Friday 20 February 2015

International Involvement in the National Agenda to develop Academic Emergency Medicine: Defining “Involvement” – Capitalism and Colonialism Versus Creativity and Collaboration !

From the Desk of Sagar Galwankar, MD

Today a lot of stress is laid on Global Health as we continue to hear words like “One World”, “Global Citizen”, “Care Beyond Borders” etc. It is now accepted that health of one nation as can affect the health of other nations with travel and movement becoming easier than ever.

The Glooming threat of EBOLA continues to haunt the world. In this era of Global Stress to contain health within the borders of nations, it is but natural that keeping other nations healthy is of paramount importance.

Such a transition in culture attracts immense opportunities for partnerships and cohesive creativity. Emergency Medicine is an important part of this compendium of “Global Health”.

I like to use the word “Emergency Health” as it signifies the core fundamental of sustaining systems to provide Contingency Care not only to patients but to the population at large. EBOLA is the biggest challenge to any Nation as it continues to test the Emergency Preparedness and response of every country across the world.

Speaking of Nations where Emergency Medicine Continues to advance at its pace, I want to discuss specifically the Aspect of International Involvement in Countries where Emergency Medicine is a new specialty.

International Involvement brings the technical inputs needed to advance the specialty in a country where EM is in a nascent stage.

It is important to not let personal interests surpass the larger vision because then the mission is compromised. This is the biggest challenge to developing Emergency Medicine with International Partnerships.

To bring Government Recognized Residency Training Programs in Emergency Medicine and getting the specialty recognized should be the First Focus of any International Partner who is working towards the goal of supporting a partner country to establish EM.

In the developing nation there will always be a surge of Enthusiasts who will see the opportunity of being big in a new career option. It is important that these Enthusiast recognize their role and capabilities. There are times when these enthusiasts misinterpret their leadership skills to be teaching skills and this is the most harmful step to the process of developing Emergency Medicine.

“Educators and Education” is a concept which takes bilateral continuous repetitive and persistent efforts to sustain and grow and advocacy leaders are not a correct choice for that role. I don’t rule it out completely but it is challenging to be an Advocacy Leader as well as a good teacher all the time.

International Partnerships should recognize the above fact and be distinct in defining the cadre of leaders and the crew of educators so as to foster both Advocacy and Education successfully.

International Partnerships should bring opportunities for collaboration in Research, Education and Patient Care. I do understand that Financial Stability is paramount for any partnership to grow, but the path to financial stability should not stem from the philosophy of making financial profits out of a nation in transition who is being supported to develop emergency medicine. Advancing Local efforts to establish government recognized Training programs should be the most important step.

Starting new unrecognized training and certification programs and charging hefty fees for unrecognized training certificates by luring local partners and forging partnerships for profit under the umbrella of “INTERNATIONAL COLLBORATION FOR DEVELOPMENT” is one fact which can harm the growth of International Emergency Medicine. When there is no EM there is a need for training, but when it gets commercialized then there will definitely be personal be short term gain but there will be greater long term harm to the whole population and country at large. This is because when Government Programs start certifying Emergency Physicians these unrecognized certified physicians will always be in a conflict over authority in hospitals and in the academic and clinical arena of the country.

When there is no EM or any Training there is always a need for Expertise Development and Skills Training. As an International Academic Partner Ethically one is expected to partner to train and grow. When Capitalism sets in and Education becomes an Expressway to enhancing profits by creating commercially viable training programs, the death of the larger vision occurs.

Encouraging Local Leadership is very important, but it is more important to not create a “COLONIAL ENVIORNMENT”. International Partners bring expertise which is more valuable than ever but when the partners want to be rulers “Divide and Rule” sets in and this is what I call “The Colonial Model”.  Deviating from the larger mission and focusing on personal gains is the worst thing an International Partnership can bring to any developmental platform as it reflects poorly on the individuals, institution and the nation from where they originate.

Uniting with other partners who are working for the same cause, uniting leaders in the country where the mission is similar should be the role of International Partners.

International Partners should refrain from speaking negatively at International Meetings and Global Forums about Nations where they are working to bring change. This reflects poorly on their individual ethos.

Cross Nation Collaboration, Organized Development, Personal Growth and Integrated Innovation are important aspects of Internationalization. Bringing the world near and the citizens closer not only by information but also by emotions should be the philosophy of any partnership.

“Partnerships should focus on Peace and Progress of Populations with Strong Prevention against Personal Gains” – This is my Mantra for Growth !

 In the race between Capitalism + Colonialism versus Creativity + Collaboration I hope the later wins because then it is then that the patients will win !

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