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ENGAGEMENT: GLOBAL HEALTH, GLOBAL RESPONSIBILITY

One of our greatest human accomplishments has been the spectacular improvement in health since the 1960’s. Life expectancy has risen from 40 to 60 years in low-income countries, and the chances that a child will survive to the age of five have doubled. Despite these dramatic increases, global health issues continue to pose some of the most significant economic, political, social, and ethical challenges of the 21st century, particularly in low-income countries.

The Center for Social Concerns at the University of Notre Dame aims to improve the conditions of people living in low-income countries by adopting a stance of solidarity in addressing global health challenges. In an October lecture given in conjunction with the Rev. Gustavo Gutiérrez, OP, John Cardinal O'Hara Professor of Theology at the University of Notre Dame, Paul Farmer, M.D., Ph.D., Kolokotrones University Professor, Harvard Medical School, reiterated this call to global health by noting, “real service to the poor requires understanding poverty and how it came to be, and understanding poverty must be linked to ending it. As the gap widens between modern medicine and our healthcare for the poor, the structural sin of poverty increases.”

The Center for Social Concerns has also addressed the issue of global health through partnering with alumni and local communities to provide access to adequate healthcare. In 2003, Dr. Peter ( ’82) and Mrs. Daly (RN), traveled to the Nuestros Pequenos Hermanos Orphanage in Honduras along with their family. During their visit, they met Angela, a then 10-year old with severely deformed legs. Angela needed a series of corrective surgeries, but the waiting list to have the procedures at a hospital in Tegucigalpa was years long. So Dr. Daly arranged to perform the surgery in St. Paul, Minnesota and Angela spent almost a year recovering there, living with the Daly’s in their home. Lulu, who earned her nursing degree at Saint Mary’s College in 1982 and was the 2010 Humanitas Award Recipient from Saint Mary’s, served as a mother figure to Angela as well as her primary care nurse around the clock.

Transformed by this experience, Dr. Daly and Lulu dedicated themselves to establishing a desperately needed surgical facility. “I thought if we just had a permanent outpatient surgery facility to complement the existing external clinic here on the site of the Nuestros Pequeños Hermanos orphanage in Honduras, we could deliver a lot more health care to people away from the bottleneck that exists in the capitol,” says Dr. Daly.  

Networking with family, colleagues, and the Notre Dame family, Dr. Daly raised the money to build the Nuestros Pequenos Hermanos Holy Family Surgery Center in 2009. The Holy Family Surgery Center (HFSC) provides same-day surgical procedures for underprivileged patients who otherwise could not afford surgery. Now in partnership with doctors in the Minnesota area, the Dalys secure annual truckloads of donated equipment and supplies to resource medical brigades at the surgery center.

A PARTNERSHIP IN GLOBAL HEALTH

In 2010, The Holy Family Surgery Center and the Center for Social Concerns formed a partnership to create the Global Health in Honduras Seminar. The seminar course offers Notre Dame students the opportunity to see first-hand how different forces can influence healthcare delivery, gain hands-on medical experience observing surgery outreach and assisting with patient in-take, and understand the role of Catholic Social Teaching in addressing global health and the complex social forces that affect it.

Through class lectures, discussions, and readings, students examine the health of populations in a global context. The major health challenges that transcend national borders and reflect income discrepancies are emphasized. These classroom sessions expose students to the economic, political, and social forces shaping global health delivery in Honduras. When students depart for their 10-day immersion, they are prepared to analyze causes, probe linkages, and identify community assets affecting Honduras.

During the week-long medical brigade, students encounter real people and communities that lack adequate healthcare. They observe orthopedic surgeries and interact with American and Honduran medical professionals. The medical brigade in Honduras is supplemented with lectures from local Honduran doctors and site visits to local public clinics to compare private and public health offerings in the Tegucigalpa region.

Upon their return to campus, students meet together in the classroom to reflect on their experience. Along with their newly informed insights, they discuss possible ways to address global health challenges.

RIPPLE EFFECT

Greg Yungtum ’14, who participated in the Global Health Seminar, described his time at the Holy Family Surgery Center. “I was incredibly impressed with the larger impacts that a single operation can have on the surrounding community. In fact, a recurring theme throughout the trip seemed to be the “ripple effect” of the surgeries being performed.”

Yungtum reflects, “through this seminar we learn that in order to make a real impact we must understand the people we are serving. That requires understanding the culture of your patients and grasping the situation that they are in. This is often hard to do in only one or two weeks’ time, so working with local healthcare providers is extremely important. Once we understand the poverty that our patients live in, a renewed sense of conviction to change that situation will automatically follow. This may show itself in countless ways, including return trips to the same area or even advocating for your patients while you are at home. And finally, as we use our new energy to improve care for the poor, we are also working to close the gap between modern medicine and the underserved. Closing that gap between modern medicine and our healthcare for the poor and – according to Dr. Farmer – reducing structural sin, is perhaps the greatest impact that a volunteer could hope to have, regardless of how long they serve.

But Dr. Daly cautions about how medical brigades and short-term programs should operate to be most effective.

“I think for us just to do things and go home, it just doesn’t enhance the level of everyday health care delivery here,” says Dr. Daly. He has already established a connection with two Tegucigalpa area hospitals, hoping to set up a partnership with their surgical teams. While visiting medical professionals will play a large role in its operation, Daly’s vision is also to use it as a training ground for Honduran surgeons.

“What I envision is for these medical brigades to be down here doing cases and have it well planned in advance so that the local Honduran surgeons can do them with us,” says Daly. “That way we can come and go, but they can use this facility on a more full-time basis.”

Merlin Antuñez, NPH Honduran doctor, “I remember the first brigade. There were around 50 people who came to the clinic—so that was not a lot. Later on, people are just telling others, spreading the word, and you see that there are 200 people there every time; it would show us the amount of people that need help, and who are rejected from hospitals, or cannot afford to pay a private clinic. To then give them the health service for free in many cases—that’s a blessing for the community—you know, having all these people that come from far away just to help them recover from any disease. That’s amazing.”

Dr. Farmer’s admonition that service to the poor requires understanding poverty, how it came to be, and that understanding poverty must be linked to ending it is especially true when it comes to short-term medical brigades. Cynthia Toms Smedley, director of the Global Health Seminar, knows that the Global Health in Honduras Seminar is not a final answer to ending poverty.  She notes, "teaching students to adopt a stance of solidarity, to partner with communities and professionals working to overcome healthcare challenges, and to listen to the community’s voice, is the first step toward addressing global health challenges."

To learn more about the Center for Social Concerns academic programs, visit http://socialconcerns.nd.edu/academic/

 

 

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