Tonsillitis, lumbar back strain, herpes zoster, viral URI, sciatica, diabetic ulcer, contact dermatitis... all typical diagnoses in the day-to-day for us as health care professionals. The difference today is we are in the jungle, we speak a different language, the clinic we are in is indoor - outdoor and flies love to try to invade your sterile field, and the differentials include Dengue fever and Japanese Encephalitis.
There are many other differences including, but not limited to:
-Children rode up to clinic on their bikes, got seen, treated, were provided with health education and medications and sent home with no parental involvement.
-The clinic we are in is fully funded by the Thai Ministry of Public Health and donations from the rural community it serves.
-Keeping with Thai culture, no shoes are worn in clinic or in any homes when on our home visits.
-Speaking of home visits! Students and providers ride to the homes on bicycles and see patients in their homes, on their porches, in their neighbors yard, or at the local market... wherever they are at that moment.
-Public health volunteers, members of the community who mostly have no health care degree or background, are a large, valuable, powerful presence in both the clinic and during home visits. They attend student presentations on their assessment of community needs and offer feedback (for example: students this term focused on decreasing dietary sodium intake in efforts to improve hypertension), they do their own home visits on their neighbors to help with medications, cooking, and compliance, among other things.
The sense of community is quite remarkable. The community is so invested in the health and welfare of each individual as well as the overarching goals and needs of the community as a whole. There is a clear trust and respect for one another as well as the Thai nursing students and us UofM graduate nurse practitioner students that have come to their community to help them achieve their goals.
It's true, in just a handful of days, we have started to become a part of this village, each day seeing the same faces..."grandma," our favorite dancing public health volunteer, the stoic children already taking accountability for their own and their family's health needs, the frustrating but endearing non-compliant patients. Despite our obvious physical differences and language barrier- when it boils down to it these people are our "sisters" and "brothers" as we have called them from the time we arrived. Working alongside them and taking care of them and their community has made me feel more connected to this earth and the diversity of the people living in it
"Differences are not intended to separate, to alienate. We are different precisely in order to realize our need for one another." D.Tutu
Among the 10+ patients I saw in morning clinic on Wednesday, not one was upset about waiting, not one was frustrated with the language barrier, each greeted me with a warm smile and their customary respectful head bow. We spoke a universal language to one another- the language of facial expressions and body language elicited by therapeutic touch and charades. This experience is already helping tune us improve our nonverbal communication, elevating physical assessment to a whole new level.
Despite all of our differences, our goals are the same: compassionate care, health promotion, disease prevention, access to care... for everyone regardless of their social status. These appear to be universal concepts.
I'm so grateful to be on this journey. I can't wait for tomorrow.
"We are all equal in the fact that we are all different. We are all the same in the fact that we will never be the same. We are united by the reality that all colors and cultures are distinct and individual. We are harmonious in the reality that we are all held together on this earth by the same gravity. We don't share blood, but we share the same air that keeps us alive." -C. Joybell C.
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