Tuesday, June 28, 2011

Sense and Sensibility

Certainly next month, many of the hospitals we work in will be limited by a shortage of human and material resources; these conditions are what warrant us to serve using our training and skill sets. However, in lab today, we were cautioned against criticisms that could have the dual effect of objectifying a humanitarian problem and ruining EWH’s precious relationships with partner hospitals. 

“We’ve gotten used to seeing the images of starving little kids with the big bellies in Africa,” J.J. said, “and begin to think of them as ‘those poor little things that need rescued’ People have views of them that aren’t humanized. That’s why, after $700 million in aid, the problems are still so bad.” EWH wishes to avoid the mistakes of other well-intentioned aid organizations, and doing so will require continued, sensible work and caution on the part of program participants, which was the reason for today’s lecture and discussion about the developing world.

“People from ‘developed’ countries typically go these places, are moved with compassion by what they see, promise all kinds of big things, and then never even come back,” he continued. “One of the reasons that EWH has been so successful as an organization is that we do come back year after year, and we don’t make those kinds of promises.” Ironically, as I was reading the Central America news from the Washington Post later this evening with J.J.’s lecture still fresh on my mind, an article cited this exact problem. Organizations in the United States and several European countries promised $1 billion in funds last year to aid the fight against drug-related violent crime, a problem which is fueled by the American demand for cocaine and that is destabilizing the region. However, only $140 million of the funds were ever delivered, a meager 14% of what was promised. “EWH has spent years making contacts and building relationships with the hospitals so that you guys are able to work in them,” J.J. added. Earning the trust of organizations that have received so little follow-through is extremely difficult, and must be maintained with great care.

As far as the work we’ll be doing, needs will vary considerably from hospital to hospital and according to the resources available, including our personal skill sets. As a general rule, there are certain things that we do not want to do, such as displacing potential local jobs by doing tasks that could be done by people integrated into the local economy. Our work needs to contribute something extra that the hospital could not have without us.

Our first task, then, is to take an inventory of the equipment in the hospital: what it is, if it works, whether it’s being used, or how it’s broken. These listings provide useful insight to EWH in order to identify sources of problems and possible resources for long-term solutions. Also, if completed, an inventory makes the hospital eligible to send in requests for replacement parts or equipment. Finally, the inventory gives us the information we need to prioritize our projects.

Besides inventory, another important task in many cases is a needs-finding interview, during which doctors or medical staff are interviewed to find out what kinds of needs the hospital has (not what equipment the hospital needs, but what kinds of needs the hospital could use equipment for). Then, solutions are developed by summer institute participants (like me!) and/or students working for EWH at Duke University.

For example, David had the excellent idea today of centrally organizing ‘quick-start’ guides, which are simple diagram-instruction sheets explaining the basics of properly using a particular machine. Although groups had previously made such sheets on an as-needed basis, David suggested cataloguing each one, so that future groups could look up a particular machine and have immediate access to its quick-start guide. Also, the hospital staff could potentially look up the guides on their own so that our time and resources could be spent elsewhere.

Another aspect of our work is the ‘secondary project’, a way of helping the hospital that is not directly related to working for EWH. In the past, for example, a group built an intercom system for their hospital. Tom and I joked about building a butterfly garden for ours, given his teeth-cleaning experience in the last butterfly garden. Of course, we’ll actually build one if we get the chance.

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