We Are Better Together: Committed Partnerships in Global Health Development

I enjoyed the thorough analysis of developing family medicine programs across the globe provided by Rouleau, Bourget, Chege, and colleagues in their recent article “Strengthening Primary Care Through Family Medicine Around the World: Collaborating Toward Promising Practices.” In this article, the authors highlighted four keys to developing family medicine programs: champions, policy windows, an adaptable core, and committed partnerships.1 I would like to continue the conversation by focusing on the development of committed partnerships and how this relates to global health curricula in graduate medical education.

In 2010, Crump and Sugarman recognized that while beneficial for learners, not all global health experiences benefit the intended vulnerable populations. In response, they introduced the WEIGHT guidelines to provide a detailed framework for the development of ethical global health programs. These guidelines emphasize the need for a well-structured partnership between sending and host institutions. Melby, et al then introduced four ethical principles to guide the development of global health experiences in their 2016 paper. This included the principle of bidirectional participatory relationships, which moved us past respectful ethical partnerships and opened the floor for shared knowledge between high-income countries (HICs) and low-and-middle-income countries (LMICs).3

It is in this context that I also invite the reader to review Beau de Rochars and colleagues’ recent article describing the state of medicine and medical education in Haiti.4 They accurately highlight the harm that can be incurred when short-term missions are not undertaken with enough care to their consequences. Both the void of follow-up care after foreign physicians leave and the impact on public opinion toward local medical professionals are real and damaging consequences described in this article.4

There is hope. When reading Rouleau, et al’s article, I was struck by the innovation displayed by each country represented. For family medicine to expand and improve public health outcomes throughout a multitude of environments and cultures, we must have ingenuity and innovation. Haiti is no exception, and Beau De Rochars and colleagues’ plea for help in training Haitian providers4 should not fall on deaf ears. By partnering existing medical education institutions with developing family medicine programs around the world, we can harness the passion of our learners with the ingenuity of those practicing medicine in other cultures, thereby fostering the exact committed partnerships that Rouleau, et al refer to. By sharing our innovations in family medicine across cultures, we all have more to gain.