Global Health in…Switzerland?

Jing Ren

Resident in Medicine/Pediatrics at MGH

PGY-3

 Global Health in…Switzerland?

For my away rotation this year, I am spending a month with the Elizabeth Glaser Pediatric AIDS Foundation in their offices in Geneva, Switzerland. While Switzerland is not the typical location for a global health away elective, as evidenced by the other posts on this blog, my hope was that working at the European headquarters of a large international NGO would complement the other experiences I’ve had working in field offices and government hospitals where many of these programs and their like are being implemented.

I recently heard a statistic that more than half of Geneva’s residents are not Swiss citizens. Certainly as I sit on the bus on my way to work as it winds and wends its way out of the city center to the northwest corner of the city where the UN, WHO, UNICEF, UNHCR and the ICRC (International Committee of the Red Cross), and a whole panoply of other acronymed NGOs, it is easy to believe that is true. In the EGPAF Geneva office alone, the nationalities represented include: Swiss, American, Canadian, Kenya, Italian and French, with the Switzerland the sole claimant of more than one citizen. The polyglot of languages represented on every sign and even automated bus announcements further emphasizes that Switzerland is a relative recent-comer on the European scene, cobbled together from territories that trace their routes to France and Germany respectively.

The other thing that jumps out at my during my first few days of getting used to the rhythm of life in the office is how essential the internet has become to the way EGPAF and organizations like it work. When I worked and lived in Sierra Leone 8 years ago for a similar large NGO, the internet was essential for contact with our headquarter offices, but given the poor quality and slow speeds of the connection, the country team was largely left autonomous, except during key times like the final stages of a report or grant submission. Now, the days are filled with emails and conference calls filtering in from multiple time zones across the world, starting in the early morning hours from the India team, then during the morning from offices in sub-Saharan Africa, stretching well into the evening with the Washington DC headquarters. (Interestingly, and inexplicably, our office phone acts like an US number.) Sure, the first 5-10 minutes of a large intercontinental conference call is still always filled with connectivity issues, but the ease with which questions and answers can fly across the world, allowing experts based in different countries and the implementers on the ground to troubleshoot and shape projects is still a thing of marvel. The careful balance between autonomy and supervision between the headquarters offices and the country offices is strongly reminiscent of the balance we try to strike in the hospital as residents while working with interns and attendings.