Why Global Health Keeps Failing And How To Fix It

WEBVTT
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Have you ever wanted to serve internationally but don't have a lot of time or money?
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Worried that you cannot be of assistance because you don't know the local language?
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Well, international service learning has a solution.
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Consider one of their many short-term service learning trips abroad where they will take care of everything from country arrival to departure.
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Choose from a wide variety of programs and an ever-growing list of countries with international service learning where their motto is travel, serve, learn.
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The website's easy.org.
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Thanks for joining us on another episode of the International Service Learning Experiential Education Podcast, where our goal has always been to share the voices of international service.
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I'm Dr.
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Patrick Hickey, or Dr.
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H, and it has been my honor to be the host of this podcast.
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It's another great day to talk about service, and joining us today to do so is Dr.
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Meunier.
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Very excited today to have Dr.
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Meunier with me.
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We've not met until just now this morning.
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We've dialogued back and forth and again, real excited.
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He's an international expert on international health care, and we're very excited to have him here today.
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But before we get started, if you don't mind, sir, just tell us a little bit about yourself and what your path was in becoming a physician.
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Yes, well, thank you very much for inviting me on this podcast, Patrick.
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I appreciate it.
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And yeah, okay.
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Okay, let me start with the beginning and why how I how it all started for me.
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Well, it all started um why did I choose healthcare and why the international field?
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First of all, I think it was based the first foundation is my moral fabric.
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I went to public school and I went to Catholic school in France, and I learned the values that are involved in uh in this religion.
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So that was the first thing.
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And then I got a French education.
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I went to high school in France, in France, and I learned the values of the French nation, as you know, liberty, equality, fraternity.
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And I wanted to apply this to global health.
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And so I translated this into freedom.
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Liberty would be freedom, access to health care.
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Equality will be no more, nobody is more equal than others.
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That means that they should have equal access to care.
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And that also fraternity is solidarity.
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And we saw in uh with the COVID pandemic how this applies, that the virus does not does not have any barrier, and we should one for all and and all for one.
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This is the uh famous saying from the three musketeers from Alexandre Dumas, and as we know, uh the three musketeers were actually four of them.
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There was Artos, Pothos, Amis, and D'Artagnan.
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And then the third pillar was my philosophy.
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Then when I went to high school in France, maybe also in Canada, we learned philosophy in the last years of high school.
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And the the two philosophies that were most attractive to me were existentialism, which was you know promoted by Jean-Paul Sartre, and which says existence perceives essence, that means you make your life, it's more important what you do than where you come from.
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And uh of course, this was the coin by uh Kierkegaard, uh, Sartre didn't say that, but that's the foundation of his uh philosophy.
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And the other one is also from a French uh another French philosopher, Albert Camus, which is, and his philosophy is absurdism, which means that uh life has no sense and it has the sense that you give to it.
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So I mean you make your you make your own, you give sense to your own life, but what you do, what you about your choices choices in life, and by your actions.
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So those were the three pillars of uh of uh my uh reason what I went into healthcare.
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But why I went into international healthcare is in uh maybe you know younger people don't remember that, it's already in the history book, but in uh in 1968 there was what they call the French Revolution, but it it was not, it was a rebellion from students.
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And at that moment, I felt that this was kind of reviving the ideals of the French Revolution, and I I I uh started thinking uh with a broader perspective.
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And as a matter of fact, a matter of fact, a few years later, two or three years later, my father, who worked for the World Bank, was sent on a mission to Brazil.
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And uh I then went there a couple of times and then decided, because I wanted to specialize in tropical medicine, that I would transfer to Brazil.
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So I studied, continue my so I started my medical studies in France, the basics, basic, uh basic sciences, anatomy, physiology, and so on, biochemistry.
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And then I continued in Brazil for five years, and then I did, and then I went to George Washington University Hospital to do an internship.
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So I'm probably the only doctor in the world.
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I do I did some research on this, but I couldn't find I said that studied basic medicine, not specialized after you have your degree and went to overseas to uh like many doctors do.
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They go to in Europe, they go to the United States, Canada, or Australia.
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But I did the basic uh medicine studies in three different languages, in French, in English, and in Portuguese.
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And that gave me a lot of information, a lot of knowledge about opening my eyes to the world.
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And and in particular in Brazil, the needs of people that are quite different, quite more acute than what I had experienced before.
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What a great base for how you started out.
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And you know, I always appreciate people sharing how they got to where they're at, and and and people wonder, you know, where where did you get your influences?
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And and thank you so much for sharing that.
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Just moving on, in your recent article, Global Health from Crisis to Transformation, you shared that the international public health infrastructure has fractured into an uncoordinated network of isolated silos.
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Can you tell us a little bit more about that?
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Yes, okay.
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So it struck me because I I worked as a general practitioner in Singapore for five years, and at that time there was a tsunami in Indonesia.
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And I witnessed this particular aspect of global health vividly, and uh it it struck me that at that moment you can see that there was international institutions, there were universities, you know, many universities have global health departments, there were NGOs, there were the religious entities, there were foundations, there were the ministries of health.
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Everybody was on site trying to help.
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And and it was a mess, actually.
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You know what I mean?
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When when on the beach there where the tsunami struck, you had literally hundreds of flags with with the name of the people.
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And sometimes there were like five, ten people only, with an NGO from Belgium, it was an NGO from Canada, and so on.
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Highly inefficient.
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A lot of waste of time, money, and manpower.
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And I this is when I decided, no, no, there needs to be a transformation in healthcare, in global health.
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And and then what I witnessed after that is crisis after crisis, it was no transformation, it was just reform.
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Reform inside the silos.
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So, like for example, the WH show, yes, there was a problem with Ebola.
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So we're gonna restructure this, restructure that, but no global vision of how it works.
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And when uh when COVID struck, you you you saw the the international response was totally inadequate.
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Totally inadequate.
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And there were many reasons for this, and one of them, of course, political, the problem with China, and they did not declare the cases and so on.
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Well, you know, I'm I'm really intrigued by by your perspective, and it really leads to my next question because you're you're talking about institutional workforce.
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You know, in your article, you talk about the mainstream international public health agencies that are undergoing financial baseline reduction and due to massive funding drawdowns, which we hear about in the news and frozen development budgets, it's leading international health organizations.
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They're they're managing a catastrophic 25% health headcount decline.
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Since you see that decline in public health workforce, do you now see a greater need for the efforts of organizations like you know, International Service Learning, Global Medical Brigades, and other NGOs that that facilitate opportunities for volunteers to visit a developing country and render much-needed health care?
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Yes.
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Well, if you look at the global picture right now in global health, you can see that the trends are negative.
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You can see if you look at historic diseases like yellow fever, malaria, chagas disease, and so on.
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And if you if you look also as at other diseases like measles, there's a resurgence of measles and so on.
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So global health is failing, has been doing so for about more than five years.
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If you look at the trends, you can see the stats.
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And of course, when this is happening, there is a need for some entities to fill the void.
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And that's what a charity organization or international service learning do.
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They they fill the void, but this it's it's the a it's a sign of failure.
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It's a sign of failure of global health, it's a sign of failure of local governments who do not supply the healthcare that is needed to their own populations.
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I guess in in comparison, I work in nursing, you know, we we have nurses that that fill a void, they're called travelers.
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And it and it's you know, they're they're there for a reason, but the bigger picture is we have a challenge that we don't have a big enough work nursing workforce.
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So we have entities like traveling nurses that fill a need, but but it's unfortunate that that we can't look at the bigger picture, which which leads to, again, I loved your article, and I hope people can can can review your article after this podcast.
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You speak about the catastrophic risk of maintaining this status quo, specifically about the challenges associated with maintaining a fragmented system without unified early warning networks, rapid data sharing, and joint response capacities, as this will guarantee that localized outbreaks will predictably scale into a catastrophic global lockdown.
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So, how can the ever-growing volume of NGOs and organizations, as I've talked about, be incorporated into what you call a fragmented system so that all of us are working together?
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As you know from your experience, many of these organizations already work under the umbrella of the ministries of health within the countries where the volunteers work.
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However, there just aren't as many that can do so, which can be quite problematic.
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Yeah, okay.
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I see I see two ways that this can be done.
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The first one is consolidation.
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Consolidation with domestic and international mergers.
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I think that there are way too many NGOs doing the same thing, sometimes in competition, sometimes it's uh it's uh at some time there is infighting.
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It's not uh the majority of cases, but this can happen.
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But consolidation needs to happen now, which means domestically, if you look at the NGOs, if you look at I was just mentioning before the the uh global health department in in universities, they should all unite.
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I don't see why there should be global health at Stanford, Global Health Berkeley, Global Health at uh at uh San Jose State.
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They should all unite.
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They will do just like big corporations, multinational corporations, they merge, there is consolidation, and you gain inefficiency, in efficiency in terms of manpower.
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I should say uh workforce, manpower now is uh is tagged as me.
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Yeah, workforce as also financial resources, merging is the uh and also the impact.
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You have only one project instead of having uh three or four different projects or more.
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So consolidation it can also happen internationally.
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Okay, go ahead.
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I was gonna say I like I like your concept of consolidation and merging, and and that that's there are so many of us that are doing the same thing, and maybe if we were better unified, we could collectively do a better job.
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Okay, so yeah, I I I'm I'm I'm I'm I'm I'm certain about this.
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I'm um so the second the second way is cooperation, increase cooperation if you don't want co- uh consolidation, because that this is always this turf war, you know.
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I mean, that starts.
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You you know, you had two uh CEOs, now you have one CEO, which one is it gonna be, and so on, so anyway, cooperation without merging, so that you unite your forces with the same goals, and then you get you gain in efficiency and impact on what you're doing.
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So those are the two ways.
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So, do you feel yourself that the volunteer healthcare organizations, the NGOs, do you feel that they're really making an impact on on the resource poor regions globally?
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Yes, I do.
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Um I mean they uh there there is okay, there's you can say this better than nothing.
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So when there was nothing, but yeah, definitely them they have a great impact.
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Better than nothing, but also a huge difference because there was nothing.
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Do you do you think that these groups that are doing what they're doing and and and making a difference, do you believe they need to be better prepared before they go to these countries?
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I do.
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I do believe that there's a lack of uh sometimes lack of preparation can cause a lot of damage.
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I'll give you an example.
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I went to a global health meeting at Stanford, and the the resident who went was there for a stint came back and said, well, he had to face, he was in the emergency department, he had to face a case of a young child who came, he had a head trauma, he had an extradural hemorrhage.
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So what you need to do in that case, to you have to relieve the pressure inside inside the brain by drilling a hole through the skull to relieve the blood.
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And the question was should he do anything because he doesn't have the preparation?
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And the answer for successful was no.
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You should not uh cross the line where you are not competent enough.
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And that's the the mentality, the the the Western also lead school American mentality.
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You don't do it because the fear of sued, being sued.
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So but the problem is not the same.
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See, you have to change your paradigm when you're there, there is nothing else.
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So you doing nothing is not an option, you have to try.
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And if you fail, you fail.
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But if you don't do anything, the patient will die.
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Well, scope of practice is what we're held to, as you know, in in healthcare, and uh and we're we're educated and trained not to do anything external or outside what you've already learned how to do.
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Yes, I agree with this, but if the if the alternative is you do nothing and the patient will die, you should there's no there's no other outcome, and if you try, you may you may save his life.
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I think uh you have to opt for the second option.
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This this is uh not sustainable morally.
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Uh obviously, I'm glad you brought up morally.
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Obviously, there's moral and ethical considerations that need to go into all of these decisions before you make them.
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Yeah, yeah, yeah.
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Okay, so this that's my first thing, and and also I think there needs to be more preparation to to have a mind a mindset shift, uh changing a shift in paradigm.
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And people they need to adjust to the new reality, and but they don't know what it is.
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They go there, you transfer them, and they are everything is new, and they get lost, and they get sometimes frustrated, they get some angry and everything, and they lose sight of the priorities and and the goals of their mission.
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So there is a lot of attrition, there's a lot of energy that's diverted to things that they should not have to if they were well prepared.
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With with the preparation, do you feel in the healthcare setting that we could do a better job in our course curriculums, for example, in nursing programs or in med school to introduce more uh cultural competencies and more about international health?
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I think that it's it's on the on a voluntary basis.
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The doctors or the nurses that are interested in in international health care or going overseas and trying to help or try to learn from overseas because it also has to be a two-way street.
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It's can't it cannot they have to be uh go there and learn locally, they cannot just go back and say, okay, and there's also this, you know, the savior of the world kind of attitude, which is which is not helping at all.
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Yeah, we call it the white knight syndrome.
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Yeah, the white knight syndrome, exactly.
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This uh so there needs to be a preparation about all this, and but all about the living condition, basically, about the sociology, what the what kind of people are they gonna mean?
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What are the beliefs of these people?
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Cultural preparation.
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So I think every medical school should offer a international medicine course.
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And of course, I attended one a long time ago, and I would give you the curriculum.
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It was one year, and there were seven topics: tropical diseases, nutrition, health and economic development, health and culture, health of migrants.
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It's a very special niche, that's special, occupational medicine in developing countries.
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And the last one was medicine and surgery in resource-challenged environments.
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If one year, if you if you learn all this, I think you're ready to go.
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Well, that's that's a great challenge to put out there.
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I appreciate you sharing that.
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You know, we'll we'll we'll lay it out there that that's your challenge for schools to adopt that that curriculum or that format.
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I want to I want to jump into your philosophy that you're a knife amongst spoons.
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I I really enjoyed reading that.
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You know, it caused me to wonder, should we all sharpen ourselves a little bit more?
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Tell us a little bit about knife amongst spoons.
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Yeah, I wrote that because of four reasons.
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There were four reasons.
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First of all, I have no conflict of interest, and if I give a perspective, it's completely 100% genuine.
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There is no taking into consideration I will hurt this, I will uh ruffle some feathers, I have to maintain the integrity of this, I have to uh make sure that the interests of the organization are not threatened and so on.
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So I have no conflict of interest.
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I have untethered critical thinking.
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You know, I see the I apply my critical thinking, and nobody or nothing can stop me in assessing the situation, and I give a raw real raw reality assessment.
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This I give it, you know, just like it is.
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And there is no putting some water in my wine and this kind of stuff.
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And the last thing is I use plain talk, I don't go into any scientific jargon, medical jargon, anything like this.
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I just use normal words, and I tend to also use words that are more stirring, jarring than than most people.
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And this is why I call it a knife, because you can cut, you can cut cutting through the uh through the BS, you know what I mean?
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Oh well, I appreciate that.
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And and it really jumped out at me, a knife among spoons.
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I I love that analogy.
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And I also love when I read up on you and read your article, you've been referred to as the father of the new global health paradigm, a transformer who rejects the foundational architecture entirely to build a completely new paradigm in its place.
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With that said, and I thought that was a great introduction.
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Can you talk a little bit about your 10-point plan that dictates exactly how future global health security must be constructed in order to neutralize the negative trends that are threatening humanity at this time?
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I think this is the topic of my next uh webinar at the end of the month.
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It would take one hour to go through all this.
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But the basic thing is it it has to do with your core philosophy and priorities.
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Those have uh have the uh are uh stemming from my uh philosophy that I've been I I I I describe uh you know very briefly.
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And it applied to each of the things the ten points.
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And then and then the second thing is this the the because you asked me you know what you're gonna you're gonna They will, but they have to be integrating in in the plan and according to what they offer, what they can bring to the table.
00:22:12.640 --> 00:22:19.920
For example, if we go to the the points one by one, highlight the global health security.
00:22:19.920 --> 00:22:20.480
Okay.
00:22:20.480 --> 00:22:25.039
There is there is a lack of resilience.
00:22:25.039 --> 00:22:32.000
There is no you can see that when a challenge, big challenge, strikes, there's no preparation.
00:22:32.000 --> 00:22:43.039
The international uh health structure is because it's siloed, it's it's it's not efficient and there's nothing is ready at at the global level.
00:22:43.039 --> 00:22:47.119
And then create and strengthen necessary mechanism.
00:22:47.119 --> 00:22:48.000
Yeah, okay.
00:22:48.000 --> 00:22:51.440
The the you can see all the weak the weak points.
00:22:51.440 --> 00:22:56.160
We have uh we can take the great revealer about this was COVID.
00:22:56.160 --> 00:23:03.200
You take COVID and the response, and you see all my points are are illustrated by the COVID response, and it has not changed.
00:23:03.200 --> 00:23:13.839
See, as I said, there's been reform inside the silos, reform inside WHO, reform inside the CDC, but no transformation.
00:23:13.839 --> 00:23:16.240
And what is required is transformation.
00:23:16.240 --> 00:23:18.720
You need to change the structure.
00:23:18.720 --> 00:23:33.119
As I said, the mer about merger between NGOs, there needs to be merging of this great thing, these big mammoth uh organizations, WHO, PAHO, UNICEF, uh even the UN.
00:23:33.119 --> 00:23:38.559
This to be only one global entity for global health, not dispersed like that.
00:23:38.559 --> 00:23:44.400
So consolidation of the global health structure, they need to have a new leadership.
00:23:44.400 --> 00:23:48.400
You cannot change, you cannot transform with the old way of the old vision.
00:23:48.400 --> 00:23:58.240
You have need to bring in people with new vision, therefore they will have new strategies, and that and the one of the strategies that have to change is prioritization.
00:23:58.240 --> 00:24:16.319
If you look at the UN sustainable development goal, because this is another thing that I'm I'm I'm I'm uh promoting, and uh which is that the number one priority in global health is uh is to reduce poverty.
00:24:16.319 --> 00:24:21.119
Poverty is the number one risk factor for all diseases.
00:24:21.119 --> 00:24:43.359
Even here, poverty, you can see it, the discrepancy, the gap between the between wealth of uh of patients, uh because in terms of acts in terms of uh quantity, access to care, you can see in the in the people in the country where you work, people who don't have a car, people have no means of transportation, they don't have access to care.
00:24:43.359 --> 00:24:54.640
And in terms of quality of care, of course, if you have you don't have access to highly sophisticated treatment or health care, if you don't have any money.
00:24:54.640 --> 00:24:57.680
So poverty is the number one.
00:24:57.680 --> 00:25:06.960
And if you look at the United Nations priorities, the goals, they have 17.
00:25:06.960 --> 00:25:14.559
And one thing I learned is you if you have too many priorities, you have none.
00:25:14.559 --> 00:25:18.480
So jack of all trades and master of none.
00:25:18.720 --> 00:25:19.279
There you go.
00:25:19.279 --> 00:25:24.640
Well, let me let me just before we move on, I just want to go through the 10-point plan.
00:25:24.640 --> 00:25:28.799
Okay, let me let me just read them out one through ten, just briefly.
00:25:28.799 --> 00:25:34.799
So your 10-point plan that dictates how future global health security must be constructed.
00:25:34.799 --> 00:25:38.880
Number one is highlighting global health security, which you've alluded to.
00:25:38.880 --> 00:25:43.759
Number two, creating and strengthening the necessary mechanisms that are in place.
00:25:43.759 --> 00:25:47.680
Number three, promoting multidisciplinary engagement.
00:25:47.680 --> 00:25:51.839
Number four, strengthening multisectoral coordination.
00:25:51.839 --> 00:25:55.519
Number five, emphasizing financial preparedness.
00:25:55.519 --> 00:25:59.200
Number six, improving early warning and detection.
00:25:59.200 --> 00:26:03.599
Number seven, collecting and sharing data in a timely manner.
00:26:03.599 --> 00:26:07.839
Number eight, conducting comprehensive laboratory testing.
00:26:07.839 --> 00:26:15.839
Number nine, developing a joint outbreak response capacity, and finally, number 10, taking science-based actions.
00:26:15.839 --> 00:26:20.880
And of course, we could go on for hours, I'm sure, on each one of these points.
00:26:20.880 --> 00:26:26.000
But I just wanted to read the 10 points of which you started to share some of it.
00:26:26.000 --> 00:26:33.200
With those 10 points, again, you alluded to it just briefly before you started talking about the 10-point plan.
00:26:33.200 --> 00:26:42.319
How do we volunteer healthcore healthcare-focused organizations, how do we fit in to your 10-point plan?
00:26:43.680 --> 00:26:46.000
Well, it's according to what they bring to the table.
00:26:46.000 --> 00:26:46.960
You see what I mean?
00:26:46.960 --> 00:27:06.160
So different uh NGOs, they have different focuses, and they themselves will choose which one in on which point they would be the most efficient, effective, and determine how they would integrate in with in the system with other with other people acting on that point.
00:27:07.519 --> 00:27:07.839
Okay.
00:27:07.839 --> 00:27:21.200
So, like a university that's sending a a a group of pre-med students to Nicaragua to do rural health care, how would they fit into your 10-point plan?
00:27:21.200 --> 00:27:27.839
Number one is highlighting global health security, and number seven is collecting and sharing data.
00:27:27.839 --> 00:27:33.119
How would we how would we look at your 10 points and fit into that process?
00:27:33.920 --> 00:27:36.240
Okay, first you determine your goal.
00:27:36.240 --> 00:27:37.759
Why are you going there?
00:27:37.759 --> 00:27:39.920
The the people who are going there, what is their goal?
00:27:39.920 --> 00:27:41.680
What is what are they trying to do?
00:27:41.680 --> 00:27:51.039
And then according to their goal and their action plan, in each point of the action plan, they see how they can fit those those 10 points.
00:27:51.039 --> 00:27:52.960
Some will not fit, some will fit.
00:27:53.119 --> 00:27:53.519
I got you.
00:27:53.680 --> 00:27:58.960
And you have to do this in in collaboration with a university, for example.
00:27:58.960 --> 00:28:03.680
Nicaragua, work with all the ministry of health, maybe they have some departments.
00:28:03.680 --> 00:28:10.079
But my point is this it's the Ministry of Health of each country that determines how that should do the coordination.
00:28:10.079 --> 00:28:11.119
They're not doing it.
00:28:11.119 --> 00:28:12.880
They just say, Okay, you want to do this?
00:28:12.880 --> 00:28:13.440
What do you know?
00:28:13.440 --> 00:28:16.559
Give show me your plan, show me your project, and yeah, you can go there.
00:28:16.559 --> 00:28:17.279
That's it.
00:28:17.279 --> 00:28:36.160
They don't tell us, they don't tell them, they might might tell them, you know, the needs are this and this and that, but they will not tell them the whole picture of the other groups coming in, what they are doing, what is the you know, what is the the length of the plan, and so on and so on, because the longevity is is the is the problem.
00:28:36.160 --> 00:28:37.599
Because I've seen too many.
00:28:37.920 --> 00:28:45.920
Well, I'm sure politically that a lot of countries don't want to share their intimate details about their health structure or lack of resources.
00:28:46.880 --> 00:28:47.839
Yeah, well, that's it.
00:28:47.839 --> 00:28:49.200
That's there's a problem right there.
00:28:49.200 --> 00:28:52.960
You cannot you cannot be effective if you don't know reality.
00:28:52.960 --> 00:29:05.920
What you so you go there and you you discover uh you know day by day as you uh as time goes by and as you work, you discover the problems, and that's not efficient, that's not the best way to proceed.
00:29:06.480 --> 00:29:09.599
So, how could how can countries collaborate then?
00:29:09.599 --> 00:29:21.200
I mean, for Latin America, for example, how can Costa Rica, Nicaragua, Panama, Honduras, how can they better work together to effectively work within their own systems?
00:29:21.680 --> 00:29:33.599
Yes, okay, so they have to identify the common problems, common challenges in the health in healthcare, for example, because of course there's another thing is that diseases don't respect borders.
00:29:33.599 --> 00:29:44.000
Nicaragua has a way to deal with measles, has a way to deal with other diseases, and then the next country a different way of dealing with it.
00:29:44.000 --> 00:29:55.039
So, and it's it is all political because some is more socialist, some is is is not is not at all supposed socialist, it's conservative, and they have different approaches.
00:29:55.039 --> 00:29:58.960
So, my uh solution to all of this is AI.
00:29:58.960 --> 00:30:09.039
AI can determine what are the real priorities, just like I said before, that I do I give you the raw the raw picture, AI will give you the raw picture.
00:30:09.039 --> 00:30:18.640
You ask AI what are the main problems with healthcare in Nicaragua, and what are the main problems with healthcare in in Honduras and so on.
00:30:18.640 --> 00:30:29.039
AI will give you the state of and and then you cannot all agree on this because this is not given with any bias.
00:30:29.039 --> 00:30:38.000
So once you have those data, you go to the different countries and you say to the Ministry of Health, okay, this is the those are the problems we can work on this together.
00:30:38.000 --> 00:30:39.920
And how let's see how we can unite.
00:30:39.920 --> 00:30:41.759
You have some ideas, we have some ideas.
00:30:41.759 --> 00:30:47.839
Let's let's see how what what this is, what smart countries like Singapore did.
00:30:47.839 --> 00:30:50.960
They did when they established their healthcare system.
00:30:50.960 --> 00:30:56.640
They didn't go follow, copy any any model, they took the best of different systems.
00:30:56.640 --> 00:31:06.240
They went to study the system in Australia, which is more socialist, they went to study the system in Great Britain, in the United States, in Canada, and other countries, and it's okay.
00:31:06.240 --> 00:31:08.559
What is the best adjusted, what is best for us?
00:31:08.559 --> 00:31:11.519
And they pick and choose and they create a neural system.
00:31:11.519 --> 00:31:14.000
And the result is fantastic.
00:31:14.720 --> 00:31:27.119
So what how do all these NGOs of volunteer healthcare focused teams or or faith-based teams, some of them are led by college, university, faculty?
00:31:27.119 --> 00:31:36.880
How do they how do they fit into this bigger system when everyone's kind of doing their own thing, everyone's going to the countries you know that they want to go to?
00:31:36.880 --> 00:31:47.759
There's no overarching global group that's that's regulating or or or giving standards for all of these entities that are out there.
00:31:47.759 --> 00:32:00.400
They're all in their good hearts, going and doing their own thing, rendering health care, making a difference, as you said, but but there's no no one supervising or or orchestrating what they're all doing.
00:32:00.400 --> 00:32:04.480
What what is your what is your recommendation for all of those entities?
00:32:04.799 --> 00:32:10.160
Yeah, well, the first thing is initial initial initiative, you know, individual initiative.
00:32:10.160 --> 00:32:12.400
The people have to meet and talk.
00:32:12.400 --> 00:32:15.279
So you have you see somebody who's doing the same thing.
00:32:15.279 --> 00:32:17.200
Let's say you don't let's say you know nothing.
00:32:17.200 --> 00:32:25.440
You go to Nicaragua and you say, okay, I'm gonna do a I'm gonna help the situation in that village, that that hospital, whatever.
00:32:25.440 --> 00:32:28.799
You go there and you discover the problems.
00:32:28.799 --> 00:32:47.599
Then you inquire about who is doing who is doing what in the country and in the next uh in the next uh in the next countries, and you'll meet with them and say, okay, this is what we're doing, what are you doing, how you go about it, let's see what works, what doesn't work, and let's work together.
00:32:47.599 --> 00:32:52.240
So it has to it has to come from the from the bottom, bottom up.
00:32:52.240 --> 00:32:54.640
But but for example Because there's no top down.
00:32:54.960 --> 00:33:16.799
For example, in Costa Rica, there could be, and I'm just I'm just guesstimating, there could be 50 to 100 different healthcare focused groups working without knowing what others are doing in different communities, all from maybe different universities, all maybe from different churches.
00:33:16.799 --> 00:33:22.160
There's there's it's a challenge for them to know what what each other is doing.
00:33:22.559 --> 00:33:31.279
Well, you know, now it's it's much easier with the with the Zoom, with with the handphone and so on.
00:33:31.279 --> 00:33:50.480
So go online, find, find uh who is who are the actors, and maybe you can find it through the Ministry of Health of that country, who is doing what, where, and then get in touch with them, talk, organize a meeting, a zoom meeting with all of them together, and you know, with an agenda, and you know, go you you you go from there.
00:33:50.720 --> 00:33:52.079
Well, uh and I appreciate that.
00:33:52.079 --> 00:34:02.880
That's a good point because everyone normally has to register with the Ministry of Health in each country, so they would be the ones that would know of all of the entities that are actually volunteering in their countries.
00:34:02.880 --> 00:34:03.759
Is that correct?
00:34:04.240 --> 00:34:14.400
That's correct, and not only that, but if the the Ministry of Health is not doing it, you can be spare-headed, uh sparehead of movement to say, okay, well, we're going to be the coordinator.
00:34:14.400 --> 00:34:28.159
Or you'll meet and ask who do who wants to coordinate all this, and somebody will will step up to the plate and and and start uh uniformity and and and also a cooperation, collaboration, and so on.
00:34:28.400 --> 00:34:35.360
Well, you know, when I started the podcast, I wanted to hear the voices of those that were involved in international service.
00:34:35.360 --> 00:34:48.559
And as I move forward with it, I'm I'm I'm finding that there are so many individual cohorts that are doing great things, but they're working, as you mentioned, in silos and they don't know what others are doing.
00:34:48.559 --> 00:34:53.119
And there may be a better way to develop collaborations.
00:34:54.000 --> 00:34:57.519
And you can put together pull together your resources.
00:34:57.519 --> 00:35:05.199
You know, you'll find no no new avenue to explore to fund your project when you meet with other people.
00:35:05.199 --> 00:35:08.719
Instead of competition, there's there's no need.
00:35:08.719 --> 00:35:13.840
I mean, you I think there is better results in collaboration and in competition.
00:35:13.840 --> 00:35:21.599
I don't think see, this is what one way where uh you know the American way, competition increase the quality and so on.
00:35:21.599 --> 00:35:24.320
This is one place where it doesn't.
00:35:24.320 --> 00:35:26.559
Uh it doesn't increase the quality.
00:35:26.559 --> 00:35:37.199
I mean, you're competing with each other, you're you don't have any other means that they have, but they have different approaches, you have different philosophies, you have different uh specialties, and so on.
00:35:37.199 --> 00:35:47.440
So this to me, this is uh this is and and frankly, now some people have hidden agenda, so so that's the problem, also.
00:35:47.440 --> 00:35:55.440
Like religious groups, they're trying to convert people to their religion or give a good impression so that people would convert to their religion.
00:35:55.440 --> 00:36:02.480
So that's that doesn't work because they want to they want to reap the benefit for themselves because they have a hidden agenda.
00:36:02.480 --> 00:36:07.760
Some don't, but at the top uh you know of the structure, there's somebody who thinks about this.
00:36:07.760 --> 00:36:09.280
I'm saying I can guarantee you that.
00:36:09.599 --> 00:36:16.320
Well, it's an admirable task that you describe of trying to pull everyone together.
00:36:16.320 --> 00:36:24.000
You know, maybe the commonality would be the Ministry of Health in each country, reaching out to the Ministry of Health, how many entities are working in your country?
00:36:24.000 --> 00:36:25.840
Let me try and pull them all together.
00:36:25.840 --> 00:36:32.960
The issues and challenges could be many, as you mentioned, you know, hidden agendas, financial resources.
00:36:32.960 --> 00:36:38.320
I mean, some of these people that are facilitating these experiences are making money.
00:36:38.320 --> 00:36:44.159
So they they they obviously don't want to share what they're doing with others because it's it's competition.
00:36:45.199 --> 00:36:45.679
Yeah.
00:36:45.679 --> 00:36:52.880
So well, you know, so you you can do reach at you, it won't be 100%, but at least at least you'll be making progress.
00:36:52.880 --> 00:37:00.559
If you can even have half of them deciding, okay, we're gonna work work work together from now on, it's a big step forward.
00:37:00.559 --> 00:37:13.440
And the thing, this the second thing is then you can produce a results and say, okay, how much more effective we are than than than being alone, and then this would create a movement with incite people to do the same.
00:37:13.760 --> 00:37:18.480
Well, you know, I'm very inspired by by what you've done and and what you're sharing already with me.
00:37:18.480 --> 00:37:35.199
Uh, I mean, I'm I'm just thinking in my head as as we go along here that you know, through my role as a podcaster looking at international service, I might be able to identify some of these groups and and and maybe be able to pull some people together and and formulate a plan where we could be a little bit more cohesive.
00:37:35.599 --> 00:37:37.760
Yeah, well, and you don't have to do it yourself.
00:37:37.760 --> 00:37:43.039
You can you can find someone and say, okay, this is your focus, you've got to work on this from now on.
00:37:43.679 --> 00:37:52.960
Well, let me tell our guests that I'm I'm very privileged because I've been able to read a lot about you, and I'm hoping that people will read some of your articles after this podcast.
00:37:52.960 --> 00:37:58.239
But one thing I want to ask you, as a doctor, I I know about your travels extensively.
00:37:58.239 --> 00:38:04.639
You've done a lot around the world, and and by doing so in a variety of roles, you've greatly impacted healthcare.
00:38:04.639 --> 00:38:08.400
And you've you've barely even scratched the surface with us today about what you've done.
00:38:08.400 --> 00:38:17.679
But I'd like you, if you don't mind, just share with us briefly what stands out as your greatest impact and and and also what is your current practice as an MD?
00:38:17.679 --> 00:38:22.239
Okay, my greatest impact was in public health.
00:38:22.719 --> 00:38:38.079
When I was in Papua New Guinea, I was the chief medical officer for Chevron, the oil company, and I was responsible for four clinics in the jungle and and a hospital in the highland of Papua New Guinea.
00:38:38.079 --> 00:38:56.480
So one of my tasks, the problem was that this, the the local people saw Chevron drilling, uh building a pipeline and everything, and they said, well, you know, that they're destroying our land without our permission, and we didn't we get nothing in return.
00:38:56.480 --> 00:39:00.079
So they started uh blocking the the airfields and so on.
00:39:00.079 --> 00:39:03.440
So the solution had to be found to calm them down.
00:39:03.440 --> 00:39:07.599
So they decided, they asked me, what would you do?
00:39:07.599 --> 00:39:10.480
And then and then the villagers were invading the hospital.
00:39:10.480 --> 00:39:23.440
They would take trucks, put like uh 20 or 30 in one truck, and land at the hospital, and then there would be a line of 200, 300 people every morning asking for for medical care.
00:39:23.440 --> 00:39:28.239
So there's the the CEO there asked me, uh, you know, what can we do?
00:39:28.239 --> 00:39:30.880
I mean, we are in a critical situation.
00:39:30.880 --> 00:39:35.039
So I told them, create a public health plan.
00:39:35.039 --> 00:39:38.239
So they said, okay, go ahead and do it.
00:39:38.239 --> 00:39:48.480
So I had I had to be dealing with the hospital, I had to be dealing with the seeing the patient, and now on top of this, they gave me create a healthcare plan.
00:39:48.480 --> 00:39:57.920
So this was for 10,000 villagers that were scattered all around the area from the the mountain because the the oil is in the mountain in Papua Nogue.
00:39:57.920 --> 00:40:04.639
So I have to drill and then build a pipeline to go to the sea where the the tankers can come and fill themselves with oil.
00:40:04.639 --> 00:40:09.679
So along that that uh track there, there were 10,000 villagers.
00:40:09.679 --> 00:40:13.199
So they asked me to to create that that plan.
00:40:13.199 --> 00:40:21.199
So I did, and it was for 10,000 people, it lasted two years, and I'll give you the what what it included.
00:40:21.199 --> 00:40:23.840
It included health education.
00:40:23.840 --> 00:40:31.840
So train the village health workers, train the trainer, because you cannot do it on your own.
00:40:31.840 --> 00:40:32.880
Train a trainer.
00:40:32.880 --> 00:40:38.239
And the third point for for health education was data gathering.
00:40:38.239 --> 00:40:42.559
You cannot, and that's that's crucial, you cannot act if you don't have data.
00:40:42.559 --> 00:40:45.280
So and we didn't know what was going on in the villages.
00:40:45.280 --> 00:40:50.880
We knew, because I told them the one of the problems is you are reactive.
00:40:50.880 --> 00:40:54.079
What you have to do is to act to this at the source level.
00:40:54.079 --> 00:41:04.159
Because if you if you have 10 people or five people every day coming for diarrhea, you give them the treatment, they will come back if the the the water is polluted.
00:41:04.159 --> 00:41:09.440
So find the sources and or they come for come from malaria.
00:41:09.440 --> 00:41:15.360
Okay, well, they're gonna be bitten if you don't uh address the the transmission of the of the of the of the parasite.
00:41:15.360 --> 00:41:20.000
So you have to data gathering, where is it coming from?
00:41:20.000 --> 00:41:24.079
We identify the the the villages, identify the source in the villages.
00:41:24.079 --> 00:41:26.960
So that was uh crucial.
00:41:26.960 --> 00:41:29.519
You cannot design a plan without data.
00:41:29.519 --> 00:41:34.960
And then you cannot even see see the improvement of what you do if you don't have any baseline.
00:41:35.199 --> 00:41:37.199
I was gonna say basic epidemiology.
00:41:37.920 --> 00:41:38.320
Exactly.
00:41:38.320 --> 00:41:40.320
Yeah, this exactly.
00:41:40.320 --> 00:41:43.840
So those were this was for uh health education.
00:41:43.840 --> 00:41:48.719
Then we knew we had to do something, for example, as I mentioned, water supply.
00:41:48.719 --> 00:41:52.800
So they decided to give portable water tank.
00:41:52.800 --> 00:41:55.599
They buy helicopter because there's no road there.
00:41:55.599 --> 00:42:10.480
So they uh Chevron built and landed and and and distributed water tanks in all those villages that had where they identified there was a problem with the water, and most of them.
00:42:10.480 --> 00:42:18.960
So also we know that there is dark disease, bacterial disease, viral disease, but they transmitted by uh feces.
00:42:18.960 --> 00:42:28.559
So and the villagers they go in the field and and and and with the injection everywhere and they transmit the disease this way.
00:42:28.559 --> 00:42:35.599
So they bought uh what they called VIP latrines, which was ventilated improved pit.
00:42:35.599 --> 00:42:40.239
So each village had a water tank and a latrine in each village.
00:42:40.239 --> 00:42:47.280
And the third point was garbage disposal, because they scattered the garbage everywhere, so you had a garbage pit.
00:42:47.280 --> 00:42:48.960
So that was the thing.
00:42:48.960 --> 00:42:50.239
Then there was nutrition.
00:42:50.239 --> 00:42:55.679
There was a problem with nutrition because the mainstay of their nutrition is sago.
00:42:55.679 --> 00:43:04.079
And and as a joke, they say sago, you spend more time preparing the meal than the number of calories we it will provide.
00:43:04.079 --> 00:43:08.719
Because you have to peel the fruit, the the uh the vegetable for how long.
00:43:08.719 --> 00:43:25.199
So diversified nutrition told them, show them what they can grow, because they have to go in in the in the garden, in their yards, in their fields, things that will supplement the deficiencies that they had in the nutrition.
00:43:25.199 --> 00:43:41.280
The next one was malaria control because there was malaria doing uh by just by uh dispatching mosquito nets and showing them, and it's impregnated with the anti-mosquito spray and insecticide.
00:43:41.280 --> 00:43:46.000
So show them how to use it at night because the mosquito pipes at night.
00:43:46.000 --> 00:43:58.559
And and the the last one that I did was the deworming of all the children, mass deworming, because the the new medication are safe, there's no side effects, so all the children receive a treatment.
00:43:58.559 --> 00:43:59.760
So that was the plan.
00:43:59.760 --> 00:44:01.280
It lasted two years.
00:44:01.280 --> 00:44:02.559
And then I had the data.
00:44:02.559 --> 00:44:05.599
I could I I have I published an article on this.
00:44:05.599 --> 00:44:11.599
Where you see the improvement, dramatic improvement after doing this.
00:44:12.239 --> 00:44:13.920
What a huge accomplishment.
00:44:13.920 --> 00:44:32.400
You must be so proud that you were able to effectively not only treat 10,000 villagers, but lay out, map out the process, collect the data, and then share that as a template for others moving forward to do something in another country.
00:44:32.800 --> 00:44:37.360
Yes, and we do the also for we did this for the the the Papua Nogini government.
00:44:37.360 --> 00:44:43.519
So you can use this and then re-repeat this, replicate this in other villages is very feasible.
00:44:43.519 --> 00:44:46.719
So because so that was that was yeah.
00:44:46.719 --> 00:44:53.920
So I saw that uh public health really uh is is the key to many, many health issues.
00:44:54.239 --> 00:45:02.239
Well, as I shared with you earlier, my my master's and doctorate are both public health, and and I always consider pop public health as population medicine.
00:45:02.239 --> 00:45:04.239
So I do appreciate you sharing that.
00:45:04.239 --> 00:45:17.760
And and and I'm glad you brought up the education perspective because when I come back from my service learning medical mission trips, a lot of my students are kind of despondent after a couple of weeks that the medicines we gave, the treatments we gave, they're probably done.
00:45:17.760 --> 00:45:28.000
But I always like to share with them that the most important thing we did was we educated the patients, we empowered the villagers to do as best they can to help themselves.
00:45:28.000 --> 00:45:30.719
And that's something that is ongoing.
00:45:31.599 --> 00:45:32.159
Right, yeah.
00:45:32.159 --> 00:45:34.159
That's that's you know, okay.
00:45:34.480 --> 00:45:36.800
Now, what is your current practice as an MD?
00:45:37.360 --> 00:45:40.719
No, I'm not practicing as a medical doctor right now, I'm just a consultant.
00:45:40.960 --> 00:45:41.840
Okay, excellent.
00:45:42.079 --> 00:45:44.800
And I, you know, we work on different projects.
00:45:45.199 --> 00:45:48.000
You've got a lot of a lot of information to share with people.
00:45:48.000 --> 00:45:51.440
One last question, and this is probably one of the most powerful ones.
00:45:51.440 --> 00:46:06.320
With everything we've said, what advice do you have for our future healthcare providers, our nurses, our PAs, our doctors, pharmacists, physical therapy, occupational therapy, all those entities that are going into the healthcare system in the United States?
00:46:06.320 --> 00:46:08.480
What is what is your advice to them?
00:46:08.480 --> 00:46:16.079
And and more importantly, how can they best prepare themselves to make an impact internationally as you have?
00:46:16.960 --> 00:46:17.280
Yes.
00:46:17.280 --> 00:46:21.360
So the first one is to realize it's a two-way street.
00:46:21.360 --> 00:46:27.920
They're going, they're going to they're gonna learn from from the experience, and people are gonna learn from them.
00:46:27.920 --> 00:46:29.119
That's how they see themselves.
00:46:29.119 --> 00:46:34.960
You know, I'm going there, I'm gonna provide services, but they should learn from from the experience.
00:46:34.960 --> 00:46:40.480
If they if they're not curious and they don't want to learn, this is not gonna be a good assignment.
00:46:40.480 --> 00:46:47.039
The second line, the second advice is do not be judgmental.
00:46:47.039 --> 00:46:53.119
One of the the traps is people start comparing and start being judgmental.
00:46:53.119 --> 00:46:57.760
They don't have this, they don't have that, they don't know how to do this, they don't know how to do that.
00:46:57.760 --> 00:47:09.920
And so, but you have to be careful and draw the line when you don't pass judgment, that you have to pass judgment when it's something is but is becoming detrimental to somebody or well-being.
00:47:09.920 --> 00:47:17.360
Say, no, you shouldn't do this like this because this is gonna cause it's just like a child when you're gonna don't put your hand over the fire, you're gonna burn yourself.
00:47:17.360 --> 00:47:20.800
So you can do anything else, but don't do that.
00:47:20.800 --> 00:47:27.599
So when you see that there's gonna be some jeopardy, cause the put the person in jeopardy, then you you draw a line.
00:47:27.599 --> 00:47:39.679
But otherwise, do not judge, they have different values, they have different belief systems, and it's none of your business, you're not there to teach anything that's beyond your goal, which is health care.
00:47:39.679 --> 00:47:45.280
Of course, sometimes it goes over the health because healthcare, okay.
00:47:45.280 --> 00:48:03.440
So this is one thing I wanted to say is that healthcare, the the the the paradigm shift in healthcare in global health is that the the the impact should be judged with a new should be what is moral should be judged by return on investment.
00:48:03.440 --> 00:48:07.599
If the return on investment is not good, that means it's not moral.
00:48:07.599 --> 00:48:10.719
That's that's my that's my my take on this.
00:48:10.719 --> 00:48:20.960
And the more and the moral, the RI should include different dimensions, it should not be financial, medical only, it should be also social.
00:48:20.960 --> 00:48:25.199
It should so also be individual.
00:48:25.199 --> 00:48:26.880
Does that benefit the person?
00:48:26.880 --> 00:48:30.719
Because you can you can say the the best the best uh analogy is this.
00:48:30.719 --> 00:48:36.719
I remember you know a while back there was a a new antibiotic for meningitis.
00:48:36.719 --> 00:48:47.519
So the guy the patient receives the treatment, they they it they do the the uh lumbar puncture and they find no germ, nothing in the blood, you know, but the patient is dead.
00:48:47.519 --> 00:48:52.639
So the patient is dead, so he she he died healthy.
00:48:52.639 --> 00:48:53.599
That's not good.
00:48:53.599 --> 00:48:54.559
See what I mean?
00:48:54.559 --> 00:48:59.360
So you you see does it improve the the health being of the what you did was great.
00:48:59.360 --> 00:49:02.800
You you focus on the germ instead of focusing on the patient.
00:49:02.800 --> 00:49:09.039
So so you focus on your goal, if you focus on whatever, but focus on the patient first.
00:49:09.039 --> 00:49:11.920
Does that improve the patient's condition?
00:49:11.920 --> 00:49:18.559
So so the other thing, so I I'll give you a few a few other uh advice.
00:49:18.559 --> 00:49:19.840
Be empathetic.
00:49:19.840 --> 00:49:31.760
If you're not empathetic, you first of all you will not be well received, and you will not establish a good communication, you will not get the information that is crucial because the patient builds trust with you.
00:49:31.760 --> 00:49:32.960
So be empathetic.
00:49:32.960 --> 00:49:38.000
If you don't have the capacity to be empathetic, you should not go on this kind of missions.
00:49:38.000 --> 00:49:52.239
The other one is be cool and collected, do not get overwhelmed by the the myriad of problems, because none it's unlike in your environment where you are, you have one problem to solve, two problems to solve.
00:49:52.239 --> 00:50:04.079
But over there is gonna sail you from different angles, you're gonna have all kinds of problems, and do not get lost and do not get frustrated and so you have to remain cool so you can discern the priorities.
00:50:04.079 --> 00:50:08.480
You have to be able to keep the goals in mind and to see the big picture.
00:50:08.480 --> 00:50:10.239
Try to do that all the time.
00:50:10.239 --> 00:50:14.400
Then, of course, the be prepared.
00:50:14.400 --> 00:50:17.280
We talked about this.
00:50:17.280 --> 00:50:20.400
And the last one is keep your serenity.
00:50:20.400 --> 00:50:29.519
Keep your serenity, and that's this is the the the thing that I took, which is accept the things that you cannot change.
00:50:29.519 --> 00:50:32.320
Because people never never go beyond that.
00:50:32.320 --> 00:50:34.159
They go and they get stuck in that.
00:50:34.159 --> 00:50:41.199
I should do this, should, should, would, could you know, this uh this kind of uh mental uh attitude.
00:50:41.199 --> 00:50:41.760
No.
00:50:41.760 --> 00:50:46.719
So accept the things you cannot change and and move on.
00:50:46.719 --> 00:50:51.039
Have the courage to change the things that you can change.
00:50:51.039 --> 00:50:57.519
That's you have to collect yourself, gather yourself and and and face it and do something about it.
00:50:57.519 --> 00:51:05.119
And then the last one, have the wisdom to know the difference between the two, what you can change and what you cannot change.
00:51:05.440 --> 00:51:11.599
Well, for for us old timers, I'm putting myself out there, those are considered pearls of wisdom.
00:51:11.599 --> 00:51:15.920
And yes, and those those pearls of wisdom come from a lot of experience.
00:51:15.920 --> 00:51:18.480
And as you were sharing them, I was nodding my head.
00:51:18.480 --> 00:51:19.920
Yes, I totally understand.
00:51:19.920 --> 00:51:24.400
You know, I I share with my students all the time that I can't teach empathy.
00:51:24.400 --> 00:51:27.119
You've got to bring empathy with you to the table.
00:51:27.119 --> 00:51:29.760
I love, I love keep your serenity.
00:51:29.760 --> 00:51:41.599
I love I love all of your points, and and I think those are are wonderful, wonderful things to really think about, you know, as we are preparing for a service learning medical mission trip or a faith-based trip.
00:51:41.599 --> 00:51:43.599
Are we doing it for the right reason?
00:51:43.599 --> 00:51:48.079
You know, are we going down there to really make a difference in in people's lives?
00:51:48.079 --> 00:51:55.840
Or and I hate to say this, but it but sometimes in a healthcare or university setting, is this something that's going to make me look good on paper?
00:51:55.840 --> 00:52:00.880
I don't know if you've had that experience where people are going for the wrong reasons with the wrong intentions.
00:52:01.039 --> 00:52:02.239
But oh yes, of course.
00:52:02.239 --> 00:52:07.519
And and then and then the the the organization, the the go at the statistics.
00:52:07.519 --> 00:52:09.360
Do the statistics look good?
00:52:09.360 --> 00:52:14.000
See, statistic is not the measurement, this is what the people say.
00:52:14.000 --> 00:52:14.960
They should evaluate.
00:52:14.960 --> 00:52:17.199
You know, see, it was always from top down.
00:52:17.199 --> 00:52:19.679
You evaluate from the top down.
00:52:19.679 --> 00:52:28.639
Well, and you have to fit, you have to fit within a certain frame and so that is not necessarily measuring the real impact.
00:52:28.880 --> 00:52:52.480
Well, one thing I learned in public health, and you you can probably speak to it, is that you don't go into a community and start doing things without gaining acceptance in the community by the gatekeepers, by the people that live in the community, because we don't want to go in and say, we feel you need this, you know, we need to work better with the communities and and work along beside them.
00:52:53.119 --> 00:52:59.039
Yes, it's it's the elder, usually in Africa and other traditional uh culture is the elder.
00:52:59.039 --> 00:53:06.960
So you have to have a gathering of the elders, you have to explain your project, you have to, and then you have to show them what it will bring them.
00:53:06.960 --> 00:53:17.519
Because I've seen things that fail because the people could go to the villages and drawing blood and drawing blood one time, two times, ten times, and at the end the people say, What's in for us?
00:53:17.519 --> 00:53:19.920
You come in, you and you go and you take out blood.
00:53:19.920 --> 00:53:22.239
This is this is this cannot go on.
00:53:22.239 --> 00:53:25.119
So they rebel and the the and the study stopped.
00:53:25.119 --> 00:53:25.599
Dr.
00:53:25.760 --> 00:53:29.679
Manier, what what when when you talk about the global process?
00:53:29.679 --> 00:53:39.440
We spoke a little offline, you're looking at it from the 50,000-foot level, I'm looking at it from the 1,000-foot level, yeah, being entrenched in in clinics and boots on the ground.
00:53:39.440 --> 00:53:47.119
What guidelines or recommendations do you feel a good number of these NGOs should be following?
00:53:47.119 --> 00:53:58.639
Should we be looking more specifically at the World Health Organization, or is there an entity out there that has an accepted standards or practices that we should be looking at?
00:53:59.199 --> 00:54:00.880
No, it's too it's too vague.
00:54:00.880 --> 00:54:08.400
They are too vague, too generic, and and also, as I said before, coming from the top down.
00:54:08.400 --> 00:54:23.119
I think you should uh establish from your experience in all those different settings, you should establish your own establish your own setting of values and what you want the people to do and to learn and and and uh and to follow.
00:54:23.119 --> 00:54:25.679
The guidelines could should come from you.
00:54:25.679 --> 00:54:38.000
And and when and also you or you can guide you can see uh find the guidelines from different uh like uh medicines sans frontier, you know, doctors without borders, they have their own stuff.
00:54:38.000 --> 00:54:40.320
So you take it from different perspectives.
00:54:40.320 --> 00:54:51.920
You take it for, for example, a religious uh group, you take it for the World Health Organization, you take it for another NGO, you take it from Ministry of Health, and you do a synthesis of this and you create your own.
00:54:51.920 --> 00:54:56.639
I got you according to the according to what you know and what you saw in the field.
00:54:56.960 --> 00:54:57.760
You see what I mean?
00:54:57.760 --> 00:54:58.079
Yep.
00:54:58.079 --> 00:54:59.280
No, it all makes sense.
00:54:59.280 --> 00:55:07.920
I mean, there's so many entities out there that have guidelines and practices and to synthesize what everyone's doing and make it work for what you're trying to do.
00:55:07.920 --> 00:55:09.599
That makes a lot of sense.
00:55:09.599 --> 00:55:10.639
Well, Dr.
00:55:10.639 --> 00:55:20.880
Manier, is there anything last any last pearls of wisdom you shared so much with us already today in in parting with with our listeners to inspire them a little bit more about getting involved?
00:55:20.880 --> 00:55:31.599
Because you know, my my hope is that the good number of the people listening have have been involved in in international service or are inspired by people like yourself that have been very involved.
00:55:31.599 --> 00:55:34.800
What is your message to that global audience?
00:55:35.760 --> 00:55:43.519
The message, well, the message of a global uh to the global audience right now would be that keep the hope alive.
00:55:44.320 --> 00:55:45.280
I appreciate that.
00:55:45.280 --> 00:55:46.960
What a what a great way to end it.
00:55:46.960 --> 00:55:57.519
And I again I'll I'll put some information on the podcast, how people can get in in touch with yourself, or how people can read your article so they can lead learn more about your work.
00:55:57.519 --> 00:56:02.480
And again, we've only scratched the surface because I've been privileged to read more about you.
00:56:02.480 --> 00:56:04.559
Thank you, thank you, thank you for your time today.
00:56:04.559 --> 00:56:09.679
I know I've been inspired, and I know I'm going to be doing a lot of research after what I've heard from you today.
00:56:10.079 --> 00:56:14.880
Well, thank you very much for having me, and I wish you all the best in your all all your endeavors.
00:56:14.880 --> 00:56:16.159
Thank you, sir.
00:56:16.719 --> 00:56:18.719
I want to sincerely thank our guest, Dr.
00:56:18.719 --> 00:56:26.559
Mounier, for his willingness to join us on our podcast and for sharing with us his extensive work in international health care.
00:56:26.559 --> 00:56:35.360
I have been inspired by his efforts, and I'm eager to learn more regarding how those rendering international health care can better collaborate.
00:56:35.360 --> 00:56:47.280
I would like to think that this podcast is a great example of how we can learn more about those involved in international service and perhaps lead to a collaboration of organizational leaders.
00:56:47.280 --> 00:56:48.639
Information on Dr.
00:56:48.639 --> 00:56:53.360
Mounier's articles will be posted in the description area of the podcast.