Office of Global Health Workshop on International Global Health Partnerships: Policies, Risk Management, Sustainability and Coordination Presented at the 2014 Canadian Conference on Global Health, Westin Hotel, Ottawa, Canada

Workshop Presenters: Melanie Katsivo - Director, Office of Global Health, Adjunct Research Professor, Dept. Of Pathology & Research Officer, Schulich Medicine & Dentistry, Western University Shawna O'Hearn - Director, Global Health Office, Dalhousie University   David Zakus - Director, Global Health, Division of Community Engagement & Professor, Division of Preventive Medicine, Department of Medicine, University of Alberta Jill Allison - Global Health Coordinator & Adjunct Professor, Division of Community Health and Humanities, Memorial University of Newfoundland  Winniejoy Nkonge Gatwiri – Graduate Student, School of Education, Kenyatta University, Kenya Moderator: Leah Mawhinney – Academic Director, Global Health International Learning, Office of Global Health, Adjunct Assistant Professor, Department of Family Medicine, Schulich Medicine & Dentistry, Western University

Learning Objectives: 1. To stimulate a national discourse towards establishing common and collaborative strategies for addressing global social responsibility related to health by Canadian universities 2. To explore and share approaches for ensuring equitable and reciprocal international partnerships for global health 3. To explore and share best practices related to global health partnership selection, risk management, ethical engagement and sustainability Workshop outcomes will be shared with the global health community and other interested parties through publications, presentations at open and closed fora and social media. Workshop outcomes will also be used to stimulate a continuation of this discourse.

Background With the ever changing geo-political situations in the world and the Canadian response to those changes, Canadian universities have to re-evaluate the nature and degree of engagement with international partners for global health. There is no consensus on what international partnerships should look like in terms of process and expected short and long-term outcomes - both from Canadian and partner perspectives, with each university deciding to adopt its own policies and guidelines to govern its international engagement. This workshop launched a conversation within the Canadian global health community that will lead to some general consensus around common goals. Influencing factors such as severe financial constraints, safety and risk management issues, sustainability of partnerships including reciprocity, ethics and collaboration with institutions across Canada were examined, as we continually critically review contributions that Canadians can and do make towards ensuring healthier communities and more equitable healthcare systems wherever they engage, in the world.

Target Groups Universities and other institutions of higher learning and the global health community in general.   Activities and deliverables: Step 1: Memorial University of Newfoundland, Dalhousie University, University of Alberta, Kenyatta University and Western University initiated this discourse by sharing experiences with the strategies used by each of them, to engage with the world.

Step 2: Participants were then divided into three groups and requested to discuss and record their views on: International partnership selection criteria and risk management Partnership equity, reciprocity and collaboration within and outside Canada Social responsibility and ethical engagement   Each of the 3 groups shared a summary of its discussions with all the participants. This was followed by a general discussion and wrap up.

Summary of Group Discussions Group 1: International partnership selection criteria and risk management NGO needs vs University needs in partnerships differ NGO’s seem to have more focus on risk mitigation, logistics and financial accountability University’s seem to have more of a focus on student safety and reciprocity Poverty and ignorance need to be addressed for risk management Student safety was a large discussion point by all groups Suggestion for specific pre-departure training (PDT) for women, additional discussion around safety Suggestion to talk about different sexual orientations as additional safety concerns Discussion around safety needs to be framed in respect for a particular culture and not a checklist of what to do/not to do as these lists only address the issues on the

list and do not develop critical thinking that can be applied to other similar scenarios. Also, many people feel their own personal freedoms are being infringed upon when instructed to act/dress in a certain way for their own personal safety (eg. above the knee skirts) but if understanding is that this certain act/dress is to respect the host site population, this is received better Teach “use your instincts” if it doesn’t feel right, change the situation (leave, ask for help, etc.). Even if the student cannot figure out why they feel uncomfortable it is important to recognize this discomfort and change the situation to a safer situation Ethical Partnerships What is an ethical number of partner sites to be able to know the sites well, to be able to respond to host site needs, to be reciprocal, to communicate effectively with each site Western University has a Safety Abroad Policy Partnerships within your own university should be known and used to forge additional collaborations- if the Faculty of Nursing has a strong partnership perhaps this can be extended to dentistry too utsidepartnerships,ifnursing faculty has a strong partnership perhaps this can be applied to dentistry too

Summary of discussions Group 2: Partnership equity, reciprocity and collaboration within and outside Canada Capacity building and education need to be offered to host sites to build equity and reciprocity Longevity-partnerships need to be allowed and encouraged to grow and develop, the needs of the partnership need to be re-evaluated after a period of growth-time to identify if needs of collaboration have changed All plans need to be attuned to the needs of the host - this involves sharing of information pertaining to needs of both partners Debriefing student experiences is crucial

Summary of discussions Group 3: Social Responsibility and Ethical Engagement The Partnership Assessment tool by the Canadian Coalition on Global Health Research was recommended for institutional partnerships. Western University also has a Policy Statement for guiding education partnership development There is need to look for supports for students to ethically engage with host communities There is need to develop strong mentorship for students especially in research, and particularly how to proceed if there is no faculty contact at the students’ home university