Ethical accountability in global health
Posted on Thursday, October 21, 2021
By David McFadden
Through the Faculty of Medicine, the University of Ottawa has become the first Canadian university to endorse a new set of principles intended to guide policy on short-term global health work, which too often fails to consider the needs of a host community and occasionally causes more harm than good.
The Brocher Declaration outlines ethical concepts to steer educational exchanges, research trips and other global health activities typically done by teams from wealthy nations visiting locations considered low- or middle-income. The principles include accountability, working with cultural sensitivity, and empowering the hosts to define their needs. It also calls for capacity-building and sustainability to help chip away at global health inequities.
Dr. Manisha Kulkarni, interim director of the Global Health Program in the Faculty of Medicine’s International and Global Health Office, said the uOttawa faculty signed the declaration in recent days. The ethical principles will help guide its educational and planning efforts in specific regions.
“[It’s] very well aligned with the direction we want to be pursuing with our global health partnerships,” says Dr. Kulkarni, an associate professor in the School of Epidemiology and Public Health. “We’re not going overseas to help. We are partnering to work together on challenges and issues that have been identified by our partners.”
With its endorsement, the uOttawa Faculty of Medicine has joined more than 40 organizations including the Yale School of Medicine and the nonprofit Consortium of Universities for Global Health, a network of more than 170 academic institutions and groups from around the world.
“By backing these ethical principles, we’re showing our commitment to social accountability in all our global health activities,” says Dr. Bernard Jasmin, dean of the uOttawa Faculty of Medicine.
The University’s support was applauded by Shailey Prasad, director of the University of Minnesota-based Center for Global Health and Social Responsibility and an academic who helped shape the declaration.
“With the reputation and stature of uOttawa, we feel that this should prompt other universities and entities in Canada to endorse the declaration,” Prasad says.
Obaraboye Olude, a second-year student in the Master of Public Health program at the uOttawa Faculty of Medicine, said Brocher’s ethical framework is needed. She observed impacts of resource-draining engagements while a medical student in her homeland of Nigeria.
While doing rotations at a hospital in a neighboring country, she recalls that a health team from overseas shipped over pricey medical equipment for a weeks-long stint providing free surgeries. But when they boarded flights back home, not only was the hospital pigeonholed into buying the equipment that was left behind, the foreign team neglected to show local staff how to use it.
“At first glance, everything seemed fine as the work was happening. But there were detriments at the backend,” Ms. Olude says.
Dr. Kulkarni says the ethics of the Brocher Declaration are closely aligned with the Faculty of Medicine’s existing strategic priorities in global health and internationalization. Its endorsement also builds on the development of its new Global Health Partnership Strategy, authorized by Faculty of Medicine’s leadership earlier this year.
Within that partnership strategy, the Global Health Program is focusing efforts on building equitable, sustainable partnerships. They will concentrate on the depth of engagements in specific regions, says Dr. Kulkarni, rather than brief ones in multiple nations.
Main photo: A maternity ward in Benin. Photo credit: Daniel Hubert
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