family Health International.

  3. Seek out mentorship via faculty or within your school’s global health programs.

  4. Invest time in your pre-departure training. Choose an organization that provides you with a curriculum to digest before you travel, and includes training on cultural humility and safety. Search for books and articles to read before and during your trip.

  5. Travel with the right mindset. Take advantage of your role as a student, and show up with the purpose of learning, not teaching or doing.

  6. Debrief and process upon return. Culture shock is real and often appears without warning.

  7. Use what you’ve learned. Hopefully your experience was humbling and eye opening to a wider view of the world. Translate these new experiences into your life back at home.

  8. Join the global health community here at UCSF! Sign up for the UC Global Health Institute’s newsletter.

  9. Read “Beyond Medical ‘Missions’ to Impact-Driven Short-Term Experiences in Global Health (STEGHs): Ethical Principles to Optimize Community Benefit and Learner Experience”.

  10. Visit any or all of the following sites: