We asked junior biology major Brennan Bollman who served in Cambodia last summer as well as Haiti this past January to share some of the insights on global health that she has gained from her recent medical missions trips to Third World countries.

‘Global health’ has become a buzzphrase at U.S. educational institutions.  When my parents attended college, undergraduates didn’t have summer internships in Ugandan clinics, or get research grants to study the traditional birthing practices of Bolivians.  There was little established connection between ivy-ridden campuses and school-less villages.  But now, I look at the paths set before me at Notre Dame: opportunities for my peers and me to travel to Thailand, Guatemala, Lesotho, basically anywhere.  But what do we learn from these experiences?  What meaning do we find?

As informed young people, we probably anticipate the grinding poverty.  But I think we are often taken aback by more insidious perceptions, as I was in Haiti.  After working with the Haiti Program for three semesters, I spent eight days over Christmas break in the coastal town of Leogane and the capital, Port-au-Prince.  Reading Dr. Paul Farmer’s The Uses of Haiti drew me to the country.  For the past year, I have devoured books and news articles on Haiti with near-obsession, trying to learn as much as possible about its political, economic, and social situation.  I thought I was prepared to see both individual Haitians’ poverty and the oppressive structures that keep them so poor.  I was wrong.

Underneath the excitement of finally making friends with Haitians and being immersed in their rich culture, I was crushed.  A slow crush.  I just hadn’t expected the level of hunger and desperation, or the ways survival mentality can direct people’s every action.

I visited what used to be a premier healthcare facility, one of the best in the country five years ago.  Now it is a ghost hospital.  Its problems start much higher than the level of the patient-doctor encounter.  Bureaucrats squabbling over money and structural issues results in unpaid doctors and nurses.  Understandably, these professionals leave, and no one is available to care for the patients.  So the patients don’t come.  They stay sick. 

Walking through the near-empty wards, I finally realized it takes more than resources and good intentions to build a public health system.  Medical missions and money donations are not enough.  If we—as smart, caring students—want to improve healthcare in countries like Haiti, we need to understand the structural problems such as those ghost hospital experiences.  We need to recognize the oppression that underwrites all poverty.  And we need to voluntarily face frustration. 

In a sense, Notre Dame’s ‘global health’ opportunities have crushed me.  Thanks to experiences my parents never had, I have seen problems so big they seem unsolvable.  But also thanks to my Notre Dame education, I’ve learned that problems may be extremely difficult, but not impossible.  As long as we don’t oversimplify ‘global health,’ and as long as we’re willing to work against the challenging structural problems, I think we can deliver sustainable healthcare to sick people—in Haiti and wherever else we may go. 

I left with a very different view of Haiti than what I expected to see.  Not better, and not worse, just different.  I’m still trying to understand.  I wrestle with Haiti each day.  I cannot wait to go back.