The room you are standing in is overflowing with an incredible spirit. The many voices around you could carry miles and miles and send joy into anyone’s heart. The spiritual presence is overwhelming and almost indescribable. You are in a Haitian church and you are holding hands and singing hymns with the community of Fond Parisien. Its unlike anything you could experience twice, this is your first trip out of the country, on top of that your first mission trip, you are ecstatic, you wouldn’t be anywhere else in the world right now. These were my thoughts and feelings on our first Sunday morning in Haiti.
No amount of research, answered questions from previous missionaries who had gone to Haiti, deep conversation or thought, doctors visits with immunizations and organized packing could have prepared me for my experience. The unknown was exciting and interestingly enough part of the reason I decided to sign up for the trip. Conversely, it would be safe to say, although this trip was very eye opening and fulfilling in many ways, I would never be able to prepare another person for the same trip, they would also have to experience it on their own. On the same note, I have a feeling any other trip to another country I could make would follow the same course.
I know I have said it many times to many people, anyone willing to listen to me ramble on about my trip, I learned more in my trip to Haiti than I have in my whole life. I also have a feeling I will forever have learned more in those short eight days than I will ever learn in such a short time span ever in my life. Haiti was my first for many adventures but hopefully not my last. My heart, mind and soul was opened up to a world I never knew existed except from my geography books and what I had seen on television in the previous weeks from the earthquake coverage.
In the following essay I will attempt to explain my knowledge, although still very infantile, on missionary work. I will explain cultural issues related to a missionary experience abroad. Discuss the steps a person should take to prepare for such and adventure. Touch on the areas of spiritual growth a mission trip can contribute to in ones life and lastly reflect on the course. The whole experience was an information overload, not a bad one, but nonetheless trying to present a concise and effective summary of everything I learned is close to impossible, but I will try my hardest. First off, to truly begin with where we started you must have a good understanding of the cultural issues you are immersing yourself in.
Healthcare is apart of any country no matter what, where there is and there is not doctor, it doesn’t matter. On top of that every country presents itself like a character in a book. Haiti is just like any other character with its own history, culture, religion and language.
It is our job as healthcare workers to treat every individual with the best care we can, but what happens if you can’t understand what it wrong with your patient or why they may disagree with your treatment style, or are incompliant to the prescribed drug therapy related to their illness. Culture and language differences in the health care setting are not only an issue in other countries, they happen in American hospitals everyday. In an article from USA Today they state,” from 1990 to 2000 the number of residents with limited English proficiency grew by 7 million to 21 million of 8.1 percent of the population,” this is statistic is offered by US Census figures (Weise, 2006). Shockingly, Glenn Flores, an expert on language barriers in health care, explains, “ Only 46 percent of emergency department cases involving such individuals used an interpreter (Weise, 2006)“ This relates to our missionary work in that a lot of cases brought to us were emergency related and all involved a non English-speaking patient. Luckily we traveled with translators; unfortunately there is still a language barrier. I spent a long lunch with one of the translators explaining to him what diabetes really is. He was an extremely intelligent individual so teaching him was a breeze. We decided if I taught him he would teach me and this is how I have come to know the very little Creole I do. One amazing and enjoyable thing about Haitian people is their thirst for knowledge and their willingness to teach.
This huge factor, teaching in healthcare, is one of the greatest assets we underestimate as healthcare workers. The language of medicine is a very different one even to English speaking people. Medicine in itself has its own culture and can create a culture shock in a health illiterate person no matter the language they speak. The Online Journal of Issues in Nursing discusses this very problem in our country.
“The seminal 2003 National Assessment of Adult Literacy (NAAL) (Kutner, Greenberg, Jin, & Paulsen, 2006) measured health literacy disparities in several culturally diverse populations of American adults. Notably, the average health literacy scores for Black, Hispanic, American Indian/Alaska Native, and multicultural adults were lower than those of White and Asian/Pacific Islander adults. Especially striking was the finding that 58% of Black and 66% of Hispanic adults exhibited “basic” or “below basic” health literacy compared to only 28% of white adults. Moreover, bilingual adults, i.e. adults who spoke a language other than English before starting school, had lower average health literacy scores than adults who spoke only English before starting school. (Singleton MSW, LCSW, & Krause AB, SM, 2009)”
In other words, future nurses prepare for patient community riddled with healthcare illiteracy. Most importantly, be ready to teach and to listen.
Language though is only one aspect of a countries culture. In Haiti Voo Doo is widely practiced. One patient I triaged had an unusual mark on his arm. The mark was a scar, a cross with ends equal in length. Close to the tips of the cross a line was drawn through it perpendicularly making a close to perfect right angle at the ends. It was very obvious to me that this mark was not an accident it was man-made, it of course stirred curiosity within me. I asked the translator to ask the man what this was. Interestingly enough, he would not tell us. I decided not to press any further and to research later. When I got home I tried to find the tattoo and to my luck found nothing exactly like it but found similar images, most Voo Doo oriented which would make since. Regardless of whether or not what I saw was what I thought it was I learned from this situation, he did not want to talk about it, it was as if I almost offended him. The smallest things can make a difference in when you are learning a new culture. This leads me to the next important factor of missionary work, preparing yourself for the mission experience.
First of all, when traveling to another country the best thing to do is to go visit a travel doctor. As we all learned you have to prepare yourself for what ever the country may have or give you health wise as best as you can. We were all given at least one shot and sent home with prescriptions for a couple different pills for reasons ranging from anti malarial to anti diarrheal. We were also given suggestions on how to prevent certain diseases by packing properly for certain circumstances and following certain guidelines such as brushing your teeth with bottled water and avoiding ice in drinks.
The diseases and health problems that we were concerned about were the health problems we saw in the patients we took care of in the clinic. Something we had to do, that we were unaware we would have to do when we signed up for the trip was to prepare for the aftermath of the earthquake. It was sad, and surprising to see the number of people that needed medical attention because of something that occurred during the earthquake. According to an article by the Australian Broadcasting News 17 days after the quake, Paul Garwood, World Health Organization spokesman, states, “There is a critical need for surgeons, an estimated 30 to 100 amputations are being carried out every day in some hospitals (AFP, 2010).” In a very similar article from the New York Times published in January 20th, only 8 days after the earthquake, “partners in Health, an organization that has been providing health care in Haiti for two decade, estimated that 20,000 Haitians were dying daily from lack of surgery (Lacey, 2010).” The article also stated that,
“At some of the hospitals and clinics now treating survivors, the conditions are as basic as can be, with vodka to sterilize instruments and health workers going to the market to buy hacksaws for amputations (Lacey, 2010).”
This was something that we did not see directly, but after the trip I can imagine it happening.
This is reality, and when you tell a person that this really happens, it seems unbelievable. Unfortunately before the earthquake-hit Haiti was already in need, this only amplified their health problems and created a less effective rebound from the natural disaster. Now something that Haiti is going to have to focus on in regards to healthcare is going to be trying to get a control on infectious disease. A large task considering, “only one in two Haitians have access to clean drinking water, while only 19 percent have decent sanitation.” These numbers to me actually seem larger than what I would have guessed them to be. Despite the hardships it was amazing to see the major relief that was being giving by caring healthcare workers and the great faith that the Haitian people had in them and God. Which brings me to my last topic.
Most importantly missionary feeds spiritual growth. It is impossible to step into an experience such as this one and not find yourself growing in everyway, especially spiritually. The best advice I can give to a person thinking about going to Haiti or any country for missionary work is immerse yourself. I know I have said it before, but I am so glad I did it. Be a sponge and soak every last drop of their culture and their spirit and try accommodate them as much as you possibly can. Learn their language, I was a guest and I knew it, but I wanted to serve them and the only way I felt I could do this was to do what made them comfortable even if it meant I had to put myself in a vulnerable situation. I learned something from every person there, I learned something from every speaker we had before and after we made the trip but something one of the speakers said to us specifically stuck with me. Joe, the older gentleman that would be leaving for Haiti one or two weeks prior to us said, go there with the purpose of serving them, not to gain something for yourself and you will find that you have learned way more than you ever thought you would.
I found this to be so true. I learned so much and got to do so much there I would not be able to learn or do so quickly here. The healthcare worker can learn so much from a mission experience. In Haiti you see poverty at its most devastating level but at the same time you see faith at its greatest. It gives you a new perspective on life and forces you to appreciate what you are given. I was a different person in Haiti, I had to be. I had concern for myself of course but I was so involved with what I was doing I began to create a new life and a new routine, one that centered on providing care for others, I loved it. I truly stop myself occasionally everyday now and long for the feeling I had there.
When I first got back home from Haiti I was so happy to see my family. I was glad to have air conditioning and indoor plumbing with warm showers. I still had dreams about Haiti every night, and at first, I wanted those dreams to go away, I wanted to be home and actually feel like I was at home. These dreams consisted of me treating patients, triaging and giving them meds. Now the dreams are much fewer and far between and I wish they would have never gone away. If it isn’t Haiti I know it will be somewhere else, I will have more mission experiences in my life but unfortunately never a first again. This trip and adventure will always hold a special place in my heart; it gave me so many great stories and experiences. I encourage everyone to try mission work at least once in his or her life.
References
Singleton MSW, LCSW, Kate, & Krause AB, SM, Elizabeth. (2009). Understanding cultural and linguistic barriers to health literacy. The Online Journal of Issues in Nursing, 14(3), Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol142009/No3Sept09/Cultural-and-Linguistic-Barriers-.aspx doi: 10.3912/OJIN.Vol14No03Man0
Weise, Elizabeth. (2006, June 20). Language barriers plague hospitals. USA TODAY,
Lacey, Marcy. (2010). Nightmare in haiti: untreated illness and injury. The New York Times,
AFP, . (2010, January 30). Disease fears plague quake-hit haiti. Retrieved from http://www.abc.net.au/news/
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