Aug 25, 2017

#GROWCommunity17: I Don’t Want Riches

Author: Charlene Kotei

During my internship in Ayacucho, Peru I began to actually understand the core mission and focus of medicine – to wholeheartedly help those in need no matter how difficult it may be. Prior to this trip, my reasoning for choosing to become a doctor was quite unclear. Why medicine, Charlene? Why medicine? I would either shrug my shoulders and smile, or I would give the generic answer: I love helping people.

Throughout my life, the field of medicine seemed to be the best field to make a good living while helping people. I always knew that I loved to help people because I always found myself giving academic assistance to my colleagues. I also give alms quite frequently. However, on July 13, 2017, my vision of medicine changed completely. On this fateful day, my reasoning for studying to become a doctor was clearly revealed to me.

My day began with a trip to Chiarra, a district in Southern Peru. Traveling from Ayacucho to Chiarra took only an hour, but the trip felt like an eternity. Buses to Chiarra only left on Thursdays, and they were on a first-come first-serve basis. My colleagues and I got to the bus station at around 8:45 am, and we hit the road at around 10 am. We probably could have caught an earlier car, but that would have meant that we would have to be packed like sardines. The ride up to Chiarra was not the smoothest. The roads had many bumps and sharp turns. By the time we arrived in Chiarra, my entire body was sore. We were happily welcomed by the people of Chiarra. They showed us their onion and carrot farms, and they gave us something to drink. The aura of Chiarra and its people made me feel at home. We observed them farm and harvest their crops for about an hour. We were then led to an area where the elders of the community would gather with us for some soda and soup.

We introduced ourselves to the people as volunteer interns from New York, with GlobeMed. After giving them a gist of our mission in Peru, the people were even more happy to have us visiting them. We asked to interview six of them – three men and three women – about their health and hygiene practices. The interviews lasted for about an hour. Personally, I was able to gain a decent understanding of the sort of life the people of Chiarra live. They may not have a ton of money, but they are hard workers. From sunrise to sunset, they work and toil to make ends meet. I began probing them further.

Is there a nearby hospital or health center?

Are you able to afford medication if prescribed by the doctor?

Are you able to easily access health care?

The answer to my questions was a solemn “no”. It was then that the people began to open up about all their health problems. It was almost as if they saw the doctor in me… I am just a rising second-year in a seven-year program. What advice could I possibly give them? I reminded myself, “I am not capable of diagnosing them if that is what they are expecting.”

In that moment something struck me, and the things I had learned in my first year in medical school began to make sense. These people opened up to me because they felt comfortable enough to trust me. Trust is the number one thing any doctor needs to in order to assist his or her patient properly. Here I am 3,718 miles away from home trying to make a difference in a community that I probably do not even know and understand. What do I do? What do I say? God, please make them stop pouring out their problems and their cries. For a split second, as I listened to them, I froze. My eyes were beginning to swell with tears, but I refused to cry. Life in Chiarra was harder than life in New York, but they did not need my tears or pity. They needed my attention. They needed me to tell them that their health problems were nothing to be worried about… But that would make me a liar. The inability to urinate, in conjunction with painful joints, did not sound too good. Yet still, I had nothing to say.

As we continued to speak, one lady confessed that her loved one had prostate cancer. However, the doctors said they cannot do anything to help him. What about chemotherapy? It isn’t an option for their family because they cannot afford it. The gentleman with the urinary problem admitted that he cannot afford the medications prescribed by his doctor. My heart was hurting, and I wanted to do something, anything, to help. “How much money does it cost to get medical help and medication?” He began to explain something, but I did not want to hear that. “How much money? How much?” He never gave me the total amount, but if he had I considered emptying my pockets for him. What if my own father was suffering? I would do anything in my power to get him help, and at that moment I saw my father in that man.

Another lady showed me her insurance card, but her insurance did not pay for her healthcare because she was not poor enough. This same lady could not afford healthcare. I was confused. My head was spinning, but I kept calm. I went ahead and asked them about their nutrition. With the little knowledge I have about nutrition I began to give them general tips. “Do not eat too much oil. Drink your water with slices of lemons or oranges. No more sugared water. I know you love potatoes but eat them moderately. Add lots of vegetables to your diet. I know there is a lot of work to be done, but please try to take breaks during the day.” Each statement I uttered was followed by multiple facial gestures of surprise… good surprise. They were unaware that too much oil and eggs were bad for you. They were happy to learn that by replacing their sugared water with fruit flavored water, they will be making a slight change in their health. At that moment, I felt relieved and happy. I may not have moved a mountain or performed a miracle, but I had at least educated a group of people on small nutritional changes that would possibly go a long way in making them healthier. I was satisfied knowing that they were willing to try my recommendations. I left hoping and praying that they will take my recommendation seriously.

On our way back to Ayacucho, we had to wait 2 hours to get a ride. Such was how it worked. You wait by the roadside and hope that someone drives by to offer you a ride to wherever you were headed to. I thought of it as an organized form of hitchhiking. As we waited for someone to offer us a ride, it dawned on me that infrastructure was a big hindrance in the ability of the people of Chiarra to get healthcare. A person has to wait hours for a ride to the city to see a doctor. It was quite a hustle. I began to understand why many of them did not follow up with their doctors frequently.

I began to think of all the ways in which I, the future Dr. Kotei, God-willing, could help communities like this. I realized that I did not want to sit in a private office somewhere in NYC with my fancy shoes and clothes. I want to be with the communities that need healthcare the most. From the rural communities in my own Ghana to the mountains of Peru, I want to be there for those who have no access to healthcare. If this means ditching my high heels for the mountains of Peru, and ditching my fancy blazers for the sun of Northern Ghana, then so be it. If this means that I will not be looking at a 6-digit annual income, then so be it. I do not want to be a doctor for the money or for the prestige. I want to be a doctor because there are people out there, everywhere, who have no access to healthcare. I am no better than another 19-year old child growing up in a under-privileged place. I am not smarter. I am not prettier. I am simply not better.

The world is an unfair place, and some people have some advantages, such as access to healthcare, over others. These same “disadvantaged” people help put food on my plate. The quinoa I enjoy in NYC…where does it come from? Who is responsible for cultivating and harvesting my beloved quinoa? Surely not the people who walk around in suits and ties.

I have absolutely no idea how much it would take to execute my dream, but I believe it is possible. Perhaps I could establish a health center in Chiarra or somewhere in Ghana. Perhaps I can institute a breakfast program so that children can go to school without worrying about being hungry. Perhaps I could learn another language so that I can educate people on healthy lifestyles. Who knows what the future holds for me and my career? I do not want to be a doctor for the money. Of course, it would be nice to be a millionaire by providing healthcare to the finest people in NYC. However, I’d rather be a millionaire at heart knowing that I am working day and night to provide healthcare to people who have no access to it.

GlobeMed Chapter: GlobeMed at CUNY City College
Partner Organization: CCC-UNSCH
Location: Ayacucho, Peru
Name of GROW Coordinator: Charlene Kotei

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