How do you prepare for an experience you’ve never had?
Patricia and I started working in the OEDK early this month, preparing resources to bring with us to Brazil this summer. We’ll be bringing two technologies, a diabetic wound care education simulation and syringe dosing clips for accurate dosing of liquid medication. We are using this time before we get to Brazil to prepare to present these technologies to physicians and staff in country.
Of course, the preparation involved varies a lot based on what we expect our internship to be like. Take the dosing of liquid medication, for instance. One study looked at the effectiveness of our technology in both Texas and Malawi (DoseRight Article). So when presenting our technology, where does Brazil fall? Which healthcare system is most analogous? How do Brazilian physicians view their own healthcare system’s stature? These questions are directly relevant to how we prepare for Brazil, but they also reflect a more general question that’s been on my mind before I travel: What should I expect?
Setting Expectations
I’ve never been to Brazil, so I did what our generation always does in the face of ignorance, I went to Google to find answers. Even google, however, yielded a wide range of imagery. The place I’ll be going, Barretos, is a small town, so the only images I could find are of a famous rodeo they hold every year.
But here’s São Paulo, one of the bigger cities in Brazil.
And here’s a favela, a slum in Rio De Janiero.
Brazil is a really diverse place, so I have no idea what to expect from the city I’m going to live in. I know that the Barretos Cancer Hospital is a world-class cancer center, but I also know that it is a very small town. It is 5 hours driving from São Paulo with a total population of 112,000, 8x smaller than my hometown of Austin. Last year’s interns were able to shed a bit of light, describing the town as having a cozy atmosphere built around the cancer hospital, but it’s hard to get a mental picture of what that really means. I keep returning to the same question: How do you prepare for an experience you’ve never had?
Brazil is insanely diverse
I’d like to think part of my question stems from Brazil’s unique situation. I started doing some research to give myself some context and I’ve come to the conclusion that Brazil has no comparable. This is a resource-rich emerging market economy, a country with extreme geographic social and economic inequality between the South and North. The country is so large that it can sustain huge internal differences in the prosperity of the population. For instance, while infant mortality reduced by 52% in the last 15 years, it remains 2x higher in North Brazil than South. While dealing with huge non-communicable health issues like diabetes, cancer, and obesity common to developed countries, Brazil is still fighting Malaria and Yellow Fever in several states. Even just those pictures of urban São Paulo and the slums of Rio De Janiero are difficult to reconcile.
You can’t prepare for everything
Realistically, there’s just no way to be really prepared for an environment so different from my own. That’s a big part of why I’m going and of what I hope to get out of this experience. I’m looking for an education in something I can’t learn from a textbook, the feeling and atmosphere of being in a country so unlike my own. I’m also looking to learn how to operate there in a productive way as a foreigner. I’ve been practicing my Portuguese a little bit in hopes of getting a fuller experience, giving the beautiful country and language my respect. In my two months there, I know I’ll learn a lot about the country and a lot about myself and how it feels to be a part of the global health field.
Thinking about living in Brazil for the next few weeks feels like preparing to meet someone I’ve heard so much about. I have so many scattered details of the country, so many preconceptions extrapolated from the little I know of Brazil and other countries I think might be similar to it.
I getting the feeling that in some ways preparing for my Brazil experience is a little bit misguided. There’s no hope that the impression of Brazil I have right now could reflect the rich diversity of the country that I will be getting to know by the end of my internship. A lot of the questions I’m asking are informed by what I know, questions that come from my own culture. And that’s part of the problem I’m trying to express. The things I know to expect, the questions I know to ask, are informed by my past experience. Part of the beauty and challenge of global health issues is how little experiences in one country inform experiences of the next. Perhaps the most valuable part of going to Brazil for 2 months is the serendipity, the chance that the unexpected surroundings and culture won’t just give me new answers, but give me the experience to find the relevant questions.
As I wait anxiously in Houston, I really want to dip my toe in the water, somehow get a feel for the place before I go, but I think part of the value of this experience is about forcing me to just jump in.