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REFLECTIONS FROM MY PRE-MED INTERNSHIP: ISSUES OF CULTURE AND RACE AS A BLACK AMERICAN ABROAD!

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September 4, 2021
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When I first learned of this study abroad opportunity, I could not believe my eyes. The description matched a dream of mine that I’ve held closely to my heart for some time now. My goal is to one day become a physician with a bioengineering background so that I can help battle health inequalities in low income communities and developing nations (although I’m not too fond of the term “developing nation”). This goal stemmed primarily from the several trips that my family and I would embark on periodically to visit family in Zimbabwe. Through these experiences I slowly started to notice differences in culture and the standard of life between Zim and the States. Many of these differences in Zim stem from colonialism and economic turbulence, but the culture still remains warm and welcoming in spite of all of this; so much so one could almost forget about the injustices that have been taking place if not careful. 

One experience that stuck out to me would be when I asked my aunt, the head nurse at Zvimba health clinic, if I could shadow her as a sophomore in high school (2015). It was there where I saw with my own eyes the enormous obstacles that medical professionals face when they are understaffed and not as well funded as they should be. Still longing to obtain a deeper understanding, I jumped on the study abroad opportunity to compare the health care system in the urban and rural areas.

Throughout the entire program I had to constantly remind myself that for the majority of the people on the trip, this was their first time being in Zim. I distinctly recall a time when someone asked if everyone in Zim takes the same malaria pills that the majority of the students were prescribed for the duration of the trip, and I caught myself responding a bit more bluntly than I probably intended to. Although to someone like me it was clearly obvious that many would not have the financial means to afford to take this medication on a regular basis, this was not obvious to everyone. I found myself having to check myself time to time and make sure to let my colleagues form opinions of Zimbabwe for themselves. Their experience and the beauty of the country, which ended up being the case, would speak volumes.

I will also say that I struggled from an identity standpoint throughout my time in Zim as well.  I found myself switching between observer and participant because I also wanted to learn of others interpretations of the country as well as an Zimbabwean-American. Towards the beginning of the trip, I was so fortunate to be able to reconnect with my family. It almost seemed like old times, but that is when I was reminded what my main purpose was. My cousin, who is a physician, told me at that very same family gathering that she found work in the healthcare field these days to be “depressing”. That set the tone for what was to follow. At the Children’s Rehab Unit at Harare Central Hospital I confronted the stigma of mental health and disability head on. In short, one of the most common conditions seen within this unit was cerebral palsy, which has a life altering prognosis. Whereas children with cerebral palsy in the US (at times) are able to receive special equipment and therapy (eg, horse therapy) to improve their quality of life, for a decent amount of people in Zim the topic of disabilities often leads to superstition and an unbalanced amount of the responsibility being placed on the child’s mother.

We had the opportunity to talk with some of the counselors and therapists about the mental and emotional burdens parents have to overcome when caring for a child with disabilities, but I wanted them to dive into more of the cultural ramifications as well. When I asked my question the response was a grim “you know how Africans are”, and yes I did. I wanted to be wrong, I wanted so very badly to have had a misconception about the culture coming in, but this was not the case. I needed my peers to hear more about how these children are often hidden from society and mistreated because of this stigma. On top of battling stigma, these professionals often faced difficulties that forced them to be innovative with what they had available for them. Overall, I can say that I was genuinely more impressed with the health professionals than I was with the health care system itself. Their tenacity, dedication, and compassion that they showed stays with me to this day.

As for the more touristy activities, I will say that I felt immense guilt. I can recognize that many people native to Zim have not been to say Vic Falls before, but I have had the privilege of doing so for years now. Going to the falls, Lake Kariba, the Chinhoyi Caves, and all of these breathtaking venues was nice, but at the same time I was very much aware that even people in my own family have not had the opportunity to do this. Here I was parading around a country, going to all of these amazing sites, but at the same time the inequity was simply blinding to me. Very early on one of my cousins tried to get me off of that mindset, but I still struggled to overcome that feeling, even towards the end.

At CRU I almost felt like I was a medical student shadowing my professors. The medical professionals I met there were so incredibly willing to make you feel like you were a part of the process. I was able to see the thought process they followed and the questioning that they went through when diagnosing patients. Furthermore, they were approaching care in such a holistic and balanced manner. A dedicated counsellor was available to address the emotional distress and concerns of the parents. The apparent goal was to help parents create a loving and warm environment for their child regardless of the extent of their disability.

At both Chidamoyo and CRU we participated in outreach opportunities within the local communities. All assistance that my peers and I offered was supervised and ethically sound. For example, through CCH I was able to help at the well baby clinic. I documented the height, weight, and mauc of the children while the nurses checked on the status of the children’s vaccination schedule. It was so refreshing being able to work in the same community that I lived in for an extended time, and it was definitely fulfilling being able to learn more about the medical professionals we interacted with on a daily basis.

This experience certainly reaffirmed my passion for medicine and reminded me why I wanted to enter into this field in the first place. At the same time I was grounded in the reality of what it truly means to be a physician. The patients that you interact with have entrusted you with their lives, often when they are most vulnerable. Your job is not to scold or reprimand, but rather to heal and advise. You do your best with what you have and hope for the best of your patients.

Although I had a wonderful experience overall, I will say that I was hesitant to participate in this program at first. My parents immigrated from Zimbabwe to the U.S., so I grew up as an American citizen. Unfortunately, I did not learn their first language of Shona, which is commonly spoken in Zimbabwe. This has always been a source of anxiety and pain for me because I feel as though I am not viewed as a Zimbabwean at times because of this fact. Eventually I forced myself to confront this feeling of discomfort head on and embrace the challenge. Although there were certainly those who were disappointed in my inability to speak Shona, I found that the vast majority of people were supportive and genuinely appreciative of the fact that someone of Zimbabwean descent had returned home.

I will end by saying I do not regret this experience for one moment. It was through this program that I was able to meet wonderful people, both within my group of peers and also externally from interactions with Zimbabweans outside of my family. It definitely gave me a new perspective and showed me that my love of the country only grew more from my encounters. There is no doubt that there is some serious work to be done, but it was also important for me to reiterate that I am not some savior who will go in there and solve everything at once. If anything, the power of working within a team of healthcare professionals already dedicating their life to the cause seems like it would be the most appropriate step forward after finishing all of my schooling. I am optimistic about the future of Zimbabwe and the Zimbabwean health care system, but progress is going to take a group of passionate, interdisciplinary people coming together to make change a reality.

BY VONGAI TIZORA

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