The Muddy Waters of Medical Humanitarianism
My name is Ciaran Clarke and I am studying a masters in Humanitarianism and Conflict Response (HCR). My background is far removed from the history, international relations, and sociology which forms a large part of my degree. In fact, despite studying a postgraduate degree, I am still an undergraduate! I am studying the Masters between my fourth and fifth year of undergraduate medicine.
This is known as intercalation and is traditionally pursued by medics who want to study one aspect of science in greater detail, such as physiology or pharmacology. Manchester Medical School is particularly unique in the breadth of options available for intercalation. However, the HCR Master’s degree stood out for me. I have always wanted to undertake medical humanitarian work, but the multitude of issues surrounding this field have always left me feeling uneasy. I felt that the HCR Masters would give me an opportunity to grapple with these issues and develop a better understanding of how medical aid can be delivered effectively.
The Masters programme has been incredibly rewarding, particularly for someone coming from a science degree. The complexity of humanitarian aid has been unveiled to me, going to a depth of understanding which I never imagined reaching. This has included asking myself questions which have never before crossed my mind, such as – is providing aid always good? A year ago I would have likely said yes, but through studying disciplines such as history, ethics and public health I have come to realise that no straightforward answer exists. For instance, there are instances of aid being used to extend conflicts, when it has fallen into the ‘wrong’ hands and been sold on a black market and provided funds for armed forces.
One of the great things about the Masters is the wealth of experience I have been surrounded with. It is difficult not be inspired when you turn up on a Tuesday morning and your lecturer starts telling you about his recent United Nations meeting or her trips to war torn parts of northern Sri Lanka to provide medical assistance. As a postgraduate taught (PGT) degree, for two thirds of the year my days are a mix of lectures, seminars and private study. After handing in my essays in May, I will then have the remainder of my degree free for my dissertation.
My dissertation gives me the opportunity to study one aspect of humanitarianism in real depth. My current focus is on the development of sustainable healthcare systems following humanitarian crises. Medical aid has often been directed towards specific diseases such as HIV/AIDS, Polio, Malaria or Tuberculosis, this is known as a vertical approach. While this can tackle specific diseases, when the money dries up it is unlikely that a robust healthcare system will remain. But many of the countries that have require medical aid have limited infrastructure and trained personnel for developing an all-encompassing or ‘horizontal’ approach. The question remains, how do we approach healthcare development in a sustainable manner without spreading resources so thin that they don’t have any effect? It seems that a compromise between the two needs to be reached!
The greatest challenge for me has been learning to adapt to a completely novel set of disciplines. Getting my head around and then critiquing theories of learning, international relations and in depth history articles has been a very different challenge to memorising the signs of liver failure!
Going forward, I still hope to undertake medical aid work in the future, but the Masters has made me realise that I must wait until I am a relatively independent practitioner. Therefore, I will continue on my medical training, hopefully pass my finals and then start as a junior doctor in 2017!
For those of you who want to find out more about the incredible staff at HCRI then click this link
Medicins Sans Frontieres (Doctors Without Borders) website http://www.msf.org.uk/
An overview on the current state of the ‘humanitarian system’ http://www.alnap.org/what-we-do/effectiveness/sohs
The full range of intercalation options open to medical students at UoM http://www.mms.manchester.ac.uk/study/why-study-medicine-manchester/intercalation/
For an insight into some of the problems with aid watch the film “The Trouble with Aid” (2012)