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The Duke Global Health Fellows Program: Lessons in cross-cultural communication

7/21/2014

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Throughout the summer, SEAD interns will be sharing with us stories and experiences from their summer internships. Today's post comes from Megan McCarroll.  Megan participated in the Duke Global Health Fellows Program based out of Geneva, Switzerland.  She tells us about the work she did with the International Organization for Migration and her visit to the Human Rights Council.
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I tried to begin my internship in Geneva with as few expectations as possible. I failed, of course, but my efforts have allowed me to be as open as possible to the myriad of perspectives and opinions surrounding the United Nations. I began my internship with the International Organization for Migration (IOM) on June 2, so I have now been here for one month. I am interning in the migration health division under the Senior Policy advisor for migration health.  She is one of those “larger than life” people—trained to be a pediatrician in the Philippines and began working in a refugee camp for the IOM, has worked in war zones and now works in the headquarters while traveling to countries in the midst of crisis to address major pressing health issues, such as a cholera outbreak in a refugee camp. While it is awesome to be working for such an interesting person, she has been away on mission for most of this month. She was in Iraq for a week, then South Sudan for 2 weeks, and now she is heading to Zimbabwe at the end of next week! She says (and I am hoping) that she will be staying in Geneva for the rest of the summer after Zimbabwe, so we’ll see… 

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As for my duties as an intern, I have written two IOM position papers—one general paper on HIV and migration and the other on HIV in emergency settings—which will be used as advocacy tools for IOM staff and various officials in the field, and I made an info sheet on HIV as well. I do not have much of a background on migration health, so there has been a steep learning curve while doing research and liaising with staff in regional offices around the globe. Some of points that have stuck most with me:
  • Migration is a loaded word with a negative context, causing migrants and mobile populations to face issues with stigma. 
  • There are many different kinds of migrants— immigrants from particular countries, emigrants in overseas work, ethnic minorities, internal migrants, victims of exploitation and abuse, and irregular migrants and displaced persons, though they are often clumped into one category when making global policy. 
  • National policies often forget to include migrants in their strategic health plans, especially in emergencies. 
  • Migrant populations + HIV = Stigma x 2   
  • Migrants are good for a host country/community. The common stereotype is that they are “carriers” of disease and steal away jobs from local people. These ways of thinking affect national policies and local attitudes. 

Several weeks ago, I participated in a two-day departmental retreat that really helped me gain insight into how a headquarter organization functions. Some of the main issues discussed were: 
  • The need to harness information systems to produce quality data 
  • Visibility—IOM’s role within the UN, relationship with UNHCR, and distinguishing its role as the lead organization for migration 
  • The need to strengthen coordination between IOM divisions and departments, UN organizations, and other sectors 
  • The need to establish a Migration Governance Conceptual Framework to improve the organization’s focus, strengthen communication within the IOM and partners, and identify cross-cutting issues. 
  • Lack of human resources—headquarters staff cannot be experts in every part of the world so they are always sprinting to keep up


I also had the opportunity to attend meetings at the Palais des Nations during the Human Rights Council in June. I was sent to take notes in meetings specifically addressing migration and/or health but I also got to attend a few that interested me personally. The Palais is a huge maze of fancy buildings and rooms and it is very hard to navigate (a symbol of UN bureaucracy?). For the Human Rights Council, country Ambassadors typically led the meetings, while other member states had country cards that they would raise when wanting to make a point. Watching countries argue over wordings of resolutions was both fascinating and mind-numbing. The politics surrounding migration created subtle tensions between certain countries, but on the surface, the mood was mild and the pace was extraordinarily slow. That, I believe, is one of the more frustrating aspects of the UN system. Last week I heard a U.S. diplomat say that Americans are obsessed with efficiency and forget that global policy has to move slowly to affect real change. Change does not happen in a couple weeks or months. It often entails major shifts in ways of thinking about a problem. Today during a talk from the World Health Organization, the speaker stated, “better to walk together slowly than to run ahead alone.” I know that I need more time to reflect on this statement and see where it lies in relation to my values and where I see my future self in the global policy field.   

Megan McCarroll is from Portland, Oregon, and is a rising senior in Public Policy with a minor and certificate in education.  After graduation, Megan hopes to gain some teaching experience in a low-income country to better understand the obstacles children face in obtaining a quality education.  She someday hopes to combine her interest in global policy with her passion for education.  In her free time, Megan enjoys hiking, swimming, and skiiing.
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A USAID Development Lab for Scaling Innovations in Global Health