In little more than 25 hours, from 3:00 p.m., Friday, September 13, to 4:30 p.m., Saturday, September 14, colleagues from over 20 Midwest universities and organizations wrestled with how to improve global health programming for undergraduate and graduate students and to advance health across disciplines and the world.
The Global Health Institute (GHI) at University of Wisconsin-Madison hosted “Better Together: Best Practices in Academic Global Health,” the sixth annual Midwest Universities for Global Health Conference (MUGH). The event was supported through a grant from the Evjue Foundation.
More than 160 students, faculty, staff and community members registered to attend the Friday night screening and panel discussion of UW-Madison Professor Gregg Mitman’s film “In the Shadow of Ebola.” More than 100 colleagues from academic and medical institutions across the Midwest joined Saturday’s conference that included a dozen live presentations, a look at the future of MUGH and a discussion of how academic institutions can increase their global health impact.
3:00-5:30 p.m.: Gender and Well-being, from Local to Global
In a conference pre-session, the Women in Global Health Mid-West celebrated the work of 48 women leaders from the region. Caline Mattar from Washington University in St. Louis looked at the challenges facing women and opportunities for change. Lori DiPrete Brown, a GHI associate director and director of 4W (Women and Well-being in Wisconsin and the World) initiative, highlighted ways the program can be replicated at other institutions. The 4W well-being model led to a conversation about self-care, care for patients and communities and care for the world.
5:30-7:30 p.m.: “In the Shadow of Ebola” film and panel
“I was really quite upset with the international news coverage of Ebola,” Mitman said as he introduced the film. “So our team decided that we needed to follow this story on the ground and collect as many Liberian voices and perspectives as we could.”
“In the Shadow of Ebola,” made in the wake of the 2015 Ebola crisis in Liberia and neighboring countries, weaves together a family’s personal story with the story of a nation. Liberian perspectives and voices come together to connect Ebola’s long-lasting effects across borders.
Panelists Peter Halfmann, a UW Ebola researcher working in Sierra Leone; Janis Tupesis, a GHI associate director who has worked in Liberia; Linda Vakunta, Madison’s deputy mayor and executive director of Project 1808 that works in Sierra Leone, and Mitman explored the aftermath of the outbreak and how to move forward. The movie raised questions about health care infrastructures and response mechanisms. Panelists reflected on programming to support Ebola survivors and how to rebuild skills for future work.
“In the eight years I’ve been going to Liberia, I haven’t seen the people as desperate as they are now,” Mitman said. “The Ebola outbreak hit, and the economy hasn’t recovered since.”
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8:00 a.m.: Welcome
UW-Madison Provost Karl Scholz welcomed participants with a celebration of global health as an extension of the Wisconsin Idea, a “commitment to outreach and public engagement activities that partner with communities to extend and apply our research, education and practice-based knowledge to help solve problems and foster learning.”
Scholz looked to UW-Madison global health pioneers including Bernard (Barney) Easterday, founding dean of the School of Veterinary Medicine, who studied animal and bird influenza viruses and, with a colleague, was the first to virologically demonstrate conclusively the transmission of swine influenza from pigs to humans. He recognized Cindy Haq, founding director of the Center for Global Health that eventually became the Global Health Institute, who also started the Training in Urban Medicine and Public Health Program in the School of Medicine and Public Health to address physician shortages in urban areas and launched family medicine residency programs in Pakistan, Uganda and Ethiopia.
“We recognize the critical work you all are doing is necessarily an interdisciplinary and collaborative effort,” Scholz said. “And we are pleased to be hosting your gathering today to help facilitate this work.”
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8:30 a.m.: The Role of Universities in Global Health
In pre-recorded comments, Keith Martin, executive director of the Consortium of Universities for Global Health (CUGH), challenged participants to determine how academia can contribute to meeting the United Nations Sustainable Development Goals to improve the health and well-being of people and the planet. Global health is local health, Martin said, and proposed reforming tenure and promotion policies to value capacity strengthening in low- and middle-income countries.
“We need to do this within the context of a single planet,” Martin said. “We at CUGH are committed to solving these problems with you.”
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9:00 a.m.: Best Practices in Undergraduate Global Health Programming
How can universities be sure students, faculty and staff are safe when traveling internationally? How do you organize undergraduate programs? What about ethics? “With the scale and urgency of current global health challenges, those of us who teach global health need to go beyond simply developing an excellent course to providing students with a holistic curricula, opportunities for safe and ethical engaged learning, and a space for agency and activism that is mediated by students themselves,” said DiPrete Brown who moderated the panel that offered practical advice to ensure best outcomes for students and the communities they visit.
Created in 2011, the Undergraduate Certificate in Global Health is one of the largest on the UW-Madison campus, attracting more than 600 students a year, Katie Freeman, certificate manager said. In 2018-2019, 284 students participated in field experiences, 61 percent internationally; 39 percent in the U.S.
GHI Associate Director James Conway looked at best practices for the safety and security of undergraduates in global health programs. Between 3,000 and 4,000 UW students study abroad each year, and global health programs, generally, go to the highest-risk settings, he said and outlined extensive policies to ensure safe trips for students and faculty. The goal: “From the classroom to the field … and back again. Safely.”
UW-Madison students, represented by Mason Flanagan, developed a UW-Madison Global Health Ethic program to ensure students who travel outside faculty-led trips understand ethical standards. The group offers guidelines and workshops to encourage students to observe and learn, not provide any form of care. They encourage students to learn as much as possible about the language and customs of the location they’re visiting, to coordinate with local health systems and to comply with local laws and customs.
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10:30 a.m.: Best Practices in Graduate Global Health Programming
How do you design a global health program to educate residents? graduate students? fellows? professionals from the community? GHI’s Patz led the discussion with Stacey Chamberlain, director of Academic Programs at the University of Illinois, Chicago, Center for Global Health; Christopher Olsen, director of the Graduate • Professional and Capstone Certificates at UW-Madison; and Brett Hendel-Paterson, director of the Global Medicine Program at the University of Minnesota.
In Chicago, the Global Health Capstone for medical students is a longitudinal process, and more than half the graduates completed capstone projects that lasted more than two years. The deliverables begin with a written paper and oral presentation after a literature review in a medical student’s first year and conclude in the fourth year with a scholarly paper, public presentation and reflection paper.
UW-Madison offers a range of programs for graduate and health professional students as well as members of the community, including interdisciplinary field courses, international clerkships, the Graduate • Professional and Capstone Certificates in Global Health and medical Spanish. The global health programs, supported by the School of Medicine and Public Health and the Global Health Institute, benefit from collaborations with schools and colleges across campus, Olsen said. He also announced the certificate curriculum is expected to move online in 2021.
Hendel-Paterson looked at global health fellowships and led with questions: “So you want to ‘Do Global Health…” he said. “What does that mean? Why? Who is going to pay for your passion?”
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12:15 p.m.: Midwest Universities for Global Health: Past, Present and Future
MUGH has been organized around its annual conference. Should there be more? GHI Associate Director Janis Tupesis facilitated the discussion with Steve Hargarten, associate dean, and Tifany Frazier, manager, from the Office of Global Health at the Medical College of Wisconsin. Hargarten and Frazier were among the original founders of the group and led a discussion about what’s next.
A culture of collaborative partnerships and regional dialogue are benefits of MUGH, Hargarten said. Managing budgets, staying competitive, and sharing ideas are among the plusses. MUGH members also share common goals: to have a sustainable impact, to be a catalyst for student learning, to add value to their academic institutions and to forge meaningful partnerships. With its annual meetings that rotate throughout the Midwest, smaller colleges and universities are attending and sharing their experiences.
The questions were many. Who’s missing from the annual meetings? What are MUGH’s goals and objectives? What structure will work best? How can members collaborate? Should the organization be limited to those within easy driving distance or expand to include the Dakotas, Nebraska and Kansas?
MUGH could help participants make connections and allow universities to share resources to be more effective, participants said. They could collaborate to secure large grants.
1:00 p.m.: Best Practices in Interdisciplinary Global Health Programming
From gender equity in global health leadership to preparing residents for international experiences to multi-disciplinary approaches to planetary health, presenters looked for collaboration across disciples to solve health challenges. Olsen from UW-Madison facilitated the discussion.
For GHI’s Patz, the bottom line was straightforward: “In light of recent United Nations reports—one on the urgency of addressing climate change and the other dealing with ongoing rapid extinctions of species—we as faculty in global health have an obligation to incorporate these health-relevant environmental threats at the planetary scale into our curriculum.”
David Gaus, who founded Andean Health and Development, offered the non-governmental organization perspective, showing that a rural hospital can be sustainable and affordable and provide high-quality care. He also cautioned universities to be sure students are well prepared before they offer to work in an international setting. He encouraged academic programs to teach residents and trainees about power structures as well as medical procedures.
Caline Mattar from Washington University in St. Louis looked at gender equity. “Everyone is welcome at Women in Global Health Midwest,” she said. Ashti Doobay-Persaud from Northwestern University discussed developing a center for global health education. “Five years is the sweet spot for programming,” she said. “You can start seeing things happen.” Sabrina Butteris from UW-Madison presented the SUGAR toolkit to prepare residents to favorably impact health in under-resourced settings. UW-Madison’s Kevin Wyne and Joel Hill looked at partnerships for interprofessional service-learning and said a key to success is returning to the same place each year and cultivating long-term partnerships.
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Academia: Reform to Increase Your Impact
Where do universities fit when it comes to global health? How can they increase their impact? Panelists Janet Lin from the University of Illinois, Chicago; Rob Murphy from Northwestern University; and Karen Solheim from UW-Madison’s School of Nursing and Tupesis pondered the questions led by moderator and GHI Associate Director James Conway.
The answers from panelists and MUGH participants were far ranging. Universities need to become comfortable with advocacy to raise awareness of health challenges, activate networks on targeted topics and push for change. They need to encourage promotion and tenure processes that acknowledge global health projects as scholarly work, even if they don’t fit the classic models of publication, grants or program development. Universities can leverage professional societies or collaborative organizations to work on projects of common interest and encourage more collaboration with groups that implement projects, including foundations, non-governmental organizations and, occasionally, government groups. They can also push for grants that incorporate topics of global importance.
Universities can be sure to include all members of the university community, engaging faculty from more sectors that can make a difference in global health. An essential part of the equation is developing students and junior faculty who will embrace changes that can become the norms for the future.
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MUGH will meet September 29 and 30, 2020, at the Medical College of Wisconsin in Milwaukee for its 2020 meeting. For more information, contact Tifany Frazer at email@example.com.