Tuesday, May 1, 2012

Let the Adventures Continue! by blogger of the month Cherec Dickey

A few weeks ago, MSIH students had their Pesach break. Some of my classmates and I packed our bags to travel to exciting places like China, Greece, Sri Lanka, Turkey, Sweden, Czech Republic, Jordan, Korea, Romania, Italy, the USA, and interesting places around Israel.

Lacking inspiration to write something that more widely applies to the general experience at MSIH (we’re in the middle of finals right now), I chose to write about my personal adventure to Jordan during this break.  I suppose I could give you a more real-time update on life at MSIH, detailing how my classmates sit for endless hours in the Caroline house, drudging through and memorizing endless facts about microorganisms, but I thought Jordan might be a tad more interesting. J

I spent most of my break in northern Jordan at a hospital for chest diseases.  It was my first time traveling internationally, alone, and on foot; I wasn’t quite sure what to expect.  Saturday night I packed my hiking backpack with the necessary essentials for such a trip, including long sleeves, long pants, long shirts, long skirts, long . . . everything.  Pretty much just layers upon layers of clothing to cover everything but my face, hands, and feet, considering I was making my first-ever trip to a Muslim country.
All of the “long” clothing I could find in my wardrobe, 
organized into modest outfits for my trip.

In my previous travels, I had never really experienced “culture shock.”  Sure, I was “shocked” by the poverty that I saw in the developing world and the state in which I found the people around me.  It even deeply affected me as I felt compassion for the people that I met.  Moving to Israel didn’t really constitute culture shock for me, either.  Though Be’er Sheva has been referred to by my classmates as a delightful mix of the developed and developing world, it has enough Western culture for me to feel comfortable with a few adjustments.  In Israel, I can still wear the clothes that I want to wear, do the things that I want to do, and go where ever I like without feeling afraid or apprehensive. 

This time, though, I experienced the real deal.  I mean rock-your-world, make-you-feel-really-uncomfortable-in-your-own-skin culture shock, and I was only there four days. Throughout my trip, I realized that I had just walked into a place that was very different from Israel, the USA and any other place that I had been.  Honestly, I didn’t anticipate that a hop across the border would take me into another world.  On a handful of occasions, I even felt personally offended by the culture in which I found myself.  As an independent, empowered woman from the West, it was difficult for me to comprehend how things really are for women in Muslim countries.  When I started to understand how few rights women have in society, I was enraged!  For the moment, anyway, then I learned to grapple with and process these new experiences and learn what I could from them.  I had been learning about Bedouin culture in Israel, but it was from a distance.  I still went back to my Westernized community and comfortably did and said what I chose.  Learning about Bedouin culture (the majority of Jordanians are Bedouin) from within, while participating in it, was a unique experience.  It was a very real experience that this idealist will remember for the rest of her life.
The clinical and personal experiences I had with patients were the most impactful parts of my trip.  Each morning at the hospital, we had clinical hours, where we saw patients who had come from far and wide.  As I sat with the doctors during these times, I met patients from Saudi Arabia, Iraq, Yemen, and even some refugees from Homs, Syria (I’m sure you know from international news what they’re running from).  Even the Jordanians that had come to be seen were from all over Jordan.  The hospital has quite an exceptional reputation.  Additionally, the services offered by the clinic are essentially free, so combine that with the most reputable care in the area and you have all of the sick people in the Middle East lined up outside your door.

In that clinic, I got to see and hear things that I never have before.  I spoke (as in, “hello” and “goodbye,” since my Arabic is limited) with women in veils (faces completely covered except for the eyes –and sometimes the eyes, too), and then I got to see their beautiful faces when they lifted their veils for the examination.  I also watched as women loosened their head scarves to reveal their beautiful, long, henna-dyed hair and stylish earrings.  That process was astounding for me; I found it odd how different these women became to me from the person they were a few moments before when I didn’t see anything but their eyes or face. For chest examinations (which we did on almost everyone, since it’s a hospital for chest diseases), I saw the colorful and/or beautifully-sequined shirts and necklaces that many women wear under their clothing. 

I watched as the doctors diagnosed case after case of allergies, colds, and sometimes more serious illnesses.  Chest X-rays were provided within ten minutes of ordering, so I observed as the doctors pointed out features of the lungs that indicate different diseases.

I also got some pointers on how to do medical interviews with Bedouin patients, which may come in handy during my 3rd year.  One of those is fairly generalized across cultures, but I’ve been told it’s specifically pronounced in Bedouin culture:
“Do you take any medications?”
“Do you take any pills for high blood pressure?”
“Yes.” *produces pills*
“I see you have asthma.  Do you take any anything for that?”
“Yes.” *produces inhalers*
In the afternoon, I followed the doctors on their inpatient rounds.  The very first patient we saw was incoherent and semi-unresponsive.  They checked her blood sugar and it was 23!  (If your blood sugar was that low, it would probably kill you.)  I watched as the doctors sprung into action to get some glucose into her, which proved a bit tricky with her tiny, evasive veins.  They successfully brought her out of her hypoglycemic coma. The following day, I got to meet her, fully responsive and awake.
Sisters from Yemen who, the following day,
told me I dress like a Yemeni woman.  (I took that as a compliment!)

On the street the following day 
in my “Yemeni woman” dress.
The inpatient rounds were probably my favorite part of the trip.  I got to meet many very sweet, and sometimes very sick, people.  These patients had MDR (multiple drug resistant) or even XDR (extensively drug resistant – the worst kind) tuberculosis, COPD, and other illnesses that I had never directly seen before.  I got to build relationships with some women during my time there.  They loved to listen to me stumble over Arabic words and giggle when I got them wrong, then graciously correct me and teach me how to say them properly.

Fatmah, one of the beautiful ladies
I met during my stay in Jordan.
My fellow bloggers wrote in previous months, “This is what we’re here for.”  As I walked around the grounds of the hospital during my stay, that kept resounding in my head. “This is what I’m here for.”  I was overwhelmed with the unique situations I had just witnessed and the experience of an actual, tangible example of what global health might look like in my future. 

With the offenses I had taken to cultural differences and the deeply-ingrained second-class status of women, I quickly got fed up with trying to “cross cultural boundaries.”  I started to (uncharacteristically) think, “Maybe it’s better for all of us to just stay within our own culture.”  Before, as I mentioned, I was separate from the Bedouin culture in Be’er Sheva.  However, when I actually had to conform to their ways, I was quite uncomfortable.  Covering oneself head to foot and having to be constantly aware of your behavior and careful to not look at a man in the eyes wasn’t my idea of global health. However, I knew this kind of work would be difficult, and I had gotten a brief taste of what these difficulties might entail.  I got to meet and speak with others who have lived within that culture for years, doing what I dream of doing someday.  Their love for the people they serve is evident, and they do everything in their power to advocate for them.

This led me to ask myself the question that I contended with throughout the duration of my trip:
“Do I love these people enough to push through these cultural barriers and serve them?”

That was the question that went through my mind every time my jaw dropped at another cultural difference that I personally found to be absurd.  Eventually, I concluded that it truly is my heart’s desire is to work with people in such an environment.  This is my dream, and dealing with these difficulties will probably end up making the work that much more fulfilling.

Though the culture was a bit for me to process internally, I thoroughly enjoyed my time there.  It opened my eyes up to medicine in chronic diseases and developing environments.  It was also my first example of long-term medicine in global health.

So now I’m back in Israel, feeling kind of naked in a t-shirt and jeans.  For the first day or so after my adventure, I was met with the two things that always meet me after exciting travels to developing countries: 1) exhaustion and 2) the pleasant realization that I can throw toilet paper in the toilet.

This is my last post for “My First Year at MSIH”, but I keep my own blog at medinthemizraakh.blogspot.com if you’d like to follow me as I attempt to document my experiences throughout the next three years.

Shalom! - blogger of the month Cherec Dickey