Southern Cross

fatkatz

October 23, 2009

Summing up the two clinic days we have found that all the bhw's do not fill up the classification portion of the IMCI form.  In Laiya Aplaya, the IMCI forms are filled completely except for classification. in Hugom, the forms are filled only up to the cough portion.  and some of the BHW's don't even fill up the Respiratory rate portion.. 

I wonder though what prevents them from writing down. Is it confidence? Is it skill? Perhaps part of it is skill and experience. Because if it was skill then they need to learn that skill comes with experience.

But how can we tell them something like that? How can we gently ask them to fill in the classifications and manage accordingly? 

I observed that it truly is difficult to correct or to ask for something on our very first meeting with the BHWs. 
The concept of "nahihhiya" is something very unique to the Philippine psyche.  It hits me though, and it irks me a little. This is a negative thing for me, on no uncertain terms. In English, it means shame. 
Truthfully, I consider this one of the very negative portions of our culture. Because this concept, in most cases, does not stem from a respect for the other person. No. It annoys me because it stems from a difficulty of receiving correction.
Plain and simple, we, as a people, don't take correction very well. We view criticism negatively instead of as a way to improve ourselves.  From this stems the delicate balance of dealing with any strange situation.  I hate how we have to walk on eggshells around each other instead of saying what is truly on our minds, like professionals.

Much as I hate it, that is the reality.  That is my reality in the community. And though I want to change it, and I know it should be changed, I know that part of our culture cannot be changed simply by willing it to be so.

I suppose my lesson here is Stephen Covey's Emotional bank account.  It truly is difficult to give any sort of feedback in any relationship if we are not in the position to do so.  Persons who give feedback have to be in a position where he or she is responsible over the person he or she is correcting. To have responsibility over a person is not only afforded by being in the position over them, but also by taking the time out to invest in the people emotionally.  In order to be able to work with someone, you have to be emotionally involved. THere is no such thing as "just work."
In order to obtain something (like a desired learning or behaivior) from the BHW's, I in turn have to invest in them. With time, emotion, getting to know them.  Without such a relationship, I would be in no position to have influence over them enough for them to receive correction from me.

Emotional investment will take time. As will being able to correct those whom we work with.  I suppose that is one of the great hindrances to our progress in the community.  There is no consistency. Every six weeks, a new batch of interns come in, and then they have to get reaquainted. Another cycle of emotional investment before something happens. But that's the reality. We have to make the best of it.