Expectations…As a volunteer working in the Community Health program in Madagascar I expect to be placed near a village clinic in a rural setting doing grassroots, community based health education. I expect the potential topics to be quite broad and varied including but not limited to reproductive health, family planning, HIV/AIDS/STD’s, water quality issues, perinatal health issues, malaria, tuberculosis, and immunizations. I expect to receive support from both the Madagascar Peace Corps staff, the Ministry of Health, the staff of the clinic I am near, and any non-governmental organizations (NGO’s) that I may be working with. I have come to realize that I am at my best in small groups and more in my element doing ‘field’ work vs. being cast in a primarily office-type setting. I embrace the relatively small group that I will be going to Madagascar with and the ‘grass-roots’ nature of the outreach health education.
I expect to feel fulfilled and inspired much of the time and know without a doubt that there will be times when I feel less than inspired and fulfilled. For the most part, I expect to feel like I’m doing meaningful work and making a difference. I also expect that there will be times when I feel that I am merely taking up space and wasting my time. I expect to feel intense homesickness on occasion and to question my sanity in voluntarily removing myself from a setting where I was surrounded by friends, family, and so much love. And then I expect to be reminded that there are friends, family, and love everywhere. Lastly, I expect to connect with my fellow peace corps volunteers with an ease and on a level that often results when people who share an abundance of common ground come together.
Personal and professional goals…I come to the peace corps as a very recent nursing school graduate and licensed registered nurse. I am aware that this assignment in no way involves clinical nursing and/or providing curative health care. It has been explained to me quite well that this is not a nursing role per se and this was the one reservation I had in accepting this opportunity without hesitation. I was worried that it might not be looked upon as bonafide nursing experience and that the intensive yet enriching year-long diploma RN program I endured and successfully completed would be in vain. In arriving at the decision to accept this opportunity I concluded that being involved in community health education projects at the grassroots level in Madagascar could only enhance and compliment my newfound knowledge and I plan to parlay this public health experience with the peace corps into nursing opportunities down the road. It is my hope to utilize my health/science perspective to enhance the effectiveness of any project whose ultimate goal is to improve quality of life and infant mortality in a nation lacking the cultural resources of other wealthier nations.
No small amount of thought went into this decision to accept an opportunity of this nature with the Peace Corps. The decision was motivated primarily by an interest in devoting myself to public service. The old American cliché “An ounce of prevention is worth a pound of cure” could only be more true if the units were converted to metric (gram of prevention, kilogram of cure), with the subsequent exponential growth that illustrates how worthy and how much sense it makes to focus ‘upstream’ at prevention efforts. And so I find it much more rewarding and satisfying to invest effort in being proactive, addressing root causes vs. treating symptoms, channeling energy to keep healthy people healthy rather than the reactive attempts to keep sick people from becoming sicker. This is all merely my attempt to convey that my personal and professional goals currently involve a hope and intention to practice nursing in the realm of public health, and specifically to public health strategies aimed at prevention. I am not attached to any picture of what the future holds but rather genuinely excited for the opportunities and possibilities that might spring from this Peace Corps assignment in Madagascar. Lastly, I have an interest if not preoccupation with death and dying and like the idea of providing end-of-life care within an in-patient, clinical hospice setting at some point in my life. I understand that the Malagasy culture has a unique approach to death and dying and look forward to getting this exposure to enhance and broaden my view(s) toward the dying process.
It might also be worth mentioning that I have had a long running love affair with Ma Nature and know that my well-being is highly contingent on maintaining an active lifestyle while enjoying human-powered exploration of natural landscapes. I have amassed a considerable amount of experience with several federal land-managing agencies in the US mostly in the realm of providing for public safety. I recognize my good fortune in receiving placement in a place that has such unique challenges in providing for cultural development while mitigating natural resource exploitation. I expect to have opportunities to contribute to ongoing Peace Corps efforts to maintain and promote Madagascar’s environmental integrity. Surely by now we have learned that human health goes hand in hand with maintaining the health and diversity of the non-human world around us. At the completion of my peace corps service I plan to take advantage of the year-long ‘status’ for government jobs that is afforded a returned peace corps volunteer and investigate options with the National Park Service. I would be most tempted by any opportunities that marry my nursing and outdoor background and experience. Alternatively I have an interest in health as it relates to international travel and would love to be considered for any nursing positions abroad with the Peace Corps.
Strategies for adapting to a new culture...I will again draw upon my recent experience with nursing school and the coping mechanisms that I developed and/or improved upon in describing my strategies for adapting to a new culture. I believe that the tactics and strategies that served me well in that context are highly applicable to these new challenges that I will be presented with in Madagascar (and highly applicable to all of life’s challenges). I recognized early on that my success in nursing school had everything to do with striking a balance and budgeting substantial time for personal health promoting practices. That is, a recognition that ultimately I was going to do better by allowing for rest, leisure, physical activity, and eating right rather than stealing time away from and neglecting those causes in favor of spending the bulk of my time engaged in study. In so doing I maintain optimal capacity for dealing with challenge.
Additionally, it has been my contention from the start that nursing school was more a test of one’s ability to maintain calm, composure and perspective in the face of extremely uncalming and composure/perspective-shaking stimuli than it was a test of nursing theory and clinical skills. This is to suggest that I expect to encounter plenty of potentially uncalming and composure-shaking stimuli while engaged in the process of cultural integration and believe that I now have an increased capacity to respond consciously (while maintaining calm, composure, and perspective) versus reacting unconsciously and resorting to deeply ingrained habitual patterns and tendencies that might only make a difficult situation worse.
Lastly, I certainly plan to rely and call on fellow current and/or former peace corps volunteers as well as staff for support when traversing the ups and downs of cultural integration. At times I expect to feel like I am the only person going through what I’m going through and hope to not let this insular feeling keep me from reaching out and finding others who are traversing the very same ground. I am a loner by nature, valuing my privacy, space, and quiet time and see that this predisposition could set me up for some pitfalls. It is only through reminding ourselves that we are an integral part of something so much bigger than our tiny insignificant selves that we avoid the tendency to slip into such defeatist states.