Global Health Case Competition Engaged Contrasting Viewpoints

Six Dartmouth students were selected to compete at the International Emory Global Health Case Competition in Atlanta, GA, in 2015. These are their reflections on the competition and on their experience working with diverse opinions to come up with solutions to difficult problems.

by Cecelia Shao '16

Since each of us was chosen individually, before our first team meeting, we didn't know who we were going to be competing alongside. It turned out to be an incredibly diverse team of six including two undergrads (Anna and myself), a MD/PhD candidate (Christiaan R.) two Geisel students (Vanessa S. and Tolu K.), as well as a Tuck student (Andrei C.). Luckily, our program directors and advisors (Jessica, Jonathan, and Suzie) came up with the idea to try out a practice case–one that allowed us to get feedback from a diverse panel of faculty and staff from campus (and even a former competition team member) to help us learn about areas where we could improve and areas of expertise.

Before we even touched down in Atlanta, we were given the case on a Saturday so that all the teams could have one week's worth of research and preparation. Plus, now that we had established some group dynamics, we knew they would transferable to the actual case. The topic (as I remember reading carefully on my phone when it first sent out) centered around gun violence in the Honduras. 

After skimming the background report, it was clear that the goal was to get to the root causes of the violence. Every day, we gathered to discuss the answers to questions like: what consequences of violence in the Honduras might not come immediately to mind, how does the material tie back to public health, what is being defined as health in this case? Beyond talking amongst ourselves, we consulted Professor Steve Peterson, Dr. Pablo Valdes Quevedo, and Marsha Patel (Medical Brigade)—three individuals with very different takes on the case. However, our conversations with all three shared a common theme: gang activity caused much of the gun violence in the Honduras. In order to reduce gun violence, as the case prompted us to do, we knew we would have to address the issue of gang activity first. Professor Peterson (who is very convincing and logical) made us fall in love with the systems approach, where we used stocks and flows to conceptualize the movement of people through gang membership. 

Here's an early email that Vanessa sent which I think explains our thought process well:     

"A few of the case studies from other Central American countries like Nicaragua and some US states have shown that mere brute force and strict laws are generally not successful in reducing violence. As a result, we're looking to "softer" approaches: working to promote stronger positive community networks using religious groups, community elders and ex gang members as resources. Since a good number of the gang members are US deportees, we're also looking at reintegration strategies like education programs and IT training that would channel skills and energy into positive ventures and might even improve the financial standing of the communities. We're also exploring how we can use soccer as a positive outlet for young people."

 In all of our proposals, we sought to balance feasibility and impact. Certain initiatives, such as a small program where gang members exited by becoming coffee growers, sounded great but would be non-self sustaining or not scalable. Another challenge we faced was deciding whether we should focus on just one or two specific measures or to try to address a broader set of problem factors. Because everyone came from different backgrounds, it was sometimes difficult to reach a conclusion. However, it was also clear that we trusted each other's capabilities as a team and we communicated and gave feedback constantly. There were a lot of moving parts to the case that involves, systems, public and mental health, business, quantitative analysis, and design. 

Our ULTIMATE PROPOSAL included:

• youth violence prevention measures
• mental health resources + program
• deportee reintegration
• microentrepreneurship 

Although we didn't advance to the final round, it was a great experience and a chance to solve interesting problems and who better to speak about their experience than the team members themselves? I asked the EGHCC 2015 group what they thought about the competition and, more importantly, the experience:

TOLULOPE O. KEHINDE MED '18

I enjoyed working on the case with the rest of the team. It was a challenging case in that none of us had much experience with Honduras or gun violence but I was very impressed with the way the team researched the problem and came up with different ideas. It was nice to see people's strengths come into play, whether it was with design, innovation, structure development or research. For me, working on the case highlighted the areas I am most comfortable with and the roles I naturally gravitate toward when working in a group. The competition gave me a look into what interdisciplinary problem solving might look like. I am definitely looking forward to more opportunities to work on real-word problems with colleagues from different academic and professional backgrounds!

ANDREI CHERNOV TU '15

Mainly, what was valuable to me was the interaction with non-business major students with diverse backgrounds. It was both interesting and challenging to work in a less-structured and more creative environment. I appreciated any contribution and efforts and learnt tons about how to work/lead/follow/or conflict in a team.

What would help (subjective): have more business-major students in a team, know whom we will present before presentation to adapt style and work on q'n'a, discipline and commitment during the prep week from ALL members of the team. 

VANESSA SOETANTO MED '18

I think participating in the case competition gave me the rare opportunity to collaborate with so many different and brilliant minds. I really loved that everyone had so many different, contrasting viewpoints on how to solve the problem of violence in Honduras and how to fit health into that framework. It was at the same time challenging to balance everyone's strong opinions as to how best to do this. Hearing from the judges also emphasized this--that literally everyone has his/her own opinion and angles/lenses on how to go about solving an issue. Any issue. It put me back on my toes and forced me to realize that my own approach and theories of health always needs tweaking and adapting. There are really innovative ideas out there, and I'm not saying that reinventing the wheel is always the best way to solve an old, seemingly unsolvable issue, but we should always be giving every idea a chance, no matter how absurd.

Although it was a bit challenging to tie-in healthcare into this year's case, I enjoyed thinking and discussing about other socio-eco-political issues that indirectly and directly affect health. It was honestly a great break from thinking about medicine from the viewpoint on how to heal a diseased physical body to be able to talk about a population's mental, physical, and social health. There were so many good ways to approach this, and I honestly think a lot of the teams presented a lot of the same good ideas. I think this year (and maybe other years too?) what determined who won might be more on how the teams presented, rather than content. 

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Christiaan A. Rees MD/PhD and Ana Marija Pongrac '15 also participated in the Emory Case Competition.