The Global Health Narratives project

"GHN" is a decade-long effort to design global health curriculum for middle and high school students. This project has resulted in three books, around 100 narratives, and accompanying teaching guides to allow students and educators to engage with the text.

The first book, Global Health Narratives: A Reader for Youth (2009), reflects central themes in global health—from addressing issues of great health and wealth inequity to deconstructing the complexities of affliction among the poor in poor countries. For instance, one narrative complicates the onset of malaria and different ways in which people perceive malarial symptoms in rural Mali.

The second book, Environmental Health Narratives: A Reader for Youth (2012), brings issues of earth, environment, and health into context, incorporating sections on “water”, “air”, “foods and farms”, “climate change”, “urbanization”, and “human impact.”  Narratives reach as widely as possible geographically as well as topically in order to foster dialogue of diverse issues from varied settings.

The final book, Community Health Narratives: A Reader (2015), provides opportunity to discuss some of the trickier hot-button issues, such as the role of social relationships in health and health care, gender and sexuality, mental health, violence, prevention, and healthcare access.

The level of sophistication and readership increases with each book, and the volumes have shown that they can be useful tools to spark dialogue about complex health inequities as experienced by twelve to twenty year-olds. Also, community health workers, social workers, and nurses in the United States have used the final book on community health to bring complex issues they see in their work to the table for discussion. Therefore, the potential utilization of the narratives (by theme), books alone and together, and accompanying teaching guide may provide varied audiences with opportunities for in depth discussion.
         

Why do stories matter?

The project places narrative at the center of each book because it has “the remarkable power to allow us to ‘perfink’ – perceive, think, and feel at once,” wrote Kate Winskell in the forward to Global Health Narratives.  Stories enable us to both deeply connect with the meaning of the problem and reflect on the broader implications of what the story might mean to the reader’s individual experience and the experience of others. The narrative medium holds the power not only to draw in the reader emotionally but also trigger collective critical thinking about the root causes of social injustice. These tools powerfully motivate reflection, engagement, and curiosity to learn more.
 

What age should educators begin using these texts?

These stories clearly lay out how social injustice cultivates poor health, but does so in a way that is not intimidating to the young reader.  The texts are designed for those students to consider before they enter the frenzy of high school in order to set the course for engaged learning and curiosity about cultures, politics, and societies different from their own. At this age, there is no doubt that students in middle school and high school can engage deeply with issues of social and health inequalities. But how these narratives are used in particular contexts matter.  For instance, the engagement students have shown with the text in a public school in rural Iowa differs from a public school in inner city Chicago, Illinois. This is because students’ familiarity with such injustice differs. Those in Iowa showed deep empathy for protagonists whose lives were different from their own—from rural Nepal to urban United States. However, they deeply engaged with struggles that aligned with their own, from stress associated with agricultural breakdown to bullying and disordered eating. In an inner city school, students showed empathy and curiosity for the lives of others. But their ears perked up and their passion was invested in telling their own stories that resembled those protagonists who confronted gun violence, food deserts, stress, and disordered eating. Indeed, in both cases, students demonstrated empathy for others while connecting to those whose lives seemed most like their own.

 

The Global Health Narrative project focused on youth protagonists from the beginning

We did this in order to provide similarities with the reader, a way for the young reader to connect. While similarities may be as simple as playing soccer or having issues with their siblings, they provide opportunities for people from very different cultures to see that human experience can share values and struggles. And yet, by breaking down the complexities of similarity and difference alike, young readers can see how human experience can be shared in some ways and how systemic inequalities can drastically influence how one person’s experience from the next. Such perspective also enables youth to realize that things that they take-for-granted in their everyday lives (such as access to safe water to drink) are not universal. It provides opportunities for young people to recognize privilege and that they live in a “minority world” of the wealthy. Moreover, such curriculum allows students to begin to understand that vast differences exist and recognize the root of these differences in order to create solutions for them.

 

Connecting with stories opens doors for students to learn more. 

By engaging with protagonists in the narrative books, students can begin to look further and discover who are heroes in global health.  Students can then become engaged intellectually, financially, and/or emotionally with programs in global health delivery, thereby finding opportunities to make real social change.  However, these stories also introduce problems associated with jumping into community-based programming without understanding local issues, and bring some critical issues with development to the fore.  Thinking about these issues early can prevent a realization that “development” programs are not always the most effective choice for addressing local problems.  Indeed, there are real ways to introduce the complexities of global health inequity with recognition of the pitfalls and privilege of the development community.  These issues come through, although less clearly than understanding inequity, although not unimportantly.
 

 These books aim to spark curiosity among young readers, from middle school to college graduate.

The accompanying teaching guides of the Global Health Narratives Project advance the utility of these tools by providing teachers with concrete questions for students to discuss after reading each story. Community Health Narratives also provides exemplar organizations that are making a big impact on the communities they serve.  Highlighting who and how people succeed at their quest for improving community health provides students with jump-off points for work in their own communities (such as neighborhoods, church, school, and so on) and futures communities they may serve (such as the global community—through politics, medicine, or public health). Cultivating an understanding of the messiness of global health inequity will undoubtedly serve to promote empathy for others, spark curiosity in youth to learn more, and encourage local engagement on issues of social and health inequity in their own communities.