Friday, 12 April 2013

How to Really Help - by Morgan Nikel



Initially it seems easy to look at Africa as a continent and see what needs to be done to help improve it. You can look at each country and pick out different aspects that need more development. These can include but are not limited to health care systems, infrastructure, governments, or economies. From the perspective of a high-income country, it is too simple to point at a flaw, and say “this must be fixed” without truly understanding how to go about making a change. While I have been in Ghana, there have been many situations in which it was clear that something needed to be improved. Unfortunately, just recognizing a problem does not help to fix it. This simple recognition only acts as an identifier, not a solution.

Before doing my rotation in general pediatrics at 37 Military Hospital, I believed that I would see a very different level of care provided than what I am used to in Canada. I prepared myself for improper sterile technique, lack of resources, and different procedures for dressing changes and IV insertions. Therefore when I observed these procedures I was not shocked to see that what I thought was true. I was actually more shocked to see the amount of resources that do exist in Ghana, and therefore found myself silently critiquing their procedures and techniques instead. I had built up such a stereotype of Ghanaian health care in my mind that I didn’t expect there to be normal saline, or gauze, or even sterile gloves. Therefore I did not expect a sterile fields or sterile dressing changes. And so when watching these, I could only picture how a sterile field would be treated in Canada, and how a sterile dressing change would be completed in Canada. Originally I could not overcome my shock of such a lack of sterility and organization in these procedures to see that they were providing competent care to the best of their abilities. I then questioned myself: who was I to criticize their process when I was not helping them to change or improve it?  

It was at this moment I recognized that I should not have entered the unit with such prejudices in my mind. It is better to keep an open mind and be willing to learn, so you can see how you can truly help. I had come in thinking I could provide the unit and nurses with resources. Then through my own disdain, looked down on their process as being incorrect. Based on Canadian standards, the majority of their procedures are done without proper sterility or technique. The nurses however, are aware of this. They explained that they understand what they should be doing for proper sterility and what the technique should be. They just cannot perform to such standards because of their resources. It therefore does not help the patient or the nurses to shake your head at their actions. Yes, what is reported is true. Ghana does need more resources in their health care system. What is not reported however is that they do not need criticism for what they are currently doing. They are doing their best with what they have.

The way to really help Ghana and Africa as a whole is to break your stereotypes against them. Do not form quick judgments from what you see in the media. Do not decide that a country would be better if one thing – such as health care – was fixed. Do not assume that the citizens living within a country do not want to or are not working towards change. You cannot help a country that you do not fully understand. It is important to educate yourself and others about a country and culture before making a decision about what kind of help is really needed. You cannot make an uneducated guess on how to truly help a country. For example, I could not help with a dressing change when I scoffed at the improper sterility. I, like many others should, needed to set aside my prejudice and judgment and see that they are simply doing the best that they can with the resources they have available. 

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