Working in International Health

Abstract

International health deals with health issues in countries other than one’s own, especially the so-called low and middle income countries (lMICs). In contrast, global health (a term that sounds as though it could be synonymous) concerns health issues, such as pandemics, that can transcend national boundaries. The target audience for this book is people interested in working in international heath and concentrates on those employed by the uK National Health Service. The three authors of this book are a physician and two non-medically trained professionals with an impressive background in international health work and are well qualified in the subject. They convey deep knowledge and familiarity through their own experience and that of many other practitioners in the field (whose quotations are liberally sprinkled throughout the book). It is highly readable and well-structured into sections relevant to one’s level of interest in, and intention to enter, international health. There is some repetition but this appears deliberate because it emphasizes several important points for those considering international health, such as language ability, resource challenges and competence to perform the required job once in-country. There are a few niggles with the format. For instance, it was difficult to read the keys on the maps, which are small and produced in black and white, but these do not detract from what is a very informative book. What is its relevance to occupational health professionals? Not much, from the way it is written. Even though there is a section on health and safety, I could find only one reference to occupational health and this was about pre-travel preparation rather than occupational health professionals becoming practitioners of international health. This is understandable because work performed when in a lMIC needs to align with the host government’s health plans and one assumes occupational health is not a high priority. Nevertheless, perhaps this is a missed opportunity? We all hear of the ‘thirdworld sweat shops’ where work takes its toll on health. Working conditions like these add to a country’s overall health burden, so some effort should go towards implementing basic occupational health measures. Also, for the niche area of disaster relief, occupational health support is needed for the team of responders, i.e. the workforce. There are useful sections on the challenges of expatriation/repatriation, monitoring and evaluation techniques, and the importance of good management skills. These have relevance to general occupational health practice. I liked this book. Even if not relevant to most of us, it is still a good and salutary read showing what it takes to practice international health effectively.