Lessons of Global Engagement: Rwandan Resourcefulness

When S. Ryan Jacobus, a student in the Medical College of Wisconsin (MCW) Master of Science in Global Health Equity Program, landed in Kigali, Rwanda, he couldn’t wait to meet his collaborators. On March 18, 2022, after months of discussing ideas over Zoom, he was scheduled to meet in-person with his Rwanda-based project mentors, Immaculate Kyarisiima and Elias Sebutare of Health Builders, an MCW partner nongovernmental organization (NGO) Jacobus had been working with leading up to his internship.

Anxious to get his internship started and advance his thesis work evaluating mental health screening tools post the Rwandan genocide, Jacobus decided to embrace resourcefulness and adaptability. He arrived at Health Builder’s health center where he conducted his first interview with a nurse on site. It was Saint Patrick’s Day, and Jacobus came prepared with green beads and celebratory swag to share with people he met, forging connections as he went. The connections he made, and his ability to embrace resourcefulness and flexibility, proved valuable in his work over the next two weeks in Rwanda. While there, he completed a scoping site analysis, medical provider interviews in health centers in two districts and investigated the existing social stigmas surrounding mental health issues.

Global Health Equity in Rwanda

“My initial thesis work during class with the thesis committee was a literature review where I reviewed as many mental health screening tools as possible for conditions like post-traumatic stress disorder (PTSD), anxiety and depression,” Jacobus explains. “But I realized once I got to Rwanda and talked to my collaborators that the thesis work plans, I made before my internship were invalid.” Jacobus observed that the stigma around mental health was so strong that medical providers were not using patient screening tools in the clinics.

“Until the social stigma surrounding mental health was properly addressed, the providers could not use what I was originally preparing,” he says. Jacobus pivoted based on his observations in the clinics and instead started gathering the medical providers’ perspectives and listening as much as possible.

“I observed that they had two major problems: funding and training for mental healthcare. I switched my thesis work to focus on the stigma surrounding mental health and offering solutions like finding funding through grants and private-public partnerships,” Jacobus says. “I also investigated solutions like implementing community mental health programs at educational institutions or sports teams with trained professionals. What I planned for my thesis work and what I ultimately did in Rwanda were two very different projects.”

Jacobus realized the very traits that are required to become a future global health leader he was learning to use like adaptability, resourcefulness, creativity, and innovation were traits he admired in the people he met in Rwanda.

“In my provider interviews, I saw people working as hard as possible with little resources out of a sheer passion for their country. They placed a high value on creative thinking and innovation in the face of those challenges,” he shares. “Their resilience is what stood out to me.” These experiences were exactly the type of learning opportunity MCW’s Master of Science in Global Health Equity Founding Director, Laura Cassidy, PhD, MS, hoped Jacobus and other students might gain from their global health thesis work.

“Through MCW’s program, students get the opportunity to learn to tailor a health project in a setting unlike their own,” Dr. Cassidy explains. “Along the way, they learn cultural competence, humility and how to engage. They see for themselves how people in other cultures can achieve much with very few resources and learn flexibility and resourcefulness. That is why we have designed an experiential learning program that is hands on and project based.”

MCW’s program was the first Master of Science in global health program available in Wisconsin and offers students an opportunity to conduct a global health research project and advance their medical education with one of MCW’s local or international partners. Partnerships include the University of Basel in Switzerland, Aegis Trust in Rwanda, the Great Lakes Native American Research Center for Health (GLNARCH), Makerere School of Public Health in Uganda, and more across the globe. Dr. Cassidy developed the program with MCW’s leadership support when she saw a growing need to prepare students to become global health leaders. She said the international thesis work is meant to illustrate the required skills to become global health leaders like their international faculty and MCW mentors, but their thesis work may also help providers and community health initiatives and NGOs meet their goals.

Current students’ thesis work are with MCW partner organizations covering such topics as intergenerational effects of genocide, mental health and regional Tribal Groups and First Nations interests together with GLARCH. The program also receives full financial support for scholarly internships and thesis work through the Dr. Rachel Thompson Global Health Equity Scholarship. Rachel Thompson, MD, MS graduated from MCW’s School of Medicine in 2008. She loved and respected her patients in all the places she practiced: from Indiana and Wisconsin to Thailand, Honduras, and Kenya. Dr. Thompson was passionate about environmental justice, vulnerable populations, and global health. She incorporated those passions into her research. This memorial funding reflects her local and international efforts and is competitively provided to honor Dr. Thompson’s legacy and support students’ faculty-mentored global health research projects that address health inequities both locally in Milwaukee, throughout Wisconsin and across the world.

Increasing Quality Care Through Partners in Health

“MCW’s program is unique because we have personalized mentorship, strong partnerships and institutional support that allow for experiential learning,” Dr. Cassidy says. “It is not a large program, so students benefit from close interaction with other students across MCW, as well as individualized faculty attention and tailor-made lessons based on student interests.” The program’s faculty includes experts in global health from across MCW and hosts adjunct faculty from around the world.

“MCW’s program appealed to me because I connected with the faculty there,” Jacobus says. “They were interesting people with varied backgrounds and are good mentors. I have developed very strong relationships here.” He also lists the international internship and community health focus as appealing in his search for programs. “The program has an established curriculum, but students use faculty to unlock creativity. I felt I could come in with an idea for what I wanted to do and learn. The program has been an incubator to develop professional skills and a solid network. After completing the program, I feel equipped to advance my collaborative thesis work.”

Dr. Cassidy says she has high hopes for providing more students the opportunity to learn about and improve equity through MCW’s program and become future global health leaders.

“We are continuously working to build more partnerships, add expert faculty and create specific tracks for students to enter based on their interests like chronic disease, mental health and more,” Dr. Cassidy shares. She also hopes to admit more students from MCW pipeline programs and students from low- and middle-income countries. “The program will continue to grow and produce high-quality graduates.”

Jacobus is confident his experience in the program has prepared him for a future working in global health.

“My experience provided me with a lot of revelations about the kind of work I want to do. I want to do work that allows every individual to develop as much as possible so they can contribute as fully as possible to the problems we all face,” Jacobus shares. “All people around the world – and also locally here in Milwaukee – deserve quality of life and well-being.”