Global Health and Development

by James Bogie

As a medical student in the UK you cover a lot of material in a relatively short 5 years. This includes all the theoretical and clinical science needed, alongside learning communication skills, health-related social theories, working with minority and special needs communities and a number of practical skills. Different specialties with different passions are all vying for time and space in the busy curriculum. Then every once in a while, we were exposed to the bigger picture.

For me, that bigger picture became evident when I did an intercalated BSc in Global Health. Within medicine, Global Health is a relatively new, nebulous subject. Its been defined academically in the following paper – https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61582-1/fulltext

As a rough rule of thumb it covers the global epidemiology of diseases, social determinants of health, inequalities, global health governance and human rights. The course gave an opportunity to examine the systems behind health and well-being. What are the social, cultural, economic and environmental factors affecting health and well-being? Who are the big players determining the direction of action? Are things getting better, worse or staying the same?

I took many lessons from that year. However, one has stood out above all else. In a small group seminar, an NGO tag-line was projected in front of us, something along the lines of “For only X-million dollars we could end global poverty”. Over the next 2 hours this statement was ruthlessly torn apart, with statistics, projections, examination of poverty cycles and global systems of economic oppression. Fundamentally, it was shown that many times that amount has been ‘given’ already, and yet poverty exists still. I reflected on my own life, for as long as I could remember poverty had existed. It became clear to me that ‘we’ as a development community are doing something wrong, the question was what? And what do we need to be doing instead?

I am still asking myself that question. I am now a junior doctor in the West of Scotland. I have visions of becoming a Paediatrician or a Global Health GP, maybe even a Public Health Consultant. My academic interests are around global child health and the obesity crisis, with aspirations of a Masters and PhD in the future. I care deeply about global health inequality, but if I am honest, I am at a loss of what works and what is good practice, and what my role within them might be. If I may be cynical for a moment, within medicine there is a standard model for international health interventions – identify specific problem in specific community, become passionate about that issue, raise money, provide clever, technical solutions, try to expand, move on to another issue. These interventions typically lack long-term sustainable improvements, cultural engagement and coordination across different sectors. (This comes from my own international experience and is not a criticism of others). In a visit to Kenya working on a schools health project, I often wonder if the friendships I made with Kenyan frisbee players and the tourist activities I took part in  were more valuable than the research project.

I think a better future is possible, I think we can share some of the wealth and development we in the UK have, and can learn from other countries as well. My journey to Sustainable Futures Africa began after a conversation with Dr Mia Perry in a cafe in Glasgow, in which I could share all my concerns and frustrations with the narrative and practices of international development. I’m hoping that here I can see a little more of what sustained, sustainable change might look like, of empowerment and mutual engagement on equal terms. I’m hoping I can reignite my belief in positive sustainable development.