a few symbiotic reflections

Maren asked me the other day, do you know of any western doctors who have come to Peru and are working within the peruvian medical system?

The questioned stemmed from both the awful ER experience described a few weeks ago  and from the fact that the doctors with the lowest test scores coming out of medical school are assigned to the most remote/improverished health posts. On the flip side, it is nice that the Peruvian government sends Doctors to these remote health posts (locations I am sure no Doctor really desires to live), but its still hard to think its a good idea to have the lowest qualified doctors working in the areas where people are at-risk for many serious conditions and are hours & hours away from hospitals.

So, back to my answer: I don't think so. I feel bad saying this, but after those few hours in the public hospital's ER, I realized that it wasn't the competency vs incompetency of the doctors/nurses....it was the inefficiencies of the system. I understand refusing to work within this corrupt/broken system means that I have little chance of being apart of the solution, but I would find it utterly too frustrating to order an urgent medicine or a test, only to wait hours for the order to be carried out.

I've asked myself, if my goal/motivation for even considering being a doctor in a place like Peru would be to help poor/vulnerable people, then shouldn't I be willing to take an active role in changing the healthcare system for the better. And the answer surely should be YES, I believe every physician should play the role of advocate for their patients in the public/political sphere. However, I could much more easily see myself following in the footsteps of some of the American doctors I've worked with here, who are working in their own charity clinic, but also are actively engaged in training/mentoring/teaching local Peruvian medical students. Demonstrating a compassionate AND efficient patient care environment could go a long way to effecting the system as a whole, because these students they are working with are the future doctors of Peru, both in the remote areas and in the public hospital ERs.

This whole mental exercise lead me to broader reflections concerning one of the principal questions I came to Peru wanting to explore: What would it be like to me a missionary doctor? This past week I finished the same book that Maren read (and blogged about) a few months ago: Gracias by Henri Nouwen. This is an excerpt from a book that really convicted me to consider my heart when it comes to missions work.

the two most damaging motives in the makeup of missioners seem to be guilt and the desire to save.  Both form the extremes of a a long continuum, both make life in the mission extremely painful. As long as i go to a poor country because i feel guilty about my wealth, whether financial or mental, I am in for a lot of trouble. The problem with guilt is that it is not taken away by the work, hard work may be pushed underground or a while, but it can never really take it away. On the other hand the desire to save people from sin, from poverty, from exploitation can be just as harmful, because the harder one tries the more one is confronted with one's own limitations. If you depend solely on the success of their work, they would quickly lose their sense of self-worth. 

Although a sense of guilt and desire to save can be very destructive and depressive for missioners, I do not think that we are ever totally free from either.

Thanks for reading yall...