Cultural Exchange: The ‘one-way’ street of Global Health
IFGH Conference 2014 Emerging Voices-Early Perspectives
Key Correspondent: Michael Johnson
What can we learn about healthcare from the Global South?
With many of our resourced hospitals, high-end technologies, and long established healthcare systems, this question may leave some perplexed. However, it would appear that nations of the Global North are neglecting many opportunities to learn from low-and middle-income countries (LMICs).
Whilst the provision of services between each country in the Global North varies, many are able to provide adequate healthcare for the majority of their citizens in appreciation of the political, social, and cultural factors implicit within their borders. Currently, these intentions are being extended beyond borders through bilateral or multilateral healthcare programs established in the Global South. Although, these partnerships are generally well informed, many are also at risk of propagating a healthcare-branded form of cultural imperialism; one that quashes indigenous practises in order to establish a decidedly western-based system. Thankfully, this one-way exchange is set to close, and be reinvented, as innovative partnerships are establishing a more mutual approach to global healthcare.
The only feasible system is one that is sustainable and rooted in the idea of true partnership.
At the IFGH Conference in Dublin, Alison Rodgers shared her experiences of ‘kangaroo care’, working as a midwife in Malawi. Kangaroo care, or skin-to-skin contact, has been used extensively in the neonatal units of Malawi. Studies have repeatedly shown the benefits of kangaroo care in reducing preterm infant mortality, severe illness, infection and length of hospital stay. In high-income countries, this method is rarely implemented due to access to modern technology and resources. However, at a time when cost-saving strategies are paramount, why haven’t we incorporated this simple technique into western healthcare practise?
It is not just experiences from lower income countries that we ignore. Despite overall resources being limited, Cuba manages to run an efficient healthcare system, with highly favourable infant mortality rates (4.2 per 1000) and the highest rates of treatment and control of hypertension in the world. As the first country to eradicate polio, it holds an impressive record for the control of both infection and chronic diseases. Evidently, there is still much to learn from middle income countries that we can apply to both higher and lower income settings.
We shouldn’t overlook the opportunity for shared wisdom and knowledge exchange, but realistically cultural differences can lead to problems. Stories circulate of how donations of vital medical equipment to LMICs are rarely used or forgotten in a cupboard. Numerous reasons exist, from a lack of technical training, to equipment that is difficult to repair, or simply that the right batteries aren’t in supply. The majority of issues are avoidable if local expertise is employed prior to these items being gifted.
Interchanges of knowledge are becoming more commonplace.
The Twinning partnership between Debre Berhan Hospital in Ethiopia and Elmhurst Hospital Center in the U.S.A. as well as, innovative health partnerships like King’s Sierra Leone Partnership, which enables exchange of students from both countries to experience the provision of healthcare in a setting different to their own, are just two examples of this dynamic interchange. Importantly, the King’s partnership works closely with the Ministry of Health in Sierra Leone to ensure that programmes are coordinated and aligned with national priorities. Both of these partnership examples are built on reciprocal learning and mutual benefits for all parties.
Whilst these novel approaches are showing success, in order to progress towards a shared responsibility for global healthcare we need to garner further respect for local knowledge, community healers and regional infrastructure. Cultures play an important, and at times overstated, role in sustainable capacity building, but let’s not reduce these problems to issues of culture.
The task of global health is beyond the scope of any one nation or organisation.
Global health requires the mobilisation and cooperation of whole communities. There are certainly things we can learn from the Global South that can be implemented into healthcare systems in the Global North. It will require a movement away from paternalistic approaches of the past, towards a deeper appreciation of cultural exchange, and a mutual transfer of knowledge.
Surely all participants have a vision of the future, but perhaps the nations of Global North need to accept that others may also have something to teach.
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