“You are not a drop in the ocean. You are the entire ocean in a drop.”
Many medical students struggle with the sense of consuming resources, time, and space, without anything to give back during their global health elective. While these sentiments hold an element of truth, there is a bigger picture to bear in mind. You are part of a much greater system that consists of a multitude of components. WCHN/UVMCOM is deeply engaged in and committed to each international site. Sending medical students from the global North to the global South is only one part of a greater whole.
Our partnerships are truly collaborative and mutually rewarding. We dedicate focused energy, thought, and intention in capacity building at each site. As educators, we and our partners bring young junior faculty from international sites to the United States to learn as much as they can, and vice versa. Local leaders select the best candidates based on the needs of their respective institutions while we in the United States try to match our resources to the capacity building needs of each site. To steer clear of brain drain, we focus on those who are already established in their home countries. When they return home, we do whatever we can to support their striving toward academic goals. They apply their newly acquired knowledge however they deem fit, shedding light on what they believe is important and transplantable. They spread their experiences and thoughts radially outward into their medical and personal communities.
But capacity building extends far beyond the impact on individuals and their communities. Given that our partners are among the most acclaimed universities around the world, and that their graduates are going to be leaders of medical education in their home countries, whatever change in perspective students gain may become implemented in medical education when they become drivers of change. Thus, any change in medical education is not only going to have a substantial impact on the life and health of patients, but eventually the focus will be shifted to teaching teachers and collaborating only with leaders.
For now, you are simply observing deficiencies, injustices, and inequalities, and investigating the reasons behind them. Somewhere down the road, you may be a powerful person in the WHO or UNICEF or another organization with the ability to have a substantial impact on the lives of the underserved. You may even return to the country that hosted your global health elective several years from now to directly give back to the community that gave so much to you. Your experiences will make an impact even if you work at the service of the underserved in the United States. The underserved is the underserved, whether under the shadow of skyscrapers in New York City or in a slum in Kampala. Your experiences will make you a better doctor, and perhaps more importantly, a better person, and that will make an impact on everyone around you.
We are investing in you because we know you will someday make a significant contribution. But remember to be patient, as it may take years before you see your efforts come to fruition. More importantly, you are working within a system that is designed to give. The system replicates and augments itself. We are not only taking from these international sites that give us so much, but are doing our best to contribute to the greatest possible extent.
Your observations, many of them difficult to comprehend, are correct. The system is not fair. Resources are not equally shared, and people suffer needlessly as a result. Accept your observation of injustice and do something with it. Do not let yourself become paralyzed with disappointment. You are now part of the movement that is fighting to gradually reduce this injustice. You can choose to dedicate your life to fighting for this cause that is the vision and mission of global health. It is a daunting and formidable responsibility, but one that we must undertake.