1. Why do international health?
Jeff Heck, MD
Executive Director
Shoulder to Shoulder

2. University of Cincinnati Honduras Shoulder to Shoulder x 20 years
The real CV
FP trained
Hicksville, Ohio
Kenya
University of Cincinnati
Honduras Shoulder to Shoulder x 20 years
WHO in Geneva
Geriatric practice, Dean of the world’s smallest medical school
Married 33 yrs, 5 kids, 2 grandsons

3. 2) What options are available for international work?
Outline
1) What type of training in medical school and residency are helpful for doing short term and long term international work?
2) What options are available for international work?
3) Can you do international work with a family? When you are in debt? If you are in private practice? Academic practice?
4) How important is language proficiency?
5) What are the risks associated with international practice?

4. I will just make a donation? The time is not right
Pitfalls
I will just make a donation?
The time is not right
I will love it because I love to travel
Global health volunteering or career work is free of hassle

5. Health Disparities: Life on less than $1 per person per day
No running water
No latrine
1 room for 6 people
Only 2 beds
No books in the house
Inadequate land to grow enough food
Growth stunted children
Intestinal parasites, anemia and vitamin deficiencies
Schooling ends at 3rd grade

6. Helping
“You must give some time to fellow men. Even if it’s a little thing, do something for which you get no pay but the privilege of doing it.”
Albert Schweitzer
Albert Schweitzer was my hero in the early days. A committed servant to humanity, especially the underserved who had no one to care for them. He came to French Equatorial Africa in the early 20th century and helped because there was a need and he could meet it. The larger his staff grew the more needs they met- endlessly. He lived what he believed.

7. Physicians have unique skills
Specific skill of medicine needed by all people
Selection bias- smart, organized and disciplined
Balance of compassion and analytical skills
Resources to travel

8. So which training is best?
Generalized +- specialized– family medicine> pediatrics> general surgery> public health
MPH degree
Short term, intermittent volunteer- do what you like at home first
Long term- consider your type of global health work

9. UNC Workshop
Jeff Heck (UNC/Ashville Department Chair of Family Medicine, Executive Director of Shoulder to Shoulder)
Wayne Hale (Greensboro/Moses Cone Family Medicine residency faculty, founder of community clinic for Latino patients in Greensboro, frequent short term clinical travel/work in Honduras)
Doug Morgan (UNC/CH Department of Gastroenterology Associate Professor, former Peace Corps worker in Honduras, active research in Honduras in GI/ID areas)
Mike Cohen (UNC/CH, Director – Center for Inf Disease and Global Health, extensive international work)
Jim Lea (UNC/CH, formerly IntraHealth – PhD background, career in international health and development)
Martha Carlough (UNC/CH Dept of Family Medicine Assistant Professor, IntraHealth Clinical Advisor, worked in Nepal for 9 years under United Mission/Government of Nepal)

10. Language
Learn Spanish

11. Travel

12. Family- it works well
They don’t generally want someone to take care of them- they want to do it themselves.

13. Risk, danger and balance
The Lady in the Garden
Girodet : The Spirits of French Heroes Welcomed by Ossian into Odin's Paradise 1801
Anne-Louis Girodet de Roussy-Trioson (1767–1824).

14. Is it possible to make a difference and not be amazing?

15. Advocacy brings justice,
indifference perpetuates it

16. Don’t wait until you are amazing- it won’t happen
Final advice
Keep good company
Get out of debt
Don’t wait until you are amazing- it won’t happen
Don’t wait until you have more time- that never happens
Don’t be too risk adverse- value courage