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.

Discussion of the health of the Earth’s people would be grotesquely superficial if it did not consider the glaring inequalities and the poverty present in the world today.  This fact is obvious to most.  However, this discussion often stops short and doesn’t delve into the multiple factors that contribute to this denial of resources and human rights.  It is even more seldom that analysis is made into how we perpetuate this situation, both as part of development initiatives and a Canadian society as a whole. 

Dr. Gerald Caplan, an international development consultant with a long history in Africa, summed up this situation eloquently and passionately in his plenary address.  He spoke of national organizations and NGOs that spend almost their entire budget in their home country or on the large salaries of the employees they import.  He spoke of ‘aid’ given by developed governments (including our own) that is tied to policies that further the economic goals of the donor.  He spoke of the overthrow of democratically elected African governments orchestrated by supposedly democratic nations.  He spoke of foreign volunteer organizations that undermine local initiatives and long-term sustainability. Dr. Caplan led into his conclusion by demanding his colleagues change the focus of development work, stating that “We must abandon this missionary position!”  Few present will forget that quote.

Although many sessions mentioned past and ongoing mistakes, the overall message was not to limit involvement in global health, but rather to change the way we operate.  Attendance at the 2005 Canadian Society for International Health’s conference was an opportunity to reflect upon my role in the world, as a Canadian and a physiotherapist.  These reflections will affect my point of view and ultimately my work.  They have brought to light the fact that the consideration of economics and politics and the advocacy and activism to bring positive changes to these systems is every bit as important as direct clinical work. 

As much as this conference had an effect on me, I hope that I had an effect on it: during many of the workshops and networking times I was able to bring forth topics regarding disability and rehabilitation.  Amongst the discussion of primary care and infectious disease there is a need to talk of the issues addressed by physiotherapy.  Our presence in the international health arena can help ensure that these issues are not left behind.

A conference is a forum for exchange.  For me, this year’s Canadian Society for International Health conference was an excellent and inspiring example of one such exchange.  For the benefit of our profession and that of the international health movement, more physiotherapists need to attend such conferences in the future.