Certificate in Global Health

By: Kayla Cropper, Candelaria Aristizabal Londono, Lucas Fisher & Graham Beresh 

Making the links gave us the opportunity to expand our understanding of health both through theory and practice. The program works to provide us students with the information needed to understand health and health determinants within our community and well outside of it. The practical components work to reinforce the knowledge acquired through the theoretical courses. Additionally, the practical aspect of the certificate is rooted in reflective practice which not only helps to apply the theoretical knowledge, but it additionally works to further our understanding of health in our own community and in communities that differ from our own. The certificate helped to broaden our perspective on health outside of the walls of our own hospitals. It  provided us with valuable knowledge and the opportunity to live and practice in different settings. Overall, this experience helped us to develop an understanding of health that is difficult to shake and sparked a desire to give back and do better. 

In Saskatchewan, the Westmount and rural placements provided us with opportunities to engage in discussion around community needs. Our time at Westmount Community school gave us a first-hand exposure to the inequities that lower-socioeconomic neighborhoods frequently experience. One example that greatly impacted us was the lack of access to safe drinking water at the school as it was in an inner-city neighborhood that continues to use lead-galvanized pipes. Other impactful realizations were the quantity of food that students received from home and the lack of knowledge surrounding one’s health. Although the specific needs of the communities were different in our rural practicum, the struggles and lack of government support appeared to be similar. In Île-à-la-Crosse and Kawacatoose First Nation, two primarily Indigenous communities, we noticed difficulties such as limited access to healthy foods, poor access to healthcare, and gradual generational deterioration in cultural identity. Our practicums provided us with a deeper understanding of the needs of our Saskatchewan communities by learning directly from the community members through relationship-building and personal stories.  

We spent time in the classroom on theory-based lectures and readings so that when we entered a community, our experiences were guided by an understanding of the social and structural determinants of health impacting the people we were working with. We learnt about structural violence perpetuated through strategic economic development for example, and how structural neglect of the northern part of a country can translate to a North versus South health divide. This is something we recognized in Ghana, but also back home in Saskatchewan where northern communities face significant barriers to healthcare access due to factors such as poor road infrastructure. We also engaged in guided reflexive practice with our mentors during our experiences to analyze our self-position in real-time and the ways in which our presence can affect the community and our interactions within it. We will carry these lessons forward into the patient care aspects of our undergraduate medical training to better understand the experiences and perspectives of the patients we meet in our community.  

Throughout the program, we learned of the broad structural inequities that permeate the medical field. These inequities, often perpetuated unconsciously, are rooted in historical, socio-economic, and political realities of the past. On all three of our practicums, we were able to witness first-hand how some of these structural biases came to be, and how they continue to pervade the healthcare sector to this day. For example, in Ghana we had the opportunity to visit the Slave Dungeons of the Gold-Coast. On this trip, we learned of the macro-scale consequences of the trans-Atlantic slave trade, including persistent health inequities in affected groups as well as improvements in medicine as a direct result of the atrocities that occurred during this time including the transmission of communicable diseases and the pathophysiology and management of severe malnutrition. For an example closer to home, we learned of the pernicious stereotypes that are foisted on Indigenous peoples in Canada, and how our government was instrumental in creating and promulgating these stereotypes throughout our country’s history. These negative stereotypes persist until today and can often dictate how interpersonal interactions occur in our emergency rooms and hospitals. It is important for us as future healthcare practitioners to recognize our own personal biases, as well as work to dismantle those that pervade our institutions.  

This program has built a strong foundation for our personal and professional growth, and we are so grateful to have this training early on in our careers as it will inform our future practice in medicine and has empowered us by building our knowledge and skillset for social accountability and advocacy. As future physicians, we must continue to improve our cultural humility and work with the communities we serve to better represent them in our future practices.  

CASCADES Summer Institute on Sustainable Health Systems

The national Summer Institute on Sustainable Health Systems was created to fill a gap in healthcare professional training and provide health research and health professional trainees with the opportunity to increase awareness of sustainable health systems and current action in Canada. It is coordinated by CASCADES Canada with federal funding.   

Through guided learning activities, meetings with local sustainability leaders and nation-wide panel discussions, the Summer Institute aims to develop trainee knowledge, leadership skills and capabilities, and build professional, interdisciplinary networks of trainees and professionals with shared interests. Daily themes are outlined below.  

Daily theme  National Panelists  Local Leaders 
Climate Change, Health and Health Equity  Dr. Rick Glazier, Dr Sherilee Harper, Dr. Fiona Miller, Dr Danielle Toccalino  Dr. Daniel Fuller, Dr. Lori Bradford, Dr. Wanda Martin
Mitigating the Climate Harms of Health Care Dr. Andrea MacNeill, Gillian Ritcey, Dr. Sonja Wicklum Lindsey Vold, Caitlin Roy, Jared Saunders, Dr. Henricke Rees
Health System Adaptation and Resilience  Craig Brown, Dr. Celia Culley, Dakota Recollet  Dr. Ulrich Teucher, Ramneet Jassal, Dr. Jasmine Hasselback, Brooklyn Rawlyk 
Leadership and Making Change  Dr. Alika Lafontaine, Caroline Tateishi, Dr. Edward Xie  The learner group attended a facilitated bison walk at Wanuskewin focused on bison as a keystone species that promotes revitalization of prairie ecosystems.

 

USask took the opportunity to host a local hub in June 2023 and spent four days engaging with a group of 7 learners from various disciplines. Our learners represented a pharmacy graduate student, a resident in Obstetrics and Gynaecology, a resident in Family Medicine, and four graduate students from Community Health and Epidemiology.   

Feedback from the participants and facilitators was overall extremely positive: 

“…local people who have been working towards making their workplaces more sustainable and observing how we all encounter so many difficulties. It gave me the nice sense of “we are so many, lots of people who want to do things”, but also showed the shocking reality of “the system is not really helping” 

“It was really eye opening to hear so many different perspectives within the group. I also really enjoyed the speakers and their informative talks. I thought the progression throughout the week was very well planned and allowed us to build upon concepts we had learned the day before.” 

 It was encouraging to see that there are students and colleagues on the local level as well as on the national level who recognize that there is need and possibilities for action. We are not alone” 

 “I learned that there are steps that the healthcare industry can take to reduce climate change. I want to contribute to this mission one day.” 

Here’s a summmary of our last day from Zoe Schipper, a graduate student in Community Health & Epidemiology:

At the Saskatoon hub, we wanted to embed ourselves in the learning. Discussing temperature rise, environmental equity, and system change during the conference activities and presentations was meaningful inside a classroom but could only become heightened through the last day ‘making a change’ going out to see it. Our group visited Wanuskewin, a heritage park in just north of Saskatoon, Saskatchewan. Wanuskewin is unique in that it holds independent conservation status, above and beyond its provincial, and federal designations. Aiming to be a UNESCO heritage site in 2026, Wanuskewin educates on 6,500 years of Indigenous environmental practises and returning to land-based learning integration. By reintroducing 6 bison to the land in 2019, the heard has grown to 35+ with 4 new calfs born in June 2023. Learning through movement and enngaging in a space of nature brought about discussion of how to implement changes in our green spaces and how to best benefit from ecosystem services. We discussed the resilience of the grasslands to adaptation in times of drought and in collaboration with keystone species. We had the fortune of knowledge keeper guides to inform us about the species diversity in this landscape and how the reintroduction of the bison, renaturalizes the landscape with every year. Located in a deep valley by glacial erosions millions of years ago, this spot was essential to the Indigenous practice of the Fall bison jump to ensure food and materials for clothing, tipis and other essentials through the winter. Through this we discussed that each person has a role to play in the future of our environment, just as each member of the tribe had a role to play in ensuring a successful bison jump. Getting to bring our group there was a calling back to the roots of the Treaty 6 land which we get to enjoy to live, learn and collaborate. We hope to attend a nature park visit in the future and encourage other hubs to find nature-based programming opportunities to engage in kinesthetic and body-balanced learning.

The planning committee consisted of representatives from Undergraduate and Graduate Medical Education, Saskatchewan Health Authority, Community Health and Epidemiology, Division of Social Accountability (DSA), Office of the Vice-Dean Indigenous Health and Wellness, and students. We are grateful to all members of the planning committee, to DSA for support with coordination, and to local sustainability leaders who presented to share their work. *   

USask has been invited to host a local hub for the 2024 Institute. The recommendation of the planning committee is to accept the invitation and partner with other Health Sciences in hosting, to expand the pool of potential learners, speakers, and organizational support.