Economic globalisation and its effect on health. Some diseases could be eradicated for the cost of a couple of fighter planes

Diabetes Mellitus: Indigenous naming, indigenous diagnosis and self-management in an African setting: the example from Cameroon

BACKGROUND

The objective was to examine how the indigenous naming, indigenous self-diagnosis and management of diabetes evolved with awareness in order to develop a socially oriented theoretical model for its care.

METHODS

The data was collected through a one-year extended participant observation in Bafut, a rural health district of Cameroon. The sample consisted of 72 participants in a rural health district of Cameroon (men and women) with type 2 diabetes. We used participant observation to collect data through focus group discussions, in depth interviews and fieldwork conversations. The method of analysis entailed a thick description, thematic analysis entailing constant comparison within and across FGD and across individual participants and content analysis.

RESULTS

The core concepts identified were the evolution of names for diabetes and the indigenous diagnostic and self-management procedures. Participants fell into one of two naming typologies: (a) Naming excluding any signs and symptoms of diabetes; (b) naming including signs and symptoms of diabetes. Participants fell into two typologies of diagnostic procedures: (a) those that use indigenous diagnostic procedures for monitoring and controlling diabetes outcomes and b) those that had initially used it only for diagnosis and continued to use them for self management. These typologies varied according to how participants' awareness evolved and the impact on self-diagnosis and management.

CONCLUSION

The evolution of names for diabetes was an important factor that influenced the subsequent self-diagnosis and management of diabetes in both traditional and modern biomedical settings.

The learning processes of international students through the eyes of foreign supervisors

Semi-structured interviews were conducted with external supervisors of international electives undertaken by Dutch undergraduate students, in order to gain insight into student learning processes during these electives. The interviews served to triangulate information on these learning processes that was obtained from students' self-reports. The results of the case study reported in this paper were largely consistent with findings from prior studies of international electives in which learning processes and sociocultural differences were examined: experiential learning processes appeared to dominate and sociocultural differences occasionally seemed to blur productive learning, especially when the differences between the national cultures of host country and student home country were substantial. It is recommended that students' experiential learning from international electives should be supplemented with 'guided' and 'self-directed' learning with a focus on the sociocultural dimension.

'I found myself to be a down to earth Dutch girl': a qualitative study into learning outcomes from international traineeships

OBJECTIVE

To explore learning outcomes from international traineeships for undergraduate medical students.

METHODS

In-depth interviews were conducted with 24 undergraduate medical students at Maastricht University Medical School, The Netherlands. The 24 subjects were selected by purposeful sampling.

RESULTS

Students reported meaningful learning outcomes in 6 domains: medical knowledge; skills; international health care organisation; international medical education; society and culture, and personal growth.

DISCUSSION

International traineeships appear to provide good opportunities for students to meet the requirements of globalisation as well as some of the generic objectives of undergraduate medical education. The tentative findings of this study need to be confirmed by further studies.

Globalization and health at the United States-Mexico border

OBJECTIVES

We studied the impact of globalization on the making of health policy. Globalization is understood as economic interdependence among nations. The North American Free Trade Agreement is used as a marker to assess the effects of economic interdependence on binational health cooperation along the United States-Mexico border.

METHODS

We observed participants and conducted in-depth interviews with policymakers, public health specialists, representatives of professional organizations, and unions.

RESULTS

Globalization has not promoted binational health policy cooperation. Barriers that keep US and Mexican policymakers apart prevail while health problems that do not recognize international borders go unresolved.

CONCLUSIONS

If international health problems are to be solved, political, cultural, and social interdependence need to be built with the same impetus by which policymakers promote international trade.

Severe acute respiratory syndrome: a challenge for public health practice in Hong Kong

Severe acute respiratory syndrome (SARS) is now a global challenge affecting more than 8000 patients in different continents. The dictum of public health practice especially for infectious disease is "prevention better than cure". It is especially true for SARS as the treatment strategies remain diverse and experimental. Maintaining a healthy and hygienic environment can be one of the effective public health measures to combat infectious disease. The major challenge is that some of the most important public health measures are to be taken outside the health sector. The community also needs to be strengthened and equipped with the health skills to promote better health and hygiene. There is also the need to create a supportive environment conducive to health for long term sustainability. The WHO approach of promoting health through setting approach would be one possible solution to face the challenge. This paper will describe some of the public health initiatives in Hong Kong through "setting approach" and "community development model" in helping the society fight against SARS. With the emergence of SARS, this might be the time to globalise public health medicine as an important component of medical practice.