5th Summer Institute (SI-5) for New Global Health Researchers

Quw'utsun' Cultural and Conference Centre
Cowichan Valley of Vancouver Island
Duncan, British Columbia, Canada
July 16-23, 2008

 

Summary Report

This year’s Summer Institute for New Global Health Researchers, our fifth (SI-5), was once again a remarkable event. We brought the Institute back to Canada after three years of holding it overseas in India, Tanzania, and Mexico. SI-5 was held on Vancouver Island, British Columbia, in a small town just off the Trans-Canada Highway called Duncan. Duncan has a large First Nations community and is the traditional home of the Cowichan people – these are the makers of the world-famous Cowichan Sweaters. The town is nestled at the heart of the Cowichan region, meaning ‘land warmed by the sun’ in the Coast Salish language. Duncan is also known as the “City of Totems” for the 80 totem poles around the downtown area, most erected in the 1980’s.

This was the first Summer Institute where, in addition to the overall theme of “research to action”, there was also a content theme: Global Indigenous Health Research. This issue shaped the original call for dyad applications and the selection of dyads based on both individual characteristics and the nature of the dyad project.

Our host organization this year was the CIHR Institute of Aboriginal People’s Health (IAPH), led by Dr. Jeff Reading, Scientific Director. IAPH supports research to address the special health needs of Canada's Aboriginal people, leading a national advanced research agenda in the area of aboriginal health (www.cihr-irsc.gc.ca/e/8668.html). SI-5 had two other collaborating partners: the Networks Environments for Aboriginal Health Research- BC (NEARBC) and the Centre for Aboriginal Health Research (CAHR), University of Victoria. NEARBC brings together individuals from all over British Columbia with the mission of creating an environment where researchers and communities collaborate to develop research capacity that is relevant to Aboriginal peoples (www.nearbc.ca/index.php). The new Centre for Aboriginal Health Research, built on the foundation of the University of Victoria’s Aboriginal Health Research Group, promotes the health and well-being of Indigenous peoples, whose health disparities require urgent attention (http://cahr.uvic.ca/).

The Summer Institute group met each day at the Quw’utsun’ Cultural and Conference Centre, a campus nestled on the Cowichan River in Duncan that provided a beautiful venue for the Institute’s activities. The Centre focuses on fostering and promoting pride in the Cowichan culture and provides a source of economic development for the Cowichan People (www.quwutsun.ca/index.htm).

Selecting Participants

As has been the pattern in previous years, the Coalition’s Task Group on Capacity Building assembled a planning team (see box 1) to design and manage all aspects of SI-5. A call for applications was prepared and appeared on the Coalition’s website in January 2008. In addition to being posted on the website, the call was widely distributed to various health and development- related organizations, universities world-wide, Indigenous-oriented organizations, Coalition members, and the Coalition’s directory. The objectives, as stated in the “Guidelines and Applications” document were:

1. To explore the “research to action” challenge—that is, how knowledge can be translated into policy, practice and community action.
2. To strengthen participants’ understanding of selected global forces that impact on the health of citizens in low and middle-income countries (LMICs).
3. Based on an analysis of the role of research in strengthening health systems, provide opportunities for skill development of relevant competencies such as advocacy, leadership, partnership building and knowledge translation.
4. To discuss issues related to global health research of particular interest and importance to those considering a career in this field.

Applications were received by dyads – two persons (one Canadian and one individual from a low-or-middle income country) who were, for the most part, already associated with a specific project. Two review teams were assembled – each of which included an SI-Alumnus. The result was that 10 teams were selected to participate in the Summer Institute.

The following individuals graciously volunteered their time to act as reviewers: Simon Brascoupé, Donald Cole, Aleida ter Kuile, Colleen Davison, Kim Scott, Katie Orr, Chantal Robillard, Francis Phiri, and Katherine Minich.

Pre-Institute Preparation

The list of successful applicants was posted on the Coalition’s website, and shortly thereafter all participants were signed up to participate in an online collaborative workspace within the Coalition’s website. Using this space, all participants submitted an individual profile and each dyad provided an updated summary of their specific research project. Following the pattern of previous years, a series of “Pre-Institute Notes” was prepared by the planning team and was posted in the dedicated web-space. These notes included relevant information about visas, travel arrangements and preventive health advice. In addition, folders were prepared for each presentation, workshop, and field trip, and posted online. Each folder included a “resource guide” (which in some cases contained relevant websites) and key recommended readings. The participants were asked to read through all relevant materials before attending each activity.

Participants and Facilitators

As can be seen from the list of dyads (see box 2), the discussions at SI-5 were enriched by a remarkable diversity of projects within the global indigenous theme, and participants from a wide range of countries. The variety of facilitators (see box 3) also contributed to the international scope of the event. A mixture of countries were represented: Argentina, Bolivia, Canada, Chile, Dominica, Ecuador, Grenada, Guatemala, India, New Zealand, Tanzania, Thailand, and Uganda. From these countries, various Indigenous groups were represented at the Institute: Algonquin, Beaver Lake Cree Nation (Alberta), Mayan (Guatemala), Mohawk, Ngati Whatua Tribe (New Zealand), Sandy Bay Ojibway (Manitoba), and Vuntut Gwitchin (Old Crow, Yukon).

 

Box 2: Participants and Research Projects
Dyad	Project
Cheryl Currie, Edmonton & Daniel McKennitt, Edmonton	Cultural continuity and addictive behaviour among urban Aboriginal Canadians
Fernando De Maio, Burnaby & Graciela Dinardi, Buenos Aires, Argentina	Eco-epidemiology and control of Triatoma infestans and Chagas disease transmission in the Gran Chaco region (Argentina, Bolivia, Paraguay)
Prabha Sati, Toronto & Vijaya Hebbare, Bangalore, India	Evaluation and dissemination of the disease control priorities India report through a randomized control trial of the politicians
Sonia Wesche, Prince George & Brandon Kyikavichik, Old Crow, Yukon	Climate change and indigenous food security in Old Crow, Yukon: impacts, adaptations and community health
Robert Geneau, Ottawa & Sylvia Shirima, Moshi, Tanzania	An ecosystem approach to trachoma control with Masai in northern Tanzania
Paula Godoy-Paiz, Montreal & Victor Lopez, Guatemala City, Guatemala	Assessing the mental health needs of Mayan Indigenous Peoples in Guatemala
Fabio Cabarcas, Vancouver & Rafael Pichasaca, Cañar, Ecuador	Reducing the harmful environmental and health effects of pesticide use in Ecuador
Karen Morrison, Peterborough & Martin Forde, Grenada & John Hawley, Dominica	Caribbean-Canadian dialogue in eco-system health
Lisa Bourque-Bearskin, Edmonton & Ana Santos Salas, Chile	Access to health services in Alberta and Chile
Adrienne Wiebe, Edmonton & Miriam Salvador, Comitancillo, Guatemala	Moving knowledge to health action among Maya-Mam women in Guatemala

Summer Institute Facilitator-In-Training Programme (SI-FIT)

The SI-5 was the second year that the “facilitator-in-training” program was offered, after being developed at the SI-4 in India. The goal of this program is to train SI-Alumni as facilitators, with the guidance and supervision of more experienced, “senior” facilitators.

The facilitators-in-training were chosen by a sub-committee of the planning team, based on letters of recommendation.

Ritsuko Kakuma and Chantal Robillard, both SI-4 Alumni, were the successful candidates who were chosen as the facilitators-in-training for the 5th Summer Institute. Ritz and Chantal provided feedback post- SI5, where it was evident that both had had a very positive and enriching experience. Several suggestions were made, including preparing a guide about facilitation and having more background information on the dyad and their project prior to the Institute. These helpful suggestions will be taken into consideration when planning for the SI-6 FIT program.

SI-5 Programme

The SI-5 program was designed to provide a diversity of events – presentations, workshops, dyad working time, “open spaces”, and cultural events. The primary challenge given to the dyads at the beginning of the week was to prepare a “research to action” plan for their research. Early in the week, the dyads summarized their project work to date for the group and then went to work creating their plans. The presentations and workshops were not exclusively based on research to action, but included various other themes. Four workshops were offered throughout the week: Research Ethics, Health Research Leadership and Capacity Building, CCGHR Task group on Global Indigenous Health Research and the SI-Alumni program, and Building Equitable & Collaborative Partnerships. The five presentations covered the following topics: Introduction to Research to Action, the Case Study, Challenges in Global Indigenous Health Research, Equity and Health Research, and CCGHR Initiatives in Global Health Research.

Other main highlights from the week included:

• A “case study” about a research ethics story that involved an Aboriginal nation, the Nuu-chah-nulth nation located at Port Alberni—a 2-hour drive from Duncan. Here participants had the very special opportunity of meeting with the Nuu-chah-nulth Research Ethics Committee and hearing how this community is engaged in the research process. About eight years ago, the Nuu-chah-nulth discovered that blood samples for DNA testing taken several years earlier (between 1982 and 1995) to study the high incidence of rheumatic disease in the community, had later been used in other research projects, including a study that was not part of the original consent. This has led to a fascinating story of a more transparent, respectful and mutually beneficial relationship between Aboriginal communities and researchers. This spurred an ongoing discussion that continued throughout the Summer Institute about the importance of research ethics, especially when working with Indigenous groups. The CIHR ‘Guidelines for Health Research Involving Aboriginal People’ were later reviewed by all SI-5 participants and recommendations were forwarded to the CIHR Ethics Office. Some participants were CIHR funded researchers, but most were international participants who had not been previously exposed to the guidelines, or the process through which they were developed. Although there was often support in principle for the various articles within the guidelines, it emerged that the CIHR guidelines would rarely realistically be able to be adhered to globally. For example, Indigenous governance structure, the use of the term 'community', and oral versus written tradition, were often starkly different between Canada and various other countries. Ethical research was the cornerstone of many discussions at the Summer Institute and the meeting in Port Alberni allowed for deeper insight and openness on the issue: “The meeting has left a lasting impact. It clearly demonstrated how important research ethics are and how they can impact communities and researchers even after a long gap of time” – SI-5 participant. Following the event, Lynnette Barbosa from the Nuu-chah-nulth Research Ethics Committee sent this warm message to the SI-5 group: “It was a great pleasure to have a group of individuals with such a wide variety of experiences and knowledge come and share in our special event… I look forward to working towards the development of these important partnerships.”
• We had the privilege of meeting with two remarkable community development leaders from Ecuador—a husband and wife team: Mayor Auki Tituana and Dr. Luz Marina Vega. They told a remarkable story of how social and economic development is being achieved through participatory democracy.

The week in Duncan ended with presentations of each dyad’s research-to-action plans. They received feedback from the rest of the group and special panel composed of Dr. Nancy Edwards and Dr. Ken Bassett. Nancy is a University of Ottawa professor in both the School of Nursing and the Department of Epidemiology and Community Medicine, a senior scientist at the Institute of Population Health and Elisabeth Bruyère Research Institute, University of Ottawa, and has recently been appointed the new Scientific Director of CIHR's Institute of Population and Public Health. Ken is a practicing physician, a senior medical consultant at the University of British Columbia Centre for Health Services and Policy Research, and Associate Professor in the Departments of Family Practice, Pharmacology and Therapeutics, Health Care and Epidemiology, and Ophthalmology. His international work focuses on the prevention and treatment of blindness in Tibet, Nepal, India and Tanzania.

During the closing session, all participants described highlights of their learning and facilitators were given an opportunity to provide comments to the planning team about what features worked well and what components could be improved.

SI-Alumni Programme (SI-A)

As part of the understanding when participants were accepted for SI-5, they will continue to implement their “research to action” plans over the next 12 months with help from their designated facilitators. A workshop was given at SI-5 to outline the SI-Alumni Program and the latest SI-A Newsletter was distributed. Participants made various helpful suggestions about this program, including elaborating on the membership directory, starting up a special interest group within SI-A, and other ways of staying connected. This discussion will be carried on at the annual meeting of Summer Institute Alumni, held in conjunction with the Canadian Conference on International Health in October 2008 in Ottawa.

Evaluation

SI-5 participants and facilitators completed evaluation forms, providing the planning team with standardized feedback information. The evaluations were very positive. Participants and facilitators especially seemed to appreciate the preparation leading up to the SI, the mixture of activities on the agenda, and the field visits. Some comments from the evaluation forms include: “Overall, an inspiring mix of people from various backgrounds, working on a range of important topics”, “…enriching and edifying experience”, “…the human touch, good leadership, meeting with an excellent group of researchers and human beings…”, “…meeting a very focused group of people determined to make a difference”, “It was the best formative event I have ever been on - really mind-changing and enjoyable”.

Post-Institute Symposium

On the day following the Institute, the SI-5 group participated in a day-long symposium sponsored by the CIHR Institute for Aboriginal Peoples Health and hosted at the University of Victoria by the Centre for Aboriginal Health Research. Most of the SI-5 facilitators made presentations based on their own work and all of the dyads prepared posters about their projects. These were on display throughout the day, and led to many lively discussions with local symposium participants. The entire event was filmed, so that a symposium package will become available for dissemination. It will include all presentations, posters and filmed excerpts of interviews. To access these resources, please visit the NEARBC website at: www.nearbc.ca/event-presentations.html

 

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