Humanitarianism and medicine

By Crystal A. Mendoza and Andrew M. Harrison

Humanitarianism medicine stands apart from both academic and non-academic medicine. Although not mutually exclusive, humanitarianism medicine is one component of the larger field of humanitarianism: a vast conceptual construct of community that transcends individual civilizations and societies across time. On November 18, 2015, the Mayo Clinic Dolores Jean Lavins Center for Humanities hosted Dr. James J. Orbinski, 1999 Nobel Peace Prize Laureate, for its inaugural Rewoldt Nobel Laureate Lecture.

Dr. Orbinski, physician, humanitarian leader, and emeritus President of the International Council of Médecins Sans Frontières (Doctors Without Borders), gave two lectures in Rochester, MN: “Humanitarianism In War: Médecins Sans Frontières And Beyond” and “Equity And Global Health — An Evening With Dr. James Orbinski”. On November 20, 2015, the Mayo College of Medicine Office for Diversity hosted its next Diversity Discussion, “International Health Opportunities & Responsibilities”, to reflect on these lectures. This event was hosted by Barbara L. Jordan and included four panelists: Ruth A. Bello (Operations Manager, Mayo School of Health Sciences), Dr. Phil R. Fischer (Department of Pediatric & Adolescent Medicine, Mayo Clinic), Dr. Lewis R. Roberts (Division of Gastroenterology & Hepatology, Mayo Clinic), and Kolloh Nimley (Council for Minnesotans of African Heritage, Rochester, MN).

As co-founder and Chair of the Board of Directors of Dignitas International, Dr. Orbinski spoke some of the global HIV/AIDS pandemic and “medicine proper”. However, in his first lecture, Dr. Orbinski spoke more of global warming as the greatest threat to human health. He spoke of access to health care as not only a basic human right, but as a matter of equity and justice as well. He spoke of the importance of economics as a tool to guide allocation of health care resources, but of the decision to use this tool for financial or health outcomes as a choice of society. In other words, he spoke less as a physician-humanitarian and more as humanitarian. In this context, the panelists and audience of the recent Diversity Discussion explored the content of Dr. Orbinski’s remarks and the implication of these remarks for both Mayo Clinic and the United States at large.

The panelists spoke on the topics of responsibilities and humanitarianism in global health. The consensus among the panel was that humanitarianism stems from the ability to provide sustainability, not medicine or supplies in underserved communities. One example of this came from Ms. Bello when she described Medical Brigades, led by physicians and students, and their challenges in helping a community in Central America identify water supplies. By training the leaders in this underserved community to properly purify their water and understand where their water supply came from, sustainability was attained. By asking “How can we help you do better”, instead of “What can we do for you”, global health leaders create long-term solutions. This is particularly important because humanitarian efforts are often driven by timelines, which may lead to solutions with short half-lives.

Our most basic goal in global health should be to “prevent needless illness and death”. As Dr. Roberts quoted Dr. William J. Mayo, “What better could we do than help young men to become proficient in the profession so as to prevent needless deaths?” The context of this quote comes from an address to the Minnesota legislature in March 1917 to allow an association between Mayo Clinic and the University of Minnesota (Aksamit AJ Jr, 2013, Humanum). It was inspired by the words of Abraham Lincoln, “that these dead shall not have died in vain”. It was also made the month before the United States declared war on Germany and entered the Great War, now known as World War I.

Medicine is an integral component of humanitarianism. However, medicine and even humanitarianism are only components of our global community. As our world becomes smaller, the implications of this realization become increasingly stark. We thank Dr. Orbinski, as well as the Diversity Discussion panelists and diverse audience, ranging from trainees to the Dean of Mayo Graduate School (Dr. L. Jim Maher, Department of Biochemistry & Molecular Biology) to the Medical Director and Chair of the Center for Humanities (Dr. Paul D. Scanlon, Division of Pulmonary & Critical Care Medicine), for engaging in one of the most important discussions within medicine.