The Role of Communal Living in Global Health

Written by Mitra Sadigh, Writer/Editor at UVMLCOM/WCHN Global Health Program, and Majid Sadigh, M.D., 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.

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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 Majid Sadigh, MD, 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.

Gratefulness

Written by Dr. Ramapriya Vidhun, Associate Professor at the University of Vermont and Program Director at Danbury Hospital


We began our partnership with the Global Health Department at Danbury Hospital in March 2014. We were thrilled to welcome Phiona Bukirwa from Uganda. She spent most of her nine months in our department learning anatomic pathology, and participating in sign-outs and unknown case conferences and slide reviews that advanced her diagnostic skills immensely.

Culture As Construct: Looking Forward to a Global Health Elective in Vietnam

Written by Elizabeth O'Neill, '20


Our view of culture is essentially a construct that differs both within and among communities, as its manifestation in traditions and customs impacts people in varied ways. I chose to attend the UVM Larner College of Medicine largely because I believe in the institution’s mission and vision to promote high-value, inclusive care to people of all cultures, both locally and globally. Direct experience with clinical practice embedded within different societies is necessary to develop into a socially responsible, culturally competent physician - qualities I strive to embody as a medical student and beyond.

Witness, Advocate, Exchange, Improve

Written by Anne Dougherty, MD, Assistant Professor at UVM Robert Larner, MD College of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, and founder and director of the UVM Global Women’s Health Education Program


On a whiteboard in my office, I have written the words: witness, advocate, exchange and improve. These are my pillars of global health. Witness, don’t rescue. Advocate, for a diversity of backgrounds. Exchange, sustainably and equitably. Improve, building appropriate technology and capacity. These core concepts may seem obvious, but they require training in global health ethics and the realities of on-the-ground work in low-resource settings.

The Urban Hospital Serving the Underprivileged in Vietnam

Written by Dr. Stephen Scholand, Site Director at Cho Ray Hospital, Ho Chi Minh City, Vietnam Global Health Program


The global health clinical experience in Southeast Asia is largely centered on Cho Ray Hospital in Ho Chi Minh City, formerly known as Saigon. Cho Ray Hospital, a massive urban hospital serving the underprivileged in Vietnam, has a bed capacity exceeding three-thousand. Almost all the major branches of medical care are represented. Because of the high incidence of traffic, mainly motorcyle, accidents in the city, a significant proportion of the inpatient population is orthopaedic. The hospital also boasts very busy Emergency Medicine and Critical Care services. In fact, the volume of patients is so high that Intensive Care Units are found on a number of medical wards.