IDSB04 - Ch.14
Doing International Health
There are various ways of thinking about work in int health: - Learning adventure for well
meaning minority-world professionals and students travelling to underdeveloped settings? -
Humanitarian/technical assistance from developed to underdeveloped countries - Mutual
cooperation to improve health
Transformative process for all involve hopeful realism *pessimism of the intellect, optimism of
the will? - intellectually analyse the situation at hand, and get ungreat results, BUT things
change because ppl hold on to hope and get things done
*be aware of history -int health today is marked by the history of past activities -after
colonies gained independence in the 19th and 20th centuries these unequal relationships
persisted: bona fida coop among countries for the most part took a back seat to more
exploitative interaction.
~ in the present we continuously need to keep in mind the troubling possibility that even
the most well-intentioned & informed int health endeavour may perpetuate in equalities in power
across the world.
One way diffusionist model from high to low income nations?
Those in more powerful countries have monopoly on necessary knowledge expertise and
resources to improve situations for poor?
Motivations no longer primarily based on self-interest?
Practising International Health
operates at 3 levels 1.) motivations & actions of indi 2.) missions & interventions of
organizations 3.) logic & structures of the world order
1. Individual level
Personal Motivations Box14-2: desire for broader perspective on public health, desire to
improve clinical skills, idealism (wish to counter mainstream efforts & change the world)-
challenge- curiosity - charity
global health tourism -primary focus not entertainment however its there - based on
generosity & helping ppl is illusory, especially when help has not been sought - indeed
most ppl who undertake a health related work/ volunteer experience in another country
find the greatest benefit to themselves - such expeditions do more harm than good,
leaving behind no capacity for follow up & applying band-aids to the problem
The bulk of int health work is carried out by locals
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Document Summary

Humanitarian/technical assistance from developed to underdeveloped countries - mutual cooperation to improve health. Practising international health: operates at 3 levels 1. ) motivations & actions of indi 2. ) missions & interventions of organizations 3. ) logic & structures of the world order, individual level. Ethnocentrism, paternalism, condescension- even with best intentions, still present -dismissing local knowledge of health/illness- see as indigenous/traditional/ backward . Training and work experience: know the setting, the political, socio-cultural & economic history, measures should reflect the social conditions of ppl. Acknowledge and respect indigenous approaches to health/illness other than western" biomedicine. 10% of worlds health problems receives 90% of the funding, leaving many probl in underdeveloped countries untouched --parallel prob: the research agenda of underdeveloped countries is mostly set by development partners" rather than according to locally defined groups. Research ethics: depart from principles of informed consent and autonomy - institutionalization resulting in part from heinous experiments conducted in past (and present?) on human subjects -

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