Global Child Health and Diversity

Dr. Ezinne Emeruwa (PGY-II) in the Global Health scholarly concentration discusses the intersection of diversity and global health. 


Q: You’re the diversity representative for the residency committee. What is this role and how you did you get involved?

This is actually a brand new role this year but essentially I am tasked with being a liaison for our residents to get involved with diversity issues that affect ourselves, our program, and our patients. My primary goal for the year is to connect our residents with opportunities to engage with the efforts that are already underway around the greater Stanford community. Although some of us are having these important conversations because diversity is an issue we are passionate about, I’d like to expand the spaces and the circles in which these conversations occur and lower that minimum level of individual passion necessary to engage meaningfully on these issues.


Q: How would you define diversity in medicine?

Diversity in medicine to me is about differences of thought that are a result of differences of experience.This includes the most talked about groupings of race and gender, but also sexual-orientation, socioecomonic status, ethnicity, nationality, physical ability, etc.  I think the natural expansion of our worldview fostered by such an environment is the optimal setting for us to grow as human beings and as physicians.

Diversity in medicine to me is about differences of thought that are a result of differences of experience.

Q: How does your diversity representative role relate to your interest and work in global health?

My interest in global health began as very personal (I am a second-generation Nigerian-American), but, I think, in some ways the natural conclusion of such a journey is a more global view of the world. There is injustice and inequity everywhere , and it seems logical to begin within our own communities. It just so happens that, for me, my definition of “my community” is not confined to the city, or even the country that I live in. So I serve my geographic community by trying to address diversity issues within its healthcare system through my role on the Residency Council as diversity representative and I serve my Nigerian community though my work in Global Health.

My experiences in healthcare abroad also serve as a way to diversify my understanding of healthcare. The differences in practice in the US and abroad prompt me to question some of the deeper assumptions about how medicine should be practiced or delivered. If the way something is done at Stanford is different than the way something is done at a particular clinic in Nigeria, is there anything wrong with either method? Should Stanford be doing it the Nigerian way or should the Nigerian clinic be doing it the Stanford way? Are the differences based in cultural considerations? Is the medical benefit significant enough that the Stanford community or the Nigerian community should try to encourage a cultural change?

My experiences in healthcare abroad also serve as a way to diversify my understanding of healthcare.

Q: Can you share a personal experience that highlights this?

Nigerian residents at the hospital I am currently rotating in not only prescribe laboratory tests, IV fluid and medications, chemotherapy, etc. but they start IVs, draw blood tests, start fluid drips, set drip rates manually, mix medications, and administer medications. Many of these tasks at Stanford are completed by specialized members of the healthcare team (nurses, pharmacists, pharmacy techs, phlebotomists, etc.). The Stanford resident perhaps leaves the hospital each day having spent more time on the higher level of medical decision-making, but the Nigerian resident comes away with a more complete understanding of the logistical intricacies of the plan they decide to set in place. The Nigerian resident is also likely more equipped to administer quality care in a more remote location with less highly trained ancillary staff. My colleagues in Nigeria have already expressed to me their frustration with their workload and the limitations it places on the time they can spend  thinking critically about their cases. Of course, it is not for me to decide if they and/or their population would be better off with a more Stanford-like model, but it provides me with an interesting perspective and leads me to wonder if lower resource settings in the US might have an easier time recruiting physicians if our training left us more comfortable administering care more independently.


Q: What are some changes you’d like to see in order to improve diversity in medicine… in global health?

I’d personally like to see a more pervasive understanding of the value of diversity in medicine. I’d also like to move farther away from the idea that to pursue diversity we need to sacrifice other measures of quality or achievement. In Global Health, I’d like to see international research garner a greater level of respect and consideration, especially research conducted by local healthcare practitioners. I do not think the barriers—including language differences, an incomplete understanding of different healthcare systems, an incomplete understanding of different cultural practices—are insurmountable in this day and age. It is possible for our system of medical knowledge sharing to allow greater global access to the discoveries in medicine, health, and healthcare delivery being made around the world.

Hailing from Riverside, CA, Dr. Emeruwa received her MD and MPH from Columbia University College of Physicians and Surgeons. She is currently in Nigeria completing a clinical rotation through the Mary Duke Biddle Scholars Program and also conducting her Global Health scholarly concentration research project.

Read more about diversity within the Stanford/Packard pediatric residency program.