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Friday, March 4, 2011



Perspective seeking in global health

Posted: 03 Mar 2011 07:44 PM PST

PIH guide to NCDs

I attended a Partners in Health conference on NCD’s (non-communicable diseases) the past two days, and it was great to see that the global health world has been coming to realize there are huge health impacts to be made outside of infectious diseases and embrace more of a focus on cancer, injuries, surgical diseases, and “lifestyle” chronic diseases like diabetes and hypertension.

It is fantastic that global health advocates are broadening the clinical services that we wish to include in an essential package for developing countries. But I can’t help but be concerned by the continuing disease-centric approaches to improving global health. It is understandable, given that the majority of folks in global health are clinicians or public health professionals, but we need perspective outside of these disciplines to have more of a voice in making an impact.

A great post about this was made on MIT’s Global Health blog about how process, management, and systems approaches are drastically needed for any of our disease-focused funding, policies, and guidelines to make an effective impact. Without these elements, all of our clinical wisdom will be impotent.

The US government just wrote an editorial in Voice of America about providing $130 million for funding medical education in Africa because, quoting President Obama: “The purpose of development is creating the conditions where assistance is no longer needed … So we will seek partners who want to build their own capacity to provide for their people.” This is fantastic, but we don’t just need funding for services and for building clinical capacity, the two things most commonly fought for. We also need management capacity, leadership capacity, IT capacity, design capacity, engineering capacity, etc. Unfortunately, these issues are massively ignored.

Some people get it though. I recently heard Michael Murphy from MASS Design Group
talk about their new hospital in Butaro, Rwanda, as well as their work to bring design-thinking into global health practice. Check out this beautiful hospital:

(More pictures here) (More info about the hospital here)

And guess what, because they had architects design the hospital with local context and needs in mind, it has tons more functionality like better airflow to prevent XDR-TB, is exceptionally beautiful, brought in local jobs, will likely improve clinician retention, and cost two-thirds less than the typical budget.

MASS Design Group is a beautiful example of what non-clinicians and non-public health people can bring to the table for global health. I hope similar groups of MBAs, software developers, electricians, road construction workers, and lawyers come together to bring in their fantastic perspectives on what global health needs beyond new clinical services.