Taking a Broader View of International Medicine

By Novak, Stephanie | International Herald Tribune, February 20, 2012 | Go to article overview

Taking a Broader View of International Medicine


Novak, Stephanie, International Herald Tribune


Once an area limited to studies of tropical diseases, global health studies now includes awareness of economic, social, cultural and political issues.

In the early 1900s, a course of study at the London School of Hygiene and Tropical Medicine might have meant traveling to a hut in Italy for several months to study the causes of malaria.

Or it might have included sailing to the West Indies to help a team of researchers investigate something called filariasis, a pathogen that seemed to be spread by mosquitoes. It could even have meant heading to Africa to help combat outbreaks of bubonic plague or dysentery.

"The colonial legacy gave rise to schools of tropical medicine," explained Dr. Peter Piot, who has been the director of the school since 2010. "Belgium, Germany, France, Portugal -- all colonial powers had them."

Such schools' main purpose, according to Dr. Piot, was to study sicknesses endemic to overseas territories before the diseases reached the European countries' shores, usually carried by sailors returning home.

Today, medical academics say that in an interconnected world, the study of such illnesses has become more complex. Researchers have realized that factors outside biology contribute to patients' well- being. Addressing public health goes beyond microbes and pathogens, they say, to factors like socioeconomic status and politics.

"Old-school tropical medicine is really a thing of the past," said Joep Lange, the head of the department of global health at the University of Amsterdam. "All tropical medical schools in Europe have to globalize and connect with top scientists or else they will become obsolete."

Physicians and academics say that the new approach means thinking about health more broadly, taking into account issues like malnutrition, contaminated water, inadequate health care and government inaction.

With that in mind, a student studying international medicine in 2012 might still travel abroad to learn about new diseases, but might also attend a series of lectures given by anthropologists, political scientists and economists.

Courses these days could include the study of cross-cultural psychiatry, with students chatting online with their counterparts in the Somaliland region of Somalia. Course catalogs have offerings like "The Politics of AIDS in Africa" and "Medical Humanities," demonstrating the cross-disciplinary approach of 21st-century global health.

Students are also driving the trend.

Mike Kalmus-Eliasz is the global health education director of Medsin, a British student organization that focuses on global health. "I wanted to do something that was a little bit different, and I think that's generally the case with a lot of students who get involved," he said. "They are interested in medicine, but they are also interested in the world outside of medicine."

While in medical school at King's College London, Mr. Kalmus- Eliasz and his fellow students worked to organize conferences and lectures on aspects of global health that were not normally covered in their curriculum.

Academics acknowledge that universities often lag behind when it comes to formally modifying medical school curricula to include courses that go beyond traditional classes like anatomy and biology.

So medical students interested in global health are going outside of the classroom to learn -- independently organizing ad hoc courses on topics like infectious disease and health care economics, attending international conferences on global health and, in some cases, traveling abroad.

"In the old days, you only had people going to the colonies, and then they came back and became professors," said Pieter van Dooren, who works at the Institute of Tropical Medicine in Belgium.

In Amsterdam, where students say that global health is still a relatively new idea, students like Stijntje Dijk work to create awareness of global health issues, organizing extracurricular lectures and conferences while advocating for more global health courses in medical schools. …

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