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Post-Trip Reflection

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Final Reflection

I think the LACS 20 experience so far has been everything I expected and so much more. I was so incredibly excited for this class, and it has lived up to everything I hoped it would be. I feel as though the combination of readings and lecture has allowed me to gain a basic understanding of Nicaraguan history and culture as well as allowing me to become closer to my fellow classmates. The readings have been educational from a historical standpoint, as well as allowing me to deeply reflect upon why I am going on this trip and what I hope to gain. I think when I first applied for this trip, I did have a sense of intention to help. I thought it was ideal to learn as much as possible first, but ultimately my goal was to lend assistance to those who I saw as underprivileged. Now, I think that my goal is more focussed on learning rather than helping. The readings, lecture, and discussion have given me a new appreciation for cross cultural learning that I did not have before this course. In addition, as someone who has planned long term to work internationally as a doctor, this class has changed my view on my future and how I will be most useful to the world. I think my plans are still developing, and I’m sure I will have even greater clarity following this trip. I am so thrilled about this opportunity and I am counting down the days until our departure.

 

Blog 7: Pictures From A Revolution

Pictures From a Revolution is a documentary film created by Susan Meiselas, a photographer who took photos during the 1981 Sandinista Revolution in Nicaragua. Ten years later, she returns to find the subjects of her photos and interview them regarding how their lives have changed since the revolution. The film largely focuses on the content of these interviews and the words of the people in the revolution. One of the main take-aways from the film is that many hoped their lives would change substantially following the revolution, though for many nothing has changed. In some cases, things have even become worse. The overwhelming theme is one of lost hope and dashed visions of freedom. Overall, I really enjoyed the film and I felt as though it effectively gave me a glimpse of the real lives affected by the revolution we have learned so much about. I also think it was worthwhile to hear about the revolution directly from those affected by it.

Blog 6: On Conducting Ethnography

Although I have always been interested by ethnography, I have never had an opportunity to truly create ethnographic research. I have taken several anthropology courses, all of which have touched on various aspects of ethnography and the ethnographic research process. In Introduction to Anthropology (Anth 1), we read a lot of ethnographic research, both old and new. A large focus of the course was on how ethnography has changed over time, both in its goals and its execution. One of the most notable aspects of the class for me was reading “In Search of Respect,” a modern ethnography of street-level drug dealers in the United States. In The Anthropology of Health and Illness (Anth 17), I had the opportunity to read ethnographies specific to health and disease, such as several papers on cancer and “survival rhetoric.” I also took a course called Ethnographic Film (Anth 12) in which I learned about the multi media aspects of ethnography and how ethnographic research can take many different forms. I think this trip will give me the opportunity, through the surveys created for our final project, to conduct a small scale ethnographic research project, and hopefully get a better understanding of how to go about such a project if I ever conduct larger scale ethnographic research. I feel as though I have learned so much about ethnography, and I am looking forward both to applying what I have learned and getting hands on experience.

Blog 5: Community Health Agencies

In other classes, particularly Anth 17, I have read a lot about different kinds of interventions in global health settings. I have learned about the differences between short term and long term interventions and what is favorable about each approach. Short term approaches, like those typical of Doctors Without Boarders, are necessary in the case of emergencies, such as the Ebola outbreak or the Cholera outbreak. However, long term approaches such as those practiced by Partners in Health allow for systemic change and the development of sustainable public health systems. These conversations have always taken an either or approach, attempting to discern which is better and why. However, Bridges to Community seems to be taking a middle ground. They stay five years, which is long enough to learn what the community needs most and to teach the local people how to sustain and continue the project without staying so long as to develop long term necessity for their presence. This approach makes sense to me and I look forward to seeing it in action. I have never spoken to those working on the ground in such organizations, so I think it will be an incredibly educational experience for me.

Blog 4: Response to Presentations

Henry and Sawyer’s presentation on credit opportunities in Nicaragua was both interesting and informative. Although I have very little background knowledge on economics, much less the current economic climate in Nicaragua, I found this presentation to be accessible. As I imagine many students are in a similar state of understanding regarding Nicaraguan economics, it was definitely worthwhile to go through a brief history of the Nicaraguan economy and financial system. I did not know that Nicaragua is the second poorest country in the Western hemisphere and it was interesting to learn that only 30% of the population has access to credit, which I assume is much less than most developed nations. It was also interesting to see the effects that the Sandinista Revolution had on the economy, including a 41% increase in literacy. It is clear that Nicaraguan economics are closely tied to actions and legislation by the United States, as I’m sure is true for many central american countries. I had never heard of the concept of microfinance before, so this concept was completely foreign to me. I had heard of a push to give out smaller sums of money rather in an effort to disperse wealth and discourage dependence, so it was interesting to hear about a the methods by which this money is actually given out. One statistic I found to be particularly intriguing was that 20% of Nicaraguans are involved with microfinance. The fact that one in five members of the population are affected by this industry must mean that it is well known and affects the economy substantially. I look forward to speaking to locals at the clinic and seeing how microfinance has affected their lives and what they think of the system in its current form.

Another presentation that I found particularly interesting was Clement, Louise, and Michaela’s presentation on sustainable poultry farming in Nicaragua. My family owns chickens, so this presentation felt very close to home. Chickens are not very difficult to take care of and can be incredibly fruitful while laying, which makes them seem like a valuable investment in this area. I think that of all the presentations, this one did the best job of laying out the basis of the idea and the plan, and why it is important. I think they also did a fantastic job of making sure they were clear about what they did not know and what was still left to discover. The plan at first appeared to be quite straight forward, but there turned out to be various unseen complications, such as chickens being stolen. I felt as though these unseen complications were typical of any health or development related project. In this way, this project seemed much like a case study. I was very impressed with this presentation and interested by its content. I look forward to seeing the livestock in Siuna, and particularly seeing how the chickens are cared for and treated.

 

Blog 3: Travel and Tourism

I have travelled to Latin America several times. I have been to Chile once, Costa Rica twice, and to Mexico and the Bahamas several times. Although most of these trips were family vacations, my second visit to Costa Rica was a school trip which involved several small community service projects (although the focus was ecology). Although I have been very lucky to travel a large amount, I have done very little service outside of the U.S., so this trip will be a first for me.

Having not worked as a volunteer abroad, I cannot speak to this. However, I will share several experiences I have had while traveling which have posed ethical questions and made me reflect on my role as a tourist, an American, and a global citizen. For some background, most of my travel has been with my father, who is often asked to speak at conferences in foreign countries for his profession as an Orthopedic Surgeon. Often, when I travel with him, we will go to the country of the conference early and spend several days in the more rural, “off the beaten track,” areas of the country. It is during these parts of the trips that the following experiences occurred.

Once in Zambia, my family (mother, father, and younger brother) and I had visited Victoria Falls and were walking back up the trail from a viewpoint. Several women selling small goods were at the viewpoint and my mother had taken brief interest in a small wooden box but had decided against purchasing it. The path up was about half a mile and steep, and as we headed up the woman followed us and, waving the box at my mother and naming her price. My mother declined again, but the woman was not deterred. She followed us the entire way up, walking next to my mother and slowly lowering her price. When we finally got to the top of the path, my mother purchased the box (which was about $15) even though she had no interest in owning it. This event made me wonder about the ethics of bartering in foreign countries, purchasing from street vendors, and giving into aggressive pursuit from vendors.

Once on the island of Flores in Indonesia, my father and I travelled to a small market in an very rural town with the intention of seeing more of the culture. The market was very crowded and our driver, an Indonesian native, warned us before we left the car that we would not go unnoticed as many of the people at the market had likely never seen white people before. Sure enough, as soon as we left the car, people crowded around us. They touched my hair and stared at us, seeming to be slightly fearful but definitely curious. They said the word “cantik” repeatedly, meaning beautiful in Indonesian. Several vendors brought produce and grain to us and attempted to give them to us, seemingly disinterested in payment. Some of the children hid behind large objects, peering out at us but unwilling to come close. I still think about this experience often and I have difficulty processing how to feel about it. Surely these people did not understand me and had just as many misconceptions about my life as I surely do about theirs. With no means of communication, the misconceptions were left to propagate unchallenged. Although I am unsure how to put into words exactly why, this experience seemed unethical. They looked at us as though we were somehow deserving of their respect, and praised us as beautiful, making me feel as though coming to their market as a wealthy, white, blonde American I was reaffirming their internalized racism and flawed beauty standards with no means of communication to say anything further.

Another ethical problem I have faced in several countries is that of dress. Many countries I have travelled to have a cultural understanding that women should not expose too much skin. When I was younger (13 or less) this resulted in multiple uncomfortable incidents when I failed to meet this expectation, such as having photos taken of me, being stared at and pointed at, and on one occasion, spat on. (It is worth noting that while I assume these incidents occurred due to my dress, they may have also been provoked by my being white, an American, or some other factor). I now take the time to research expectations of dress before visiting a country and try to adhere to these understandings. However, I have and continue to struggle with this concept. I often find myself wearing incredibly uncomfortable clothing in hot countries for fear of offending those who live there. As someone who feels as though women should be allowed to wear whatever they feel comfortable in and would not expect a women to change her style of dress while in the United States, I have struggled to fully come to terms with this concept. Of course there are exceptions, such as places of worship, but the expectation not to bear too much skin is something that I am still working on forming my thoughts on.

I hope these three small thoughts have been thought provoking and interesting. I would like to note that these are obviously candid and do not contain fully formed thoughts. I am still working on understanding the intricacies of each of these circumstances and share my thoughts only as a reflection and not an attempt to comprehend these events fully.

 

Blog 2: Language

The only language I am fluent in is English. However, my mother grew up in southern Arizona and has lived in Belize for extended periods of time. My grandmother’s first language was Spanish and she taught it to all of her children at a young age. My mother is fluent and worked as a translator for 3 years. Because of her close connection with the language, she made an active effort to teach my brother and me Spanish at a young age. Her attempts were only slightly effective, as I am still working to learn the language today. Currently, I comprehend well but can only communicate on a basic level.

Rather than being concerned about speaking Spanish on the trip, I am looking forward to the opportunity to practice with native speakers. I have wanted to do an immersion program for some time, and while this will not be full emersion it will certainly be a taste. I hope to become fluent in Spanish, and I am practicing every day to continue improving. Becoming bilingual is a huge goal for me, and I believe this trip will only bring me closer. In addition, I am looking forward to learning more about Nicaraguan culture, as much of my cultural exposure to Spanish speaking countries has been with Spain.

 

Blog 1: Why the Nicaragua CCESP and why LACS 20?

I will be traveling to Nicaragua in December to work with the community health team.

As I am hoping to pursue a career in public health, I have spent a large amount of time in the past year researching various opportunities to volunteer in clinics both within the US and internationally. Throughout this research, I have struggled to determine which programs are genuinely interested in establishing short and long-term public health development in the surrounding areas. Many programs that I am initially interested in, upon further inspection and research, often misunderstand the culture they aim to serve. In addition, I worry that interventions focus too heavily on the short term rather than considering the long-term consequences. Finally, many of these programs fail to allow volunteers to work with community members and collaborate with local public health professionals. It has been these concerns that have motivated me to pursue the Nicaragua trip.

After speaking to those who have gone on the trip, attending  information session, and attending the first day of the course, I feel this trip works intentionally to educate volunteers before immersion, create long-term public health development, work with local community members, and promote a culture in which volunteers can consider the anthropological aspects of their time abroad. These values are particularly important to me, especially as I have never volunteered internationally before. I hope attending this trip will allow me to develop a sense of which programs and techniques are genuinely beneficial to the surrounding community, allowing me to better direct my efforts in the future.

This particular trip is also appealing to me due to its location. I have taken Spanish in school since elementary, although I have never had an opportunity for longterm immersion. Spending 10 days in Nicaragua will allow me to practice my Spanish with native speakers and get an opportunity to interact with patients in their own language. It is my intention to use Spanish in a global health setting, making this trip a great opportunity to get a sense of the challenges and benefits of patient interaction in a foreign language.

In addition to allowing me to understand international volunteerism and interact with patients in Spanish, this trip will allow me to understand what it means to practice community health in a remote, foreign setting. Although I have dedicated years of class work, read countless books, and watched multiple documentaries on the subject, it is impossible to understand the experience of a community health worker without physically experiencing it. Although I know the theories, mechanics, and philosophies behind global health, I have very little experience practicing it. As it is currently my intention to make international community health into a career, I feel responsible to learn as much about the experience as possible. Currently, I am preparing for a job that I do not fully understand, and I believe the Nicaragua trip will be my first step towards a deeper comprehension.

An important aspect of a relatively short trip is to make sure there are long-term benefits for both the community and the volunteers. As a member of Dartmouth Emergency Medical Services and a nationally certified Remote EMT, I have spent a large potion of my time at Dartmouth learning the value of patient interaction and patient experience. I believe deeply in the value of cross-cultural learning and I think there is a lot of intersection between remote emergency medicine and remote community health medicine, making the Nicaragua trip a learning opportunity from an emergency medicine perspective. Having the opportunity to see how patient interaction, remote techniques, and emergency protocols differ between the New Hampshire and Nicaragua will be both interesting and educational.