Ethical Challenges in Short-Term Global Health Training
CASE 1: Developing Cultural Understanding

In this case Jane, an American medical student doing a rotation at a clinic in a Middle-Eastern country, violated a cultural norm when she invited a male friend over for dinner. She received feedback on her actions from her advisor. Later in her rotation, she used this new awareness to good effect when she observed a colleague encountering conflict with the same norm.

This scenario offers several important lessons for trainees in short-term global health training experiences abroad.

First, trainees, sending and host institutions, and sponsors share a responsibility to ensure that trainees understand the culture in which they will be training. This requires awareness of one’s own cultural norms, knowledge of the local norms, and skills to navigate situations when norms differ.

Second, one of the most important ways trainees can navigate these situations is through asking for assistance and advice from advisors, local colleagues, and others. Partnerships that are mutually collaborative can facilitate this process.

Third, even with adequate preparation of trainees by sending and host institutions (such as language training and learning about cultural history and norms), not all differences can be anticipated. Flexibility and ongoing open dialogue with trainees can help to ensure a rewarding and productive training experience.

This scenario was designed to help introduce trainees, sending and host institutions, and sponsors to some of the complex issues that arise when cultural norms differ during short-term training experiences abroad. It was not intended to provide a complete “how-to” guide for dealing with differing cultural norms since much will depend on the particular circumstances in question. For example, in some cases a particular cultural norm might be of such significance, or require such unreasonable efforts at accommodation, that ending the collaboration could be the best course of action. The appropriateness of taking these sorts of actions is far beyond the scope of this module.

Violating cultural norms knowingly because of conflict with one’s own set of cultural norms disrespects local communities and may negatively impact the service being delivered by global health trainees. Being proactive in seeking guidance and supporting colleagues in the process of resolving cultural conflicts is the critical first step. Attention to identifying and navigating cultural norms will help ensure a quality experience for trainees and a beneficial one for the local community.

Additional Resources



© Stanford University Center for Global Health and the Johns Hopkins University Berman Institute of Bioethics.

Project funding provided by Doris Duke Charitable Foundation (DDCF)