How to define global health?  

Global Health is a broad term and it is difficult to define. Although there was an agreement on the main themes, the interviewed students interpreted global health in many different ways.

“Trying to advance individual and population health – but doing it on a larger scale”, a medicine student said, while another pointed out that it is “Health in the overall population, but maybe also outside the country’s border – and maybe health in different ways both regarding diet and exercise but also regarding pesticides and other things that could have an impact”.

Some of the repeating themes were infectious diseases, the modes of transmission and the need to prevent and treat in the most effective way, including improving the sanitary conditions. The diseases students mentioned were mainly infectious diseases like HIV/AIDS, Tuberculosis and Malaria. There was a focus on cross-border diseases and illnesses that are more common due to globalization and travelers.

“The world is globalized, and because you can easily go from A to B, there are some infectious diseases and some tendencies like obesity and diabetes that easily move around”, concluded a medical student.

Is there a solution?

The interviewed students agreed that there is no definite way to solve global health problems. They also underlined that the global health issues are not only linked to one country. Even though the North and the South have different problems, interaction, cooperation and communication between – and within – the countries is essential.

“I think that a solution on Global Health could be a better cooperation and a better communication between the countries”, suggested a public health student. Better communication will save resources as “a country does not need to use resources in solving a problem which another one have already faced and solved”, explained a public health student. 

Other suggested solutions for global health problems were e.g. access to medicine and health care systems, focus on a specific area, and a better implementation of health programs. Also focus on UN programs such as the Millennium Development Goals, vaccination programs, improvement of simple sanitary conditions and human and economic resources were mentioned as important issues.

The importance of education was also mentioned. It was underlined that investing in education in developing countries is essential and improves health of the population. Also focused education and information to risk groups was seen important.

”I think education means a lot. We could say, you should do it this and that way, and you should take this pill. But I think that where we change something is to educate people globally e.g. in health related issues, like midwife-courses for pregnant women and special education for HIV-infected persons or maybe leprous and their relative about risk factors, but also in general that there exists a functioning school system”, said a medical student.   

The medical studies curriculum  

Even though the medical students saw global health is an interesting field, they admitted that these lessons are not prioritized, because they are not part of exam questions. According to the medical students the biggest focus in their curriculum is on diseases that are important in Denmark, their pathology and treatment.

“We have some global health in each module, but the problem is, that it is not exam-related”, a student said and another complemented that to pass your exams: “… it is enough just to learn the diseases. But when you have learned the diseases, then we also look a little out in the world – if we can do something outside of Denmark.”

Many students believe that one way of increasing focus on global health is to include these topics into students’ exams.

At the same time there was some criticism about the varying quality of global health lessons:  “… It has only been limited information we have had” and “maybe they should tell us a specific place to find more about it”.

The majority of public health students were not satisfied with the focus on one particular continent in their Global Health courses. “We are only focusing on Africa, and what is going on in Africa, as if global health is only about Africa”, said a public health student. The students called for a wider perspective to the globalized world’s health issues, for instance one explained: “the content is good but we have a lot of things about Africa and Asia, and we are not talking about the European health problems, the American health problems… there are a lot of new emerging health problems in the west as well. I think those things should be considered in our course”.

Other students were pleased with the content and reading materials they are exposed to. “… the materials they referred to were pretty comprehensive and actually I have read a lot of things I didn’t know about before… I’m really happy about the lectures and materials”.

There is room for improvement but broader approach to global health might be difficult to implement in a limited course length of 2-3 months that global health has in the curricula.  Therefore, a specific focus might be needed.

Gabriel Gulis, Associate Professor of Public Health, supports this by pointing out that there are enormous differences in curricula for public health student in European institutions.

“There are programs that are oriented towards the medical approach to public health, programs that are oriented towards the social/political approach to public health, and programs that are oriented towards the sociological approach to public health, and this in fact is good – I’m not against it at all”.

This gives students a possibility to focus on the areas they are interested in. But this requires that it is easier for students to participate in exchange programs. There is, of course, still need for a common baseline for what public health students should learn so some similarity in different universities’ curricula is needed.

“ I think it [global health] should be prioritized high in funding priorities, exchange programs, more organization, more working in comparison of curricula, creating internship possibilities” Gabriel Gulis concludes.

 

Examples of responses:

Definition of Global Health	A solution?	The Curriculum
“… Health-problems outside Denmark and likely to be different than any of the problems we have here”, med.student. “Health-conditions all over the world – the concept that you try to improve health all over world, in proportion to diseases and epidemics”, med.student. ”It is about the overall health globally and it could be about diseases but also about economics and education”, med.student. “… interconnectiveness of the world. We travel all around the world, we create networks all around the world, we work together, we trade together, we do tourism together. We learn about each culture, all this is leading to a very substantial and to me positive interconnectiveness of the world and that naturally has some health impacts”, Gabriel Gulis.	”There is no definite way to solve the problems of global health”, PH-student.”To concentrate on one part of the population or one part of the country, and make people understand the main idea behind the help – then we can concentrate on the global health”, PH-student.”A solution is first of all education – but also prevention, changes of lifestyles, improved sanitation, safe sex, and tell the hospitals how to disinfect their equipment before surgery – all basic things”, med.student . ”To solve the problem is to maintain a good intersectual relationship between the countries and within the countries”, PH-student. ”It is important that you are a part of it and are where it happens. But it is also something about creating equipoise and I think it is a bit difficult because every country has so different basis”, med.student.	“The content is really good in SDU, but the duration of time – the 3 months – I don’t think that’s enough time for global health learning”, PH-student. “I have been very happy with what content I have been exposed to here and the reading materials that they gave us – the teachers gave us and the materials they referred to was pretty comprehensive and actually I have read a lot of things I didn’t know about before”, PH-student.   “… I would wish there was more focus on it, but often it isn’t relevant for us”, med.student.   “There could be more lessons, I will not deny that, but it still has to be relevant”, med.student. ”We have lectures about global health but actually it is given a low priority because it is not exam-related and that is frustrating. We have some lectures but often it is where you shut it out”, med.student.