Global Citizenship – why bother?

The Scottish NHS is facing unprecedented challenges as we approach winter 2022.  People are waiting longer for treatment when they go to hospital, more operations are being cancelled, and the country is in the grip of a cost-of-living crisis not seen for decades.

You might be thinking, as healthcare at home gets more challenging: shouldn’t we be concentrating on our own patients and our own local issues first, before getting involved in partnerships with other countries (and particularly in low- and middle-income countries (LMICs))?

As an advisor to the NHS Scotland Global Citizenship programme, whose aim is to encourage and provide guidance to NHS Scotland staff to get involved in international health partnerships, I’m asked this question increasingly frequently.  Here are four reasons why I believe that global citizenship matters now more than ever, and why it is in fact essential for our own health system.

1. Our challenges are global challenges 

Climate, pandemics, health inequalities, scarcer resources, lack of funding.  The solutions to these problems must be global rather than confined to a single country.  After all, where is the justice in working towards 100% Covid vaccine uptake in Scotland, when uptake in Africa averages at 24% for a single dose?  Even from a local perspective, low vaccine uptake in LMIC ensures that new variants will continue to emerge and threaten the Scottish population.  Therefore, it’s in Scotland’s interests to ensure Vaccine equity – that vaccines reach a much of the world’s population as possible.

2. As NHS challenges grow, we can learn from the way others do things. 

We have had little experience in the NHS of working with finite resource.   Countries which experience a chronic lack of resources (be it equipment, staff or financial) have extensive experience of allocating these in the fairest way.  Is it possible that we could have the humility to learn from them?  The authors of this paper describe what the USA could learn about prioritising cancer care during a pandemic from the experiences of Rwanda and Tanzania.  Incidentally, much of this expertise could already be in Scotland, if we are open to listening, from our many diaspora NHS staff from all over the world. One in three doctors and one in eight nurses in the UK were trained in another country.  “Experts in our midst”, as the Tropical Health Education Trust refers to them.

3. Working in the NHS is hard going at the moment. 

The workforce is reeling from two years of covid pandemic, and burnout is increasingly common.

Global Citizenship work can refresh and give NHS staff a new perspective – you can hear the experiences of three members of NHS Scotland staff (one of them is me!) in this podcast.

In another article, two recovery nurses from Scotland reflect on a visit to a hospital in Zambia:  “this experience has brought to light how versatile the nursing profession really is and how we successfully overcome such challenging environments. Returning to the UK, our positive experiences have followed us and will continue to do so.”

4. It doesn’t all have to be trips abroad 

There are projects you can get involved with from home.  On Call Africa has a call out for remote fundraising volunteers, to support their work.  The Zambia Anaesthesia Development Program and Ethiopia Anaesthesia Development Program offers both in-country and remote teaching fellowship roles for anaesthetic trainees.  Our very own Active Global Citizenship resources outline other ways for NHS staff to make a difference at home.

NHS Scotland’s staff contribute much of Scotland’s global health involvement.  Scotland has a progressive approach to global citizenship and the Scottish Government’s international development strategy review in 2021 emphasised the importance of global solidarity, collaboration and partnerships, equality and inclusion/diversity.  At a time of great uncertainty, and increasing general atmosphere of hostility and xenophobia within UK politics, we have a great opportunity within Scotland to lead the way in looking outwards, with the joint aim of learning from each other and facing the huge global challenges of our time together.

Want to know more?

In Scotland:  find out who your local GC lead champion is – there is one for most NHS geographical  and special boards.  They will be able to put you in touch with other like-minded individuals, signpost you to useful information and let you know if there are any global citizenship activities happening in your area.  You can find out by emailing ScottishGHCU@gov.scot, and also sign up for our emails.

You can read the stories of other NHS Scotland in our storybook. Or alternatively listen to NHS Scotland staff talk about global partnership work, in this podcast from 2020 and this podcast from 2021.

You can find us on the Global Citizenship Programme website, and on twitter @ScotGHCU.

With thanks to Dr Kalonde Kasengele and Dr Ayman Mustafa for their invaluable guidance

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