Message from Dr. Katherine Rouleau

December 5th, 2017

In our family, one of the less solemn end-of-the year rituals includes recording my daughter’s height against previous measurements on a well-worn door frame. Beyond the “ooh’s” and “aah’s” that inevitably accompany our little ceremony is an opportunity to look back not only on how many centimetres she has gained but also how much she and we have learned; how much we have all grown.

Growth and learning have similarly permeated my recent reflection on the Global Health activities of DFCM in 2017.  A number of important milestones have marked the past year:
The fifth edition of the Toronto International Program for emerging global leaders in family medicine with a total of 51 participants and 6 international faculties from 13 countries since its inception

A very successful fourth edition of the Global Health Primer (now renamed Global Health, Equity and Primary Care)

Two new global health projects supported by the Office of Education Scholarship, adding to the two previous ones.

Over 50 DFCM faculty engaged in teaching international learners eager to learn about Canadian family medicine from our local experts

Increasing numbers of visitors and delegations from around the world in our department (Ethiopia, China, United Arab Emirates, Brazil, Nigeria, Saudi Arabia) and many visits and presentations around the world by our travelling faculty engaging with family medicine colleagues around the world

And the list goes on.

Beyond these exciting milestones, we also note a maturation of our global health activities into more sophisticated and integrated endeavours. Our gradual transition over the past decade from a valuable but somewhat limited and peripheral contributor to the work of our department to a portfolio central to our collective reach was nicely underscored by the addition of the term “Social Accountability” to the Global Health portfolio.     

More than a mere “name change”, this addition highlights a number of important aspects of the work which had thus far been simply brought under the rubric of Global Health. First, the term social accountability acknowledges our department’s explicit commitment to equity as one of the pillars of our collective work. Secondly, it reminds us that our work is not to be exclusively focused internationally but must also address the needs of those impacted by adverse social determinants of health (SDOH) in Toronto, in Ontario and in Canada. Thirdly, the inclusion of the term accountability implies a responsibility for us to demonstrate how our work actually impacts the health of those we seek to serve, particularly those facing adverse SDOH.

As we launch into a new calendar year, our explicit commitment to social accountability will serve as an impetus for us to engage more earnestly, as a department, in the area of local global health. Fortunately, we are not starting from scratch. Over the past decades, many DFCM leaders and innovators have contributed to addressing the needs of those most impacted by adverse social determinants of health.  They have done so through family medicine education, research, advocacy and innovation. Be it in the development of the now ubiquitous “poverty tool”, the care of refugees, addiction services for pregnant women or the care of the homeless to name only a few examples, our department is already engaged in expressing its commitment to social accountability.

As we strive to advance our work in this area, our collective tasks will be to ensure that we weave, grow, study and share the rich work we already do to ensure that we ultimately bring real improvements to the lives of our entire DFCM-related patient community.

Nowhere is this imperative more pressing than in contributing to improving the health of Indigenous peoples. The depth of expertise and the commitment of our academic community to providing quality family medicine must be engaged to address the health needs of those most egregiously affected by adverse determinants of health, namely, Indigenous peoples.

Over the next few months, we will consult with representatives of Indigenous communities with the intent to engage in meaningful, responsive and respectful collaboration. We will endeavour to do so with humility, acutely aware of the need to identify, engage and support indigenous colleagues to assume leadership for this important work.

As a starting point, a group of DFCM faculty and staff will take part in the Ontario Indigenous Cultural Safety Program offered by the Southwest Ontario Aboriginal Health Access Centres.  We invite all members of the DFCM to consider participating in this program. Not only is it a rich source of information, it also provides a pathway for reflective learning and transformation and stands as a clear expression of our commitment to accountability.

The renewal of the Global Health and Social Accountability portfolio in 2017 invites both celebration and hope. We express our gratitude to the many DFCM and international colleagues who contributed to making this past year a successful one and look forward to a fruitful 2018.

Dr. Katherine Rouleau
MDCM, CCFP, MHSc.
Vice Chair, Global Health & Social Accountability

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