Today I realized the limitations of my public health degree and work. We visited an EPI session to observe our data collector as she practiced prior to starting data collection for our EPI field study, which starts tomorrow. Naturally a crowd gathered around the “videshis” (that’s us – foreigners) and so we introduced ourselves, and explained why we were visiting their village. This flowed into a brief conversation on Infant and Young Child feeding practices. One women asked what she should do if she could no longer give breast milk to her 7 month old child, and another women had a 4 year old that didn’t want to eat. While we have been doing a lot of research in this area, Shivani and I did not feel qualified to appropriately counsel these women in such a large setting – instead we gave brief tid-bits of information, encouraged the women, and told them that we were working on developing services that would make this information more readily available to them. But I wanted to help these women – I wanted to be qualified to answer these questions. And then when a father voiced concerns about in-utero twins that were growing at disproportionate rates, all I could do was encourage him to go to an Upazila Health Complex. The problem is that some of these families are too poor to travel to the health complex, let alone receive the services that could help them. They may never know how to support these twins, and I am left with a sense of regret. I want to help, I want to understand how we can improve these health challenge, and I want to enter into the struggle with these community members. I believe that in order to fully understand the depth of public health problems, I must enter into these problems alongside these families – how will I know how to appropriately improve access to healthcare, if I do not have the knowledge, understanding, or interaction with the actual health outcomes? This is where my public health degree falls short, and is the reason why I am currently balancing this internship with medical school applications. I always knew that public health would make be a better physician, but now I see that I cannot be the best public health practitioner without medicine.
As we returned from the field by auto, I again encountered a scenario where my education and preparation fell short. We got into the auto next to a mother and her son. Throughout the ride the son cried “Mama” and in response his mother nestled him into her shoulder. His pain was reflected in her eyes, but all I could offer were non-verbal gestures of empathy. In this scenario it wasn’t just my lack of healthcare knowledge that was preventing me form serving, but it was also my lack of knowledge of Bangla. My limited vocabulary has put chains around my potential to serve this community. In order to serve the community not only do I have to understand them, their culture, their challenges, and eventually medicine, but I must first understand their language. Working through a translator has been frustrating so in the future I will devote myself to intense language training prior to going to any culture that is not my own.
As I reflect on these events that occurred this morning I am wondering how I can also apply them to FCAB’s work. While community engagement is the key to FCAB’s mission, I wonder if the ways they choose to go about this community engagement biases the feedback that they receive. For instance this morning, we approached a community and as soon as they knew what we were interested in Infant and Young Child Feeding practices those were also their concerns. Furthermore, because we were restricted by our public health perspective; I wonder how often our limited understanding of the health outcomes prevents us from improving those outcomes. Similarly, I must ask how FCAB’s perspective on health and service, limits their ability to understand the complex challenges their community faces. Throughout these remaining weeks, I want to work alongside my fellow interns to understand FCAB’s perspective, and determine how we can leverage that perspective to build organization capacity that better serves Bagdumur, and neighboring villages.