IPSL Reflection #3

Kathleen Ackert

IPSL

Topic #3

16 March 2015

Prompt: How does the community interact with the agency? What is the image that the community has of the agency, it’s programs, and it’s volunteers and participants? Does your topic have any social component? How does it positively/negatively impact the community?

            This is a great prompt for me because my service placement is so integrated into the community. As I have discussed in my last two reflections, I go into the community with various doctors and nurses and provide health care, whether it be social, mental, or physical.

            It is hard for me to define the image that the community has of the agency because of the language barrier. Just going off of what body language and general tone of voice, I would say that the community respects my agency. There have definitely been cases where we knock on people’s doors, and they don’t want to answer questions. However, I think this is because we have to talk to them for a long time and in some cases, have them answer questions that can be a bit uncomfortable, such as how much their household income is.

            I chose an article from the WorldBank, where the government, partners, and villagers are reviewing a community driven development project in Myanmar.  In the article they talk about how the project has a “people-centered approach by which communities themselves choose, design, and implement the projects based on what they need most” (WorldBank Online). I think that choice is a really important thing to have in a community driven development project. In the article, they also talk about how these government officials (and even the VP) are discussing issues and goals directly with the villagers. I think that this is incredibly important because who are we (we being me, other students, WHO, doctors) to create these programs for communities without knowing what they want.

           However they perceive us, I think that there is a positive impact on the community.  The reason that the public health care system has programs like this in place is to better the community as a whole.

Works Cited

http://www.worldbank.org/en/news/feature/2014/09/03/government-partners-and-villagers-review-community-driven-development-project

IPSL Reflection #2

Kate Ackert

Reflection Journal

March 2^nd, 2015

Topic #2

                  For this assignment, we had to find an article that relates to the agency we are volunteering with and that also relates to the role that they play in the community. I am volunteering with the Ministry of Public Health at the Oskar Jandl hospital, and I have chosen the article “Dying for Change”. The publication was compiled by the World Health Organization. “Dying for Change” tells the tale of those who have struggled with poverty and health their entire lives. It recaps events that these people have experienced, such as going without clean water, inhumane treatment in hospitals and clinics, and the pangs of hunger that they experience on a daily basis. I have been working at the hospital for a week now. I have helped with a program for the elderly and with the house visits to the poorer areas of the Galápagos. I would like to expand more about the house visits, and to compare and contrast what I have seen to some of the case studies the article talks about.

In it’s opening words, the article says, “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity” (Dying for Change Online). People often view being healthy as having a properly functioning body. However, after only a week with the hospital, I see that health is so much more than that. Part of what I have been doing here aligns with WHO’s definition of health. Because the island is so small, everybody knows each other. This means that the hospital knows exactly who is sick. On my first day there, they explained to me how they keep track of the patients here. In the head administrator’s office, there are three big foam boards with sections of the island on them. The houses are all mapped out, and there are thumbtacks all over the place. Each color thumbtack represents a different illness or health issue. It was really interesting to see the spread of what health issues plagued what areas. For example, we went to the barrio Manzanillo to talk to people into coming to the hospital for their high blood pressure and depression issues. Before we left, I was looking at the board where Manzanillo is located. It was abundant with green thumbtacks, because green designates at-risk for unstable housing, water cleanliness, etc. Manzanillo is one of the poorer areas of the Galapagos, so that is why they have those types of problems. In some of the nicer areas, there were not as many thumbtacks, but some that designated at-risk pregnancies or diabetes patients.

For the final paper, I would like to focus on health care systems in a developing world and talk about how possibly the hospital in San Cristobal could adapt to become more efficient and use my possible solutions to overcome problems. This connects directly to the mission of the service agency and the type of work I am doing. What we aim to do on these house calls is to educate them and to provide the best health care away from the hospital that we can. This connects to me because I am using the knowledge that I have to educate administrators, physicians, and nurses on what public health in a developed world is like. As we talked about in the IPSL meeting last week, I am not here to go into the hospital and flip it upside down with my American views and customs into something that would be completely inappropriate for life on an island. I am here to learn, observe, and see if there are any changes to the health care system that I would be able to suggest in my paper.

IPSL Reflection #1

Kate Ackert

Reflection Journal

February 16^th, 2015

                  To hell with good intentions, right? I absolutely loved this reading. As we discussed Hitler, Mussolini, and more, my 10^th grade European History teacher always said, “the road to hell is paved with good intentions”. My 16-year-old brain didn’t quite comprehend this as well as I can now. In terms of service for me, good intentions are defined as wanting to help others altruistically. I don’t believe this is always the case.

                  In the reading, Illich says, “all you will do in a Mexican village is create disorder. At best, you can try to convince Mexican girls that they should marry a young man who is self-made, rich, a consumer, and as disrespectful of tradition as one of you. At worst, in your "community development" spirit you might create just enough problems to get someone shot after your vacation ends and you rush back to your middleclass neighborhoods where your friends make jokes about "spits" and "wetbacks." You start on your task without any training. Even the Peace Corps spends around $10,000 on each corps member to help him adapt to his new environment and to guard him against culture shock. How odd that nobody ever thought about spending money to educate poor Mexicans in order to prevent them from the culture shock of meeting you?” This is one thing that I really want to focus on. I want to be here and learn how to serve while respecting the culture of the Galapagos, without making this out to be a “voluntourism” trip. You know, one where you come home with a sunburn, lots of pictures for facebook, and another item to add to your resume. This leads me back to my constant internal conflict about service. Is service done for the wrong reasons still worth it? To the students, to the community, to the 'common good'? We are humans and have expectations for our service experience, we want to use our talents and skills, but the community may be expecting to complete a different but necessary task they have prioritized with no regard for your resumes achievements or personal/professional goals for the semester. This is something that is very close to me right now as I am now starting the application process for medical school. When I first spoke with Amy, the IPSL coordinator, she mentioned that she was looking into me working at Casa de Cultura, which would be a summer camp (summer here is now) that focused on the arts, photography, etc. This would have been a lot of fun, and I think I would have been very useful because I am good with children, but I had this internal conflict that made me talk to Amy about seeing if I could work in the hospital or with a doctor. I didn’t know exactly how I should feel about doing that. On one hand, I have all of this science knowledge that I have been cultivating and a need gain health professions experience. On the other hand, I want to do what they need me to do here. By asking if I can work in the hospital, am I pretentiously imposing myself on these people? As Illich said, I am here to recognize my inability, my powerlessness and my incapacity to do the "good" which I intend to do here. I have only been on the Galápagos Islands for one week, but I have already recognized how tiny my place in the world is. However, I think this is a good starting point for me.

                  My expectations almost always are proven wrong, but I’ll say what I am expecting anyway. I think (hope) that I will be interning with the doctor as he or she visits patients in their houses that are too sick to go to the hospital. I am not completely sure what my role in this will be. Hopefully, it will be as hands-on as possible. In the United States, when I have shadowed physicians, it usually entails me standing in a corner observing silently. It has been really interesting to watch and definitely a learning experience, but I think I am ready for some more hands-on experience. Of course I would do whatever the doctor needs me to do, such as helping move patients, writing down vitals/statistics, but I hope I also get to practice things such as taking pulses, blood pressure, etc.

                  Many people try to leave something permanent on the Galapagos. Some try to do this by leaving things here, such as graffiti. This is neither permanent nor something that is helpful to the community here. I want to leave my permanent mark by making an impact on the lives of people and patients that I have helped. Even if they don’t remember my name or face, the fact that I helped someone feel more comfortable is the impact that I would like to leave here. That is the legacy I would like to leave on the island.