Skip to main content

Table 3 Emergent themes found in the reflective essays, accompanied by the number of essays attributed to these themes and samples of essay responses related to the themes

From: Student-led interprofessional global health course: learning impacts during a global crisis

Themes

# of essays

Samples of essay responses

Inference

Policy, Politics and Ethics

69

“I am reminded of the importance of government legitimacy. The population needs to trust the government and public health decisions. This trust had to be built in the years before the disaster by having a strong civil society, allowing the growth of social capital, and from the government taking action to ensure population well-being.”

Within this theme, students presented ideas around rapid and coordinated governmental action in responding to pandemics, the role of inter-governmental agencies like the WHO, and ways to improve international models for care.

Other students reflected on the various actors involved in a public health response: “government, economic, sanitation, climate, politicians”. In doing so, it was clear students who chose to reflect on this topic understood the roles of policy and politics as well as the role of public trust in government institutions may have on a response to a public health crisis such as COVID-19.

Access to Healthcare and Resources

52

“Many inequalities have become increasingly apparent depending on the demographics of a certain region, the extent to which reliable information is available and the government’s efficiency in providing the appropriate protective equipment to health professionals and other citizens.”

Most of the submitted reflections discussed inequalities and disparities in access to healthcare resources exacerbated by COVID-19.

Maternal Health

43

“The COVID-19 pandemic also has an impact on maternal and child health. Indeed, delivery procedures are impacted by the crisis. In Canada some mothers now must deliver their babies in the absence of their significant other in an effort to reduce the number of people visiting hospitals. In some part of the world, it also means that preventable birth-related complications may be fatal due to a lack of resources.”

Many reflections also highlighted the impact of the pandemic on maternal and child health, emphasizing the lack of support due to hospital capacity restrictions and a strain on resources due to the pandemic.

Elderly

27

“Covid-19 raised awareness of these issues in a broken system for our elderly population.”

Several reflections also noted the gap in care for the geriatric population.

Indigenous Health

23

“Indigenous communities across the country where access to clean water and territorial rights were already important issues are now bracing the challenges of ensuring food, water and medicine security in a period where baseline services are slowing down everywhere.”

“The indigenous communities are also affected by the COVID-19. In Canada, the government decided to help these communities by supporting them at both the individual level and the organizational/community level since they are prone to face many barriers to access healthcare services. Thus, special funds were created and some payments have been deferred.”

Students noted that the challenges of food, water and health insecurity faced by Indigenous communities were worsened by the pandemic.

Racial/Ethnic Disparities

21

“Stigmatization and racism towards those who are assumed to be from China has increased exponentially. People’s fight or flight instincts kick in, resulting in knee-jerk reactions that are extremely selfish and individualistic.”

“The effects of the pandemic on mental health are massive. Speaking to the general populace – it is unnatural to stay inside for so long – we miss touch, conversations with others, and traditional social settings. Religions may no longer be practiced in the same way (for example: Ramadan). Jobs are terminated or relegated to online, reducing our ability to fulfill the human need for connection. Many able-bodied healthy people have been able to overcome these issues through applications like Zoom and going for walks outside.”

Within this theme, students highlighted increased discrimination towards East Asian populations as a result of the pandemic and the impact on the public’s ability to practice religion.

Climate Change

18

“Finally, this pandemic may bring some positives aspects to our world. First, it seems like the outside world can finally take a breath of nice fresh air. Indeed, since fewer cars are outside, the level of CO2 have dropped considerably. This is good news, especially for China who has been struggling with polluted air for years. More locally, Montreal has also decreased its level of smog, and we are finally able to see Montreal a little more clearly when we are on top of the Mont-Royal Mountain.”

Students emphasized the positive impact of the pandemic on environmental health in relation to air quality both locally and abroad.

Poverty

16

“People who have low financial stability have increased barriers to getting access and surviving this pandemic. In addition to access to medical services, the shortages of food, the loss of jobs, the forced isolations and the panic buying, all put already vulnerable groups in extremely difficult situations.”

“it cuts the finances of people who live paycheck to paycheck because of the lack of resources, it affects elders who are left alone in their homes or residents, unable to see their families or contest improper care. It leaves single moms struggling to find places to leave their children so that they can work to put food on the table.”

“Social determinants of health, like gender and SES, help define what groups are more at risk of being negatively affected by the virus.”

Several reflections noted the increased strain for those experiencing poverty in attending to their basic needs due to the pandemic, emphasizing the importance of addressing social determinants of health.

Reproductive, Maternal and Child Health

14

“Children’s nutrition and development are also impacted by the crisis as it poses challenges for food accessibility in some regions of the world and even here in Quebec where there are accounts of desperate parents being unable to get a hold of the baby formula that their child needs. Because children are confined at home, their development may also be impacted since they are deprived from the stimulation that they receive at school and that may be lacking in certain home environments.”

“Namely, women and children in the global south, indigenous communities, and the elderly, who were already at high risk or suffering from malnutrition, now face higher vulnerability.”

“In many countries, the accessibility of health care is not very accessible to most women. They might not even have time to go to the hospital or a clinic to take care of themselves as they either live too far away, have to take care of the children instead of themselves, don’t have the money to afford treatment, or are uninformed. This is why, during this pandemic, health care measures must take into consideration women’s health and make treatments more accessible for them and their families.”

Students highlighted the impact of the pandemic on women and their access to health services as well as the impact of the stay-at-home order on the development of children.

Water Sanitation and Hygiene

13

“As was mentioned in the Global Health Water Sanitation and Hygiene recorded class, what to do when lacking masks or if it is acceptable to re use gloves are questions that are always present in low income countries given that lack of resources is a common problem; however, now we found ourselves having those same issues.”

“Further, the lack of access to water, particularly in very remote regions, results in poor ability to perform proper hand hygiene.”

Several students linked the lack of healthcare equipment and decreased access to natural resources caused by the pandemic as a potential factor in decreased sanitation and hygiene practices, locally and abroad.

Migrants, Refugees, Asylum Seekers

12

“Populations facing poverty also feature refugees, homeless people, immigrants and migrant workers who need to keep moving and travelling to sustain their livelihoods.”

“The refugees/asylum seeker demographic are one of the most prevalent marginalized population suffering from this pandemic. This is secondary to their asylum seeker status, which forces them to find low paying work despite the many comorbidities that may contribute to their deteriorating health. Additionally, due to the limited access to healthcare, they are at risk of developing serious complications from COVID as they do not have access to family doctors or primary care nurse practitioners. There is an unequal resource allocation issue that is currently placing these marginalized individuals into the direct hands of death. Why should they suffer if they are unable to describe symptoms due to language barriers, or experience cultural incompetence from the healthcare provider? Secondly, this vulnerable population have been experiencing the many financial instabilities with the downturn of the economy. Hence, the downstream effects include limited access to the appropriate protective equipment that is recommended by Santé Publique. If these already marginalized individual[s] can barely feed their families, how can they ensure their safety as well?”

Within this theme, several students reflected on the decrease in safety and security of the migrant, refugee and asylum seeker population as a result of the decreased access to care and services due to the pandemic.

Housing

10

“For example, the difficult housing situation and overcrowding makes it nearly impossible for the confirmed or suspected infected patients from isolating from other members of their family.”

Some students noted overcrowded housing as a barrier to following COVID-19 quarantine guidelines.

Oral Health

7

“Another concern during this class was worldwide oral health. Currently, due to the accumulation of sick people in the world, and the lack of resources to treat them, many hospitals have had to prioritize their health care services. Which makes oral care even less accessible to many communities, which is worrisome because it is deemed that 3.5 billion people globally are affected by oral conditions.”

Several reflections noted the re-prioritization of health care services, especially the decrease in access to oral care as a result of the pandemic.

Immunocompromised

6

“While I felt somewhat helpless being immunocompromised in a global pandemic, I had never experienced a helplessness to this degree. Watching and waiting as my disease flared and the government swore that all non-COVID patients who needed the meds were getting them. While I can understand the struggles of allocating a scarce resource, I feel as though the government failed to put into place the appropriate safeguards which would ensure all those who had no other treatment options would get the medication. With how helpless I felt, I can only imagine how other, even more vulnerable populations must have felt.”

“Throughout my time in the global health course, I have seen time and time again how important equity is, rather than equality. For me, the COVID19 pandemic has emphasized this differentiation is as vulnerable populations tend to be forgotten and pay the price.”

Students reflected on the challenges faced by vulnerable populations including the immunocompromised, observing that global health is present for all of us.