This team is tackling injustices in global health emergencies & humanitarian crises

A little over a year ago, several researchers working on ethical and justice based questions arising in global health emergencies (health crises of global concern) and in other humanitarian crises came together on a Wellcome Trust funded project entitled:  “Vulnerability and Justice in Global Health Emergency Regulation: Developing Future Ethical Models.”  Our key concerns were around how inequalities, vulnerabilities and various forms of injustices are often reinforced in these contexts, and how future public health responses could be better attuned to these issues.

We are delighted to announce that we recently launched our website “Justice in Global Health Emergencies & Humanitarian Crises”.

On this platform, we’re aiming to explore issues around vulnerability and justice during global health emergencies and humanitarian crises through a range of media:

  • Short animations that explain concepts that are central to our project, such as structural injustice, epistemic injustice, the importance of denaturalising disasters, among others.
  • Blog-like applied illustrations of the relevance of central concepts in real-world scenarios and examples.
  • A podcast, “Just Emergencies”, where we sit down with humanitarian workers and researchers to talk about their work and interests.
  • A series of invited blog posts, which capture the knowledge and experiences of a diverse range of people who share with us the pressing issues of working in the global health and humanitarian sectors.
  • A developing section dedicated to modelling for global health emergencies in the future.
  • A list of articles, books and websites that might be of use to those researching, teaching or generally interested in these topics.

We’re hoping that this website is a useful resource to academics, humanitarian workers, students, and the interested public alike. Ideally, we would like this to develop into a platform where researchers and humanitarian actors can engage with these topics and in dialogue with us.

If you are willing to share your thoughts and experience as practitioners or researcher in the form of a blog post, or would like to talk about your global health emergency or humanitarian crises experience on the podcast, please get in touch at

New content will be posted on a regular basis, so we warmly invite you to sign up to our newsletter. You can also follow us on twitter (@GanguliMitra)

Foundations – Gautham Krishnaraj


Perspectives from a new Global Health Student and Humanitarian Health Care Ethics Research Group Trainee

Gautham Krishnaraj, MSc Global Health Candidate (McMaster University)

From Montreal…

In September 2014, at the peak of the Ebola outbreak that inundated the minds of media and global citizens alike, I found myself in an unlikely situation. I, as a third year Microbiology & Immunology student at McGill University, was working as part of a global coalition of health professionals to research, compile and brand training protocols for the International Medical Corps (IMC). Here, I was able to see the laboratory techniques and virology concepts I was learning in the classroom be applied in real time by the IMC’s Multi-Agency Training Collaboration (MATCO) to support the Ebola response in West Africa. As an aspiring Humanitarian Health Care Professional, it was an exciting first exposure to this fast paced, international, and interdisciplinary sector.

…to Hamilton,

Two years later, I find myself in Hamilton Ontario, in a ‘classroom’ that seems to defy all classical connotations of the word. The program, McMaster University’s 12 month Masters of Science (MSc) in Global Health, is a wildly successful (2015 CIBE Program of Excellence) experiment in international collaborative education. This morning’s lecture is a prime example of why; it’s happening 6,000 kilometres away at the University of Maastricht – and next week, students from the Netherlands will tune into our classroom here in Hamilton. Each lecture is followed by a chance to virtually connect with our global groups to work on assigned policies with real-world relevance and impact.

Working through time zones, language barriers, and diverse motivations, we face real challenges and prepare for the rigours of pursing a profession in this sector. One of the first ethical challenges we must consider is the language of correspondence itself; how are we (native english speaking Canadian students) placed in a position of power within our global teams? How does this influence the sharing of ideas and accessibility of information, and how can we work with our peers to dismantle these structures and enable full participation? Furthermore, how do language and regionality impact where, how and to whom humanitarian aid is delivered? With our expert mentors and a plethora of toolkits at our disposal, we will work together to tackle these challenges in pursuit of a greater understanding of this diverse sector. As a trainee in the Humanitarian Health Ethics Group, I hope to delve even deeper into the ethical underpinnings of humanitarian aid, and the impact of working in austere environments on the provision and providers of palliative care. Indeed, we must strive to keep the humanity in our humanitarian workers.


Perhaps one of the most anticipated elements of McMaster’s MSc. in Global Health is the two-week Learning Symposium at Manipal University, in the Karnataka State of India. Field-based training has been identified as an invaluable asset in the professional development of humanitarian health professionals, and despite having travelled quite extensively, I eagerly anticipate the opportunity to do so under academic/professional auspices. Students from partnering universities will come together from around the world to receive a unique field orientation and engage in critical dialogue surrounding our theses and scholarly papers. In preparation for this international experience, I have looked to Global Health Training – Ethics and Best Practices Guidelines for Training Experiences (Crump et al., 2010) for preliminary ethical considerations to guide my journey through the Program. Crump, Sugarman and the Working Group on Ethics Guidelines for Global Health Training (WEIGHT) identify three main populations in Global Health Training; Sending/Host Institutions, Trainees, and Sponsors, each with unique responsibilities and recommendations.

Focusing on the trainees for the purposes of this discussion, the first responsibility of the trainees is to “Recognize that the primary purpose of the [international] experiences is global health learning and appropriately supervised service.” This may come partly in response to countless case studies such as those presented by Dr. Robert Huish (2012) in a special issue of the Journal of Global Citizenship and Equity Education. Huish draws attention to the various complex ethical conundrums faced by an increasing number of medical students undertaking International Health Electives. Major challenges included “Navigating different cultures [of medicine], moving beyond one’s scope of practice, and unilateral capacity building” (Huish, 2012) (Elit et al., 2011). These situations not only place the trainee under immense stress, but also increase the liabilities of the institutions and diminish the quality of care received by the local populations.

The McMaster program appears to address these challenges and reflect the priority of learning by means of a tightly facilitated curriculum with a diversity of mentors to guide personal, professional and academic growth. Furthermore, being immersed in the Symposium’s academic setting should allow deeper engagement with cultural and local contexts, ideally allowing us to “demonstrate cultural competency and engage in appropriate discussions about different perspectives” (Crump et al., 2010).

…and beyond.

It remains to be seen if the two-week Symposium will provide sufficient field exposure for students to concatenate theoretical to practical competencies, and then demonstrate them during our practicums and thesis research. The fields of Global Health and Humanitarian Health Care not only share inherent ethical challenges, but also both suffer from a lack of professionalization and standardized competency based-training (Johnson, 2013). McMaster’s blended (online, in-class, field-based) classroom model is also particularly adaptable to the mobility needs of Humanitarian Health Care Professionals. I anticipate that this program will continue to evolve with each passing cohort, and provide valuable insight into the future of ethical Global Health and Humanitarian Health Care training for years to come.


Crump, J. A., Sugarman, J., & Working Group on Ethics Guidelines for Global Health Training (WEIGHT. (2010). Ethics and best practice guidelines for training experiences in global health. The American Journal of Tropical Medicine and Hygiene, 83(6), 1178-1182.

Elit, L., Hunt, M., Redwood‐Campbell, L., Ranford, J., Adelson, N., & Schwartz, L. (2011). Ethical issues encountered by medical students during international health electives. Medical education, 45(7), 704-711.

Huish, R. (2012). The ethical conundrum of international health electives in medical education. Journal of Global Citizenship & Equity Education, 2(1).

Johnson, K., Idzerda, L., Baras, R., Camburn, J., Hein, K., Walker, P., & Burkle, F. M. (2013). Competency-based standardized training for humanitarian providers: making humanitarian assistance a professional discipline. Disaster medicine and public health preparedness, 7(04), 369-372.

From ‘suffering others’ to ‘aspiring mothers’: the contemporary image world of global maternal health campaigns

by Margaret MacDonald

Maternal mortality was once described as the neglected tragedy of global health. Though it was estimated in the 1980s that nearly half a million women died each year from pregnancy and birth related causes – 99% of them in the global south – little attention was paid and little progress was made for many years. Recently, however, the problem of maternal mortality has become somewhat of a cause célèbre attracting the attention of world leaders, billionaire philanthropists, celebrity journalists, and filmmakers. Former supermodel Christy Turlington, for example, made a documentary film about maternal mortality in 2010 and launched her own NGO, Every Mother Counts. Melinda Gates has become a key advocate and donor, gracing the podium of most significant global meetings on the topic. Canadian Prime Minister Stephen Harper, for his part, has made global maternal and child health his legacy issue, launching the Muskoka Initiatives I and II which garnered billions of dollars in funding commitments from G8 and G20 nations, and holding an international summit in Toronto in 2014.

As the global campaign to reduce maternal mortality has been scaled up, so has its ‘image world’ (Sontag 1977) in order to meet the expectations of this new era of high profile humanitarianism.  In this brief blog post I share a few insights about this image world from my anthropological research, starting with the photo below.

Schoolgirl WD foyer 2013
Photo by Margaret MacDonald

I took this photo at the Women Deliver conference in Kuala Lumpur in May 2013. (Women Deliver is perhaps the most influential women’s health advocacy organization in the world). It is one of a series by American photographer Mark Tuschman, commissioned especially for display at the conference. This photo and the others in Tuschman’s series speak to the viewer of a social injustice overcome or medical disaster averted: the teenage girl in the photo is still in school; a nurse talks to a pregnant woman in a functioning health facility; a smiling new mother holds her healthy baby.

An Outbreak of Outbreaks: Humanitarian Epidemiology in West Africa

by John Pringle

I was disappointed that I couldn’t go to West Africa sooner. The Ebola epidemic was at its peak in the fall of 2014, the same time that I was preparing for my doctoral defence. I watched “Ebola Frontline” which conveyed tragedy and urgency. The documentary followed Médecins Sans Frontières (MSF) doctor Javid Abdelmoneim as he cared for Ebola patients in Sierra Leone.[1] It was graphic and raw, something out of Dafoe’s A Journal of the Plague Year. That people had to be turned away from Ebola treatment centres was profoundly inhumane. That traumatized aid workers had to turn people away because treatment centres were overrun, to watch helplessly as people died agonizing deaths in cars or on the ground—was yet another searing reminder of our collective failure, that there is no shared responsibility for global health, and that our notion of ‘international community’ is more dream than reality.