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Global reach

Carolyn Hawley, Ph.D.

School of Allied Health Professions alumni translate their skills into worldwide care

Health issues know no borders. And neither do the efforts of alumni of the Virginia Commonwealth University School of Allied Health Professions. Those who are compelled to take their skills and expertise to far corners of the earth say that working abroad places an entirely new perspective on the interconnectivity of all mankind and the need for global health care efforts.

Following are a few of the thoughts alumni gleaned from their experiences.

Aly Cooper (M.S.W. ’09; Cert. ’11/G)

Cooper is a gerontological social worker who lives in Taiwan and volunteers with the Garden of Hope Foundation, an organization that works with women, children and youth who have experienced sexual assault and/or exploitation and domestic violence.

When did you first develop an interest in working abroad and what sparked the idea?

With my husband working and my son in school, I had a strong desire to seek out volunteer opportunities and to be aware and involved in social issues that were affecting my community. Having worked in thedomestic violence field, I knew this was an area that I wanted to pursue, thus leading me to seek out volunteer opportunities at the Garden of Hope Foundation.

What among your studies at VCU prepared you for the experience?

Having a Master of Social Work degree with a focus on aging studies, I have a love for people and a desire to advocate for at-risk and vulnerable populations. I attained an appreciation for the aging process and a greater understanding for human systems, as well as a broader view of the world at large, within my aging studies classes and research. Social work classes led me to think broader and outside of myself, and to be less ethnocentric, with a greater appreciation of differing cultures. Understanding risk and protective factors, in addition to one’s potential for resilience, has been critical to this experience.

What are some of the ways in which your international work differs from what you do (or did) here in the States?

There are different facets to every organization. In the U.S., a great deal of my job responsibilities included providing direct care by working directly with clients. My work at the Garden of Hope, inTaiwan, is much more “behind the scenes,” if you will. While I am not providing direct care services, I am directly assisting in the proofreading process (after materials are translated from Mandarin to English) to ensure that translated materials make sense prior to being disseminated. Though very different from previous positions I’ve held, I’ve become more aware that each job within a foundation or organization is no less important than another. Each is a vital piece in the fight against domestic and sexual violence.

How would you say that you benefit from working internationally — both as a person and professionally?

International work has taught me to be patient and increasingly empathetic, and it inspires a hunger in me to research my new home, including culture and the history of the people. I’m actively taking Mandarin classes, making attempts to assimilate into my new environment. I’ve learned to let the little things go. Things that seemed important in the U.S. seem trivial in comparison to what is actually going on in the rest of the world. Though cliché, working internationally really makes you appreciate what you have.

What makes health a global matter?

It becomes easy to only be concerned with what directly affects us, but health is a global matter. Whether we may realize it or not, women and girls around the world affected by domestic and sexual violence have a profound impact on each of us. It will take a global effort in order for change to take place.

Nickie Damico, CRNA (B.S. ’97; M.S.N.A. ’99/NA)

Damico is an assistant professor of professional practice in the VCU Department of Nurse Anesthesia, who served on the Plastic Surgeries Team in Belize for the World Pediatric Project.

When did you first develop an interest in working abroad and what sparked the idea?

I first became interested in working abroad in the early 1990s. I was working as an ICU nurse at the University of Virginia Medical Center. My roommate, a pediatric nurse, volunteered with Operation Smile. I knew then that I wanted to donate my time and services in that way, too. I first became interested in working with the World Pediatric Project, formerly the International Hospital for Children, when I was working in private practice here in Richmond. The organization sponsors a number of surgical specialty teams that are often comprised of VCU graduates. I was invited to take part in the Belize Plastic Surgeries Team by Dr. Tom Bohannon, an anesthesiologist that I was working with at the Virginia Eye Institute Ambulatory Surgery Center. I immediately accepted!

What among your studies at VCU prepared you for the experience?

One of the strengths of the VCU nurse anesthesia program is that students are exposed to a wide variety of facilities, equipment and anesthetic techniques. This aspect of the program was very helpful in preparing me for the conditions I faced in Belize. I left my familiarity of the machine and equipment in the U.S. at home and had to quickly adapt to what was available. Fortunately, I had worked with the equipment they had in Belize during my training, so it wasn’t as stressful as it could have been.

What are some of the ways in which your international work differs from what you do (or did) in the States?

First and foremost the resources, equipment and pharmaceuticals are all different in Belize. At the same time, we simply would not compromise the standards of care that we adhere to in the U.S. So we had to be flexible and creative to make that happen using the resources (or lack thereof) that we had at our disposal. While I care for a lot of pediatric patients in my practice here in the U.S., I do not commonly have the opportunity to participate in the kind of procedures that we do in Belize, so the cases were very different.

How would you say that you benefit from working internationally — both as a person and professionally?

Professionally, I found the lack of resources and equipment, and unfamiliarity of the environment to be very stressful. My experience in Belize totally changed my perspective. In hindsight, working outside of my “comfort zone” helped me grow. I appreciate the things we have here in the U.S. even more, but I have also found that I am now always looking for ways to do more with less in my practice. I try to be less wasteful. I had the chance to see that my patients’ outcomes can be just as positive without some of the drugs and equipment I used previously.

On the personal side, for me this was an amazing experience. I met new friends that I will continue to have as a part of my life for years to come. I traveled with a team of providers that I had never worked with before (other than the anesthesia providers). We bonded quickly under the stressful conditions we faced. Working in a foreign country — and not just visiting as a tourist — was an entirely new and very different experience for me. I feel as though I really experienced what life is like there.

What makes health a global matter?

Across the world, we have the same desire to protect and provide for our children. I met (but couldn’t verbally communicate with) a lot of parents on this trip. It pulled at me as a mom. These families have little money and limited means of transportation, yet they traveled across the entire country of Belize to attend our clinic, in hope of getting the opportunity to receive services from our team. In some cases, this was for relatively “minor” cosmetic procedures that were life altering for these children. The parents wanted their children to be able to live a “normal” life without fear of being ostracized over, for example, facial burns. Our basic desires and needs are the same no matter where we live.

Carolyn Hawley, Ph.D. (Ph.D. ’06/HRS)

Hawley is an assistant professor in VCU’s Department of Rehabilitation Counseling and principal investigator for the Israeli/American Resilience Project, which works to enhance the global scientific knowledge base and application of resilience as a means for increasing the capacity of individuals to withstand and recoup from negative and traumatic events (part of VCU’s International Partnerships Major Initiatives Award).

When did you first develop an interest in working abroad and what sparked the idea?

While I have always had an interest in working abroad, the opportunity that this project provided happened much by chance. My colleague Dr. Amy Armstrong and I have been working with veterans, bolstering resilience and community re-entry, particularly for those who have experienced a mild traumatic brain injury and/or post-traumatic stress disorder. In October 2010, Amy had the opportunity to visit Hadassah Medical Center, in Jerusalem, where she shared the research we were doing with veterans. The response was enthusiastic and they were very interested in utilizing this topic with their own population. Thus our research partnership was born.

What among your studies at VCU prepared you for the experience?

Obviously, the scholastic material I was taught at VCU — including how to acquire funding and to develop, conduct and interpret research — was instrumental in my ability to do a project such as this.  However, I cannot emphasize enough how the support of the VCU community has been key. Through the networks I initially developed at VCU, as a student years ago, I have colleagues and mentors with various knowledge and opportunities that I continue to call on and utilize (and thankfully they still take my calls!).

What are some of the ways in which your international work differs from what you do (or did) in the States?

What makes the work different is learning the political, social and cultural nuances of another nation, such as Israel. Thus, I am grateful for the support of our project partners Drs. Meiner and Shiri from Hadassah.

How would you say that you benefit from working internationally — both as a person and professionally?

I find there to be something very comforting in working with people who are culturally different, or from somewhere else, as it reinforces our sameness. As people, we share similar desires, passions and feelings of suffering. This understanding provides a great opportunity to connect with someone, no matter the cultural divide.

What makes health a global matter?

The world has become a very small place and issues occurring somewhere else have a ripple effect that we cannot be isolated from. For instance, our work in Israel and with our veterans demonstrates that someone who has been physically and/or mentally injured through war or political violence brings these scars back to their homes and communities. Without the proper supports, such wounds can be further manifested in unhealthy ways that impact us all, like, for instance, unemployment, suicide or depression. So the need to think globally isn’t just an altruistic one.

Kristen Hurst (B.S. ’04/RS)

Hurst is a nuclear medicine technologist who lives and works in Brisbane, Queensland, Australia, and is dually accredited in the U.S. and Australia.

When did you first develop an interest in working abroad and what sparked the idea?

Interestingly enough, I think it may go all the way back to the second grade. I can remember choosing Australia as the country that I wanted to give a report on. Little did I know that I would one day live there. I also played soccer in Germany one summer and traveled a fair amount. This traveling gave me a keen interest in other cultures and people. Most importantly, I have always wanted to spread my wings and test myself. I love the challenges that work and life can present. In the end, I think that it would have to be a combination of all these things.

What among your studies at VCU prepared you for the experience?

There honestly was no one subject that prepared me for my experience more than any other. It was more the entire course load. The thoroughness of the nuclear medicine program was — and still is —amazing. I had to take an international exam to get my Australian license and I can honestly say that there is no way I could have passed that exam without my education from VCU and its nuclear medicine program. The teachers and clinical advisers were instrumental in giving me the tools and knowledge to take — not only to any hospital in the U.S. — but to any hospital in the world, literally.

What are some of the ways in which your international work differs from what you do (or did) in the States?

Language is the big difference. From the simple day-to-day talking with people, to the name for drugs and medical equipment — there is a learning curve that required a lot of patience and determination in order to not get frustrated. The first time that I saw esophagus or hematology, I really had to look twice.

The only real change in my day-to-day practice is in the measurement for our doses. In the U.S., doses are measured in millicuries. In most of the rest of the world, it is in megabecquerels. The amounts of radioactivity are generally the same, but one millicurie is equal to 37 megabecquerels. Consequently, the doses look much larger when you first encounter them.

In addition, there is generally a more informal approach to life in Australia. I would never, ever call one of our attending physicians by their first name [in the U.S.] and here it is almost expected. The same goes with speaking to a patient. I can’t remember the last time I said, “Mrs. Smith” or “Mr. Jones” when talking to a patient in Australia. Otherwise, nuclear medicine is nuclear medicine the world over. There are no more changes here than there would be if I went from say VCU to UCLA.

How would you say that you benefit from working internationally — both as a person and professionally?

Personally, I have benefitted by seeing the rest of the world and confirming my thought that no one group of people has all the answers. I have learned humility and patience, and I continue to learn those things! I am a more confident person and unafraid to take on most any challenge. I value things that I once took for granted, like being able to see family and friends at the drop of the hat. I found the person that I plan to spend the rest of my life with and that is without a doubt the greatest benefit of all. She encourages me to be the best person I can be every day.

Professionally, there is probably no better place for me to be. With 12 times the population in the U.S. than there is in Australia, there are about that many more technologists as well. That is 12 times more people to go through to get to a position where you can have a greater influence on your profession. There will be four hospitals opening in Queensland in the next eight years. The opportunities here are much greater. I would also say that working outside of the U.S. allows me to see both what happens in and out of the country. When working in the U.S., often what is happening in the rest of the world is lost. I was almost completely unaware of the nuclear medicine field outside of the U.S. while in school and it was only once I left that I realized how vast and varied the field can be.

What makes health a global matter?

Well, we could talk about this all day. When it was hard to travel, move about and even communicate, world health was very segregated. A person in Australia didn’t need to know about a disease in the U.S., simply because there was no method to transmit the disease from one place to another. Now that is a thing of the past. We must know all that we can about our world, or we will be caught off guard and unable to deal with the consequences of our ignorance. Avian flu, swine flu, the re-emergence of whooping cough, HIV, Alzheimer’s disease, cancer — the list is endless. Where I work in Australia, we are making great steps in PET working with different isotopes to optimize imaging and some cancer-related therapies. These days, all it takes is a phone call or computer to reach one of the centers in the U.S. that might be doing the same and there can be an exchange of ideas that would have taken weeks or months only 20 years ago. Joint efforts between centers across multiple continents are now commonplace. This is increasing the rate of new ideas and techniques that are emerging. In addition, the world is becoming more standardized in its approach to imaging. What is done in one country is very likely to be performed in the rest of the world as well.

Melanie Gray (D.P.T. ’05/PT)

Gray is a physical therapist who participated in two international medical trips, including Tagacaba, Brazil, in 2008, and Jacmel, Haiti, in 2011.

When did you first develop an interest in working abroad and what sparked the idea?

I have always enjoyed traveling and have had the opportunity to travel to many places around the world. I was first introduced to international medical trips through my church. Also, one of my physical therapy friends was very involved in medical trips, specifically to Haiti, and I was inspired by her pictures and stories. She decided to stop going to Haiti, which left the need for a therapist to take her place, so I volunteered!

What among your studies at VCU prepared you for the experience?

I feel that my clinical rotations helped the most, because they provided different hands-on experiences that allow me to feel comfortable and confident while working with a variety of patients in a variety of settings. These clinical experiences provided real-world experiences that supplemented what I learned in the classroom and through text books. Also, my pediatrics class helped significantly because that is the population I work with the most in Haiti.

What are some of the ways in which your international work differs from what you do (or did) in the States?

It is actually amazing how similar my days in Haiti are to my days in the U.S. The biggest difference is the lack of resources available in Haiti. In the U.S., I split my time between home visits, for children up to 3 years old, and seeing outpatients at the hospital. Similarly, when in Haiti, I also work with children up to 3 years old at Pazapa school and do home visits. Also, when in Haiti, I don't have access to all of the medical supplies and equipment available in the U.S.; however, I have learned to be more creative and to make do with the materials that are available. It’s amazing how many activities can be done with a chair!

How would you say that you benefit from working internationally — both as a person and professionally?

My work in Haiti has given me a new appreciation for everything I have in my life. It has helped me to not take myself so seriously and to make every day count. It amazes me to see what little the Haitian people have, yet they are still happy and so appreciative for everything they’re given. I feel a renewed sense of hope and I feel energized to make a bigger difference in my day-to-day life after returning home.

What makes health a global matter?

No one is immune to health problems, and access to good health care can mean the difference between life and death. Health is a global issue because there are many diseases and conditions that are preventable if the proper resources are available. I saw several children in Haiti who would have benefited from shunts or feeding tubes, which are common treatments in the U.S.; however, the risk of infection was too great for these procedures to be performed in Haiti.

Sister Pat Eck, C.B.S. (M.H.A. ’81/HA)

Eck is a congregation leader for Sisters of Bon Secours of Paris who has worked in Ireland, France, Peru and South Africa, and 2011 recipient of the Cross Pro Ecclesia et Pontifice medal, a papal award that represents the highest honor given to a member of a religious community by the Vatican.

When did you first develop an interest in working abroad and what sparked the idea?

My interest has primarily come through the shared ministry of the Sisters of Bon Secours across the globe. In the last five years or so, the Bon Secours Health System provided some support for our ministries. They also developed a group within the health system to bring together our local delivery systems interested in global ministries. At the same time, work was going on among Catholic health care systems in the U.S. to see if there was any way to better coordinate the work of systems providing care in other countries. Bon Secours Health System focused its work in Haiti, Peru and South Africa.

What among your studies at VCU prepared you for the experience?

Probably the systems theory, general health care management, quality management and public health were most directly helpful.

What are some of the ways in which your international work differs from what you do (or did) in the States?

My role changed in 2009, when I was elected the congregation leader of the Sisters of Bon Secours of Paris. What has been very gratifying for me is that the work and support of our ministries is more direct now. I have had the opportunity to visit Ireland, France, Peru and South Africa, and to see these ministries firsthand. They all are different and all have different needs and resources.

In my experience, the most significant difference in providing health care, particularly in Peru and South Africa where we minister, is the level of true basic need and the difference relatively small amounts of money make. Health care becomes dealing with the basic needs of food, shelter and water, preventing childhood diseases with basic nutrition, and hand washing. All it takes is one visit to the poor in Peru or South Africa, where we are, to realize that the world’s priorities are wrong. No one should live in poverty and want in one area of the world, while others are living in such obscene luxury in another.

How would you say that you benefit from working internationally — both as a person and professionally?

One true benefit in working internationally is how it allows you to recognize the gifts, talents and contributions of other countries and cultures. It becomes clear that the U.S. does not have all of the answers and, in some instances, we have created problems by exporting some of our approaches to issues. Professionally, I think I have learned that sometimes simpler is a lot better and easier. Taking the time to be with people and understand their issues and problems, and working together to come to a better place is important. Personally, I think I am learning about the beauties of different cultures and peoples, and the resiliency and happiness of those living in very simple and uncluttered environments. It makes me want to be more simple and to take more time to be with and enjoy the presence of others. I visited one village up in the mountains of Peru where the entire village came out to greet me with a band and speeches. We danced and prayed. It was an incredibly moving and powerful visit.

What makes health a global matter?

Our world is so small now. We all are responsible for the health of it! We know immediately when people are suffering in another part of the globe. Look at the experience of Haiti. How can we have that experience on our borders, and see the anguish, and not know that health care is global? We know that many infectious diseases can be carried from country to country. We know that some of our corporate stances, like extracting minerals from the earth for example, can and do cause major health issues. We know that how we live either creates an environment that holds the potential for sustainability of our earth or it diminishes life. Basically, we are all in this world together and are responsible for it!

Tim Randolph, Ph.D. (M.S. ’87/CLS)

Randolph is an associate professor and researcher, Saint Louis University, Department of Clinical Laboratory Science, and founder of Randolph World Ministries Inc., an international ministry program and organization that partners with 24 Haitian clinics to improve laboratory services.

When did you first develop an interest in working abroad and what sparked the idea?

In 1996, God was nudging me to expand my ministry, but I was not sure in what direction he was asking. At the time, I was doing music ministry for worship services, camps and retreats. In 1999, while doing the music for an adult retreat, a friend asked me to join a mission team going to Haiti to build a school. This was the open door I was looking for, so I agreed and made my first trip to Haiti in 1999. Three months later, a pastor friend emailed me after returning from a trip to Haiti and described a clinic he toured that needed help with their lab. I contacted that organization and visited my first Haitian clinic in the summer of 2000. From those humble beginnings, Randolph World Ministries Inc. was born.

What among your studies at VCU prepared you for the experience?

While at VCU I advanced my studies in clinical laboratory science and engaged in biomedical research. Today, the primary focus of Randolph World Ministries is to partner with and improve the services provided by our 24 Haitian clinic clients. My focus within Randolph World Ministries is to improve laboratory services among our Haitian partners.

As a faculty member at Saint Louis University, research is part of my job description. Currently, I am engaged in several research projects to develop novel laboratory testing methods that can overcome testing barriers encountered in Haitian clinic labs. The education in laboratory medicine and in biomedical research that I received at VCU prepared me for this ministry opportunity.

What are some of the ways in which your international work differs from what you do (or did) in the States?

As a bench clinical laboratory scientist, early in my career I performed diagnostic laboratory testing ordered by physicians and reported the results I obtained. For the past 24 years, I have been a faculty member at Saint Louis University where I teach hematology, hemostasis and research design, perform biomedical research, and engage in service opportunities within and outside the university.

Regarding laboratory testing, the methods we use in my Haitian clinic labs differ dramatically from those used in U.S. labs. Many Haitian labs do not have electricity and those that do often generate their own power from small undersized generators. This fact, along with a lack of funds, refrigeration and running water, coupled with poorly trained lab staff, make instrumentation in Haiti very difficult. Nearly all testing in the U.S. is performed using modern, sophisticated laboratory instrumentation, whereas in Haiti nearly everything is done manually. To date, nearly 90 percent of my research has been redirected to the development of laboratory testing methods that overcome these barriers and can therefore be performed in Haitian labs.

How would you say that you benefit from working internationally — both as a person and professionally?

Most Americans live an insulated life, shielded by what goes on in the rest of the world. Although we Americans are aware of the poverty experienced in many parts of the world, as a whole we do little to nothing to redistribute our resources to assist others. A minor reduction in luxury can literally save a life elsewhere, yet most of us continue to bask in luxury and give away only leftovers, should any be available at the end of the month. Immersion in the real-life experiences of others living in other parts of the world makes me continually aware of what God is calling me to do to address this problem. Not only is it my duty as a Christian and human being, to live less selfishly, but it is my duty to share my experiences with others in hopes that they will do the same.

As a professional, I have knowledge and resources that can be redirected to move the health care systems in underdeveloped countries forward. This is my calling and my obligation.

What makes health a global matter?

Humans are humans everywhere and diseases are more similar than different across the globe. Since diseases are similar, so are diagnostic testing methods and treatments.

As the U.N. promotes international trade, I am promoting international sharing. The sharing of health care is the sharing of life. Healthier people make healthier countries, which improves productivity, global trade and the global economy.

As a Christian and human being, assisting my brothers and sisters in need is a global concern, whether in health care or in other areas. The key to personal satisfaction and peace is forcing ourselves to stop looking inward and to start looking outward. Only then will life have purpose.

Jessica Lynn (M.S. ’11/OT)

Lynn is an occupational therapist for Children’s Hospital of Richmond at VCU, Bon Air Therapy Center, who recently worked with conjoined twins from the Dominican Republic who were surgically separated by pediatric surgeons at CHoR.

What among your studies at VCU prepared you for the experience of working with international patients?

Occupational therapy, in general, puts a heavy weight on client-centered care that views the individual within their environment and the various contexts that they function in. This holistic view requires the clinician to consider and include a client’s culture in treatment. The OT program at VCU expands these values by providing case studies and service-learning opportunities, which challenge us to be aware of our personal cultural values, and to understand how somebody else’s cultural and social views impact their health beliefs and behaviors.

What are some of the ways in which this experience differed from your day-to-day experiences?

The family only spoke Spanish, so we relied heavily on a translator to communicate. Otherwise, there were a lot of gestures and charades used while trying to communicate. Additionally, the rarity of this case challenged me to apply my knowledge of pediatric development and rehabilitation in a unique way.

How would you say that you benefited from working with the twins — both as a person and professionally?

Working with the twins was an incredible experience. I learned so much from them. By seeing a family make a difficult decision that had the potential to jeopardize their children’s lives — I was challenged to assess my values and overall outlook on life. Working with them also reminded me of the universality in making difficult life decisions. Professionally, I learned the importance of going the extra mile. By taking the extra time to sew life-sized, weighted dolls, to help the girls cope with separation anxiety, I instantly established rapport with both of them as well as their mom. It forced me to think outside of the box to offer intervention that would be appropriate across cultures and to establish rapport despite a language barrier.

Lastly, as a new alumna and member of the allied health community, what would you say makes health a global matter?

Health is a global matter because of the significant role it plays in life and well-being, no matter where you live. This is especially true with advancements in technology that make it easier and easier to communicate with people all over the world. It is important that we share our knowledge and practice in the health care field internationally, in order to continue to make advances in medicine and health care provision.

Without considering health as a global matter, the twins would never have been given the opportunity to be separated.

Lucio B. Mutia, Th.D. (Cert. ’87/PC)

Mutia is the president of Philippine Association for Clinical Pastoral Education and Practice Inc. and executive director of its CPE program.

When did you first develop an interest in working abroad and what sparked the idea?

Right after my clinical pastoral education residency with the patient counseling program at MCV Hospitals and working with other clinical pastoral education supervisors at the hospital, as well as through Virginia, in general, I realized that there was a great need for a dynamic CPE development in the Philippines. I thought it was important for CPE leaders to be highly competent in organizing, sustaining, guiding and journeying. Respect among co-supervisors and co-educators is empowering. My hands-on learning of pastoral care management contributed to my sense of confidence. All of these things are important in my work as I organize, develop and inspire pastoral care and CPE leaders in the Philippines.

What among your studies at VCU prepared you for the experience?

After my exposure, both clinically and academically in the U.S., I sensed that I was ready to promote and reinvigorate CPE in the Philippines. While at the School of Allied Health Professions, in the patient counseling program and the Department of Pastoral Care, I took it upon myself to be a participant as well as an observer for the way the school and the department runs the program. I also chose to be involved in activities and programs related to CPE, like grand rounds of the hospital and other university lectures. Back here in the Philippines, it is important for CPE leaders to be highly prepared, as our task is to organize, sustain, guide and journey. These were all available to me in my education at the School of Allied Health Professions and the university.

What are some of the ways in which your international work differs from what you do (or did) here in the States?

Right now, I serve as the president of Pastoral Education and Practice Inc. and in the meantime I serve as executive director of the CPE program, developing a second liner.

Currently my task is to develop “second liners.”  PACPEP now has two supervisors-in-training, four supervisory education students and six participants in advanced levels (level two’s). Now, with four active centers and supervisors-in-training on hand, I can go around and supervise both the centers and the supervisors-in-training.

How would you say that you benefit from working internationally — both as a person and professionally?

The benefits of working internationally, for me, include continuing to develop my creativity and the characteristics of being congruent, as well as unconditional positive regard and a sense of emphatic understanding. Professionally, I continue to inspire churches and their seminaries to open up to CPE education, and the further study of pastoral care, as we have a lot of brokenness and pains in our churches, particularly, and in larger society in general.

What makes health a global matter?

Health and health care are global issues. My worldview includes belonging to one cosmos. Everyone is interconnected, interrelated and interdependent. Someone here says, “When a Euro-North American sneezes, colds occur in the Philippines (or Asia).” Though this statement is political, it is true. As we are interconnected, interrelated and interdependent, there is a need to share each other’s wisdom in caring for one another and the world as a whole.