(by Sajni Tamby)
My first experiences with global health began in high school. When my grandfather decided to retire in India, my family and I started visiting him regularly and I impulsively decided to volunteer at a local orphanage for children with disabilities to pass the time in the sleepy beachside town that my family is originally from. The first time summer I volunteered there, I remember feeling deeply uncomfortable with everything I saw. The nuns who ran the orphanage were understaffed, overworked and operating with limited resources. I was confronted with extreme poverty for the first time, and it made me feel intensely guilty for privileges I took for granted every day. As I went back in subsequent years, I learned a great deal about how these nuns took care of sick children in this particular setting, and I developed an interest in global health. A few years later, I had the opportunity to participate in a global health service trip to Rwanda, where I worked on community-initiated projects in urban and rural locations in the country. It was on this trip where I developed a sense of evolving mission of global health.
In my high school days, I viewed “global health” as wealthy countries sending health care workers and resources to poorer countries to deliver better health care. I was aware of some of the complexities involved—after all, despite being ethnically Indian, I was essentially a complete foreigner in India, completely unfamiliar with the language and lacking important knowledge about cultural norms and practices regarding health care in general and specifically the care of children with disabilities. Therefore, I was acutely aware of the fact that what I was receiving (in the form of knowledge and experience) amounted to far more than I was providing (in terms of support).
My trip to Rwanda was more formally organized, and it was through assigned readings, planned discussions and on-the-ground experience that I was introduced to global health as a formal discipline. I developed the view of global health as a field that aims to develop and strengthen health care systems in developing countries. Crucially, I took away that one of the basic tenets of achieving this goal is to strengthen existing local systems in order to achieve sustainable success. Rather than coming in to set up an independent or parallel organization fully reliant on international funding, I saw that a best role for foreigners is serving as a resource and as an ally to local leaders and healthcare workers.