DRAFT: This module has unpublished changes.

        At first the numerous reflections, readings and coursework for NS 4600 seemed a bit redundant and I did not understand why we were required to reflect so much. I now understand why the course progressed in this way though, and actually enjoyed the reflecting, especially on my field experience. I did not realize how much I could learn from my field experience, by reflecting back on it and examining it through different lenses and frameworks. I was surprised about how much I could learn about my experience and myself without actually physically travelling back to Senegal. The six dimensions of global health, although not always in the back of my mind, have proved in the end to clearly outline the intersections in the material we have explored throughout the course.

         Upon examining the six dimensions of global health, it is clear that we have covered multiple aspects of each dimension, and that I have learned a wealth of information about each dimension over the length of this course. We examined many diseases, including: HIV/AIDS, smallpox, TB, malaria, malnutrition, and waterborne diseases. Additionally we examined many groups of people, cultures, and communities; ethics was a main component of the course and was discussed throughout. I think that my group’s presentation on Traditional Medicine really helped in the discussion of these topics. We discussed subjects like cultural relativism, beliefs, taboos, and rituals and even delved into some of the effects of Western imperialism. In the first part of the course we discussed many of the actors, interests and politics, which influence global health decision-making. Some of the group sessions also focused on this dimension; the Romney versus Obama group discussed a lot of the politics behind global health, and other groups discussed lobbying and other actors like the WHO and USAID. Throughout the course there existed encompassing discussions about delivery systems, like the vertical-horizontal debate and topics like the brain drain. Based on these delivery systems, the solutions dimension of global health was also discussed at times. Education and nutrient fortification are both examples of such solutions discussed throughout the course. Social process encompasses each of these dimensions of global health and is the final dimension, which affects each aspect of global health.

        The social process is a crosscutting lens, which takes into account the participants in the situation, the perspectives that each participant contributes (goals, beliefs, assumptions), and also presents a context for their interaction. However many frameworks, or measurements are considered, global health is never as clear-cut as it may appear. The many interacting beliefs, communities, and actors, make the field of global health rather complex and dynamic. In this way, the field of global health is both a science and an art.  Research and frameworks produce a certain set of results, making it similar to a science; but, there is also a nuanced aspect to this field, which requires policy-makers to consider cultural considerations, and ethics at all times.

       Although I now have more knowledge about each of the six dimensions, I think that it is more important that I now understand how each operates, and consequently cannot be isolated from the other dimensions. All six intersect at times to compose the field of global health. I think that although having a variety of frameworks at the ready is helpful, the need to consider ethics is of greater importance. One can cut an issue in a variety of ways, but the only facet, which fully considers the implications of any framework or policy, is ethics. This is why my favorite framework, which my group actually presented to the class, is the complexity framework. This framework takes into account that a variety of issues, beliefs, and systems are at play in any community, and that the complexity of this in itself is a framework.

       I did enjoy examining Professor Pelletier’s last framework: The Values (Life Satisfaction) Matrix. It is sometimes hard to determine what matters most to one, when so many interests compete for one’s attention. Professor Pelletier suggests that comparing the rankings and areas of life where one gains satisfaction in some way can help to determine the optimal level of life satisfaction. Although clever, this seems a bit too calculating for something as intangible as life satisfaction. I think that if I were to rank my values and personal satisfaction in a matrix like this, I would always be striving to obtain something more in one of the boxes, rather than enjoying what I have right now. Does everyone really need to have it all: job satisfaction, health, wealth, education, love, respect, and power? Of course it would be ideal to have it all, but is that really what makes us satisfied or happy? Satisfaction is a funny thing, because as soon as we have more, we want more; I speak from experience. As much as I travel, or learn, or indulge, I want more. Who doesn’t want more of a good thing? Not to be a pessimist, but at some point, one must evaluate their life for what it is, rather than always looking for more. So often I fall into that trap, and take on more and more until I just crash. I think that Professor Pelletier is correct though that these different aspects like respect, love, learning, and ethical living can be harnessed in many areas of our lives, and not only in the obvious ones. One can learn from personal life, and volunteer as a professional.  This is probably the smartest way to go about striving for a sense of accomplishment, but happiness, well that is a whole other ball game.

       It is certainly true though, that global health can be strived for in any sector or lifestyle. I hope that in whichever field I end up in that I will always keep this in mind and follow through on helping to make this world a little bit better. I think that Professor Pelletier’s advice about keeping career goals in line with personal ones is particularly wise. I think that what makes most personal lives and work lives incompatible is when they do not both fit into what is perceived to be one’s life goals and values. I think that if I value global health, which I do, then this will naturally show in my livelihood and personal life, if I choose both a spouse and an occupation that value the same sort of priorities.

       I believe that my options for after graduation reflect the sort of values and priorities that I hold. Whether I end up doing research, teaching, working, or going to graduate school, I think that in each of these areas there is a way to incorporate global health even if it is not so apparent at first. I think that I would enjoy working directly in the field of global health, and am considering opportunities where I would be working in the field, like I did in Senegal, but I am wary of the same challenges that I faced in Senegal. It really wasn’t an easy experience being away from everything that I love, and taking on new challenges; but it was exciting and breath taking all the same. As a result of this experience, I have learned so much about the world, and myself and I feel like that it would be a mistake to not consider continuing to do such work.

       At the same time, I am still very troubled by what I saw in Senegal, especially, when it comes to the Talibé children. I want to find some way to help them; short of adoption I have not come up with anything yet. But their memory is so etched into my mind that it is hard to think of giving up.  Of course, there are so many global health problems to fix, as the diverse perspectives and experiences of the other students in the class have shown, but I think that focusing on one problem at a time might be the best way to approach a field as broad and diverse as global health.

       Certainly, one of the most important consequences of taking this class is that it has left me recharged and encouraged to continue in this field and to explore global health problems once more. I was so drained after coming back from my field experience; I was confused and hurt. I experienced some really terrible things during my field experience, but in retrospect it was nothing compared to what most people in places like Senegal experience on a daily basis. I never shared this on this forum, but I went through a pretty brutal mugging and beating, just a week before I left Senegal.  I was so scared, and felt betrayed and angry; I swore that I would never return to such a place. I am thankful for the experience of reflecting in this class, because although at first it made me depressed and upset, in the end it helped me to sort through my emotions and reflect on what actually happened abroad.

        My interest in global health first stemmed from my curiosity in health and medicine. I started pursuing a global health minor, because it seemed to be a way to further explore health care. I was also drawn to the global aspect of this field, because of my interest in languages, cultures, and peoples. After completing my field experience, I was still drawn to the field of global health for all of these reasons, but I found a deeper meaning behind global health through completing my field experience and truly reflecting on it in my Explorations in Global Health class. Global health was no longer a distant, intangible field, but was instead a real and complex challenge; one that I was recharged and ready to face after evaluating my experience abroad. Although by all means it was a challenging experience, what I gained from it has inspired me not to give up on this field despite how overwhelming the problems it addresses can seem.  I want to continue to work in this field, focusing on one problem or area of study at a time, so that I can affect real change in that area even if it is accomplished little by little. The field of global health encompasses many diverse and interesting people, cultures and languages, which I am excited to learn about, but I also must keep in mind the universality of the work in this field and that however diverse, each of us are human beings, and in that way we are all similar. I am passionate about the fight to diminish global health inequities, and I hope to help in this field with partnership and persistence, regardless of the sector in which I end up working.

DRAFT: This module has unpublished changes.