A Travellerspoint blog

Pre-Departure SIT: Health and Community (Spring 2013)

Thoughts about Heading Abroad

snow 18 °F

This spring term I will be traveling with the SIT IHP: Health and Community Program to New Orleans (U.S.A.), Chennai (India), Buenos Aires (Argentina), and Cape Town (South Africa) with a group of 32 other students to study Global Health through a variety of lenses. In our 4 months abroad we will be taking courses on Community Health and Research Methods, Globalization and Health, Health Culture and Community, and Public Health: From Biology to Policy. These courses will be supplemented by visits to community organizations and health systems within each country as well as visits by guest speakers with different expertise. It’s an exciting opportunity to travel and really engage with many of the issues I’ve learned in my medical anthropology and public health courses at Yale.

What are you expectations for the Program?

At first, the idea of traveling to three different continents in the course of a semester seemed too vast and the idea of comparative health or cross-cultural analysis seemed too delicate of an assumption on which to base the foundation of a program. Yet, thinking about it more, I recalled the curriculums I’d been exposed to in college. In Prof. Richard Skolnick’s Global Health Cases we covered almost 30 different countries’ health systems over the course of a semester and learned so much. In my anthropology classes we read ethnographies from the U.S., the Caribbean, Africa, the Middle East, Asia, and Europe to study concepts of masculinity, disability, pharmaceuticals, indigenous rights, and structural violence. Even the public health courses I took focused on epidemics and outbreaks from various different parts of the world. In today’s world its important not only to know the intimate workings of a culture and society, but also the larger forces at play and what lessons we can draw from different health campaigns. The more and more I thought about it, the more I was drawn to the idea. What other opportunity would I have to visit these countries and learn first-hand from the people there? What other opportunity would I have to challenge my almost exclusive focus on Latin-America and branch out to other areas in the world? What other opportunity would I have in college to see if I am truly passionate in Global Health or if I’d rather focus my studies on something else? And so I approach this program with an open heart and mind.
One of the things I really hope to achieve in this program abroad is a firm foundation through applied experience in Global Health. As an emerging academic field, Global Health is tenuously comprised of public health-related, anthropological, economic, political, ethnic, and gender studies courses with the hopes of holistically integrating these approaches both nationally and internationally to provide the ‘best’ care possible. Due to its interdisciplinary nature between departments, such as the sciences and humanities, it’s very difficult to integrate these courses. Even more difficult is the application of lessons learned in the classroom to the real world of international bodies (i.e. UN, WHO, IMF), non-governmental organizations (NGO’s), public health systems, and community-based efforts on the ground. What truly drew me to this program was the opportunity to travel to these distinct countries and actually observe community-based efforts, study the well-meaning but often ineffectual work of NGOs, talk with people who participate in the public health system, and understand the impact of overriding decisions made by international bodies on individuals in these countries.
Most importantly I think the day-to-day experience of living with a host family and exploring these cities will be the most enriching (and the most challenging). I look forward to eating a traditional meal with my host family, engaging with their children, and having conversations with the parent(s) about their city and country. I look forward to listening to the hum of the sitar, the throaty chords of the bandaneon, and strong beats of Afrikaans music. I look forward to eating masala, picanha, and fermented pap. I look forward to participating in holidays and religious ceremonies. I look forward to traveling in rickshaw, tram, subway, and overcrowded buses. I look forward to getting to know the families I will live with, the cities I will live in, and the health issues I will be studying.

How would you describe ‘healthcare’?

Healthcare is practiced everywhere. What is most important to recognize is that healthcare is practiced on all levels – not simply the biomedical – and that sociocultural issues can affect health and healthcare seeking strategies just as much as the larger economic and political issues. From my studies I’ve learned that healthcare can be as formal and medicalized as the state-run hospital and as informal and traditional as the street-side pharmacist of the religious healer. People more often than not access healthcare only when they are ill – that is to say when there are pathological symptoms or bodily complaints, which deviate from the ‘norm.’ More profound questions arise when we begin to discuss the idea of a ‘norm’ and illnesses with no pathology. This sickness is seen as something separate from the individual, which must be cured. The patient often assumes the sick role referring to a healer or doctor within the biomedical system who can address this patient’s concerns. Based on access to resources, transportation, availability, beliefs, and ability to pay, these concerns can go unaddressed or can be directed to family members, local healers, street-side pharmacies, public health outposts, or private medicine. Once the person is healed/cured, they can return to daily life. But more often than not in the world of Global Health, people encounter obstacles to this practice of seeking and receiving adequate healthcare. These are some of the issues that I hope to address in this program.

What do you know about the four sites you will be visiting?

New Orleans, U.S.A.
I’ve heard so much about New Orleans. When deciding to study abroad I had to have a long meeting with our residential college Dean Ryan Brasseux, a historian and musical aficionado from Louisiana whose love for NOLA is only surpassed by his love for the more French-Cajun Bayou. He warned me – you’re going to catch the bug. New Orleans is a city steeped in sensuality: the sweltering heat, the spicy beans and jambalaya, the loud rancorous music and swooning brass. It’s a Southern port city with a distinct flavor that reflects its diverse inhabitants – African-American, Caribbean, Latino, and French. Perhaps it's a little romanticized, but I expect New Orleans to be just like that – a hot stir of cultures and people in a bustling port city.
While the people and culture are so vibrant, I can’t forget the hardships they’ve gone through recently. I imagine the wreckage of Katrina still echoes in the poorer areas of New Orleans. I imagine all the issues with large urban cities – the poverty, the projects, and all the health problems that can come with low income living. New Orleans has a darker side and a vibrant population fighting to pull itself out of the wreckage. Then again, these are all musings – you’ll never truly know a place until you’ve gone.

Chennai, India
Similarly, I’ve heard much about Chennai (formerly known as Madras). My parents just came back from a medical conference there bringing both photographs and stories of their experience there. My mom fell in love with India, but my father was overwhelmed by what he calls a country of extremes. Colors – the most intense colors you have ever seen, people wearing bright reds and blues and yellows. Spices – the most spicy foods you have ever eaten, breakfast with unbearable heat and a burning mouth. Richness – hotels and commercial buildings that are unbelievable palaces of grandeur and wealth. Poverty – the most extreme poverty you have ever seen, people begging on the streets wearing little clothing, reaching out to touch you. The colors and spices I can handle. It’s the dichotomy between wealth and poverty I am concerned about. I’ve read so much about the income inequality and pervading social stratifications of a former caste system. I’ve also read about the aftershocks of British colonialism and the lack of infrastructure after they left. I don’t know how I will reconcile such extremes. Yet, I’ve also read much about the resilient spirit of Indians and how they peacefully fought back against colonialism. I’ve read about how they are developing their country at an astounding rate sending the south-Indian high-rises of Chennai and Mumbai up into the night sky. India is a country of huge tradition and huge possibility. Perhaps my imagination is colored by the vivid images of Slum Dog Millionaire, but I imagine Southern India to be immensely beautiful and overwhelming.

Buenos Aires, Argentina
I’ve been to Buenos Aires before. I still remember the old European facades and trellises. I remember the crisp blue and white striped flags with their blazing suns. I remember eating alfajores and drinking matte from a hot metal bombilla. Buenos Aires is a proud city with its historic Recoleta area and beautiful cemetery. It’s lively city from the dark tango clubs to its fluorescent bars. It’s another city full of possibility. Yet it also has a history of pain and anguish – la Guerra Sucia and the Mothers of Plaza de Mayo that still march for their lost sons and daughters. Its’ a city still struggling with a lack of infrastructure and financing for Public Health – particularly in the poorer areas of the city where street violence still occurs. Yet despite all of its past and present tribulations, its’ one of the cities I am most excited to visit because of its distinct culture and my ability to really communicate with the people there in their native tounge.

Cape Town, South Africa
Of all the cities we will be visiting in our travels, I probably know the least about Cape Town. I know that it is one of the most populated cities in South Africa (right after Johannesburg). I also know that it is a much safer and more beautiful port with a lot of Dutch colonial influence. Nestled between the oceans and the mountains, I expect Cape Town to be a bright colorful hub of commerce and tourism. Cape town is written to be 5% Black, 20% White, 70% Coloured (mulato), and 5% Asian. This is an interesting melting-pot of cultures and although I believe people get along fine form day to day – one cannot deny the racial tensions that still must be felt even after apartheid. I expect to see this all over the city, from the penitentiary on Robben Island where many anti-apartheid leaders (including Nelson Mandela) were held, to the balcony of City Hall where Mandela made his first speech marking the beginning of the end of apartheid. I’ve read in the New York Times how despite these dreams of racial desegregation and one of the most progressive constitutions in the world, South Africa is still held back by infectious diseases (HIV/AIDS, TB, etc.) and surges of violent drug-related crime or xenophobic violence. For the first part of the trip we will be living in the formerly “black-only” township of Zwelethemba, which is still wracked with poverty, unemployment, and disease. For the second part of the trip we will move in to Bo Kaap – a colored area in Cape Town proper. Of my friends who have done this program I’ve heard the best experiences have been in Cape Town, both academically and culturally. I’m pretty excited to see what my experience will be like there.

~Bon Voyage~

I'm writing these last few words curled up warm at home. The snow is heavy outside and it’s nice to be back home for a week to settle. In a few days I’ll be heading first to New Orleans and then abroad. I've been having trouble sleeping these last few days with all the excitement – my head keeps brimming with the colors and sights and sounds I might experience when I’m abroad. I have no idea what to expect, but I know that 4 months from now I’ll be back home – my head brimming, not with expectations, but with memories of my travels abroad.

Posted by Fabian1993 14:57 Archived in USA Tagged leaving beginning pre-departure departures

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