Global Learning, Global Health

Through the lenses of sociology and biology, first-year students research health care systems, making connections and discovering their own answers.

After spending her fall 2016 semester teaching in 12 countries through Semester at Sea, Susan Ferguson, professor of sociology, returned to Grinnell inspired to design more global courses. She teamed up with Shannon Hinsa-Leasure, associate professor of biology, to develop a course that would explore global health through multidisciplinary study in four countries. The result of that collaboration was the spring 2018 Global Learning Program course, Global Health: Costa Rica, Cuba, Denmark, and the United States.

Interdisciplinary and International

Ferguson and Hinsa-Leasure expected their 15 students to enter the class with more knowledge about the U.S. health care system than any other. The remaining three countries were chosen due to the frequency and scrutiny with which their health care systems are studied and to offer contrasts to the United States. Costa Rica’s public health care system is changing through privatization and medical tourism, Cuba offered an example of a completely different infrastructure of socialized medicine, and one of Denmark’s highlights was the drastic difference in how reproductive health is managed.

“It's incredibly important to realize that in today's vastly connected world, one must be prepared to work across disciplines and cultures in order to achieve solutions,” says Liam Liden ’21. “As my first time traveling outside of North America, it was incredibly beneficial to see systems other than our own.

Before setting off for Costa Rica and Cuba over spring break, each student selected a topic to research. Yared Melesse ’21, for example, chose to investigate the doctor-patient relationship at the primary care level and how it differed among the four countries.

“The students went into the field prepared with questions and took advantage of the opportunity to do primary research,” says Ferguson.

In addition to scheduled speakers, the students had the opportunity to learn from health care professionals and residents of the towns and cities they visited. Having a topic to focus on throughout most of the course gave the students clear goals for research in each country. It also gave students as much opportunity to learn from each other — and each other’s research — as from the professors and experts they spoke to.

La Picadora

Of all the locations the class traveled to, La Picadora, Cuba, represented the height of what course-embedded international travel could offer. The students spent two days and nights in the town of roughly 250 people, falling asleep and waking up to the sound of mosquitoes and livestock.

In contrast to their experiences in other countries where they were constantly traveling, La Picadora offered a chance to more thoroughly witness how health care works at a community level.

“Doctors and nurses lived and interacted on a local level. They were part of the community rather than a one-stop shop to get your medical needs met,” Liden says. “La Picadora was the greatest introduction to Cuba we could have had, and it was a wonderful experience to take some time and just learn from a new culture.”

At the beginning of the course, Cuba was largely a mystery to the students. They expected to be entering an unwelcoming country with a repressive government.

What they observed when they arrived was that although poverty in the United States is correlated with low education, poor food supply, and unstable housing, the residents of La Picadora, who would be considered poor by U.S. standards, faced no such barriers.

“I would go as far as saying that the most culture shock I experienced came in Cuba, where I had to abandon everything I thought I knew and open myself up and embrace everything that Cuba really was,” Melesse says.

Global Learning, Local Impact

“This was a global health care course,” Ferguson says. “But global also means local.” Hinsa-Leasure and Ferguson are keen to extend the impact of the course beyond one semester.

“We challenged the students, after thinking globally, to take ideas from the course and make them local,” Hinsa-Leasure says.

Already one student has become involved with Mid-Iowa Community Action, focusing on food availability and distribution. When the global learning students return to campus in the fall, they will continue drawing from what they learned in the course to make change in the Grinnell community and plan to share their research at academic conferences.