This One’s for Mandela – Solving the Problems of Global Health Systems in Africa

“We can’t impose our will on a system. We can listen to what the system tells us, and discover how its properties and our values can work together to bring forth something much better than could ever be produced by our will alone.”  ― Donella H. Meadows.

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How do we fundamentally improve a system? That was the looming question for our African Experiences Abroad mission to Uganda. It is also the very soul of the Professional Masters of Applied Sciences in Global Health Systems in Africa. As in Donella Meadows’s Thinking in Systems: A Primer, it is not to force upon Western values and beliefs to solve the greatest problems facing the African continent. The United Nations has done an excellent job summing them together through the Millenium Development Goals, but now we must ask how do we implement the solutions that are being worked upon through research, policy and business? The approach we have is to introduce three terms that define our goals with the new Master’s program. Interdisciplinary, Multidisciplinary and Transdisciplinary, and the evolution of the terms to capture the spirit of solving systematic problems.

An interdisciplinary approach is the close integration of two or more separate fields to solve a problem, for example ethnic studies being at the crossroad of sociology and history, or a research project on fish biodiversity requiring the combination of biology and ecology to address the topic at hand. It is by using the principles of both fields and having the solution rest within the realm of the intersection of these disciplines. When addressing Global Health Systems, the one caveat is that sometimes even the combination of disciplines cannot cover the entirety of a problem – they may be limited by theory and understanding that cannot withstand the dynamic change of a problem that continuously changes. It can very well be that the problem itself cannot be defined even with the shared Venn diagram of the intersection between two or more fields.

A multidisciplinary approach is using the knowledge of separate disciplines separately to address a problem in a more piece-meal approach. Rather than having the solution rest within more than one realm of a discipline, the individual cogs of the problem can be addressed by separate disciplines with the overall solution being a solved puzzle of different pieces but together by different theories. A great example is healthcare, with each specialization dealing with a separate area of health and the overall wellbeing of a person being the sum of their health at a mental, physical, emotional and physiological level. One again however, how do we address the economy of a crucial water body like the M’panga River, where addressing the environmental impact would be detrimental to the development of the river for the growing population that lies along it?

Finally, we arrive at what the Africa Institute defines as the core of the new Professional Masters of Applied Science in Global Health Systems in Africa. A transdisciplinary approach. As per Goring and Amgelstam, “Transdisciplinary approaches to solving some of the most complex problems facing society are based on integration of multiple disciplines and the active participation of stakeholders representing different societal sectors in the processes of problem definition, knowledge generation, knowledge translation to science/engineering solutions or policy and management outcomes, and knowledge dissemination. Those involved in transdisciplinary teams contribute their unique expertise, but work together to create ‘new conceptual, theoretical, methodological, and translational innovations that integrate and move beyond discipline-specific approaches to address a common problem.’” It is through the addition of stakeholders, those who do not possess the specific expertise demanded but the experience of being at the focal point of a decision’s impact, to give input that connects the top and bottom levels of the system at hand.

It’s needed to build a future for our forests that integrate chimpanzees and wildlife biodiversity, as per our conversation with Jane Goodall.

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It is needed to address the root cause of HIV/AIDS infection levels and build a solution that moves us away from ARV dependence, as per the “great challenge” of Dr. Peter Mugyenyi.

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It is needed to develop ecotourism that can genuinely improve the environment for both wildlife and the people living in the premises of tourist activity, as we learned from Kabarole Tours. It is needed to understand the impact that growing numbers of tourists will have on Queen Elizabeth National Park and how to maintain the high numbers of wildlife which are one of the main draws of the country.

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It is needed to make healthcare more accessible and of a high quality to citizens living in the Bwindi hills, and for locals to relieve the burden on a shortage of healthcare professionals in the area. It is needed to build a sustainable future for orphans like Gift.

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It is needed to improve the wellbeing of small-holder and subsistence farmers near Lake Nabugabo, and to improve fisherman yield without destroying the habitat of the fish they survive off of. Lastly, it is needed to insure against the effects of climate change, whether for NaFIRRI at the government level or for the women working on the ground salting the fish administered by the government.

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Through a transdisciplinary approach, one must work with every stakeholder, whether human or nature, to understand and address the problems that face this planet Earth. The African continent should be seen as the beacon of opportunity to solve some of the greatest problems facing the human race, namely climate change and poverty. The goal of the Master’s program is to bring together people who have a vision to create sustainable change, empower them with the tools and skills to make it happen, and work with the stakeholders on the ground to together see action unfold.

For two weeks the Africa Institute delegation in Uganda has learned about these transdisciplinary problems, but more importantly the opportunity and the ability to see solutions to them. We leave the country knowing that there are people who care, and they are coming together to improve the livelihood of a continent ravaged by circumstances that were out of their control. As Nelson Mandela famously stated, “It always seems impossible until it’s done.” Let us make sure his words weren’t in vain.

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