Making a Difference

By Nathan Douthit

Global Health Case Reports (GHCR) at BMJ Case Reports can help practitioners of global health in all settings, cultures and situations. These practitioners are doctors, nurses, social workers, students, dentists and others who care about those missed by more traditional healthcare models. They seek to treat the patient but also to change the true causes of their disease—the social determinants of health.

Global Health has three core facets. Global health is global in scope; it crosses international and local barriers. Global health is global in focus; it addresses the whole patient's well-being physically, socially, mentally, and environmentally. Global health is global in approach; it requires interventions from teams composed of multiple disciplines in order to address the issues faced by individuals and communities.

GHCRs address the scope of global health. They can address the barriers of conflict as in "Complications of dysgerminoma: meeting the health needs of patients in conflict zones," as well as opportunities and models for overcoming these barriers. In this case, a young woman from a country torn by conflict is treated in a neighboring country. Due to concern that she would not receive appropriate care due the devastation of her country's infrastructure, "it was agreed that the patient remain in this hospital for chemotherapy as it was unlikely that treatment would have been possible in her home country." The doctors and hospital administrators went above and beyond to ensure that the patient received appropriate treatment.

The focus of global health can be seen in GHCRs. As "HIV in India: the Jogini culture" shows, patients require more than healthcare to improve their social standing; access to education and economic viability are also essential. The Non-governmental organisation that brought her to the hospital for medical care also, "advocated for her to the government and helped her to understand her rights to a pension and a home as legal entitlements of all former Jogini." They had to address the determinants of her health in order to ensure that she would not return to the same conditions that made her ill in the first place.

To be successful in global health, a multidisciplinary approach is necessary. Excellent examples of these approaches can be seen in GHCRs. "Family as the primary caregiver: palliative care in the Golan Heights" describes the need for a community to gather around the patient to equip them to meet their needs. Input is needed from many disciplines to have a successful outcome. The physicians went above and beyond to ensure that the father was trained to care for the patient; in addition to weekly visits they made themselves, "available for contact at any time, in case of emergency." Nursing staff visited the family 2 times per week, and, "a social worker was available to the family to aid with non-medical and bureaucratic issues." This commitment to the patient enabled the healthcare staff to facilitate, "emotional healing of the family and the village in a way that could not have been accomplished far from home, in the halls of the closest hospital."

In 2018, BMJ Case Reports has chosen the theme of "Making a Difference." For GHCRs, this theme will be emphasized to show how global health case reports can change the lives of patients and practitioners. Global healthcare providers advocate for change, educate patients and practitioners, and most importantly are willing to go above and beyond the ordinary limits of medical practice in order to make a difference in the lives of their patients. We will be highlighting the ways these practitioners make a difference through global health in the coming year. Check the blog frequently for more updates on this theme, join us by writing a case report for a global health patient, and follow our social media accounts for more information.

Competing Interests

None Declared

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