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Third World Learning Curve
Kendra Campbell -- I have lived here in Dominica for close to two years. In ten short days I will be leaving my home and returning to the States to start my clinical rotations. I know there are a lot of students out there who have lived, worked, or gone to school in so-called Third World countries. For me, it’s been an experience that I will treasure for the rest of my life. For those of you out there who haven’t lived in underdeveloped countries, but are considering doing so for school or as a volunteer, I thought I’d compile a fun list of things that I’ve learned while living here in Dominica. Enjoy.
1. Having a rooster for an alarm clock. No matter where you live in Dominica, you’re likely not far from a rooster. Mine wakes me up religiously at 6:00 every morning, whether or not I ask it to. I guess I’ll have to go back to the electronic variety in the States.
2. Using Chinese food restaurants as convenience stores. In Dominica, almost everything closes on Sundays. If you need food, soda, or other beverages, your only option is to get them from the Chinese food restaurants, because they are the only businesses that are open.
3. Not having an address. They don’t have a mail delivery system in Dominica, and although I think the roads might have names, they don’t have any road signs. My address is “Banana Trail, Portsmouth.” If I’m getting food delivered, I specifically say that my apartment is past the green house on the top of the hill with the dogs that bark loudly, and across from the black and white goat.
4. People carry machetes instead of briefcases. Pretty much everyone here owns a machete, and it’s commonplace to carry it around with you. Instead of the bland briefcases that I’m used to seeing everyone toting around, people walk down the streets with sleek and stylish machetes.
5. Traffic jams because of runaway cows, sheep, goats, or other livestock. I was quite used to traffic jams in the States, but I’d never seen a herd of goats causing traffic mayhem as they run down the street with a torn rope around their neck dragging behind them.
6. Electricity is a luxury. No seriously, it is. The electricity usually goes out at least once a week, and I’ve seen it off for days at a time. You eventually learn tricks to live without electricity like having lots of candles, and making sure you have a gas stove. If you don’t have a huge exam to study for, it can actually be pretty fun. If you do, then you try to avoid the temptation to burn the house down.
7. Being kept up all night because of mosquitoes. The mosquitoes can get so bad here that they literally buzz you out of your mind! Even with netting, mosquito spray and special candles, the little buggers will find their way to your ear at 3:00 in the morning.
8. Eating expired food. Shipping things to Dominica can be tricky for a variety of reasons. It’s not uncommon to see food on the shelves of grocery stores that has been expired for over a year. I guess eventually you just get used to the taste of stale food.
9. Hitchhiking is safe. Actually, it’s not only considered safe, it’s pretty much the only way to get around. If you stick out your thumb, either a transport, a person driving a pickup truck with an empty bed, or just about anyone else will stop quickly and take you where you need to go. Even young children use this method to get to and from school everyday!
10. Taking showers in brown water. The water here is very unpredictable. After it rains, it will turn off for hours and then if you’re lucky, it will come back on. But it’s frequently a lovely shade of beige, and loaded with sand. It might sound unbelievable, but you really do feel cleaner after a muddy shower!
If any of you have lived or currently live in an underdeveloped country, please do add to the list!
April 7, 2008 in Kendra Campbell | Permalink
Comments
hahaha i like #3 and #4 :D but if electricity is a luxury, how do u get time to go online? :O
and how come u're doing ur clinical rotations in the states? doesn't dominica have a hospital?
Posted by: Jun | Apr 8, 2008 4:44:25 AM
Luckily, the electricity stays on enough of the time to get most of my online stuff done. Plus, there are restaurants that have backup generators, and sometimes I just go there and mooch off of their power!
Dominica does have a teaching hospital, Princess Margaret Hospital. In fact, I just finished up my rotations there. But the problem is that it doesn't have all specialities that are ACGME approved, so you can't take every rotation there. That's why I'll be coming to the States in t-minus 8 days, 28 minutes, and 23 seconds! :)
Posted by: Kendra | Apr 8, 2008 10:52:31 AM
Kendra, I miss you.
Posted by: | Apr 8, 2008 3:35:22 PM
Kendra,
You forgot about eating food that is so fresh that the animal providing is (usually milk) is standing right there......................
Posted by: | Apr 8, 2008 5:41:16 PM
Great more ways to highlight to "first world" countries how downtrodden the third world is...I liked the article but I feel like 1st world countries miss the point of what developing countries are like and focus on for example how electricity is not always available and say "oh my gosh what an impoverished nation" and are so shortsighted to the other things that make that country great for the people that live there.
Posted by: | Apr 8, 2008 6:00:03 PM
Another thing to add to the list - David Attenborough's wild kingdom in your bathroom. When I lived in India my bathroom was not completely enclosed, and therefore well ventilated and filled with crickets and other bugs. The geckos had a field day hunting in there and often put on great shows for me while I was sitting on the toilet.
Posted by: Sheila | Apr 8, 2008 8:30:24 PM
Thanks for the comment about the fresh foods. That is very true! You can get fish literally seconds after they are pulled out of the water!
To the other commenter on first-world countries, I do agree with you. While their are disadvantages to living in underdeveloped nations, there are also many advantages! And trust me, I am all too aware of the downside of living in a first-world country. I'm going to be face-to-face with all of those issues in 7 short days!
Posted by: Kendra | Apr 9, 2008 4:54:00 AM
Hey Kendra, I'm just graduating from my undergrad in 10 days and am technically a year behind in the "typical" route towards medical school. I'm taking a year off to apply to the Master's International program for an MPH and 27months in the Peace Corp. I'm getting second-guessed all over the place for wanting to volunteer in developing countries, especially since it puts me 3-4 years back from medical school. What do you think about the value of international work experience and/or an MPH before taking the plunge into med school?
Posted by: Rachel | Apr 9, 2008 12:34:58 PM
There are advantages and disadvantages to living in developing countries, there is no perfect place, but I would like to point out one of the advantages, at least for my country, our social security system!
Posted by: Vera | Apr 9, 2008 1:47:53 PM
Hi Kendra(and everyone)
nice article!!!
I've seen many of our visitors come in with their noses up in the air expecting the red carpet treatment...when all we have to offer is water dripping from a pipe at the end of the town or a room with a view of the hospital/clinic's mortuary!
Some learn,became well adapted and return home with a whole load of experience that their peers will never experience or come across(one example is inducing labor in a post term mother in the middle of nowwhere)...sadly though..there are others who don't seem to adapt and ended up leaving before their stint has ended, hating the people(who happen to be their patients) and the system!!!
But like u've said...there's alot more than meets the eye when you go to a third world country!!
So for those planning to volunteer...althoug it might put u back two or three years in ur medical life...its a great and rare experience!!!So go for it!!! with Kendra's list in ur hand lol!!
Posted by: emire | Apr 9, 2008 7:55:08 PM
I will miss the occasional mental escapes that your entries provide, but am sure you will enlighten us with a different perspective on mainland medicine.
Have safe travels!
Posted by: Thomas Robey | Apr 9, 2008 8:10:47 PM
Kendra,
I've been reading your blogs for some time now. (Never posted a comment up until now :)
Just wanted to say that I love your blogs. I'm sure you'll make a fantastic doctor. Although I'll miss your blogs about Dominica, I'm sure you'll have lots of interesting and insightful observation of the states. So, have a great trip back to the US!
Posted by: Yuri | Apr 14, 2008 10:50:19 PM
You are so right about living in another country to become a physician. It seems to me that those that didn´t get accepted in the USA, if they really wanted so dearly to be a doc, will go elsewhere. I chose Mexico. I must say, I brought my kids with me to do it. Challenges, yes! Marathon, yes. Not so underdeveloped, although. Criticized by many, yes. Even myself. But the opportunity of a lifetime it has been. My daughter is entirely bilingual, she is 12, my son, didn´t have enough English when he got here so he answers me in Spanish, yipee. Learn it as well as you can, son, even if you end up as an ESOL student, I´ll just simply do the reverse with you, is what I tell him. "Your sister learned the English, first, then the Spanish. You´ll be the reverse." He just recently turned 7, but all I ask is that you learn the Spanish well and never let it go.
Here we have seen a multitude of funny things. Like trees that were not cut down when they paved the street, so the trunk is let´s say, feet from the curve.
Another, it´s lawless. Call 911, you can. But it is some other number, I used it only once. I learned my lesson. Took the cops, who are only 2 blocks from the house, 20 min. to get there and 3 of them came on foot.
Healthcare visits to the pediatrician are $2.00 dlrs. Hospitalization for IV antibiotics or hydration when the diarrea hits is $50. in the Mexican neighborhood. Nice facility too. Tiled floors. Hand painted murals. Immaculately new facility. Neurology Specialist for sciatica pain when you sat in class for 8 hours, 6 days a week with only 10 min. breaks each hour- $50. including doppler study. Student insurance pays for surgeries, if needed in emergency.
What else? Lived through American Consulate being shut down in several states, various times, due to the drug Lord wars. Drive by shootings in plane daylight.
Never sit in a restaurant with your back to the door. Never know when someone around you will be ambushed and you could get caught in the crossfire.
Neighbor behind me had a rooster. Cock fights are common here and legal, but one day, in 2005, we heard no rooster no more. The night before apparently several granades went off in a so called Palenque down the street and the rooster is gone and the house has been empty since that event. Was he a victim of the 8 killed that night? Another Drug Lord incident. I will never know.
Election year in 2006 found you hearing about decapitations of political leaders, heads left in coolers in the state capital building to scare those politicians trying to win. That was 20 hours away so, not so close to home. But reading about it left you wondering whether you would ever get out of this place alive, yourself.
Oh, not to mention that since you are an ex-patriot, while here, even as an international student, you have to register with the American Consulate. So, what does that mean? E-mails of warnings of things happening around the globe and nation you are living in. How decent. As if you don´t have enough do to, reading all the books needed to pass your class, then the boards back home for when you do the cross-over. You get all the nasty news around you.
So you continued to wonder, will we survive? How do you get out of here alive?
It´s possible. Just stick to your goal of studying medicine.
The people are curious to hear your foreign accent, when you speak spanish to them. They ask you what it is like to live in "El Norte." Not everyone leaves Mexico. Here in Guadalajara, there are 10 million inhabitants. They are humble folks and nasty pompous ones, too.
You see so many genetic mishap cases. Only 10 yrs ago, they prohibited cousins from marrying. Lot´s of Downsy kids. Cleft lips. Dwarfs. You name it, you´ll see it.
But even if you didn´t like it all, from the very first Day on campus, you are referred to as "Doctor So and So"
Doctor, this, doctor that. You begin to believe you will make it in the end. Some do, some don´t.
You have the interior beauty of the country, to see on your scheduled vacations, yearly for the years that you are here. The pyramids, the mariachi´s, all the 70´s bands come through this town. You also get a taste of the USA, Toto played last month. Liza Minelli, this month. Depok Chopra was here. Placido Domingo was here 4 days before Pavarotti died. Kansas is scheduled to come in a few weeks. Elton John was here several weeks ago. Arethra Franklin and Riverdance. Oh and of all person´s 7 hours away in the Distrito Federal, Billy Joel. Now I know how those old school folks are making their money, they leave the USA and play elsewhere where they are still 30 yrs behind in music styles. It´s like living in a time machine.
It´s interesting get to see the US happenings on CNN on cable TV or the internet. No frequent blackouts in my neighborhood, but surely other´s suffer the loss, daily, including the water cut offs by the city for repairs. Coca Cola- Mexico has it´s own bottle water, an offshoot, makes millions monthly.
You have gorgeous houses and lot´s of graffiti. Interestingly enough, due to potholes in GDL, Michelin Tires doesn´t give guarantees on their tires in this city. Jijiji.
But you got your Walmart, Blockbuster, Dairy Queen, Sears, and malls galore, McDonalds, Burger King, Cinemas but movies are in Spanish, sometimes in English with Spanish dubbing. It really hasn´t been so third world but a deep change in point of view. Yes.
I never read in any US History book about when the USA invaded Mexico and planted their headquarters in the presidential palace in the Distrito Federal, for almost 10 months, way back when in that war they had, trying to claim more of Texas and all the southwestern states. I learned about this because my daughter has to learn the history of Mexico and this topic discussed every year. Then you wonder about the anti USA sentiment. This country stood it´s line about it´s borders from then on and still does.
One can go on and on. Living in another country really let´s you see another point of view, one that is much more worldly.
Then you go home and now as a bilingual physician, you get to care for so many in the melting pot, that really haven´t been able to master the English, but are there and you can´t do anything about it but serve them, clinically. Beautiful. It was my ultimate intent, to become a bilingual doc.
I am enjoying all of this and when my daughter gives me her point of view, it is, "mom, I´m going to miss the Tacos."
I am in my 3rd year of medical school, finishing my rotations. 3 more semesters and we move on. But the experience will linger for a lifetime, for all of us in our family. We are a much more well rounded bunch as a family. Studying medicine was difficult enough as a mom with kids, to have survived to this to date. I am an RN to MD and can proudly say, I have never to this date, regretted my calculated move to have come so far to realize my self actualized dream of a lifetime.
So those who really want to be a doctor with a worldly view, go for it. Don´t listen to what anyone has to tell you that ECFMG doc´s are different or that there is enough MD´s in the USA. No way. I hear there is shortage of over 400k nurses in the nation, now, and by the year 2010, there will be 1 million short. Who do you think is going to have work, galore? The docs.
Even as the recessiong sets in back home and possibly a depression, they speak of now, healthcare continues to need to be provided to all who reside within the borders of our country, you simply can´t deny it. Remember, all the baby boomers are retiring and living longer. Who will care for them? Do tell.
So, as a third year medical student, push on for now, it is and in another country.
Loved to hear others survived abroad, offshore, or in the America´s. As here, the mexican´s will tell you we are all American. And they are so right. It´s the continent, period. Can´t argue that one!
Enjoyed summing it up.
Liz
Posted by: Liz | Apr 15, 2008 10:43:36 PM
currently doing a short rotation in a major government hospital in india. it's not quite as interesting as what you write of in dominica but it's quite a fresh experience for me after living in the sterile concrete jungles of singapore.
delhi is developed but in a patchy sort of way. there are parts of delhi which are very developed. there are other places where the buffaloes will stand in the middle of the street. we live opposite a large drain which is probably fed by the entire area of delhi here. it's summer, and it smells of pollution and excrement, especially with the water drying up.
yet delhi is beautiful in its own sort of way. people are hardworking, they don't take things for granted, and they are great hosts. it's barely past 1 week here and i must say it's a lot of new experiences. working in a hospital whose resources are so stretched the defibrillator isn't charged is certainly a different experience from back home where diagnostic pathways and protocols runs like clockwork.
But at the end of the day, the different experiences are truly an eye-opener, and I would definitely urge medical students studying in first-world places to get a taste of what it's like to work at a third world place!
Posted by: neo | Apr 16, 2008 9:57:26 AM
Amazing posts! You all may have just convinced me to go to medical school in the developing world!
P.S. I'm currently living in Micronesia with my fiance as a health communications consultant.
Posted by: Karien Stuetzle | Apr 16, 2008 12:36:20 PM
Hi Kendra,
I loved reading your posts. Good luck with your remaining clinicals and hope you will get into the residency that you desire!
I'm 27 yrs young and planning to do my basic sciences at IUHS St. Kitts (heard many negative things about the way they offer the MD program and am aware of the licensing issues in many states) but, it is my best option.
Thanks for all your great posts. I enjoyed reading them.
Posted by: Nick | Apr 18, 2008 6:56:32 PM
Hey all!
I've written on here a few times already...been a while though.
Anyway, I've also been going to med school in the so-called "developing country" of Mexico, having come from another so called "developing country", Jamaica. The experience has been interesting, and taxing, but very beneficial to me I must admit. I guess, learning medicine in Engish might be considered challenging enough by many, imagine in Spanish! Hehe! But, it's been great, and I can safely say that I don't believe my performance on exams have been negatively affected because of the different language.
I write now as I'm preparing and studying for the first exam of my final exams for my last semester here in Mexico. After this, I leave to return to my country for internship. I can't believe that the time has gone by so quickly! Five whole years! I'm so grateful for the opportunity that I had, especially to become bilingual as Liz mentioned!
Although I found it really difficult to adjust to many of the cultural differences and in my first year, I was determined to leave, I stuck it out, and well...I'm gonna be a doctor!
So, just encouraging everyone who has dreams of studying medicine--whether in your home country or abroad, go for it! If it's your dream, make it happen, and I'm sure your life will be fully enriched as mine has been!
Posted by: Karla | Apr 20, 2008 7:20:26 PM
