Culture Shift

Last week was my first week of clinical practice and boy was it ever an eye opener! Talk about a major 'culture shift' experience. .. I have travelled to third world countries and seen poverty and sickness before, but I have never worked in it. I wasn't aware that I had any expectations of what working in a third world hospital might be like. However, after my first shift, it was evident I did because my experience wasn't anything close to what I had expected. I had the opportunity to work in the Out Patient Department (aka emergency room) and observed clinical officers diagnose and treating cases, such as malaria, tuberculosis, HIV, and malnutrition. In addition, I practiced basic patient triage. Going into this clinical placement I hadn't taken into account how challenging it would be to communicate with patients who didn't speak english and who's culture I wasn't accustomed to. I like to think that my previous travel experiences would give me a bit of a leg up in being able to communicate, but trying to get answers from my assessment questions and needing a translator often proved to be a challenge. On top of the language barrier, cultural differences, and new environment, this hospital runs their outpatient department (OPD) very differently from what I am accustomed to. Although different, I am amazed by the nurses and clinical officers' ability to assess and diagnose without the use of many diagnostic tools. Their observation skills and knowledge of tropical diseases put me to shame...they truly are professionals at what they do. 

Upon reflection the majority of the challenges I experienced adjusting to my new environment came from having the mindset that what I had learned back home was the proper way of doing things...and anything other than the 'best practice' I have learned is not good enough. I caught myself thinking..."if I was in Canada this is how it would be done...". I quickly realized that this is dangerous thinking. I am not in Canada and the nurses and doctors are doing the BEST they can with what they have, and let me tell you, they are doing a fantastic job. As my instructor said during a debriefing session, "we tend to think that the North American way is the best way of doing things, but often it isn't." She is 100% correct. For some of us it is so ingrained in us to do things that are familiar to us. If we don't check ourselves, we can end up with our priorities skewed.

I strive to remain open- minded and willing to learn, because I believe the people I am working with can teach me so much more than I could ever read about in a book. I have been here one week and I already I very humbled. The line ups of people requesting medical attention seem never-ending. The medical officers work non-stop from start to finish everyday. Despite their heavy workload and staff shortages, they remain kind, welcoming and willing to teach. I am grateful to have met these fine professionals and humbled by my experiences with them this week. 

This week I will be in a rural clinic as well as assisting with data collection. I look forward to working in these different setting and continuing to practice my Losi (one of the Zambian languages).

-Carolyn