The Ethical Conundrum of International Health Electives in Medical Education

This paper discusses the ethical challenges of global health education programs and, specifically, International Health Electives (IHEs). The growing popularity of IHEs in medical school has ballooned in recent years largely from students who genuinely want to serve in resource-poor areas of the global South, and also from those students who wish to use the field experience to build a superior CV. Medical schools have responded to the demand, but ethical considerations have not kept pace.  In fact, the practice of many of these programs has brought about complex ethical concerns of individual hubris of Northern medical students, and of structural dependency from resource-poor to resource-flush settings. In light of these two concerns, IHEs largely require restructuring.  This paper proposes that program changes need to focus on the very ethical issues that the current programs perpetuate.  While many IHEs do offer some pre-departure training on ethics, pre-departure training can be trivial if it focuses largely on the behaviour of individuals working in resource poor settings.  I propose that a complete reorientation of moral ethics pedagogy and a fresh introduction of social theory training are needed so that the IHE experience is aimed at overcoming current global health inequities at the structural level

Going Where Nobody Should Go: Experiential Learning without Making the World Your Classroom

It raised many questions when students at Dalhousie University were asked, as part of an experiential learning class assignment, to help someone escape North Korea in 2015.  When students organized human rights protests, fundraised for a rescue team within China to escort refugees to safety, and engaged politicians on North Korean refugee needs, it challenged the norms of experiential learning in a university setting.  Is political engagement appropriate for the classroom? Should Canadian students even get involved with such complex human rights and political issues?  Most importantly, could this experience still be considered experiential learning if the students never met the North Korean refugee?  If they never went there?  And if they organized their efforts all entirely in the classroom for credit?  In this chapter I argue that actions of solidarity can have an important place in experiential learning.  The chapter explains the classroom experience of building solidarity with vulnerable populations a world away, and argues that deep values of solidarity can emerge from the classroom, even to places that are impossible to go to

Solidarity Trumps Fear: Cuba is a Model for Global Health in the 21st Century

In the height of the COVID-19 pandemic Cuba offered its own health care workers to countries struggling to cope with enormous health care demands. While Cuba has a long-standing history of sending health workers to countries in the Americas, for the COVID-19 pandemic, Cuba offered its resources to affluent countries such as Italy and Spain. This article discusses how, and why, Cuba is so well positioned to offer medical cooperation to other countries in times of pandemics, and why it offers a compelling model of cooperation and solidarity in times of pandemics

Going where no doctor has gone before: The place of Cuba\u27s Latin American School of Medicine in building health care capacity for Ecuador.

Martin Luther King said that “of all the forms of inequality, injustice in health care is the most shocking and inhumane.” Today, despite the overwhelming quantity of attention and resources given towards global health, social inequity has never been worse as many in the global South remain perilously marginalized from the receipt of sustainable primary-care services. Amidst this backdrop Cuba developed the Latin American School of Medicine (ELAM) as a response to the global South’s lagging supply of human resources for health. The school has received 11,500 students from 29 different countries, including the United States. Every student receives a free, six-year medical education as part of a moral commitment to practice their skills in areas where they are most needed. This dissertation explores how ELAM is building capacity to meet the needs of communities in Ecuador, a country that has endured structural adjustments to its public health sectors. It is about sharing the lived experience of certain ELAM graduates to understand if they are able to reduce health-care inequity in their communities despite personal and structural challenges. This is best understood in how graduates practice community-oriented primary care (COPC) within their communities. This study finds that ELAM’s institutional ethics are counter hegemonic to dominant neoliberal tendencies in health-care service provision, but that only with appropriate social and political support will the ethics and skills of these graduates scale up into positive changes in community health. The study conceptualizes ELAM as an alternative-development project grounded in a tradition of Cuban medical internationalism. It offers insight into the program of study, discusses the nature of public health care in Ecuador, and then explores the professional experiences of several Ecuadorian ELAM graduates. This dissertation serves as a preliminary step in understanding how ELAM impacts the accessibility of vulnerable populations to health-care services in Ecuador. It demonstrates the strengths and challenges of ELAM graduates in seeking to strengthen human resources for health. The ELAM story shows how investing in people can work towards overcoming neoliberal health-care hegemony, which has done a great deal to promote health-care inequality rather than ensure social equity

Integrating health and human security into foreign policy: Cuba's surprising success

Human security has been thoroughly debated as a concept and discourse that is more sensitive to the needs of disadvantaged populations; however it has been only marginally implemented in the foreign and domestic policies of the countries where its application has been most actively discussed. We feel that it is unfortunate that energy has primarily focused on theorization of the term rather than examination of empirical examples where human security is or could be put into practice. To provide a stark contrast to the much talk but little action on human security, we offer a case study of Cuba's foreign policy initiatives in primary health-care provision. Cuba sends thousands of health-care professionals to under-serviced regions of the world, and trains physicians from modest and humble backgrounds. The Cuban experience demonstrates how a policy committed to combating structural violence in the developing South leads to a practice that provides basic needs and enhances capabilities for the marginalized - at root a central concern of human security! Cuba has done a great deal to develop such policy, but this has come with internal challenges, political turmoil, and at times questionable outcomes, amid limited recognition. Nevertheless, Cuba's 48-year foreign policy of providing assistance and security at the individual level is a fitting example of human security beyond rhetoric for the twenty-first century. </p

A treatise on the nature, economy, and practical management, of bees; in which the various systems of the British and foreign apiarians are examined, and the most improved methods laid down for effectually preserving the lives of the bees. Containing also an accurate description, illustrated by plates, of the hives invented by Lombard, Ducouedic, Huber, Vicat, l'abbé della Rocca, and other foreign apiarians; and of a newly invented hive for the purpose of depriving the bees of their honey, with safety and expedition: forming the most complete guide to the study and management of those valuable insects.

Pages [397]-398, advertisements.Mode of access: Internet.1

The history of the private and political life of the late Henry Hunt, esq., M.P. for Preston, his times and cotemporaries; exhibiting the rise and progress of those great political events which led to the passing of the reform act: embracing also the history of the momentous crisis, by which the Tory government of the country had been abolished. /

Added title-pages, engraved, have imprint: London, 1835; title vignettes.Mode of access: Internet