In-country Blog Post #1

On Sunday, when we were first going to meet our host families, I was so anxious and nervous to meet mine. All I was told before we came to Zambia was that our host mom was the new family addition to SAIPAR this year and that she had been to the United States before. All ten of us were sitting at a table outside the lodge we had stayed in the previous night, waiting to be picked up. Everyone was joking about having to sleep in a bunk bed and Tatyana said that we shouldn’t worry, we would have our own beds. Tatyana and Esther were making bets on whose host family would be the first to arrive. I wanted mine to be first  and as the minutes passed by and the sun started setting, I became more nervous. The first host parent was Paul and Karl’s host dad. He was really friendly, making jokes with the rest of us while the guys got their luggage. As each new car pulled into the parking lot, I wondered if it was my host mom. My roommate, Libby, and I were the second to last pair to be picked up and the first thing our host mom did was hug us. We packed our luggage into her car, said our goodbyes to Tatyana and left the lodge.

She told us that she couldn’t wait to meet us and her kids couldn’t wait either. It was comforting to know that even though she had no idea who we were, she was ready to welcome us into her home for four weeks. She started telling us about what she did when she came to the US and then she talked about her job and her kids. She’s a teacher and she teaches nutrition for students in secondary school. She also bakes cakes for various occasions, such as weddings, birthdays, etc. She began speaking about her six kids of her kids, two of which are her own, two her sisters and the last two were from a family member who passed away. She said was “You guys are my babies now too,” and that made me feel so welcome. She said that she loved helping people because when she needed help in the past someone had helped her out. That’s an amazing value to have and that’s how I feel being at Cornell most of the time. Coming from a low socio-economic neighborhood, which is difficult to get out of, it was definitely a challenge transitioning to the rigor Cornell sets for its students my freshman year. Without the support of my advisors and my family I wouldn’t have been able to push through so whenever I get the chance to talk to high school students about my experience, I take it.

When we arrived at her house, the two boys opened the gate to let us in. When Libby and I got out of the car, we were welcomed with 2 pairs of open hands ready to hug us. We met everyone else once we got inside and they hugged us too. The two babies were a bit nervous and our host mom said they would open to us very quickly. She showed us to our room and the first thing I noticed in the room were the bunk beds. How ironic. Less than an hour ago, our entire group was discussing bunk beds and I would be spending my four weeks sleeping in one. Seeing the bunk beds also put me back to my twelve-year-old self when I used to sleep in a bunk bed. I used to sleep on the top and my sister on the bottom so I opted to sleep on the top bunk. I started unpacking some of my clothes realizing that I would be with a new family for a whole month. Our host mom called us to see the rest of the house. The room next to ours was were four of the kids would be sleeping. My first thought was ‘wow, all of them in one space’ and it dawned on me that we had taken the boys room so they would have to sleep in the other room for the month. Our host mom let us unpack for a bit and then came back a few minutes later handing the both of us chitenge. It was so nice of her to not only accommodate us into her home but also give us the traditional cloth. She called us out to eat dinner with everyone. Libby and I sat on one couch eating nshima with chicken, watching an Indian show called ‘Twist of Fate,’ which I’ve grown to really like.

Family means a lot to me; my mom, my sister and I do everything together. No matter what is going on, we’re always there for one another. Of all the summers I’ve spent away from home, this one was the most nervous for me because I was traveling out of the country. I’ve only traveled once before on a plane and the flight was four, almost five, hours long. I also knew beforehand I wouldn’t be able to talk to my mom and my sister as much because of the six hour time difference. The fact that our host mom has a full house makes me happy because I love kids and the two oldest girls are close to my age. Since the family is so big, and the kids were busy laughing and running around, that distracted me from being homesick.

 Our host mom is my second mother. She definitely took away most of my worries that night because being in a new country and knowing that someone is looking out for me is comforting. It’s been two weeks and we only have two left with our homestay and I plan on making the most of it.

In Country Post 1

Despite having been here for two weeks I find myself learning new and exciting things every day. Twelve days into my time in Zambia, we had our first full day shadowing at UTH. I walked into firm B of the obstetrics and gynecology ward which contained 12 beds allowing for no personal privacy for the patients. We spent the morning following the doctors around on their grand rounds which turned out to be a lot of standing around trying to overhear as much as we could of what the doctors were discussing. The first patient they discussed was a school girl probably only 15-17. She was off getting scans but they proceeded to discuss her case in her absence. Her primary care doctor presented her current case and subtly mentioned that this pregnancy resulted from a sexual assault. A majority of the doctors paid no attention to this fact and continued to focus on her current case. As they discussed, I found myself distracted, one because I felt pity for that girl attending school, while pregnant and what if her rapist also attended the same school; and two I was caught up in disbelief of the doctors’ utter disregard for the sexual assault. I found it difficult to reconcile what I was observing with how I personally felt about the situation and how I am used to people treating a situation like sexual assault.

After the doctors had easily passed over the subject the counsellor brought the conversation back to the sexual assault inquiring if she had been treated at the time of the attack. She asked, have we handled this girl from the beginning? Is anything being done about the case? Is it a medical-legal issue? Was she treated at the time of the attack? Was she tested for STDs? The doctors did not have answers and seemed shocked at the myriad of questions just thrown at them. One responded that she probably had been treated but did not know if anything was being done in terms of prosecution of the perpetrator. The Counsellor responded inquiring about what is done for sexual assault cases as these cases are handled by firm C. Doctor C. responded by reciting a protocol for treating sexual assault victims to prevent/treat STDs. The counsellor began grilling Doctor C with questions on how to treat individual infections, with what antibiotic, and what dosage; however, he could not answer her questions. She inquired what else is done besides administering antibiotics and another doctor chimed in saying that they are supposed to have the victim stand over a collection bag and take nail clippings and collect any DNA and evidence remaining on the victim. He followed this by saying that although this is intended to be the standard protocol, it isn’t done in practice. The counsellor, expressing her disappointment said, “it seems as though we have not handled this patient properly, it is not a matter of following protocol to treat patients. You are treating a person and you must treat them first how you know and then consult a protocol.” The counsellor was the voice of my thoughts, asking the doctors the questions I was wondering like why she hadn’t been treated and why no one really cared about her situation. They had become desensitized to that fact and just glanced over it. They were ready to give her treatment and send her on her way which shocked me.

The importance of this experience was the insight into the way in which things operate in the health system in Zambia and also the culture in Zambia in general.  I could tell that the doctors operate on a protocol, a scripted method of treatment for a condition to send them on their way. On the first orientation day at UTH we learned the necessary education and training to become a doctor which is much shorter than that of the U.S. This conversation showed me the differences in practical training; the doctors just followed scripted protocols without inquiring who made them or bringing in their own knowledge and training on proper treatment. It was unsettling to treat this small conversation as just an observational experience without making judgements. I realize that things are done differently here but it was hard to remain unbiased in my thoughts. I kept thinking of how differently the situation would be handled back at home and found myself judging things for not being done the same way or people not expecting that standard.

This experience was the first time this trip I have felt challenged between what I know and believe and what I am experiencing. It was hard for me to reconcile how I think it should be done with what I observed all while not being able to voice my opinion. What got me through it was the fact that at least someone was questioning why her case was handled this way. I was comforted by the fact that the counsellor admitted that this patient hadn’t been handled properly. This challenged how I know these situations are handled administratively, how patients are handled and treated and how people respond to sexual assault culturally. I chose this experience because it I was challenged objectively and emotionally. I struggled to remain objective in treating the whole situation at the time as just an observation. While reflecting on this moment I struggled emotionally with how to settle what I observed being different from what I feel is right.

I’ve spent my first two weeks being really observational trying to learn about Zambia. It’s a completely different place than I’ve ever experienced so everything that’s happen I’ve been able to compartmentalize as something different about Zambia that does not necessarily conflict with my life experiences it’s just different. However, this moment was the first time that what I am experiencing conflicts with my life experiences and I think that’s why this moment stands out most. It was a moment where I couldn’t separate what I’m seeing and what I know and I think that was a point of struggle for me. This experience really showed my inability to remain inherently unbiased and reminded me that I have my values that might not always agree with what I am experiencing.

In country Blog Post 1

Today, I learned the true meaning of privilege. It was my first day at the hospital and I was super excited to be in the OB/GYN department and get some unique shadowing experience. However, my day did not go as planned. I got to the hospital and about 30 minutes in, I passed out. It wasn’t because I saw something gory or because I was overwhelmed by the environment. It was just simple dehydration. Before I go into what happened after I passed out, I want to talk a little bit about the hospital ward that I was in. I was in the recovery and newborn ward. The recovery ward was basically a series of rooms with multiple beds in them. Unlike in the States, where most patients have their own rooms, each section of the recovery ward had at least 6 beds in it. The room wasn’t over-crowded with patients or anything, but there were still many patients there who needed medical attention and a doctor to come and check up on their recovery.

When I woke up after passing out, there were literally five doctors crowded over me examining me. I remember being very confused as to where I was and why I was being examined. The doctors helped me up and I thought they were going to put me on one of the beds in the recovery ward, just so that I could gather my senses. Instead, they took me to a private room and had the nurses make up a fresh bed for me. In my still confused state, I remember being annoyed that they were taking me into a private room because I was almost completely fine and there were other patients in the recovery ward who could have probably benefited from a private room. The room also had 2 other beds, which could have been used to give some other patients a little bit more privacy. But because I am a student from the US, I was given this private room for a menial health problem. I am still very upset about this unintended privilege which I received.  

After I had rested a little bit, one of the doctors came in and told me that they wanted to run some additional tests on me because I had suffered a small seizure when I passed out. Obviously, I got freaked out when I heard this, but I decided that some tests would be best. For the tests, I was taken to the casualty ward, which is kind of like the hospital emergency room. The casualty ward was extremely crowded and there were at least fifty people in the waiting room with various (and some very severe) injuries and illnesses. Probably 99% of the people in the waiting room were in greater need of immediate medical care than I was. However, due to my citizenship, I was expedited through the check-in process. I particularly remember one man I was put ahead of who had his bloody hand wrapped in a dirty towel. I just felt so guilty for receiving medical attention before he did. I was also escorted through all my tests by one of the doctors from the OB/GYN ward. It was really nice of him to come with me through all of the tests, but at the same time, I’m sure there were patients who could have used his knowledge and expertise in the hour that he was helping me. The casualty ward was extremely crowded and had five or six beds and maybe five doctors. Three of these doctors attended to me and ran my tests. I was so shocked and angry that I was receiving this much attention when there were so many other patients in desperate need of medical attention. Some of them looked like they had been waiting for hours. But I had three doctors running multiple tests on me like pregnancy, malaria, and blood glucose and asking me multiple questions about my medical history. Again, I felt so embarrassed and guilty that I was receiving all this attention when there were so many other people in need.

I always knew that US citizens have more privilege than other citizenships, but I never realized how drastic this effect was until I experienced it firsthand today. I do not enjoy this privilege because it disgusts and embarrasses me. Why should I be treated well because of where I was born? However, I am glad that I had this experience because I now have a renewed perspective on how medical practice differs around the world and why disparities in medical care exist. This experience inspires me to work towards my goal which is to alleviate some of the inequalities in healthcare that various populations around the globe face.

Blog Post #1

           One experience that sticks out for me is my first time at the Kulima Tower bus stop; those were an overwhelming few moments to say the least. What first hit me was the sheer amount of people surrounding me, each going there own way, each with there own plan and destination. It was 8 in the morning on a Monday, and Lusaka rush hour was in full swing. I think initially what surprised me about the amount of movement and activity surrounding Kulima Tower was that rush hour was apparently a universal phenomenon. Even though we were on the other side of the world, people still woke up in the morning and needed to get to work; students still had to get to class; and while the way they were doing might have looked different, the underlying principle was the same. This general idea, that while it may look different, life here is not all that different, is one of the biggest take aways I have had so far.

            While I started to realize some of the similarities between my life thus far and life in Lusaka, my first moments at Kulima Tower also served as a reminder of just how different I am perceived here. It was probably my first time in a packed public area here, and I immediately began to feel the stares coming in from all sides. Everywhere I looked, it seemed people were intently interested in me; which is not something that had ever happened to me. Whether they were curious, or surprised, or just plain amused, it seemed everyone was taking a good look at me. I tried to keep my head down and go about my business, hoping to give off the appearance of comfort, but every corner I turned brought a host of new staring eyes and interested faces. I began to realize just how out of the ordinary I appeared. Where I come from, for my entire life, diversity has been a given. I can’t imagine any time in my life where seeing some race of people would have been a surprise to me. In the places I have been, you have to be doing something seriously weird to draw the type of attention that I was drawing at Kulima Tower (which, I’m sure, is partly what made me so uncomfortable). However, as I had already begun to learn in Zambia, and as this experience reinforced, the diversity that I am familiar with is not something you find everywhere, and in fact may be quite rare. This was the type of realization that I have grown accustomed to having here. Realizations that, while seemingly obvious in hindsight, only can come from these type of disruptive experiences.

            Finally, after navigating the winding shops and stands, the jostling crowds, and the ordered chaos of buses moving in and out, we were on our way, and I was hit finally (and maybe ironically) with a feeling of fitting in. While I looked, talked, and acted different, I was simply on my commute to work, alongside all the other working Zambians. I was glad that I was figuring out my own way, and was showing the local people that while I may look like an outsider, I was not all that different from then, and that while I may come from a developed country, I did not think myself above taking a minibus to work.