SocMed and EqualHealth: Educating Beyond the Biologic Basis of Disease

In both the SocMed Uganda and Haiti courses, students share objects that represent their culture, providing a unique space for reflection and intimate dialogue on personal history and context.

pic1Health professionals regularly witness the effects of social and economic forces on the lives of their patients, but many have extremely limited knowledge of and experience with how to respond. This inadequacy stems, in part, from the absence of robust, standardized training on the social determinants of health in medical education. The organization SocMed is working to counter this status-quo by providing a tangible curricular model of transformative education to prepare future leaders in healthcare with experience and practical tools to utilize in their professional careers. We stand beside Beyond Flexner in pursuit of health equity and we hope that this blog post will generate further discussion and collaboration in the days ahead.

Hundreds of students have participated in and shaped the SocMed curriculum throughout its six years in Uganda, and other partners and countries immediately became interested in partnering to expand the SocMed model and increase its impact around the world. Expanding on the demand for engagement with social medicine, the SocMed curriculum has been adapted and offered in Haiti since 2013 in partnership with EqualHealth, an organization aiming to inspire, empower, and support the development of leaders among Haiti’s next generation of health professionals.

Stecie M., a medical student from Haiti describes her SocMed Haiti experience with EqualHealth,

“Studying social medicine helped me realize the ways that the social determinants of health affect people unequally and how the current system perpetuates health injustices. I don’t want this to continue. Though there is much work to be done, by truly partnering with stakeholders we really can make a difference. After the SocMed course, I have realized my responsibility and personal implication to share what I have learned with my colleagues in order to the be the change for Haiti.”

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SocMed Uganda, 2013. Course participants gathered in the courtyard of Lacor Hospital

SocMed offers the social medicine immersion course Beyond the Biologic Basis of Disease: The Social and Economic Causation of Illness in Uganda and in partnership with EqualHealth in Haiti, with each class being composed of half local students (i.e. from Uganda or Haiti) and half students from around the world. Curricular methodology is founded on the critical pedagogy of Brazilian educator Paulo Freire, focusing on Praxis (coupling constant reflection with pragmatic action), the Personal (acknowledgement of the influence of context on individual perspective and that who we are and where we comes matters deeply), and Partnership (effective and authentic accompaniment). Students engage in critical dialogue about their experiences with power, privilege, race, class, gender, and sexual orientation far beyond the classroom during their SocMed experience. Living and learning together engages students with the local context, fostering a network of deep friendships that enables students to cultivate their potential to be co-creators of change in real time.

 

Danny M., a medical student from the United States, reflects on the SocMed Uganda course:

“I found myself in a room full of keen students, mostly from Uganda and elsewhere in sub-Saharan Africa. They were well behind me in terms of privilege, but miles ahead in terms of insight and grit. During my month in the SocMed course, I formed deep friendships with remarkable people, who I never would have met otherwise. In this process of developing personal relationships, our class collectively engaged in what Paulo Freire terms “praxis,” the act of reflection that leads to meaningful action. We shared stories of suffering, joy, and inspiration. We discussed the impact of global economic policy on the life and death of individual people. We grieved over the atrocities during the recent years of insurgency and military response in Uganda. We talked about how to listen attentively to the stories of people who have suffered. In group discussions and individual conversations, we reflected on all we had learned. Then we acted. We produced a compelling and cogent petition to the Ugandan government to expand funding for the health sector. The SocMed course provided a concrete framework for how I think about social determinants of health and how I can engage. What I learned there in Uganda solidified my own vocation to practice equity-oriented primary care for low-income and marginalized people back home in the United States.”

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SocMed Uganda, 2015. Discussing the health impact of macroeconomic policy with Ugandan Minister of Parliament Hon. Sam Okuonzi.

Angella N., a nursing student from Uganda, recounts her SocMed Uganda journey:

“Before I joined SocMed, I was passionate about changing the status of health care in my community but had very little knowledge about how to go about doing so. Through SocMed, I gained real-life perspective on creating effective change through health advocacy. My SocMed experience inspired me to intern at a civil society organisation working to pass a Tobacco Control Bill in Uganda. As I reflect on my engagement with the Tobacco Control Bill, I’ve realized that my current work is reminiscent of my SocMed experience. As the only health professional in the organisation I work with I’ve realized the true need for more health professionals to get involved in health advocacy to run effective evidence-based projects, and I believe SocMed is taking the right step to train health professionals.”

SocMed and EqualHealth are providing future medical professionals with a context in which to richly comprehend and tangibly engage with the myriad social factors that impact human health. This concrete education in social medicine has effectively propelled health professions students into careers that are dedicated to health equity. SocMed and EqualHealth seek to provide not only direct education, but also resources for medical educators who want to incorporate issues of equity and social determinants of health into their pedagogy. The goal of Beyond Flexner is well aligned with that of EqualHealth and SocMed: make health more equitable by reshaping health education.

Efforts to achieve this goal in the United States are deepening. This spring (April 28-30th, 2016), leading thinkers in social medicine education will come together in Minneapolis, MN through the support of a grant from the Josiah Macy Jr. Foundation to dialogue as part of a symposium on Teaching the Social Determinants of Health. Hosted by SocMed and EqualHealth, and supported by a consortium of other partners, including Partners in Health, Harvard Medical School Dept. of Global Health and Social Medicine Program on Medical Education and Social Change, University of Chicago Pritzker School of Medicine, and Pozen Family Center for Human Rights, the objective of this symposium is to share innovative curricular models and move toward establishing best practices in social medicine education. The Beyond Flexner movement is a tremendous resource through which organizations like SocMed and EqualHealth can glean new information, connect with partners, and influence meaningful change in health professional education. SocMed and EqualHealth are eager to continue engaging with Beyond Flexner and its network in our collective efforts to realize better, more equitable health.

If interested in learning more, please contact us at socmedglobal@gmail.com.

Post by Melissa McCoy, Daniel Mays, Cassandra Fox, Michael Westerhaus, Michelle Morse and Amy Finnegan. SocMed Haiti, 2013. Cultural Objects, Personal Narratives.

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