Before You Go: 10-Question Guide for Learners Headed to Low- and Middle-Income Countries

Above. Chris Reynolds with Michigan Medicine student Rachel O’Reggio and Dr. Lemfuka Dieudonne at ELWA Hospital in Monrovia, Liberia.

A new publication from U-M authors and an international collaborator offers an easily digestible guide for learners planning international educational experiences in low-resource settings.

Written by U-M Medical School student Christopher Reynolds—with Center director Joseph Kolars and the University of Global Health Equity’s Abebe Bekele—the paper, Ten Questions to Guide Learners Seeking Equitable Global Health Experiences Abroad, is now online at Academic Medicine.

As the title indicates, the team presents a list of essential questions every learner should ask before heading abroad in order to ensure an experience that is ethical, equitable, and engaging.

“Learner interest in global health is robust. Despite the appeal of such opportunities—international travel, cultural competency, and lasting partnerships, among many others—dilemmas proliferate, including unethical clinical practices, unsustainable medical interventions, exploitative data mining, coercive program planning, and unequal funding priorities,” the authors note. “By incorporating these learner-directed questions with an ethos of personal responsibility and self-reflection, learners, faculty members, and their LMIC partners can participate in mutually beneficial experiences that are aligned with global health equity.”

Here are the ten primary questions and sub-prompts adapted from their paper.

What are my motivations for this experience?

• What are my core values, and how do they align with my motivations for this trip?
• How will I work through motivations at conflict with each other (altruistic versus self-focused?

What impact will my presence have on the local setting?

• What are my hosts having to do to prepare for my visit?
• What perceptions or biases do I have about my impact or ability to help?

How can I mitigate the disruptive effects of my presence?

• What trip planning can I do to alleviate this responsibility from my hosts?
• Have I discussed ways I could provide benefit to my partners?

Does this experience build toward a “greater good” of sustainability?

• Does my experience promote a sustainable partnership?
• Beyond my project or experience, how will this work continue?

Am I prepared to approach opportunities with cultural humility?

• What self-centric tendencies do I have that limit my ability to live by the Platinum Rule?
• What steps am I taking to increase my cultural humility?

How can I anticipate and respond to ethical dilemmas I experience?

• What ethical dilemmas might I experience?
• Who can I debrief with at my home and host institution regarding ethical dilemmas encountered?

How will I bidirectionally communicate with my partners and navigate power dynamics?

• Can I acknowledge and diminish these power dynamics through communication with my host?
• Which sacrifices will I need to make to be a collaborative and respectful partner with my hosts?

Are the financial resources required justifiable?

• How will I reconcile the tension between working for health equity while using resources for personal development?
• Can part of my funds be allocated for host remuneration or support locally designed projects?

How will I provide feedback to my host and home institution?

• When will I share in bidirectional feedback with my host?
• When will I complete my written report, and who will I deliver it to?

How will I reflect on this experience to grow as a partner of global health equity?

• What will I do during this experience to track my own improvements in global health perspectives (journaling, reflection conversations, goal setting)?
• How have my perceptions of myself and my role in global health changed?

Reference

Reynolds, C.W., Kolars, J.C., and Bekele, A. "Ten Guestions to Guide Learners Seeking Equitable Global Health Experiences Abroad." Academic Medicine (April 2023).