15 minute interview: Social responsibility

What are the aims of Physicians for Social Responsibility in Ireland (PSRI)?

The aim of the organisation is to assemble people in the healthcare profession to combat apathy, injustice, and inequality in Ireland, in Europe, in general, and internationally. It began last year when we attended the International Physicians for the Prevention of Nuclear War conference in Berlin and were impressed by what so many other countries' students were doing. When we were asked about Ireland, we had to say that we knew of nothing similar.

How do you plan on achieving those aims?

Traditionally, throughout Europe, mental health has been a major source of conflict over human rights and the rights of the individual. In Ireland, mental health legislation has not been reformed since the 1960s, so last December we put in our recommendations for its overhaul. We also held a series of workshops to educate medical students on refugee health, mental health, and the health of the homeless. At the end of each workshop we considered action points, so, for example, there is an enormous language barrier between refugees and time-limited general practitioners or hospital staff. With the International Federation of Medical Students' Associations, we are organising translation forms and working on multi­lingual signposting in outpatient and emergency departments.

What role do you see for PSRI in the future?

From the point of view of homelessness, our role will be mainly research: attending clinics and discussing with the homeless what their impressions of health care have been. We would also like to work more with Amnesty International, which is running a campaign against small firearms. Finally, as regards electives, students can have a hugely positive influence in the places they go to. But, at present, you head off, get your experience, and come home; there is no continuity. We would like to arrange training and maybe develop specific electives that are continuous from year to year, forging a strong link between ourselves and the developing country.

Have your peers and teachers been supportive?

Medical students are stereotypically focused on their studies, so it was inspiring to see so many coming to the workshops. We feel there is a sense of powerlessness or a lack of knowledge of these issues among medical students, so the workshops are important educationally. The sheer pressure of being a medical student means that everyone is busy: that is the real problem. Also, the dean of medicine at University College Dublin was enthusiastic about the project and felt that we should explore ways to integrate it into the curriculum. The Peace through Health programme at McMaster University in Canada educates medical students on the issues of how health affects a community, how community building affects peace, and how we can prevent conflict. Doing something similar is one of our big aims.

How do you start an organisation like PSRI?

If you plan big, things will happen. The main thing with setting up an organisation is getting together a group of people who are energetic and have an interest in the subject. After that it is important to have good communication and to empower everyone so that they feel their own talents and skills are of use. For us, it snowballed from the first workshop: we were gathering people together that wanted to know about these issues.

What sparked your interest in social justice?

I worked for six months for L'Arche, a community for the handicapped in France. There I realised how important individuals are and about the impact of health on individual lives. Also during that year I worked in India for six months in an isolated clinic in Bihar, which is one of the poorest provinces. The people were disempowered, and I saw the impact of the political situation in that place on their rural lives. You would think that they would be withdrawn from the world, but it was all there in every single face that came into the clinic.

Have you ever wondered if you are wasting your time?

I am often asked that. I suppose it is something you constantly have to ask yourself: if you are persuading people to do something and trying to energise them. You are going to come across these issues that will block your care for patients, be they refugees, homeless people, or people with a mental illness. If you want to treat that person's illness completely, you have to include the politics and economics that underlie it. And when you try to be a good doctor on an international scale you have to include international law and international medical issues.

Has your involvement with PSRI altered your own perspective on medicine?

It has been a real education. It has given me direction in my career, in the sense that I have a goal, a specific group that needs treatment. I think it helps day to day in the hospitals as well, as you become much more aware of minorities and your interactions with them.

My choice of specialty changes from week to week. I would like to do public health, infectious diseases, maybe obstetrics and gynaecology, or even psychiatry. But no matter what specialty you go into, you will be dealing with a diverse range of communities, so your attitude toward them in whatever work you are doing is more important than the specific work you do.