Column | Feb. 10

Taking a course in experience

During my internship at an HIV/AIDS research center in South Africa, a clinician recalled to me one of her earliest experiences with an HIV patient from a township in the Western Cape. The patient was a middle-aged woman who worked during the day and, when her children came home, took care of them and her husband. She was a provider, a mother and a wife — an entire support system within one individual. This woman had already completed a significant portion of the HIV treatment by the time she spoke to the clinician. However, during this particular meeting, the patient said quite simply that she wasn’t going to come back to finish the rest of the treatment. The clinician couldn’t understand it. Frankly, neither could I.

Coming from a science and health background academically, I had learned about disparities in health care, health education and medicine among different regions around the world. I had learned for so long what made these societies different from the “privileged” lifestyle with which I had grown up; I consequently judged all of those communities for not jumping at a resource once it was finally made available to them. I was very wrong.

In guest contributor Kyle Berlin’s Feb. 2 column, “Service is a bit like faith,” he masterfully navigated the institution of service by Princeton students in community development projects around the world, highlighting the sins behind the “savior syndrome” and the superiority complex. He cited four common misconceptions about service that we should understand and reject in order to avoid reducing “the dignity and autonomy and capability of those accepting help.”

I applaud him for pointing out the misguided and condescending aspects of service. However, as a corollary to Berlin’s acknowledgement of another culture’s differences, we should also recognize that these differences might not be as big as we think. Each person we encounter formulates a logical argument for why he does what he does, based on his own cultural circumstances. Just because that person has not had the opportunity to a formal education, does not mean that he has not had an education. That education could have come through personal experience, interaction with people in his community or discipline at home. To that person, making a decision using an experience-based education could make as much — or even more — sense as another person’s decision making based on a formal academic education.

For example, after the meningitis B outbreak scare, 91 percent of the University community trekked to the clinic in Frist Campus Center to receive the first dose of the vaccination. During this time, health officials informed these participants that the second dose of the vaccination, which would be administered in February, was needed for maximum — if not for complete — protection against meningitis. However, despite this notification, many students on campus have said to me during my involvement in the vaccination campaign with the Student Health Advisory Board that they may or may not go to get the second dose. They cited reasons such as the myth that the second shot would hurt more than the first, that there has not been enough research and clinical testing done on the vaccine to ensure minimal risk of complications, that one shot could give minimal protection, which is “enough for their purposes” and the like. In fact, I was one of these students wavering over whether or not to get this necessary vaccination. I found myself listing reasons that were not based on personal scientific research, but rather hearsay, a fear of dealing with a sore arm and, perhaps, even a laziness to go all the way to Frist.

Now, don’t I seem foolish for judging that patient from South Africa? She had once told the clinician that her immediate priority was to spend time laboring to provide for her family — to keep them alive with food in their stomachs and money to purchase the bare essentials. She would not come back for the final stage of her treatment because her focus rested in her family’s immediate survival.

I have no idea what that responsibility is like, regardless of the books I’ve read, the films I’ve watched and the stories I’ve heard. In this situation, my formal education had prevented me from even listening to her argument — an argument that had endured in spite of witnessing people in her community dying of AIDS. Now think back to when I made trivial, illogical arguments for rejecting the second dose of a vaccination. How could I have admonished her for making the difficult choice to refuse treatment and access to a health clinic when I, as well as others, remain idle with my health care benefits, my undergraduate education in biology and physicians right in my backyard?

When participating in “development work,” the criticisms and judgments we make in our own societies shouldn’t be projected on a community whose culture and ideology are different from our own. Because, while we’re so busy trying to explain to others how wrong they are, we often forget that it’s we who don’t understand.

Isabella Gomes is a sophomore from Irvine, Calif. She can be reached at igomes@princeton.edu.

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