Surgery and Healing in the Developing World - Dartmouth-Hitchcock

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452 Surgery and Healing in the Developing World
was “How has this trip changed you?” Each had their own individual way of responding:
“I got more perspective in two weeks of this than in the 22 years prior.” “I
learned to appreciate more what I have and am motivated to return to help others.”
“I was humbled, and energized to learn more.” “I am less a selfish brat.” “I have
learned so much more about not just medicine, but also the world in which most
people must live.” “I wanted to construct a hospital.” “This trip inspired me.” “I
should now appreciate what I have.” “I grew as an individual.” “I feel good and am
proud.” “I have grown, but I am not sure just how much until I am back and have
time to reflect on what I have seen and done.” “This was a reality check, causing me
to appreciate everything, taking nothing for granted.” “I will now have a greater
appreciation for everything.” “I officially have Haitian fever.” “It has made me reconsider
my career directions.”
Discussion of Results
This critical question of analyzing a change in self, which preconditions the
responses for the set that follows on how the future might look different on the far
side of this experience, had made most all of them respond that they are eager to get
back to plan their next experience, and also to encourage others to go based on their
own transformations in this experience. Many had experienced some minor inconveniences
of traveler’s diarrhea and I treated one of the young men for lobar pneumonia
from which he recovered completely, after reporting that his most memorable
event had been “that I almost died. But, then, I didn’t so I am eager to come back.”
None of the group experienced any of the violence or any robberies that had been
the chief concerns expressed by several before the trip. The inconveniences (cold
showers!) as a pretrip concern vanished, as did those showers, in some part of the
trip when the conditions of those around made such cavils forgotten. Yes, mosquitoes
made both the pre and post-trip lists of the fears that were actually encountered,
but “not so bad, once you distract your mind from it.”
Among all the comments about the trip being awe-inspiring and life-changing,
only one comment was even slightly negative in the desired outcome not having
been achieved. The assessment is quite possibly true for both the participant and the
team leader in evaluating this person’s performance, and probably had to do with
the self-image and information base carried to the field reflected in the pretrip questionnaire
and the self-introductions at the outset. This individual probably had the
weakest overall grasp of the medical issues, patient care, and experience of health
care practiced in a foreign environment, not excepting the college students without
either medical or public health backgrounds. When we were all asked to introduce
ourselves at the outset, she told the group in only five words; “I’m a Global Health
Consultant.” This astounded me, from someone who was unqualified to take care
of any single patient for any given health problem, that she might consider this to be
a credential for taking on whole populations of patients and being paid to give them
advice on the basis of so slender a knowledge base. During the course of the mission,
she had very limited contributions, but when she did, they were global answers
regardless of misunderstanding of the right questions; “e.g., what we should really
be doing here is just distributing truckloads of condoms.”
She expressed an interest on questionnaire A in “Seeing first hand the medical
aspect of public health,” but was overwhelmed by the volume of patients, the intensity
of their problems, and the huge information load required in beginning to address
any one of their myriad problems, and eventually objected to so much hands-on