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Friday, February 8, 2013

February Update


Hello! It's been a little while since the last update. Things are going well here in Tixan and at the moment, everyone is gearing up for Carnival, which kicks off tomorrow with the crowning of the King. Ecuadorians take their parties very, very seriously, so it should be a good time!

We're also in the middle of 2 weeks of school vacations, so I've mostly been hanging out at the clinic. It seems strange now that I used to go there all day every day, because while theres stuff to do... theres not THAT much to do. I'm also becoming very conscious of the fact that I'm leaving in 6 months, so I'm trying to back off a bit in terms of the free labor. There are some things I do at the clinic that are mostly outside of their work area (nutrition counseling, organizing/reorganizing the files), things that wouldn't otherwise get done if I wasn't there. However, there are other things that I sometimes do because theres nothing else to do... but I probably shouldn't. Sometimes I help take vitals, do some filing and help clean, because I'm bored. The problem is that these are things that are explicitly in the job description of other people, so to some extent, I'm enabling their inefficient work habits by doing part of their job.

Occasionally, I help out because theres just no one else to do it (like the days when all the nurses leave to do vaccines, and the doctors are left without anyone to take vitals), but this is also problematic. The doctors are perfectly capable of pulling files and taking vitals themselves... it's just that it takes so goddam long to do, people will end up waiting for literally 5-6 hours. My conscious always sides with the patients, so when I help out its always to make things more efficient and pleasurable (as much as possible) for the sick people. I think that people appreciate and like me for this, which is great for me... but what happens when I leave? Will things just go back to the way it was before? When everyone yelled and treated the patients (and each other) like crap?

I don't know. It's impossible to know now. I worry about it though, and I wonder if there are any measures I can put in place to help prevent things from reverting back to the inefficient, unhelpful status quo. To some extent, I think that my presence sort of shames people into acting better. I don't yell, I say please and thank you, I don't give people a hard time about stupid, random things. I'm always mystified on the days when the occasionally enforced "rule" is that people can only get one appointment per family. What if 2 kids are sick with fever? What if the family comes with 5 people because they live really far away and can't make it more often? What if the mom needs to get her birth control TODAY and her child is sick? (All of which happened the other day).

I should point out that I don't think its not like this everywhere. Other clinics and hospitals have a better system, more management oversight, and more doctors. The major problem with my clinic can be summarized in one word: burnout. People are jaded and don't even try to have patience anymore. Burnout exists in every field, in every area of the world, but its especially harmful in this sort of first-tier dealing with the public situation. Tixan is a difficult area to work in, FOR SURE, but it doesn't excuse the behavior of some health workers. I've had days where I just have to leave after a few hours because I can't believe how horrible people are being and I feel like continuing to work condones their behavior. Could I say something? Maybe, if the perfect opportunity came up. Otherwise, I keep my mouth shut, because after all I'm just a random, privelleged gringa. There are some moments when I put in my 2 cents, moments that are more suited to my areas of expertise, but when it comes to basic human behavior... nope. I'm no one's mother. The way most Ecuadorians avoid taking the blame for anything (even in situations when it was clearly their fault), it would be suicidal to give a name to the obvious problems.

I've thought about possibly bringing up some of my issues right before I leave, but if I ever want to come back to visit and actually be welcomed, I can't do it. Be smart, Chloe! When has burning bridges ever been beneficial in the long run??? Never ever ever.

Anyway! In terms of other work... the health classes I teach at the two schools have been going really well. The kids are finally calming down, so classroom management hasn't been as big of a headache as at the beginning. I also finally got the 6th and 7th grade teachers at Escuela Luz Elisa Borja to pay attention to me and help me out with behavior issues, so my last classes in January were very pleasant and productive. It took nearly 2 months of complaining, walking out of a couple classes, and finally complaining to the other teachers to get them to change, but better late than never! For the first time, the kids listen, participate appropriately, and are (mostly) respectful for the entire 40 minutes I have with them. Imagine! Its a small miracle.

In my spare time, I'm also working on compiling my lessons into a manual for the teachers to have once I leave. Probably no one will use it, but hey, you never know! I mentioned this project to a woman who works at World Vision (the largest NGO in the world. You know, "for only pennies a day you can sponsor a child...") who is in charge of a national effort called Escuelas Promotores de Salud or Health Promoting Schools or something. Last year, I presented at a conference for the schools in my area, but they haven't asked me to do anything else. Anyway, I mentioned that I'm putting together this manual of lessons for health classes and Veronica seemed interested in possibly using it for this network of healthy schools. I'm going to try and get it done in the next month or two, because it would be awesome to promote it at the participating schools before the year ends in June. The Health Promoting Schools project is a great idea, but its also really vague. At the conference I went to, they didn't exactly teach the teachers how to incorporate health lessons into their curriculum. They mostly just told them stuff they should already know, about hygiene, sexual health and nutrition. To me, taking that information and translating it to the classroom is the real challenge! Luckily, I've got a bunch of tried and true lessons that do just that.

There are a few others projects in the works, such as a women's jewelry cooperative, a girl's club, baking/cooking classes, and English lessons, to name a few, but I'll return to talk about those another day. It's funny that with 6 months left, all these opportunities suddenly fall in my lap. I wish I'd had these bright ideas a year ago, but what can you do?

Lastly, I applied to the Portland State University Master's in Social Work program for entrance this fall, so fingers crossed they let me in and give me lots of money! This means that I'll be heading back to Portland after Peace Corps ends in July or August, which is pretty exciting. It feels really good to have something of a plan and a place to be for the next couple years... which is a big reason I signed up for PC in the first place. I can't seem to settle down in one place on my own, so I have to force myself to do it using other means! Restlessness is really a big problem.

Anyway, I hope you're all doing well! I'd love to get an email update when you get a chance. Seriously! I'll leave you with a picture of me and some of the health workers after our Christmas program at the clinic. The ladies helped me buy my outfit and get all dressed up, which was a lot of fun!