“We must be more than do-gooders: we have to thoughtfully engage with communities in an intentional way to have meaningful impact. Otherwise we risk replicating the very inequities we seek to mitigate.”
Q. DARTMOUTH RECENTLY ANNOUNCED THE ESTABLISHMENT OF ITS NEW CENTER FOR GLOBAL HEALTH EQUITY, WHICH UNITES GEISEL’S CENTER FOR HEALTH EQUITY WITH THE GLOBAL HEALTH INITIATIVE AT THE COLLEGE’S DICKEY CENTER FOR INTERNATIONAL UNDERSTANDING. WHAT CAN YOU TELL US ABOUT THIS CHANGE?
Adams: The “One Dartmouth” model encompassed by the Center for Global Health Equity is not new, but the new structure will allow us to coalesce what we’ve been doing all along. I helped launch the Global Health Initiative at the Dickey Center in 2006, and in 2013 I became the inaugural director of the Center for Health Equity at Geisel to meet the needs of medical students, but I always maintained the connection between the two. That’s one of the benefits of Dartmouth’s size—we share a community and can work so easily across departments, disciplines, and schools. With the new Center for Global Health Equity we’ll have additional resources for Geisel’s educational, clinical, research, and outreach initiatives with medically underserved populations.
And when I say “One Dartmouth” I mean Dartmouth-Hitchcock, too. Our colleagues there initiate and grow many of our programs. They serve as research advisors for international students, and many Dartmouth-Hitchcock clinicians do capacity building at our partner sites. After speaking at medical grand rounds in 2013, I had doctors who previously knew nothing about the program eager to get involved. It was like planting a seed and watching it grow.
Q. IN WHAT WAYS IS DARTMOUTH A LEADER IN GLOBAL HEALTH EDUCATION?
Adams: We’re one of the few institutions that make reciprocity with our international partners integral to our programs. It’s critical to our mission. When we first launched a bilateral student exchange it opened our eyes to what sending and receiving students actually involves—the burdens faced by our international hosts who provide these learning opportunities to our students. Practicing reciprocity equalizes opportunities across partnerships. If health equity is our mission, equity in partnership is the means to achieve it.
Dartmouth also puts quality over quantity—we build deeper, durable relationships rather than expand to more sites. The priorities of our partners drive our agenda—we never impose ourselves on a place. And we spend a lot of time preparing our students before they go to a partner site. We focus on cultural humility and ethics—for example, what does it mean for a student to be in a place with colonial histories and legacies?
Q. IN WHAT WAYS HAS THE CENTER FOR HEALTH EQUITY BEEN IMPACTFUL?
Adams: Our partners want to stay engaged with us, they invite us back. We may start at a site working on infectious diseases but if another opportunity arises, for example something in gastroenterology, our partners are keen to explore it with us.
We’ve made progress toward a tuberculosis vaccine thanks to research done with our partners. We co-established the first pediatric HIV clinic in Tanzania. And generations of trainees, from Dartmouth and from our partner sites, now have flourishing careers in academia, government, and nonprofit organizations.
Q. WHEN DID YOU DISCOVER A PASSION FOR GLOBAL HEALTH, AND WHAT DO YOU THINK IS DRIVING INTEREST AMONG STUDENTS TODAY?
Adams: I came to Dartmouth Medical School knowing that I wanted to work with underserved populations, but I didn’t know what that was going to look like: A family doctor in Maine? An inner-city primary care provider? Then I did an elective in Tuba City, Arizona, with the Indian Health Service. Being situated in a Navajo reservation, working cross-culturally every day, recognizing that I was a guest—it opened my eyes. You couldn’t ignore the social and cultural aspects of medicine and I thought, "This is what I want to do." It spoke to my heart and my mind.
Today’s medical students have grown up in a globalized world. Going overseas is such a trend in higher education because we’ve recognized the benefits of taking people out of their comfort zones and helping them see the ways they can grow as global citizens. Global experiences expand our minds—we’re more effective when we can work across cultural differences.
Q. WHAT’S NEXT IN GLOBAL HEALTH EDUCATION?
Adams: I’m interested in pursuing more cross-programming with Geisel’s Urban and Rural Health Scholars—whether you’re serving a community in rural New Hampshire, New York City, or Dar es Salaam, there are so many similar challenges.
It’s all about the health equity piece. If you care about health, you care about equity in health. And if you care about equity in health you care about doing it in the right way. Dartmouth is poised to change the paradigm and set the standard for how global health practice and education is done because of the approaches we take. Passion is not enough in this work. We must be more than do-gooders: we have to thoughtfully engage with communities in an intentional way to have meaningful impact. Otherwise we risk replicating the very inequities we seek to mitigate.
The Center for Global Health Equity is a fundraising priority within Geisel’s Interaction campaign. Alumni interested in supporting the Center may contact Bob Holley at Robert.D.Holley@dartmouth.edu or 603-653-0733.