Losing myself: My out-of-programme experience in India

The turning point

Two months in, my body started to feel the strain: I was hospitalised for a week with high-grade fever and became virtually bed-bound for a further 2 weeks. My confidence had plummeted and I started to question what I was doing here. During that period of ‘purposelessness’ the team at DHR offered me unforgettable support. They would take it in turns to spend time with me and share their life stories. I was encouraged to look at this illness as part of the package and a necessary resting period. It gave me time to take in the massive cultural shock and question my own expectation of ‘creating a change’. This became my turning point.

We sometimes have the ambition to do something and be somebody. With all good intentions, I had desired to utilise my skill-sets to help others (and also make me feel good), without first understanding them and their priorities. I faced the inevitable truth of profoundly letting go of my ‘need to do’, choosing instead just to be with people.

Thus, I spent the following 2 months not being a doctor. Instead, I played cricket with the kids, sung folk songs with the elders, attended school, cooked with the mothers, picked cotton in the fields, took the cows to graze, and enjoyed hearing life stories over chai. Without trying to achieve anything, I started to feel something remarkable – that I was one of them. I was no longer an ‘educated outsider’ trying to impose my ideals, but instead merely a simple person wanting to learn.

The fun begins

During this period of having ‘no purpose’ I had built a special trust with a few of the people in the village. One of them was Manju Tai, the village nurse and mother of two. Despite her simple nature, she pointed out remarkable insights that helped us initiate a unique project aimed at young mothers, with a view to improving the health of their children. Each week, groups of five mothers would come together to do something unthinkable – they would use an iPad to film and interview one another with respect to village health, nutrition, hygiene and sanitation issues (Fig. 1). These women, who had never before seen or touched any kind of filming equipment, let alone speak on camera, had now become journalists for their own village. In effect, they were learning to do research for themselves. The completed film would then be aired to the entire village in the evenings. It would raise awareness, spur debate, and cause plenty of fun and laughter. At the end, after understanding the issues, villagers would agree to make certain changes to their daily habits. This participatory video method put people in charge, allowing them to take ownership for their own change. The result was a renewed enthusiasm to raise healthier and stronger children. Now, almost a year on, DHR has taken the program to neighbouring villages and schools. OPEN IN VIEWER

The issue of ‘Identity’

My initial frustration lay not in my environment, but in my need to hold on to ‘myself’, or in other words, my identity. This identity of being a ‘well educated, professional western doctor, determined to promote healthy change through elaborate project plans’ was precisely the reason I got stuck. My identity turned out to be nothing but a compilation of fixed (yet arbitrary) beliefs that formulated my ways of being. Although they had a role in shaping decisions, I fixated on them. When these fixed mental beliefs (irrespective of their magnanimity) were confronted with a reality that was against them, the situation became unworkable. In the global health and international development arena this cannot be closer to the truth. We go in trying to change people, not realising that the basis of our change is rooted in our own parameters for development and not theirs. The fallacy lies not in our skills, resources or even intentions, but in our unwillingness to first change ourselves by letting go of our own ideological baggage. Otherwise, we run the risk of ‘being monkeys trying to save the fish from drowning’, where well-meaning but misinformed actions can do more harm than good.

Approximately 70% of India’s population live in villages. Factors such as vulnerability, powerlessness, isolation and poor physical health contribute to the vicious and often inescapable cycle that we simplistically label as ‘rural poverty’ (Chambers, 1983). This is largely hidden from our sight, unless one is willing to put aside their personal agenda and just be open to what is. Despite India’s rapid economic growth, universal primary healthcare remains a distant ideal, with enormous social challenges and inequities yet to be overcome. Organisations such as DHR continue to establish universal primary care, and I am personally indebted to them for providing loving hospitality and a space to explore myself.

In summary

The skills I gained during this experience in India have already come to use as a GP trainee, particularly in the realm of communication. My consultations have profoundly improved by way of active listening and creating mental spaces for patients to open up. Seeing such huge cultural, economic and linguistic variety in our day-to-day practice, I felt the experience gave me the ability to adapt my style according to patient need, thus making each consultation unique and thoroughly enjoyable.

In terms of international volunteerism within the healthcare profession, I strongly encourage the sentiment. From my experience, the most important thing was to let go of my expectations, fixed ideals and self-identity, and instead engage wholeheartedly the with people, culture and environment. In doing so, it became an incredible process of self-discovery. Sometimes the best way to find yourself is to lose yourself.