By Nathan Douthit
BMJ Case reports published its 15,000th case earlier this year. This milestone represents innumerable hours of patient interaction, research, writing, and editing. These cases have given a forum for health professionals and students to discuss difficult and interesting cases of high educational value and to use their patient experiences as a means to teach others.
Of particular importance is the 70+ global health cases published by BMJ Case Reports. While a small number in volume, these cases have helped bring to light issues faced by practitioners around the globe in a variety of settings, and established a formidable base of literature in their texts and references regarding the true causes of disease—the social determinants of health. As an author privileged to publish two of these cases with the journal, I can attest that they have been a formative part of my education in global health. As I encountered patients with avoidable negative outcomes, I reviewed the relevant literature on global health and social determinants in order to understand why these patients had been ill, had delayed presentation to care, and had so much pain wrought in their lives and the lives of their families. This helped me to suggest alternatives and solutions to the current state of affairs in these areas, and to learn innovative ways of dealing with difficult patient populations in low-resource settings.
As a global health associate editor I have reviewed all of these global health cases and am continually learning. Whether this includes the plight of Syrian refugees and their fear of losing their belongings, rare presentations of tuberculosis, the ill effects of complementary and alternative medicine in the USA and in Africa, or the common desire to die a death in accordance with local customs regardless of culture and medical history, there is something to be gleaned from every case. Paul Farmer, American Anthropologist and Physician wrote: “Human rights can and should be declared universal, but the risk of having one’s rights violated is not universal.”[1] Sadly, many of these situations are avoidable, and these case reports motivate all who read them to advocate for their patients in local, national and global settings. It is our hope that these cases will be used to educate practitioners and students about global health, so they can contribute to the solution to these complicated problems as they advance in their own careers.
The first 15,000 cases is truly something to be celebrated. Hopefully the next 15,000 will continue the work begun here by BMJ Case Reports. This literature base will be of great use to future clinicians as they attempt to change the world, one patient case at a time.
[1] Farmer P. Pathologies of power: Health, human rights, and the new war on the poor. Univ of California Press; 2004 Nov