From the field – Summer 2018: Bringing about systematic change in global health & development
My time here in Zanzibar has largely been spent working in the laboratory of the Mpendae Primary Health Care Unit. Every day I, along with two other students, three lab technicians, and patients, squeeze into the small, ten by ten lab facility. And every day, I see something new that completely shocks me.
Over the past few weeks, I’ve eaten cake only a foot away from a patient whose blood was being drawn, found durian being stored with the microscope, watched a needle fall and be inserted back into the arm of a patient, seen urine samples poured down the sink, and watched as technicians perform mRDTs without gloves and throw away blood-contaminated supplies into a normal trashcan. These things, in our eyes, are blatantly wrong – but in theirs, are perfectly acceptable.
It’s hard not to judge the fact that disinfectant is stored in Fanta bottles or that the staff’s lunch is kept in the same fridge as the drugs and vaccinations, but over the past few weeks, I’ve learned to not judge the circumstances here, but rather acknowledge that this is reality. There is an obvious lack of resources and space in the hospital which leads to the reuse of supplies and other problems, and it is clear that there aren’t strict procedures in place. I’ve come to realize and acknowledge that while these are problems in the U.S., they’re not considered an issue here.
However, we have to remember that acknowledgement isn’t acceptance, we don’t have to ignore these problems or justify them by a lack of resources – instead, we have the capability to help change the reality of the situation. Instead of saying “that’s just how things are here,” we can strive to learn what the causes of these problems are, whether it’s a lack of structure, education, or resources, and work to change it.
This inevitably brings a million questions to mind. How can you even change a system? How can you work to change the habits and attitudes of not just a few individuals, but an entire hospital? Where do you even start?
I’m still struggling to find the answers to these questions, but I hope that I can take my experiences here and use them to help make a change, even if it is a small one.
If I have learned one thing during my time here, it’s the importance of not being afraid to question the world around us and speak up about the problems we see. The only way that we can help make a change is to observe, question, and learn.