Global Perspectives on Healthcare- Volunteering in Nepal

nursemadhavan

Healthcare is the maintenance or rehabilitation of a person's physical, mental or spiritual status. It is culturally relative and therefore it means, and requires, different things in different societies. The healthcare that people in different areas of the world receive is heavily affected by financial, technological, political, and educational resources.

For example, here in the United States, the world's richest country, there is a health insurance system which covers a majority of the population at a relatively high cost. Those who are insured are privileged to enjoy access to high-quality health care. There are opportunities for the uninsured to have access to free or reduced-cost healthcare, with as government-run and community-run screenings and clinics across the country. Unfortunately, however, the framework of the US' insurance system still excludes many people from adequate health care coverage.

Most countries in the world have a large percentage of people living in poverty as compared to the US. According to the World Health Organization's website, 1.2 billion people in the world today are struggling to survive on less than a dollar a day. A person has to wonder how these populations are able to access any sort of quality healthcare or health education at all. being born in another part of the world shouldn't affect a person's right to quality healthcare, but it clearly does. Fortunately or unfortunately, what the US does affects many other countries.

As the richest country in the world, it is important to realize that the US is not out of reach from the rest of the world. What happens outside of the US can very well affect what happens within the US. A disease present in a certain area of the world can find a resurgence in frequency in other countries due to travel, interspecies transmission, and other means.

This has already happened with typhoid. With all of the technological advances made in the last 100 years, that has changed and typhoid is no longer a common disease in the US. However, in many other countries, it still is. The vast majority of the world remains without proper sanitation, potable water, and adequate food. According to the National Institutes of Health, the Centers for Disease Control and Prevention reports that about 400 Americans contract typhoid annually, most of them while abroad. This is just one example of many vaccine-preventable diseases that thrive worldwide today, which find its way into the United States despite its aggressive vaccination programs.

If we work hard to fight these diseases before they become worldwide epidemics, it is possible to prevent these diseases from killing more people than necessary, and it will also curb the effects of the disease on the rest of the world. Wouldn't it make sense to begin treating and vaccinating people against typhoid and other diseases in other countries before it makes its way into the US? Isn't it worth it to prevent the suffering of thousands of people worldwide, and prevent possible catastrophe from coming to our homes in the process? Would it save money to vaccinate people in foreign countries rather than treat infected Americans? Some people follow the belief that the US should not interfere with the healthcare status of people in other countries. However, if the intervention is one that prevents suffering and the funneling of money into treatments for diseases that can be avoided through vaccination, where does the detriment lie?

One thing to keep in mind is that even though an individual person might not be able to ship medical materials such as syringes, vaccines, and drugs, time and money are valuable resources as well. Donating money to a charitable organization helps by placing money where it is needed most, but many people are reluctant to donate because there is really no way to be sure exactly if and where the funds are being applied. Volunteering, then, is a good option for people who wish to contribute to the less fortunate whether they are in the US or abroad. In addition to helping others achieve their goals, it gives a sense of fulfillment to the person providing the service. one good idea, which will also enable a person to better relate to the community they serve, is to buy clothes once arriving at their destined volunteer site, and donate the clothes they arrived in when they have finished serving their volunteer term. This allows a person to make a material contribution in addition to everything else they provide.

Volunteering is wonderful because it facilitates the exchange of information, and provides hands-on service to people personally. Providing education is especially important because the benefits of practices taught in the US which have been proven to save lives (hand washing, etc) may be relatively unknown, underestimated, or harder to achieve in other countries due to lack of resources.

Volunteering abroad is a precious experience that has changed my life. As a prospective nurse, it made me realize that it is important to understand the cultural practices of others because the US is a multicultural country. What constitutes good health in one country does not necessarily constitute good health in another, because people from different countries might have different priorities in life. A country that seems to have nothing can yield happy and productive citizens. Just because a population does not have a certain amount of money or the same technology we do in the US, it does not mean they are unhappy or disadvantaged in every other aspect of their lives.

My experience volunteering abroad consisted of spending eight weeks living with a host family in Kathmandu, Nepal. I had planned for about a year to volunteer during the summer of 2007, but I was not sure where to go. Volunteer costs helped me make a decision quickly. Every volunteer program and organization I came across during my lengthy searches required the prospective volunteers to pay a high fee to cover room and board with a host family, continuous guidance and support from the organization, and staffing. I found one program that had a lower volunteer fee than the other programs asked for. I engaged in a few email exchanges with the program director and previous volunteers and my plans for the summer were established.

Once arriving in Nepal, I did not find it very difficult to adapt to the customs of my Nepali host family, since Nepali culture is pretty similar to Indian culture, and I am of Indian heritage. However, it did take work for me to put those practices in use because I was raised in the US and I have not visited India in a number of years. I was raised with some Nepali customs such as eating with my hands or washing with water after using the bathroom instead of using toilet paper. It did take me longer to get used to the things I had not been exposed to in a while such as cold water for bathing and sleeping on a wooden plank.

One thing I immediately noticed, and really enjoyed about Nepal was the concentration and blending of the Chinese and Indian culture. I particularly enjoy Nepali music, which I think sounds equally Chinese and Indian. Even the faces of Nepali people have equally Chinese and Indian characteristics, which is particularly lovely. Like China and India, two huge economic entities, become more westernized in everything from clothing to music, Nepal seems relatively untouched. there was the occasional up-and-coming Nepali rap star on tv touting his beats, but people still walked the streets in traditional clothes.

My first week in Nepal was spent sightseeing, shopping, and touring with a staff member. I also underwent one-on-one Nepali language training for two hours every day during that week. I was provided with a small textbook with transliterated Nepali words and their English translations. My Nepali language skills increased steadily throughout my time there because my host family and the patients I saw every day helped me retain whatever I learned. Hindi and Nepali are very closely related languages, so the fact that I don't speak Hindi was to my detriment, but even so I feel I picked up Nepali pretty quickly. I requested that my language teacher focus on teaching me healthcare-related vocabulary such as "do you have a fever?" and "where does it hurt?"

After that, I was sent to work in the clinics. it took me a while to memorize the paths and get used to the numerous stray dogs that wandered the streets. I worked in two clinics: I spent from 10am-1pm at the Gothatar health post, located in Gothatar, a rural village within Kathmandu valley, and from 2pm-5pm in another health post, which was fully funded and staffed by the organization I was volunteering through. The clinics were on the same road, and it was about a 30-minute walk between the clinics and my organization's office. My focused vocabulary helped me greatly in the clinical setting because during my entire two-month stay in Nepal I had only met one patient who knew English fluently enough for us to have a significant conversation. By the time my volunteering days were over, I had built up such a strong bond with the staff and patients that it was very difficult for me to say goodbye, in part because those I worked and lived with were truly grateful that I was there, and they spoke to me with warmth and sincere interest I had never remembered receiving from anyone else before. When I went to the clinics each day, each patient I saw thanked us volunteers profusely. We were always greeted with "ji" after our names, which is a sign of respect. On the one hand I was flattered that they were so grateful to us, but on the other hand, I was saddened by the reality that they would only be receiving our care for a limited time, and that most of the health care faculty within the clinics we worked in were not trained to my extent, even though I had only just finished my first year of nursing school at that time.

In the clinics, I mainly assessed patients, administered medications, educated patients, and discussed healthcare topics with the staff. It wasn't until I began working in the clinics for some time, that I became really invested in the meaning of the work I was doing, realizing especially how important education was. I heard one patient, who was severely anemic and underweight, state that she did not want to eat vegetables because she believed they would make her gain weight in an unhealthy way. I heard one more patient, whose child was suffering from recurrent intestinal worms, state that she was not boiling her tap water, only filtering it because she thought that alone was sufficient.

I also began to realize how different reality is for different populations. I cared for a woman who had injured herself while cutting rice with a sickle, and after I disinfected, bandaged, and splinted her finger, I was shocked to hear her say that she would be back at work the very next day. I asked her why, and she asked me, "if I don't work, who will feed my child?" Another patient had an open sore on the sole of his foot and came into the clinic wearing thin, exposing sandals. after I and the other volunteers told him that it was not good to have his sore exposed to all of the dust from the roadsides, he revealed to us that he did not own another pair of shoes.

I came back to the US and continued my research. It is difficult to volunteer in a developing country and feel like nothing you are doing is helping the people there. I realized that symptomatic treatment in a clinic is not going to help anyone long term unless waste was properly disposed of, water was purified, and people were educated on such things as how to purify their water through boiling and filtration. I again found myself searching for words, however, when one patient stated that she simply did not have any source of heat with which to boil her water.

Now that I have volunteered abroad, I cannot imagine traveling anywhere in the world without at least being a responsible traveler, by not exploiting a land or culture or judging a culture's way of doing things. I feel that my time in Nepal has had tremendous positive effects, for myself and for those I worked with. the u.s. is indeed the veritable melting pot of the world, and it is critically important to know how to understand and respect the different components of what's inside that melting pot. We are all humans; how can we truly value healthcare when we don't care about health in a global perspective?

Global Perspectives on Healthcare- Volunteering in Nepal

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