Global Health Experiential Education: From Theory to Practice

Book Title: Global Health Experiential Education: From Theory to Practice

Book Author: Akshaya Neil Arya and Jessica Evert, editors

Publication Information: New York, Routledge, 2018, 338 pp., $150, hardcover

Global health has experienced significant and perhaps overdue growth in the medical professions. The academic study of global health was largely a public health pursuit in the past: the literature on international development, social determinants and the root causes of global inequity have mostly arisen from the public health sciences encompassing social and biomedical ones, but not until recently has it included clinical medicine. The relatively archaic concept of missionary medicine was perhaps the main underpinning that clinical sciences have, and this was reflected until the last couple of decades in the paucity of academic, rigorous global health didactic curricula in US medical schools and residencies.

Drs Arya and Evert thus immediately do us a great service through the selection of topics and authors for this edited book. They have assembled a multidisciplinary group while keeping a focus largely on the medical students, learners, and practitioners at whom the book is targeted. As the practice of medicine changes, we see greater inclusion of nonmedical professionals teaming with and teaching their physician counterparts. The book models this and indeed shows us how much we all have to learn from one anothers’ disciplines when working with the highly complex set of interconnected concerns we lump together as global health.

The editors’ introduction is an intellectually honest one. It sets forth their motivations in writing the book, the intended audiences, and importantly, personal shortcomings and learnings the editors faced in their own global health journeys. The book is divided into the following parts:

• “Pedagogies,” which reviews educational paradigms, curricula and best practices in education.
• “Ethics,” which goes far beyond a token chapter on the topic to a seven-chapter exploration of power dynamics, ethical standards, cultural humility, and a provocative discussion of neocolonialism.
• “Host Perspectives,” exploring in case study form the perspective of volunteer recipients. This includes a fascinating discussion on “critically engaging host communities’ praise for foreign healthcare volunteers,” an important chapter that reflects in a way the more cutting-edge content of the book: deeply interesting and important content with much but not all the scientific underpinning for a definitive understanding.
• “Contemporary Conversations” feels like a grab-bag section of the chapters that did not neatly fit any of the others, but this is far from faint praise. This section is actually home to some of the most well-reasoned and developed chapters, such as one by the late, great Dr Tom Hall and others, and addressing critical topics such as global health job opportunities, short-term experiences in global health, LGBT health in the global context, and women’s representation in global health leadership. On this last topic, it has been my observation that we are fortunate as a society that women are comprising a greater number of educational leaders, physicians, and indeed in some entering medical school classes. However, they are inadequately represented at the highest levels of GH leadership, and at the lowest end of the economic spectrum, bear a disproportionate burden of child-rearing and employment.
• “Case Studies” rounds out the collection, with informative bites on key initiatives in the global South and North, and a concluding chapter by the leadership of the Consortium of Universities of Global Health ties it all up nicely.

One concern regarding chapter organization pertains to the online materials. While it is common now for books to have accompanying materials, I could not access the three online-only chapters at the URLs provided in the book. Perhaps it would have been better if those chapters had simply been reprinted in the print version.

The editors deserve credit for stitching together a remarkably coherent volume in a field where the influences and determinants are incredibly diverse. Certainly leaders of global health programs, particularly in medical school and residency, need this book as a collection of our current state of knowledge on this set of topics. One can see individual chapters forming important discussion areas for journal clubs as well.

This book seems to be part of a journey not yet complete. That makes it no less an accomplishment. As the state of knowledge on these key topics evolves, the next edition will likely include chapters with a more assured and complete knowledge base, and an even broader authorship from the developing world. In the meantime, this book is an important, even essential, contribution to global health education.