Sunday, October 9, 2011


The weekend provides a bit more time for reflection, reading and processing of the time here.  One of the books I am reading is called, "When Helping Hurts, How to Alleviate Poverty Without Hurting the Poor and Yourself"  by Corbett and Fikkert.  I am finding it very helpful and personally challenging.  Near the beginning of the book the authors challenge the reader to consider their motivations for helping the poor.

Here's a quote - "Development practitioner Jayakumar Christian argues that the economically rich often have "god-complexes", a subtle and unconscious sense of superiority in which they believe that they have achieved their wealth through their own efforts and that they have been anointed to decide what is best for low-income people, whom they view as inferior to themselves.

Few of us are conscious of having a god-complex, which is part of the problem. Consider this: why do you want to help the poor?  What truly motivates you?  Do you really love poor people and want to serve them?  Or do you have other motives?  I confess to you that part of what motivates me to help the poor is my felt need to accomplish something worthwhile with my life, to be a person of significance, to feel like I have pursued a noble cause... to be a bit like God.  It makes me feel good to use my training in economics (medicine) to "save" poor people.  And in the process, I sometimes unintentionally reduce poor people to objects that I use to fulfill my own need to accomplish something."

This is certainly causing some self evaluation...  and hopefully a more humble approach to my efforts in improving healthcare here.  It is easy to "teach" and tell people how it should be done, or how we do it in the US, or what the research shows...  and while there is certainly a place for sharing knowledge, the "HOW" it is done is crucial.

After reading later sections of the book, I have re-designed my approach for a meeting with the hospice nurses aides this week.  I was going to teach them about pain assessment, charting tools, etc.  to help them improve the quality of the care that the hospice patients are receiving.  After more reading and reflection today, I am going to start the meeting asking them each what things that they do well as nurses aides/people - what talents do they have?  Then I am going to ask them what they like about the hospice...  then what they don't like or what we could do better.  Would they like to be patients here if they were very ill?  What would they change?  Hopefully, this will prompt them to come up with the gaps  (ie.  not asking about pain everyday)  and maybe a few more things that I have not noticed.

Anyway - it has been a good weekend.  It is Ugandan Independence Day today, so tomorrow is a national holiday.  We will be working in the clinic and hospice anyway, but maybe the work will be light.  Baby David is coming back from the hospital tomorrow, so it will be good to check him out, see his wound, etc.  I saw his adopted "dad" at church today and he reported that David is improving.

I am very much enjoying Andrew Wright, the Australian physician who is leading the efforts here in the clinic development.  I think we complement each other well - he is soft-spoken, thoughtful and has a great sense of humor.  I am the bull in the china shop, often apologizing for being too energetic or opinionated.... oh well, hopefully I am learning.


  1. Hi....reading about "When Helping Hurts..." reminded me to find the book begin (with Warren) to read it. I loved the change in approach you found after reading the later chapters. I thought how nice it would feel to me, if I was asked those questions...empowering...valued. Got a nice return facebook note from Irene...:) Love you! Mom

  2. Loving reading your blog Laurel.....thank you! You have wonderful reflections and I almost feel I'm there! xx nett

  3. Love reading about all your experiences Laurel. I agree with he comment above - I feel like I am there!!!