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Imagine you’re a physician on the ground in an escalating civil war and you witness what appears to be ethnic cleansing. Do you speak out in the hope that international attention will limit the damage, or do you stay quiet to ensure access to the victims who desperately need your care?

That is one of the tough questions the University of Toronto's . This year’s event brings together experienced experts in activism and global health with new doctors and medical students, for an afternoon of roundtable discussions and presentations.

Speakers will include Bob Rae, Canada’s special envoy to Myanmar, and Dr. Nabiha Islam, an internal medicine resident who recently spent three weeks treating Rohingya refugees in Bangladesh. Setsuko Thurlow, a Hiroshima survivor and anti-nuclear weapons activist, will give the opening address.

Read more about Bob Rae in Myanmar

Read more about Dr. Nabiha Islam in Bangladesh

Read more about Setsuko Thurlow

“I’ve attended this event several times and it’s always fantastic to meet with young medical trainees who are so committed to global health, many of whom have already had experiences in the field,” says Dr. Leslie Shanks, a family physician in Toronto, member of Inner City Health Associates and former medical director of Médecins Sans Frontières - Amsterdam.

Shanks (pictured left) will lead a roundtable on how activism has improved health interventions for disenfranchised people in several countries. But she plans to focus on the need for strategy, and why global health practitioners should carefully weigh the impact of their actions.

“We often think about activism as denouncing things that are wrong, marching in the streets,” she says. “But before that happens, we need to think about how best to benefit the people we’re working with.”

Shanks says making those calculations often requires a risk-benefit analysis – which she first experienced during conflicts in Zaire and Yugoslavia in the 1990s. In each case, activism came with the risk of reduced patient access, and the potential for harm to health-care providers and aid workers or to the very people who need help. 

Good decisions about advocacy for global health interventions also require good data, Shanks notes. “Sometimes we need to build the evidence base ourselves to convince policy-makers of the need for change. That can mean implementing a research agenda,” says Shanks. There are also many good examples locally of how the right research questions can drive change, Shanks adds.

“The bottom line,” says Shanks, “is that as health-care providers doing advocacy, we need to do our homework to ensure our activism is driven by good scientific evidence.”

Global Health Day runs from 12:30 to 5 p.m. at the Li Ka Shing Knowledge Institute at St. Michael’s Hospital, hosted by University of Toronto Postgraduate Medical Education.