Science Summit at United Nations General Assembly (UNGA78)

The colonizer mindset continues to ripple through academia, educational institutions, healthcare centers, and communities. Rooted in an empowerment rather than dependency model, the Nuvance Health / University of Vermont Larner College of Medicine Global Health Program with active participation from domestic and international partners has and continues to gradually implement unique features from decision-making to resource allocation, participant education to community engagement, capacity building to brain gain. We aim to continuously shed a truthful light on a tragic past and present while evaluating our program’s components that combat and contribute to the savior complex model.

An integral component of GH exchange programs is the bidirectional hosting of GH participants from HIC to LMIC, and reciprocally from LMIC to HIC. However, these exchanges are being more critically investigated in order to better understand and ameliorate the discrepancies, among them the disconnect between the levels of support given to HIC participants and LMIC participants. While many discussions have been held about inequalities in GH, this particular form of inequality has yet to be addressed. A critical first step involves giving the platform to LMIC participants to safely share their experiences in HIC.

Global Health (GH) programs in HIC spend ample resources ensuring the emotional and physical safety of HIC participants while on GH electives in LMIC. From extensive pre-departure orientation training to reviewing of weekly written reflections, host family cultural integration to longitudinal mentorship on arrival home, HIC GH participants are given thoughtful attention as they adjust to a new culture and medical setting while encountering numerous structural and personal challenges. However, LMIC GH participants are not given this same level of attention when hosted in HIC, even though they often encounter greater challenges than their HIC counterparts in being unable to put hands on patients, access patients’ medical records, or participate in clinical discussions or scientific dialogues. Regardless of their level of training, they are purely observers and listeners in HIC while even first-year HIC medical students can participate more fully in the clinical experience while in LMIC.

Furthermore, LMIC participants often experience mistreatment, microaggressions, and other biases that affect their comfort, emotional safety, and ability to learn and work, not only without protection but without a platform on which to discuss those experiences without fear of repercussion. Amidst the push to combat power imbalances in GH today, this topic has been left largely unaddressed. In this panel, we ask participants from LMIC what their challenges have been during their time being hosted in HIC, and what can be done to empower them on their GH journeys.

While many aspects of GH partnerships are currently under discussion and restructuring, the relative lack of support for LMIC participants while hosted in HIC has been far overlooked. There is no question that we have a long way to go to equalize GH, and this panel may not offer any solutions. However, giving the podium to partners from LMIC to discuss their perspective may open new dialogues around the structural, personal, and cultural barriers that may prevent LMIC participants from having an optimal GH experience, and ultimately enrich the path toward more equitable GH partnerships.