Global Health Gateway

Settings

There are loads of different global health settings that health workers can be involved in, and each setting has implications for both the health worker and the host community. The settings described here are designed to bring to life some of the diverse ways health workers are involved in global health around the globe. The descriptions are certainly not exhaustive, but hopefully they will give you a unique and personal account of what life is like as a global health worker.

Now, before launching into the individual settings lets have a think about the big picture of working in global health.

Humanitarian vs Development

International aid is roughly divided into the humanitarian and the development realms. The humanitarian realm is analogous to the Emergency Department, with an emphasis on responding to crises in a way that saves lives and stabilises the situation. The development realm encompasses everything else, with an emphasis on longer term improvement and fulfilment of community potential. Obviously there is a significant middle ground that humanitarian and development activities and organisations invariably share. But this general division does highlight some key points of difference between various settings.

Humanitarian vs Development
	Humanitarian	Development
Situation	Acute crisis E.g. war and conflict, natural disasters, famine, displaced populations	Chronic deprivation E.g. poverty, slum communities, vulnerable groups, rural & remote, post-crisis situations
Outlook	Short-term (months)	Long-term (years)
Emphasis	Saving lives and relieving suffering E.g. Food and Nutrition, Shelter, Water and Sanitation, Health, Livelihood recovery, Security.	Improving living situation, building infrastructure and enhancing capacity. E.g. Health, Education, Agriculture, Microfinance & Economic, Human Rights, Peace & Governance.
Organisations	MSF, ICRC, UN	CARE, World Vision, Oxfam, many other small and large NGOs (non-government organisations)
Environment	Intense and often highly stressful Unstable => significant personal risk	Relatively predicatable Stable => little personal risk

MSF = Medecins Sans Frontieres; ICRC = International Convention of Red Cross/Red Crescent; UN = United Nations, NGO = non-governmental organisation

Humanitarian Settings

The ‘refugee camp’ setting is archetypal of the kind of work health workers can be involved in within the humanitarian sphere. Other humanitarian settings include: environmental catastrophes (e.g. earthquakes, tsunamis and flooding, drought, and hurricanes), famine, and disease epidemics. While these are not considered specifically, many of the issues raised in the 'refugee camp' apply to all humanitarian settings.

Development Settings

The ‘hospital’ and ‘community’ settings are two broad settings within the development sphere, and there are a variety of roles and experiences health workers can have within these settings is broad, as you will see from the discussion and vignettes. Also included in the development section are ‘specialist short missions’ (although these may also have a role in the humanitarian sphere).

Non-clinical Settings

The ‘public health’ setting includes internships with organisations like the WHO. Involvement in ‘research’ can be accessed through formal educational programs or instigated unilaterally. Other non-clinical settings for involvement in working abroad include:
Advocacy (arguably the biggest way to make a difference)Policy (e.g. through professional Associations and Advisory taskforces).

Ready to explore?

As you read through the various settings consider what sort of experience it would give you, and what the challenges and the rewards might be for you and those you are serving. If you already have a particular job in mind you will be able to consider more specifically what the implications it will have for you and your host community.

For you as a health worker, the setting will define: