The Unpaid Debt

15 07 2011

By Joy Liu

The last few weeks of our childhood vaccination study in Muhuru Bay have been both eventful and insightful. Our project is now approaching its fourth week. The first week was devoted to talking with the local clinic and fleshing out goals and steps. The second week was focused on developing and refining a questionnaire for mothers in the community. Last week was devoted to surveying. In order to have a more comprehensive understanding of the reasons for incomplete vaccinations, our aim is to get various perspectives from invested groups. This includes not only health care providers, but also mothers responsible for taking their children to the clinic, community health workers, midwives, and fathers. We have already talked to some clinicians and mothers. Our plan for the upcoming weeks includes hosting focus groups for community health workers, midwives, and possibly fathers. In gaining a better understanding of the health system here, we have also noted the importance of dispensaries and will visit local dispensaries. In addition to gathering information, we are also beginning to analyze the data from the surveys of the past week.

Developing and revising the survey was a learning process, but what I was more surprised at were my realizations after conducting the surveys. All through the week, our group went into various parts of the community with translators and interviewed mothers with children under three. I have been graciously invited into the homes of these women, who have let us into their world for a short half hour. The more I think about it, the more I realize what a unique kind of interaction it is. I come into their homes for half an hour on a weekday morning. I ask questions. I smile at their children. I thank them for their time. Then, I leave. Maybe they will remember me and maybe they won’t. I will never know. The lack of confidence about our impact is something that many of the DukeEngagers here have struggled with, not only in research work but also in teaching.

There are times when I don’t want to learn more. The more I survey and the more I find out about the system, the more I see the structural problems within. It’s not merely the distance or fee or ambivalent attitudes towards the medical community, but a combination of all those and more. Even if all mothers wanted vaccinations and all clinicians gave it freely, there would still be issues with infrastructure, supply, regulations that seemingly no one here, least of all us, can really change. To each mother I feel an obligation, but I’m not sure I can do anything that will benefit them directly. But I catch myself, because I know that I value every minute they have given me. They are allowing me to see their world, giving me knowledge and perspective. Maybe one day, I can act upon this knowledge and change something. Maybe it won’t be for them, but it’s an unpaid debt I hope to be able to repay in full someday. It’s funny what thirty minutes can leave you with. These mothers, and all those people I have been fortunate enough to make meaningful connections with here, have given me a great responsibility, a great gift-a motivation no one can take away.

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