Conclusion
Qing’s situation reveals some ethical issues that can arise when short-term global health training experiences create costs or burdens on host institutions. While the form costs or burdens take will depend on the particular context (and cannot be exhaustively covered in this brief case), two themes should be emphasized.

First is being able to recognize such burdens in the first place. Local staff may expend significant amounts of time and energy to orient trainees, arrange for housing and transportation, provide translation services, and give general logistical support. Financial burdens might include costs associated with hosting or housing the trainee as well. Trainees, sending and host institutions, and sponsors share the responsibility to be aware of these burdens. Trainees, by virtue of being directly at the host site, might have a unique chance to observe them.

Second is understanding how to minimize these burdens. Part of this requires open discussion among the partners involved in the collaboration. Importantly, poorer host institutions may be hesitant to address concerns with wealthier sending institutions out of fear of jeopardizing the partnerships; because of this, wealthier sending institutions and sponsors should address this issue frequently and repeatedly with poorer host institutions. Only then can strategies be developed for minimizing or mitigating the effects of these burdens.

Additional Resources

The following references may be of interest:

• Provenzano A.M., Graber L.K., Elansary M., Khoshnood K, Rastegar A., Barry M. Short-term global health research projects by US medical students: ethical challenges for partnerships. Am J Trop Med Hyg. 2010; 83(2):211-4.


• Mutchnick IS, Moyer CA, Stern DT. Expanding the boundaries of medical education: evidence for cross-cultural exchanges. Acad Med 2003; 78 (10): 1-5


• Crump J.A. and Sugarman J. Ethical considerations for short-term experiences by trainees in global health. JAMA 2008; 300(12): 1456-1458.