Not All Definitions Are the Same

Leilani has been living in Teotitlan del Valle with the Chavez family and volunteering at the public health clinic. She has two weeks remaining of a four-week summer externship program that is part of the UNC Chapel Hill School of Nursing global health education curriculum. Because I work at the university, I was able to help arrange this learning experience for her and what she is learning is hands-on, on-the-ground public health nursing. The take away message: not all definitions are the same when interpreted from different cultural perspectives.

Leilani is experiencing public health intervention and education.  She happens to be there during one of the three times during the year — February, May, September — that vaccination campaigns are underway.  With her co-workers, clinic doctors and nurses, this week Leilani spent three days walking the hillside village of 7,000 people to administer vaccines.  On another day, they drove to the highlands to remote mountain villages to see people. “We are working on keeping everyone vaccinated,” she reports.  So many who need vaccines are children.  Leilani noticed that people are not always eager to be vaccinated and she surmises that they don’t totally understand the benefits. Even with local health care providers doing the explaining, there is a lot of resistance, according to Leilani, who wonders how much people still rely on folk traditions to drive their decisions.  In a relatively prosperous village like Teotitlan which has one of the highest standards of living in Oaxaca because of their national rug-weaving reputation , this is not really surprising. There are other barriers to accepting health care technologies — many of the older, traditional people still only speak Zapotec as their sole language.

In the last week, Leilani helped around the clinic, worked with patients who needed their vital signs, height and weight measured before seeing the health professional for a consultation. She changed out the sheets and medical instruments in the consultation rooms.  Leilani reported that she cleaned the instruments using a mix of bleach and detergent, then wrapped the instruments in paper as instructed. Her supervisor explained that this was to keep them “sterile.”  This was not the definition of “sterile” that she was used to working in the U.S. health care system.  She wondered how the word “sterile” translates differently from one culture to another?

Her co-workers are friendly, warm and gracious. They tease her about her curly, thick hair and plaster it down with cream to make it more “work appropriate.” They laugh and sit around the kitchen table sharing stories about life in Mexico and the U.S. “I really like going to the village market,” said Leilani. “We usually make a stop there when we’re walking around the village to give vaccinations. I love the dulces, and I want to try some chapulines!”

Oaxaca dulces (sweets) are delicious, and chapulines (spicy, fried and ground grasshoppers) are a taste treat condiment that tops tacos, enchiladas and soups.

2 Responses to Not All Definitions Are the Same

  1. Eve, the UNC Chapel Hill School of Nursing blog is http://www.carolinanursingnews.com and the website is http://nursing.unc.edu

    We think Leilani’s volunteer experience in Teotitlan will be the first of many for future students who might like to do this. The SON has service learning programs in Guatemala, Africa, South America and Asia. We think it’s important to learn about cultural competency through these experiences.

  2. Hi, I just returned from visiting Oaxaca with my family. I wish that I had run across your blog earlier! I am a Women’s Health Nurse Practitioner and could not help but look for answers to many questions about the status of healthcare in the area and would love to hear more about Leilani and her experiences. In revisiting Teotitlan after 31 years, I was struck by the changes in the area – so many new home/workshop estates have proliferated along the road in to town. The comparative well being of Teotitlan, though well-deserved, seems to be an exception in the Oaxaca valley. We saw many signs of poor health in the area and heard that even well educated people in the higher economic strata in Oaxaca City suffer from inadequate medical care. Please send me contact information for Leilani or links to the UNC Nursing program. I would love to learn more!

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