A chance to network and a chance to learn

by Shaun Cleaver

International health means many things to many different people.  And many different people are involved in international health.  Every November hundreds of these people gather in Ottawa to share ideas and discuss the issues and even the purpose of international health initiatives.  The event is the Canadian Society for International Health’s annual conference and the participants make an eclectic mix. There are medical professionals, environmentalists and systems analysts represented.  There are clinicians, students, researchers, administrators, policy experts and diplomats.  There are Canadians as well as participants from no fewer than 17 countries.  This year I was fortunate to be one of the two physiotherapists present.

The theme of the Conference was “Your Money or Your Life: Health in the Global Economy” (full program available at http://www.csih.org/what/conferences2005.html).  The sessions were varied and dynamic and discussion with co-attendees was provocative and energizing.  Presence at this event brought to light one powerful observation: The people most involved in international health are concerned with far more than what is normally defined as health.

Ethiopia is one of the world’s poorest nations, with a population more than twice as large as Canada’s.  The World Health Organization estimates that 10 % of Ethiopians are living with a disability, which translates to roughly 7 million people.  In this country, with a landmass similar in size to Ontario, there are currently only 11 practicing physiotherapists.

There have been sporadic attempts at training physiotherapists in Ethiopia in the past, most at a diploma level and none that were sustainable.  The physiotherapists practicing in Ethiopia today are generally expatriates, or foreign-trained nationals, and the vast majority work in the capitol city, Addis Ababa.  In 2003, the University of Gondar in northern Ethiopia began the nation’s first Bachelor of Science Physiotherapy degree program.  The project began with two Dutch volunteer physiotherapists and a supporting team of Ethiopian physicians who believed that physiotherapy could improve quality of life in their country.

Afghanistan has had a long history of conflict.  Situated in a strategic geographical area, the country has often faced internal strife and has been overrun by foreign invaders with imperial ambitions: Persia and India in the 16th and 17th centuries, and between Britain and Russia in the 1800’s.  Since Afghanistan’s Independence in 1919, Russian and US interests were played out on Afghan land, and after the Soviets withdrew in 1989, rival Afghan factions fought a fierce civil war that led to the rise of the Taliban.  After Sept 11/01, the US and their allies began a military campaign, and defeated them.  This most recent conflict set the conditions for the most recent flood of refugees into Pakistan, the area where Handicap International Belgium (HIB) was working in 2002.

Afghanistan is a ‘Post’-conflict situation the lack of a strong central government leads to warlordism and insecurity. As well, decades of war, drought, ethnic violence and lack of funding combined to create a precarious humanitarian situation for the people of Afghanistan.