Working in a developing country is an exhilarating experience, but a challenging one at the same time. An important lesson I’ve learned has been the need to identify and work around limits I’ve had to set for myself. I am interning in a public hospital in Uganda serving 30,000 residents of a small city and its surrounding villages. The ethical and professional guidelines aren’t quite on a par with those of the US, to say the least. For example, on my second day I was stationed in the outpatient department and given instructions to diagnose patients on my second day. By my second week, I was assisting in operations. While I was thrilled by the amazing learning opportunities and experience of being so directly involved in the work of a hospital, I soon came to realize that I have to set my own standards and limits based on my own expertise (or lack thereof). The doctors and nurses are competent and highly skilled, but they believe strongly in practical learning and do not have the same strict rules for what interns should and should not be doing compared to other countries with more well-developed healthcare systems.
The opportunities the doctors and nurses have given me have been invaluable, but often I find myself realizing that I really am not qualified to be carrying out some of the tasks that they would let me do. In practice, setting boundaries for myself has meant standing back and watching rather than doing, and, conflicting with my strong sense of independence, asking for help when I don’t feel confident in treating a patient by myself. When I step back and decline a task, I remind myself that I am a student and that it is my job to learn before I do anything that requires strong skills.
Similarly to setting my own limits, I began to think about limits of foreign aid in general. In talking with other foreign health workers, I found that many of us share a certain feeling of “charity guilt”. While we want to do all we can to help, it might not be in the best interests of the ones receiving the help. A friend brought up the point that there is a level of dependency on foreign aid that is not sustainable or beneficial in the long term. With a constant flow of volunteers from other countries, Uganda has become, to a large extent, dependent on these workers to reach the health care level that they should be operating at without the extra help. This represents the double-edged sword of foreign volunteers and aid in a developing country. On one hand, it can fill a gap and help provide needed resources and services, but the downside is that the recipients become dependent on them, and don’t have a strong incentive to try and replace them with local resources and capabilities. An American I met here found a functional solution by empowering the local people in the work she does. She started an NGO in education and a bowtie company here in Uganda, where she provides what she likes to call “hand-ups”, not “hand-outs”. Rather than giving out things or simply fundraising from abroad for her projects, she focuses her work on finding ways to generate income and sustainability from local resources and people.
Being involved in aid projects requires a high level of creativity to come up with sustainable solutions and trust in locals to continue the work after the foreigners are gone. Too many projects are abandoned after their initial installment. To avoid this, I feel that more effort should be given to the upkeep of the established facilities rather than the startup of many new but temporary ones. Before starting any project or commencing a volunteer position in a developing country, we must ask ourselves, where should we set our limits as individuals, organizations, and countries? And how can we avoid fostering dependence?
Mika White is a second year biochemistry major at Northeastern expecting to graduate in 2018. This semester she is on her first co-op in Uganda interning at a rural hospital in the town of Iganga and establishing a malnutrition treatment program in Namutumba District. She loves to travel, read, and run. Feel free to reach out to her at email@example.com and LinkedIn, and read her personal blog at mikawhite25.wordpress.com.
Photo: Hintisberg Climbing, Mike Bean, Flickr Creative Commons