Ethical Dilemmas in Global Health: Promoting Global Consciousness

Written by Dr. Stephen Winters, and Dr. Robert Kalyesubula, cofounder of the African Community Center for Social Sustainability, Nakaseke, Uganda


From a series of discussions about ethical dilemmas in global health, with responses from one global health leader in the Global South and one in the Global North. Please leave us your feedback in the comments section below, and send us ethical dilemmas you would like to see discussed.
Many students and faculty visiting other countries often deal with culture shock. How can the stress and frustration of culture shock be mitigated? What steps have you taken as a leader in global health to address the challenges of dealing with diverse participant backgrounds and expectations?

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Ethical Dilemmas in Global Health: Strengthening Global Partnerships

Written by Stephen Winter, MD, Director of Global Health at Norwalk Hospital, and Robert Kalyesubula, MD, cofounder of the African Community Center for Social Sustainability, Nakaseke, Uganda


From a series of discussions about ethical dilemmas in global health, with responses from one global health leader in the Global South and one in the Global North. Please leave us your feedback in the comments section below, and send us ethical dilemmas you would like to see discussed.
There are many collaborations between the Global South and Global North, each with their own interests that must be met in order to make the collaboration fruitful. What are the key ingredients of a balanced collaboration, and what must both sides consider before setting one up?

Letter from the Editor: A Call to Write

Written by Mitra Sadigh, Writer/Editor at the UVMLCOM/WCHN Global Health Program and Editor of Global Health Diaries.


As reflective writers, we process our experiences and emergent feelings in the immediacy of writing them down, each word a wipe on a foggy mirror. In the midst of a slowly sharpening image, we uncover truths about ourselves, others, and the ways in which we exist in and interact with the world.

Growth in Many Directions

Written by Dr. Majid Sadigh, Trefz Family Endowed Chair in Global Health at Western Connecticut Health Network, and Director of Global Health at University of Vermont Larner College of Medicine


As we pass the five-year mark since the inception of our Global Health Program in June 2012, we celebrate the remarkable multidirectional growth that has transpired. We have substantially increased the number of our network participants in international training sites, developed a robust bidirectional component in support of junior faculty from our partner sites for extended capacity building experiences at WCHN, deepened the academic teaching curriculum at home and abroad, and added a significant volume of scholarly publications to expand the academic footprint of the Global Health Program.

The Role of Communal Living in Global Health

Written by Mitra Sadigh, Writer/Editor at UVMLCOM/WCHN Global Health Program, and Dr. Majid Sadigh, Trefz Family Endowed Chair in Global Health at WCHN and Director of Global Health at UVMLCOM


From a series of weekly notes to global health participants

“There is a community of the spirit.

Join it, and feel the delight of walking in the noisy street and being the noise…

Open your hands, if you want to be held…

Why do you stay in prison when the door is so wide open?...

Move outside the tangle of fear-thinking...

Flow down and down in always widening rings of being.”

-Jalāl ad-Dīn Muhammad Rūmī


When in an unfamiliar environment, small, unexpected events easily become unmanageable obstacles, and simple problems overwhelming. A global health elective brings a wealth of unfamiliarity in the culture, clinical settings, surroundings, and daily lived experience. Students, especially those who are traveling to a place different from their home for the first time, may feel isolated in the plethora of feelings that arise- among them confusion, frustration, helplessness, and loneliness. To help process these feelings, it is crucial that students be embedded in a network of support with fellow medical students, residents, and physicians with whom to share experiences and discuss thoughts.

A Lifetime of Privilege

Written by Michelle Mertz, M.D., Assistant Professor at University of Vermont Larner College of Medicine and member of the Global Health Leadership Team


Having been on your elective for some time now, the initial shock of being in an unfamiliar environment may have subsided, Hopefully you feel more confident and comfortable. Perhaps you are also starting to feel less intrigued, more emotionally fatigued, and frustrated with certain aspects of the culture surrounding you. Initially your efforts may have been focused on finding similarities with the people in your host country, but fatigue sometimes causes a shift toward focusing on differences.

Combating Medicine’s Hidden Curriculum

Written by Stefan Wheat, '18


"But we had forgotten that alongside Orwell's dark vision, there was another - slightly older, slightly less well known, equally chilling: Aldous Huxley's Brave New World. Orwell warns that we will be overcome by an externally imposed oppression. But in Huxley's vision, no Big Brother is required to deprive people of their autonomy, maturity and history.” -Neil Postman
My family reached the saddle of Thorung La pass on day fifteen of our twenty-one day trek of the Annapurna Circuit in Nepal, the 300 km trail encircling the Annapurna massif. On day sixteen I turned nine years old, and on day seventeen I developed appendicitis. That first night after I began to develop symptoms, I remember clearly when our sirdar, the leader of our expedition, entered the tent where I was screaming bloody murder—writhing in pain, but perfectly lucid. He sang a very tranquil song in Nepali and proceeded to inform my father—within clear earshot of myself—that he did not think I would survive to reach the nearest hospital. This marked my first experience with poor bedside manner.

A Bridge Connecting Two Beautiful Islands

Written by Dr. Majid Sadigh, Trefz Family Endowed Chair in Global Health at Western Connecticut Health Network, and Director of Global Health at University of Vermont Larner College of Medicine


Excerpt from a panel entitled "Building ethical and effective partnerships between institutions in LICs and HMICs" at the 2017 Consortium of Universities for Global Health Conference.
Forming and sustaining equitable partnerships with international colleagues is a challenging endeavor. It requires passion, leadership, transparency, cultural sensitivity, friendship, and endurance. All the time and effort spent is an investment toward something valuable, and mistakes and miscommunication are unavoidable. Pain is an inherent part of any growth process.

Global Health Electives Provide Lessons in Patient Advocacy, Health Equity, Humility

Written by Dr. Majid Sadigh, Trefz Family Endowed Chair in Global Health at Western Connecticut Health Network and Director of the Global Health Program at UVM Larner College of Medicine, and Mitra Sadigh, post baccalaureate student in pre-medical studies


For many medical students, training in a resource-limited setting is their first exposure to the way most of the world lives, where nylon gloves are used in place of catheters, where the number of radiation machines in a nation can be counted on one hand, where a bed shortage might mean patients sleep on the floor. Working in this environment requires self-awareness, strength, and humility to accept and then overcome challenges to one’s way of being, thinking, and perceiving the world.

The Forms of Voicelessness

Written by Dr. Majid Sadigh, Trefz Family Endowed Chair in Global Health at WCHN, and Director of the Global Health Program at UVM Larner College of Medicine


As a medical resident, I traveled to a site that will be forever living in my mind, in a tiny hospital in the South of Shiraz. This land was home to the Ghasghaei, a multi-ethnic nomadic tribe of roughly 1.5 million who live in Iran and the surrounding countries. Possessing neither archives nor a written history, the Ghasghaei pass their legacy through a rich oral tradition. The scene that first comes to mind is one of family members gathered around a blazing fire. The light danced on faces entranced by the slow cadenced words of a community leader and elder. These evenings were a time for older generations to hand down the traditions and values, beautiful and singular, that have taken shape over thousands of years.