I．Introduction

The Center for Preventive Medical Sciences (CPMS) has been conducting an international study tour since the year 2013. The international study tour was canceled for the years 2020 and 2021 due to the COVID-19 pandemic. However, the study tour was revived in the year 2022 and has continued for the year 2023^［1,2］. Geneva, Switzerland is located at the southern end point of Lake Geneva surrounded by the Jura and Alps mountains, the most famous being Mont Blanc. In this Geneva study tour, we had the opportunity to visit and hear from 10 organizations for the year 2023. The objective of the Geneva study tour was to give an opportunity for students to learn about the importance of global health and to engage actively in discussions with the staff members of each organization. The graduate students have learned many broad global perspectives by visiting each organization that has a unique theme which leads to global public health and world peace. The total number of participants for this study tour was 14 students, which includes three students from the School of Medicine, seven students from the Graduate School of Medical and Pharmaceutical Sciences, three students from the Graduate School of Nursing, and one Japanese student who is studying medicine abroad, and the authors. The program of the study tour is shown in Table 1.

II． Visit to WMO, IFRC, and The Permanent Mission of Japan in Geneva

The first day of the study tour took place on Tuesday, September 12^th where we headed to the WMO Headquarters (World Meteorological Organization). We were greeted by Mr. Tatsuya Kimura (Director, Public-Private Engagement Office) who introduced us to the conference room where he gave the students a brief introduction about the WMO along with the themes of climate, water, and the global environment. This session gave a brief insight into how the WMO uses the latest satellite technology to update meteorological information across the globe, and the WMO and the WHO (World Health Organization) work together for the fight against climate change.

The second speaker of the day was Mr. Yutaka Tatewaki (Protection Officer) from UNHCR (United Nations High Commissioner for Refugees). He briefly introduced us to what is the UNHCR and what role they play for displaced people and refugees around the world. A pamphlet containing recent statistics from the UNHCR was given at the session which explained various issues regarding a rise in the number of refugees around the world (UNHCR’s Refugee Population Statistics Database, https://www.unhcr.org/refugee-statistics/). Mr. Tatewaki taught us how people seek refuge due to wars, scarcity of basic provisions and poor living conditions which contribute to people seeking a higher quality of life in a different country.

Following this session, we were introduced to Ms. Hiroko Nakayama who is a senior specialist for peacemaking and conflict prevention program division for peace at UNITAR (United Nations Institute for Training and Research). She gave us a brief introduction about her role and gave us a short lesson on how cessation is negotiated through dialogue during the time of war. The session for both Mr. Tatewaki and Ms. Nakayama mentioned many themes in recent global news at the time such as the war in Ukraine, the migration crisis of Europe as well as the United States from the African, Middle East, the Central and South American regions. The students were able to learn about modern global peacekeeping initiatives and efforts, giving them a broader view of the world.

After this session, we moved to the IFRC (International Federation of Red Cross and Red Crescent Societies). The session for IFRC was presented by Ms. Rika Ueno who is an official delegate responsible for operations in Asia. She gave us an introduction to what is the IFRC, the organization layout and what activities they are involved in around the globe. The session at IFRC gave students a view of how a large international organization operates and how many people are involved in the commitment to global public health regardless of role within the organization. (Photo 1)

After the IFRC presentation, we walked to the Permanent Mission of Japan to the International Organizations in Geneva from the IFRC Headquarters. We were introduced by Mr. Ayumu Kudo (First Secretary). Mr. Kudo gave a presentation on how to apply for international organizations as a Japanese individual. This was followed by the explanation of requirements and pathways for entry to global institutions found in Geneva such as the JPO (Junior Professional Officer) programme. JPO is a career program where they take in young professionals with a master’s degree under the age of 35 years old and a minimum of two years of professional work experience for career support and development. The JPO programme is supported by the United Nations Member States’ governments. The qualified candidates in JPO gain practical experience from within the chosen international organization they applied for. After one year, they have an opportunity to renew their current job position or to apply for different positions within the organization (Japan Ministry of Foreign Affairs JPO Dispatch System, https://www.mofa-irc.go.jp/jpo/seido.html). Mr. Kudo also explained to us how Japan is being represented and recognized in the international organizations but also emphasized that more Japanese people are needed. This presentation gave students an opportunity to ask questions about the recruitment process and to listen to the advantages and the life-work balance in Geneva. (Photo 2)

III．Visit to WHO Headquarters

The second day of the study tour took place on Wednesday, September 13^th which we headed to WHO Headquarters. At the headquarters, we moved to the M605 conference room where all the sessions were held for the day. Our first session of the day was the introduction of WHO by a Medical Officer, Dr. Yumi Kisaka (External Relations Officer, External Relations, and Governance). She gave us a brief introduction to the structure of WHO, what are the principles of the organization and what opportunities are available at WHO. This gave a great overview for students on what WHO represents and how important this organization is for influencing global health initiatives around the world.

The second speaker of the day was Dr. Yukiko Nakatani, one of the 12 ADGs (Assistant Director-Generals) who works directly under the Director General, Dr. Tedros Adhanom Ghebreyesus. She is responsible for access to medicine and health products around the world. She gave a presentation on the brief history of her career, followed by what are the objectives and the prospects for the future of WHO as an organization moving forward. This presentation gave us a good look at what the WHO has challenges within the post-COVID 19 era such as emerging AI integration, the continued fight for climate change and the challenge of an aging society around the world. Dr. Nakatani is a great role model for students, and the students were inspired by her presentation. (Photo 3)

The third speaker was Dr. Marina Takane who is a bioinformatics expert, working for the WHO’s water sanitation and health team. Her presentation gave students a look at the circumstance of water sanitation around the world by introducing recent data and analyses being conducted at multiple countries to meet the targets of water sanitation levels acceptable in modern global society (WHO, Water, sanitation, and hygiene (WASH), https://www.who.int/health-topics/water-sanitation-and-hygiene-wash#tab=tab_1). Her presentation gave a great insight on how there are still many places in the world where drinking water and sanitation levels are not up to current global standards set by the WHO. This session has helped students realize the importance and appreciation of water standards that we have in Japan, which we should not take for granted.

After the presentation, lunch was prepared, and the students were introduced to the five current JPO members working at WHO. The five JPO members from Japan each shared their experiences on their background and what they do as a JPO member in WHO. Students learned from the JPO members that it is possible to make use of their profession to explore alternative routes from their original career within WHO. The meeting with JPO members gave students a more open-minded perspective of the capabilities to cultivate their own career paths within their specializations or change to a different career path.

Afterwards, the fourth speaker was Dr. Nahoko Shindo who is a Senior Medical Officer and a former neurosurgeon. Dr. Shindo is responsible for the Influenza and Respiratory Disease Team of Pandemic and Epidemic Disease Department. Dr. Shindo has given us a presentation about not only infectious diseases but also how other countries and the WHO manage pandemics like COVID-19 and Influenza. Dr. Shindo’s presentation gave a great insight on how a pandemic not only has health effects but also societal changes, which influences the decision making of crucial pandemic responses based on given information from governments around the world. The students have learned about the awareness of health and societal impact of pandemics, which can change the view of health among people in a positive or negative look. This session helped students realize the importance of communication within society about health to insure the trust of the people.

The last speaker was Dr. Diarmid Campbell-Lendrum, who is the Head of the Climate Change and Health Unit. He gave us a presentation of how our wellbeing is affected by climate change. Dr. Campbell-Lendrum gave us an explanation of WHO’s initiative of climate resilient health, which has three important points. Address the health issues which are influenced by climate change, promotion of health co-benefits of climate change in multiple regions around the world and strengthening of environmental sustainability in health systems and facilities (WHO, Climate Change and Health, https://www.who.int/news-room/fact-sheets/detail/climate-change-and-health). This presentation gave a broad view of how the effects of climate change alter health on a multilateral scale on a global level. The session gave the students a heightened awareness of climate change issues that contribute to global health.

After the end of the session, one of the authors, Professor Todaka guided the students inside the WHO Headquarters. There were pictures of memorabilia from past WHO Director-Generals, multiple artifacts donated from UN Member States and a time capsule placed and created by Dr. Tedros for the inauguration of the new WHO building in 2019. The WHO visit is one of the highlights of the study tour for many years since 2013. Overall, students were engaged in asking questions and have gained crucial experience from the experts of WHO. (Photo 4)

IV．Visit to MSF, ILO, and UNICEF Headquarters

The third day of the study tour took place on Thursday, September 14^th where we went to visit the MSF (Médecins Sans Frontières) (Doctors Without Borders) Headquarters. At MSF, we were introduced by MSF humanitarian representation team assistant Mr. Quentin Blanchet. Mr. Blanchet briefly introduced us to what MSF is as an institution and what the objectives are for the organization. Our next speaker was a team leader for the emergency management. She was trained as a nurse and had a dream of joining a humanitarian aid organization from a young age. She gave a presentation of her brief background followed by the experience she has gained throughout the years working for MSF. She discussed about her contributions to the continent of Africa especially The Democratic Republic of the Congo but also the Middle East. Her story of fieldwork at MSF had a profound impact on students. This presentation gave a good look at what leadership is like at MSF.

The second part of the MSF session was conducted by MSF Japan via Zoom which introduced us to Ms. Yoko Kimura, Dr. Emiko Nakayama, and Ms. Chika Murakami. They each gave a presentation about their struggles as medical professionals in low- and middle- income countries. This includes the interaction of the local people, who are involved in areas of conflict. Despite their different experiences, they shared the same philosophy and determination that is needed as an MSF member. The students were able to learn a compelling message of resilience and perseverance as health professionals from MSF members, who are actively engaged in helping others in active field duty in dangerous regions.

After the MSF session, we headed to the ILO (International Labour Organization) /UNICEF (United Nations Children’s Fund) building which is a short walk from the MSF Headquarters. Here, we were greeted by Ms. Sun Amano who helped guide us to the conference room for the ILO presentation. The first speaker was Mr. Yuta Momose who gave us a brief history of his background and his work for ILO as a JPO Social Protection Officer. He is responsible for helping create social protection policies for labor organizations around the world. Students learned about the importance of human rights and social protection support which helps people not fall into poverty or vulnerability among society. This is an important lesson to students as they gained insight on how people are protected with rights and how labor initiatives lay the foundation of improving the well-being of people and society.

The second speaker of ILO was Ms. Amano who gave a presentation about her JPO role in Gender, Equality and Non-discrimination. Ms. Amano has described many topics such as the gender transformative approach, which looks at having a gender inclusive support across society to reduce discrimination and other social injustices. Another topic of interest was an initiative promoted by ILO for equal pay by the EPIC (Equal Pay International Coalition) (ILO, Equal Pay International Coalition (EPIC), https://www.ilo.org/global/topics/equality-and-discrimination/epic/lang--en/index.htm). The target of this initiative is to reach full and productive employment for all men and women along with young people and persons with disability with equal pay and value in the work environment. This session mentions many recent issues among society where discrimination based on gender or disability brings a deficit to societal well-being. It was an important session for students who learned about the changes to social norms in this era but also changes related to the workforce around the globe including the healthcare sector.

The final session of the day was at UNICEF which is located on the 3^rd floor of the ILO building. For this session we were greeted by Ms. Yukie Mokuo who is the deputy director of country relations at UNICEF. Her presentation consisted of what UNICEF represents as an international institution, what the objectives of the organization are, and the principal treaty at UNICEF which is the “Convention on the Rights of the Child” (UNICEF, Convention on the Rights of the Child text, https://www.unicef.org/child-rights-convention/convention-text). Ms. Mokuo also gave very important life lessons to the students regarding her background working for UNICEF and the challenges she had to overcome until now. Students at the UNICEF session had asked many questions regarding the topics of health support for Japanese children and the socioeconomic factors in high-income countries, which have shown to significantly affect for the livelihood of children compared to children in low-income countries. This session provided valuable experience for the students in understanding the commitment of UNICEF and gaining valuable advice from Ms. Mokuo for professional development as graduate students.

V．Visit to UNOG Library and City Tour

The final day of the study tour took place on Friday, September 15^th. On this day, the students and staff visited the UNOG (United Nations Office at Geneva) Library located at the Palais des Nations. For this UNOG Library tour, we were guided by Ms. Yuka Asai who is the Chief, Collection Development and Maintenance Unit for Library Services Section. She introduced us to the main library where they store many books and original document archives which are signed by world delegates and leaders throughout the history of the organization. The library was donated in 1927 to the League of Nations (1920-1946) by the American philanthropist John D Rockefeller Jr. There were many artifacts, paintings and even Noble Peace Prize medals awarded to various UN organizations displayed at the library. This session helped students learn about the history of how the library kept records for over 100 years and gave students an important understanding of the foundation of modern international organizations. The students also learned of the UNOG Library’s contribution to the history of global peacekeeping. (Photo 5)

After this session, the students and staff attended a city study tour by a Japanese guide about the history of Geneva, prominent buildings and how public health was established in Geneva. Students learned from this tour about the creation of the city of Geneva but also how the founder of the ICRC (The International Committee of the Red Cross), Henry Dunant and other surrounding organizations have influenced Geneva to become a global hub for international organizations around the world.

VI．Conclusion

The strong connections between the CPMS of Chiba University and the international organizations show the commitment to interest in global health and the capabilities with the ENGINE (Enhanced Network Global Innovative Education) program (Chiba University “ENGINE”, https://www.chiba-u.ac.jp/engine/) provided by Chiba University. These opportunities for learning should be implemented more often to nurture the next generation of healthcare professionals capable of standing at the forefront of global society.

Contributors

ET was involved as the head organizer of study tour management. MT was involved as correspondent and study tour management. CM was involved as the executive representative of study tour management. The manuscript was written by KS under the supervision of ET.

Financial Support

The authors declare that they have no financial support associated with this paper.

Conflict of Interest

The authors declare that they have no conflicts of interest, financial or non-financial, regarding the content of this paper.

Ethical approval

Not applicable.

Data availability

Not applicable.

Acknowledgements

The authors would like to sincerely thank the international organizations of WMO, UNHCR, UNITAR, IFRC, The Permanent Mission of Japan to the International Organizations in Geneva, WHO, MSF, ILO, UNICEF and the UNOG Library for their cooperation and support for the Geneva study tour. We would also like to thank the staff and the presenters of each organization for their time and effort to make this study tour possible.