I really enjoyed the final article we are reading for our last class, “Introducing Nursing Students to Childbearing Practices in Rural Guatemala”. I especially think that reading a piece like this is important for all of us, as many of us are going into nursing and other health care professions. The author outlined the ways to maximize the benefits for both students and the communities involved in service learning, and how much thought and preparation must go into a service learning trip, even a short one. The author discussed the importance of cultural competency and humility, student qualifications, the scope of work, and how to avoid making mistakes that may seem insensitive or ignorant. I would like to discuss a trip I’ve went on last summer and how it relates to each aspect of this reading.
I went to Ghana for 10 days on the Global Medical Brigades trip through Emory. Out of the 10 days, 2 were spent traveling, 1 was spent preparing medicine, 2 were spent hanging out with the community, 1 was spent sight-seeing, and only 4 were spent in the free medical clinic we set up in the rural village of Ekumfi Engo. I would have preferred a longer program, but I was familiar with this trip from friends who had gone the year before. Also, I knew everybody that was going. I am happy that I went, because I have always wanted to travel to Africa and work in a medical setting. But overall, I cannot say I was completely satisfied with the experience. Global Medical Brigades could be improved if some of the aspects the author talks about were implanted in the program. Even though the trip wasn’t specific to maternal health, it is still relevant to what is discussed in this article.
The author mentions the importance of pre-trip meetings, where they went over procedures, aspects of the culture, and expectations of the students. We had a couple of meetings before the trip, but I felt incredibly unprepared. We were only taught how to triage ONCE before the trip. I went into our first clinic day barely knowing how to use a blood pressure cuff. The people lined up outside our clinic were not going to be my guinea pigs, so I made a more experienced girl do it when we were both assigned to a triage station. I felt way too uncomfortable to learn how to take blood pressure on these people who were expecting experienced medical staff. We should have had many more training sessions. I didn’t have access to a pressure cuff to practice with on my own.
The scope of our trip was similar to what the author discussed – mainly based on observation, and helping only when we were qualified to do so (like taking temperature, measuring height and weight, and sorting medicine at the pharmacy). However, none of us knew the local language (many Ghanians who live in the big cities know English, but the people who live in small rural villages do not). The author talks about how Spanish-speakers were a high priority, and I can understand why – it is hard to be helpful when you can’t understand the people you are trying to help. We had translators at each triage station, and the Ghanian doctors, dentist, pharmacist and OBGYN all knew English and could translate for us. This aspect of the trip made me a little bit embarrassed. What were we really doing there? The entire clinic could have been run by the translators and Ghanian medical staff. So many times throughout the clinic days, I thought about how pointless we all were, in our scrubs looking useful but not actually being useful. I had to keep reminding myself that we were there to shadow Ghanian medical staff (which was an awesome experience – they were incredibly knowledgeable and also taught us about the Ghanian healthcare system) and provide free medicine to this rural community, whose nearest health clinic was an incredibly far walk away (most didn’t have cars, and even if they did, the road was barely drivable). Even though we were only there for 4 days, free medicine one time is better than nothing at all.
One thing I’m glad our trip did right was the gift giving aspect. We all provided donations before leaving, but did not distribute them ourselves. This way, there would be no inequality in gift receiving, and we wouldn’t appear as “white-savior”-esq.
Reading this article, I realize that the trip I went on probably wasn’t the most successful service learning trip. I feel that the community did not benefit as much from the trip as the students did. We got to explore Ghana and learn about a culture completely different than our own, which was a valuable experience. But overall, the community would have benefited much, much more from students who were more experienced medically (such as nursing students!) or students who actually knew their language.
As an undergraduate student at the University of Kentucky, I went on a 10 day service learning trip to Santo Domingo, Ecuador. A University of Kentucky pediatrician set-up a non-profit clinic in this community and took four trips yearly to visit the clinic. Even though I wasn’t a nursing student at the time, I knew my interests in global health and I was glad to be able to spend time at the clinic in with the Tsachilla, an indigenous people of Ecuador. I did not have any particular useful skills as I did not speak Spanish and was not in nursing school. However, I had been a pharmacy technician throughout college and was able to help out in the pharmacy, mixing suspensions and giving out medications. Some service learning trips can do more harm than good to the community, but I think that it sparks an positive interest in the people that go on these trips to want to educate themselves more about various topics around the world and I think that’s a great thing.
Camille that sounds like an awesome trip. I like what you said about “white savior” though. I know way too many people who want to go in to communities and ‘save’ people from themselves, when really what they should be doing is working with the leaders in communities. This way they’re culturally competent, and not overstepping any boundaries if they are working within the context of a liason. Too often I believe we don’t give those in developing countries enough credit for the tireless work they do, like Monique! I suggested this in class once but having people from developing countries receive educations from Western universities could be super beneficial to their communities, as opposed to someone just stepping in. But like you said, there is no trouble in wanting to explore another environment/community as long you are respectful about it.