Arrival and living

After a 24 hour flight with Air-France I arrived. Santiago, a city that occupies the fertile central valley of Chile between the Andes and the coast, with the Mapocho River crossing the city from east to west. The most remarkable thing about Santiago, with five million inhabitants, is perhaps its diversity. It is a city with many faces, and a social and political landscape that sometimes takes us back to the colonial city it once was.

When I left Stockholm we had -22 degrees. Suddenly I was in a totally new environment including the climate. Summer and approximately +32 degrees! Someone from the University picked me up at the airport which was very convenient since this was my first trip to Chile. My hotel was situated in Providencia, home to a large upper-middle-class population and with the region's highest percentage of population over 60. It is notable for its old and elegant houses inhabited in the past by the Santiago elite and now mostly used as offices. Providencia includes Barrio Suecia, an area filled with pubs and nightclubs, and Barrio Bellavista, a bohemian area populated by artists and performers.

I stayed at the Neruda hotel located in the heart of Providencia, surrounded by all the commercial, tourist, and financial activities in Santiago. The hotel provides free-internet, printed some stuff at reception which they did not charge for.  Access to a gym and a heated pool which were pretty old fashioned and run down were some of the assets. The staff was friendly but had limited knowledge of English.

Language and culture

All lectures by nationals were held in Spanish whereas international faculty used English. Simultaneous translations were given accordingly in English and Spanish respectively.  As always teaching in one language with students on the on the recipient end getting messages via translation pose challenges. This is however a reality in the Spanish speaking world as well as in eg. China where ¼ of the world population live and were KI has ambitions to make a difference. In both contexts KI has a lot to learn and to contribute. Among culture differences I was pleasantly surprised by situations were men open doors, and as well as an overall sense of respectful relationships including those between students and teachers. Chile as other South American countries are known to be macho cultures. Given that I must say that I experienced quite a lot of equity as a member of faculty.

When the Spaniards arrived in the 16th century, the land known today as Chile was inhabited by various indigenous groups. Estimates today suggest that the indigenous population exceeds a million. Among Chile's most famous contributions the two Nobel laureates in literature, the poets Pablo Neruda and Gabriela Mistral stands out. Lately the Chilean wine has become world famous. The geographical conditions with the Andean mountains and the Pacific ocean has created an ideal climate for the grapes.

Leisure time

Chile's population of 14 million inhabitants is relatively young. Nearly half the population is under 25 years of age and 72 percent is under 40. Women have an average of 2.4 children. Despite the country's length of 4000 km, most of the population is concentrated in the southern and central regions - Santiago alone accounting for 5.5 million. Chile as a whole has practically eliminated illiteracy, and the average school attendance level has doubled in the last two decades.

The city is comparatively safe and very modern. The University of top standard and the nightlife is “Latino”.

 Universidad de Chile, Scholl of Public Health, Salvador Alliende is higly recommended!

Other activities

Very fruitful and positive discussions were held with the dean, head of department of Health Promotion, course leader, as well as other faculty members of the School of Public Health. During the meeting with the dean, he emphasised the possibility of KI support in analysing and reporting public health statistics in scientific papers. This was mentioned as a possibility in strengthening future collaboration between the two universities. 

One of the faculty members, a journalist, has been involved in national tobacco control work and we had several discussions about future projects. I proposed writing a joint paper given the availability   of interesting statistics and wishes for joint concrete deliverables. Another idea  discussed inspired by one of my presentations was the possibility of launching a Chilean Quitline based on the Swedish example (see above).

Preamble

During 2009 I was asked by the international co-ordinator at Karolinska Institutet, (KI) to become a visiting lecturer at Universidad de Chile. KI and institution of Public Health Sciences has an agreement within the Linneaus/Palme programme.  Until now we had mostly received students and teachers.  For the continuation of the agreement both sides should send teachers/students. I agreed to a three week visit at Universidad de Chile, School of Public Health during January 2010. The School of Public Health is the only accredited school of public health in Chile and has enjoyed an integral role in Chile’s public health education, research and policy development. Founded in 1943 upon an agreement among the University of Chile, the Chilean Ministry of Health, the National Institute of Health and with support from the Rockefeller foundation of the United States, the School has been responsible for training graduates in a number of public health areas and professions.

Reflections

Most interestingly the first part of my stay in Chile coincided with the last week of the presidential election. The outcome made many Chileans proud. Not necessarily because of the president elect (Pinera) but rather the democratic process as such. Before the end of the day of election, the sitting president could phone Mr Pinera and congratulate him. By end large the election process seems to prove that Chile now is a mature democracy. It can also be mentioned that Chile recently joined the OECD, an example of its economic success.

A growing number of Chilean women hold key positions in Chilean politics (a leading example the sitting president) and business; women represent almost 30 percent of the labor force. I had the privilege of meeting Salvador Alliendes niece,   a member of Parliament. Moreover, during my stay, the School of Public Health was officially renamed to “Salvador Alliende” School of Public Health during an official ceremony.

Public Health is a broad- cross multidisciplinary field that includes many other disciplines than health sciences.  The School of Public health had a not a medical focused education which I found very interesting.

Moreover their global health course focused more on global traden economic globalisation and their impact on health.

Teaching/time

The courses: “Evaluation in Health Promotion” and “Global Health: An emerging discipline in public health” were both one week courses. The former was aimed for professionals working within the public health area. Background profiles for the participants were: psychologist, physiotherapist, physician, sociologist, public health expert. The global health course was for academics, professionals and students in public health and health sciences, interested in increasing their knowledge of or making a career in global health. Both courses were part of the summer school which has been given annually since 1998.

During the first course I presented my thesis “Telephone support for smoking cessation – The Swedish example“(quitline). Focus was on evaluation of a public health intervention including effectiveness but also cost-effectiveness. Methodological issues were discussed and the students had the opportunity to pose questions with relation to their own experiences from the field. I also taught tobacco policy with Sweden as example and Chile as comparison. Since Chile has the highest smoking prevalence in South America the participants and faculty found the topic of highest relevance.

The background of the course leader was anthropology which added a dimension. Usually courses in health promotion are given by health professionals which are more biomedically oriented. During this course the context, social determinants of health and role of society was more emphasised.

During the Global Health course KI was presented as a leading medical university. Both education and research were discussed. In general, there was a lot of interest in possible future collaborations and interactions.

I then presented “The global tobacco epidemic”, something I have presented before at the Shandong University in China. This time the presentation was customised to fit into the context of the region including specific Chilean statistics. This resulted in a very intense discussion. The faculty for this course included professors from Northern Arizona University, US, University of Ottawa, Canada, and Univercità Commerciale, Luigi Bocconi, Italy.

Time Introduction to Change Theories in PH - Individual and Community level (4 h)

Followed by group work and dicussions (4)

Evaluation of telephone support for smoking cessation (6 h)

Supevising on evaluation: 2h

Tobacco Control in high and low income countires/The Tobacco Epidemic ( 4)

Facilitator at group works (6h)