The Privilege Walk
|Lesley Everett and Tim Kaselitz|
Take a step forward if your parents owned the home you grew up in. Step backwards if you have never had health insurance. Go forward a step if English is the language spoken in your home. Move back one step if you have ever gone more than a day without food. Those are the kinds of instructions you might find in the ‘Privilege Walk,’ a group exercise used to increase awareness and spur discussion about how circumstantial privileges (or lack thereof) of race, class, gender, and power often have life-long impacts.
“When I turned around and saw where I was standing compared to my Ugandan classmates, I was immediately embarrassed - and I was a bit surprised,” says M4 Tim Kaselitz. “I knew that as a US medical student, my lot in life was significantly improved by the circumstances of my birth; but the degree of separation really hit home.”
For Kaselitz and fellow UMMS student, Lesley Everett, their Privilege Walk was the culminating group experience in the month-long social medicine course they recently completed in Uganda. The course ‘Beyond the Biologic Basis of Disease,’ was conducted by SocMed - a small organization with a big interest in merging the teaching of medicine with an understanding of the socioeconomic, cultural, political, and historical underpinnings of illness.
|St. Mary’s Hospital Lacor in Gulu, Uganda|
According to Everett, an MD/PhD student who is half way through both programs, there were 30 medical students enrolled in the course: 15 from Uganda, a handful of international students, and the rest from across the US. Says Everett, “the nice mix really added so much to the course. It enriched the experience and our ability to learn from each other.”
The course used several approaches to create a learning environment where medical students could practice being both learners and teachers. Coursework on biology and environmental factors of disease was combined with films, classroom presentations, interactions with politicians and community workers, and clinic rotations. This experiential integration was one of the main attractions to Kaselitz. He points out that “A good social medicine course like this provides a wonderful model for the translation of medical school competencies.”
He adds that Uganda was an ideal setting to examine the social and economic contexts of health. “The country has been part of an ongoing war for decades,” he says, “and, though they are enjoying a time of peace right now, the effects of the war are still right in your face. Being immersed in a post-war setting presented an unfortunate, yet rich set of circumstances to learn from.” Everett echoed his sentiments; “Traditional med school curriculum is limited in what it teaches about the social factors that contribute to health and providing good care. This was a history lesson, and a political lesson, and a cultural lesson, and a medical lesson – all at the same time.”
|Lesley and Tim with classmates|
Everett sums up the lessons she took away from this experience, “Some people enjoy privilege at the expense of others, but sometimes it’s just happenstance of birth. It’s heartbreakingly unfair to think that where you are born and where you grow up dictates how the rest of your life will go, particularly when there are enough resources to go around. To see someone our age sent home to die of congestive heart failure because of rheumatic heart disease that could have been prevented by less than a dollar’s worth of antibiotics, is one of the lessons that I hope will serve as a point of inspiration and reflection for me - reminding me of what it is that is broken and how my actions might help fix it.”