Go to the people.

Go to the people,
Live among them,
Learn from them,
Love them.
Start with what they know,
Build on what they have;

But of the best leaders,
When their task is accomplished,
Their work done,
The people all remark:
WE HAVE DONE IT OURSELVES.

- Yen Yang Chu (1893-1990)

JAIH-S International Health Training Camp 2008.

I was given an opportunity to participate in a four-day global health training program that was carried out by the Students' Division of the Japan Association for International Health (JAIH-S) from March 13th to the 16th. The main aim of this annual program is for the participants to be able to (1) create an image of what working in the global health field is like, and (2) know what you can do and how to start it.

We had lectures done by people currently working at the front lines in this field, including staff from the International Health Center Japan, a tropical medicine researcher, an epidemiologist, officers from the Ministry of Health, Labor, and Welfare (MHLW), and health specialists from NGOs, JICA (Japan International Cooperation Agency), and UNICEF. The lectures were followed by many group activities including discussions, debates, and a PCM (project cycle management) workshop which we had to work on through a night to complete.

My impression? Well... frankly speaking, I felt a little weird throughout the program. Of course, all the participants were highly-motivated, deep-thinking, yet thoughtful people who had gathered from around the country, and without question, the chats with them were really stimulating and one of those memorable times. However, most, if not all of them, were drawn by the terms 'global health' or 'international health', while on the other hand, my interest doesn't necessarily have to go beyond the border, as my 'theme' is community-based health care or primary health care (PHC). Yes, often times, these words have been talked about more in the developing communities rather than the industrialized ones so no doubt it does have a 'global health' taste to it, however, when you take a close look at the developed communities, you actually do see many forms of community health, and plus, there are many things these communities around the globe can learn from each other.

And, another reason for my feeling not right is probably due to the fact that many of the speakers have already literally abandoned the clinical part of being a physician. In other words, many of the doctors in this field do not see patients anymore at a hospital or clinic. Yes, it is true that so-called logistic-type jobs are more needed than specialized people like doctors or nurses. For example, when you take infectious diseases, the main underlying issues in the developing communities are more basic, such as sanitation or health education, and tackling these issues is the most radical solution. Treating patients and prescribing drugs is also a job that can not be cut, but it does little in terms of remedying the bigger picture. So what's needed in the field of international cooperation? Leadership, management, communication skills, and creative thinking. It's what one of the lecturers said, and I agree.

However, at this point, I have no thought of abandoning the clinician's work. Well, that's what I am studying medicine for right now! To obtain specialized skills. Yes, I am interested in public health, community health, and doing positive things for the bigger public, but I want to do that through interacting with the patients. So the image of my future I have right now could be called 'clinical epidemiology-based community health'. In other words, through interacting with the people, know the community, know its strengths, weaknesses, and hidden potentials, and do something creative to bring out their strengths to make the community happier as a whole, with the people in the community. This training program helped me reaffirm my interest.

By the way, I had a chance to talk with Dr. Honda, the founder and current chair of SHARE, the biggest non-profit organization in Japan specializing in international health cooperation, and I was deeply moved by his talks, as he and I had so many common interests... his 'theme' also sounded like community-based health care and primary health care (PHC). :-)

Social entrepreneurship.

I'm seeing this word more and more often these days...

A glimpse of the word may give you a weird feeling, as the words "social" and "enterprise" aren't often seen in the same sentence... well, at least until now they weren't. But today, an increasing number of people in Japan are showing interest in doing something for the society. Hence the popularity of jobs in the fields such as international cooperation. However, up until maybe a couple of years ago, these activities were thought to be exclusive to the non-profits and the government. Well, times have changed.

We have many global issues. Some of them are small, while others are bigger. Many people notice them, and some of them stand up and say "I've gotta do something about this." However, for them to really get down in the mud and get some things done takes more preparedness than just saying it, because (1) you need a lot of time, (2) you need manpower, and (3) you need to make your own living. But one who is willing to do all of this while simultaneously staying true to the passion to work for these global, social issues, I call a "social entrepreneur".

Whether it's a private business or a non-profit organization, it must be a sustainable one for it to continue pursuing what it has to do. You need time, manpower, finance, and those resources also have to be managed effectively and put into use in the best way possible. So, I believe a business-like approach is essential for the non-profits too, the only difference between a business being whether its ultimate mission is to make money or to make positive changes to the society.

But then again, existing businesses are also changing. Long term survival in the industry has become more challenging than ever before. They need to thoroughly understand who their customers are and what they truly want. They all need to find their niche. And, catering to the specific needs of those people can sometimes also be considered doing something for the society. Ah... heading towards becoming "social enterprises"?

Of course, all of this depends on how one defines the word "society". And though many organizations will still remain like an ordinary NPO or an ordinary business, I believe the differences and the disconnects between those two will continue to erode, in a very positive sense. :-)

Am I interested in international cooperation?

Am I interested in the field of "international cooperation" or "international health"?

The answer is yes, and also no.

Nowadays, an increasing number of young people talk of wanting to become involved in international cooperation. Of course, it sounds interesting, and I'm sure it is. You can definitely use your English skills for those who are good at it, or it'll still give you opportunities to train it if you aren't as good. You'll probably get to travel overseas and get to know many people from other cultures and backgrounds too.

But, there always has to be an objective, I think. At certain points in our lives, we find things that we want to do. Things we want to devote our time, energy, and the resources that we have in. And I think these are the things that we truly yet naturally feel that we should do. If that's something that involves a country other than your home country, that's something "international", right? If that's a not-for-profit kind of work you do with people from other countries, that can be called "international cooperation", right? If that has something to do with health care, that's "international health", right?

The point I want to make clear is that when I talk of "international cooperation", it's just a character of the picture I want to be a part of. We're doing things that we want to do and as a result, that could be seen, or classified in other words, as "international cooperation", but I think there's nothing more to that term. It's just one way of categorizing.

To make a long story short, my interest is in using health care as a tool or a catalyst to bring a people together and bring more happiness. This I'll probably talk about another time... but anyway, if this thing I'm thinking about is outside Japan, then I guess it can be called "international health", but it's not because it can be called that way that I'm interested in this. :-)