I'm strating to think about the end, which is to say about grading final papers, giving good-bye presents and scheduling my taxi to the airport.
The six students here sit in two groups, one each at a round table. One table has the older nurses who work at a public specialty clinic, quietly absorbing and concentrating. The other table has the younger nurses working in acute care, wiggling and giggling and trying to speak English. The two groups being a small sample of the nurses in Chile. And both groups coming to terms with their assumptions about how to improve health and the role of the Ministry of Health in do so.
Each time I teach this course here, I struggle with this too. What is the "correct" balance between entrepreneurial health programs and social responsibility as administered through a government? I come from a country which has a history of favoring the private sector's initiative and business approach to achieving health for its citizens. But, where's the profit in helping the disadvantaged to gain equal footing or being compassionate with the dregs of the street who slap all outreached hands? Maybe because I just finished one of Anne Lamont's books, I'm feeling both more radicalized and spiritualized about health care systems.
Chile has a history of dictatorship which has left the boot print of oppression throughout its bureacracy. I saw this during my interviews with people in the Ministry. It was more like a bruise, still sore enough to limit mobility. There is a "system" in place for all citizens to receive health care, and the primary care clinics, called consultorios, are neatly placed throughout the contry. But where's the benefit of creating new options and programs when the resources are distributed centrally based on a plan that has no known origins?
Neither system is right and neither system is perfect. But I do see individuals in both systems who are stepping forward and into the murky waters of what is ethically and morally and socically needed.
27 July 2010
10 July 2010
Santiago Work
I've lived in Santiago Chile before, each time for about 5-6 weeks. Long enough to get comfortable, but not so long as to get bored. This year, I'll be here 5 weeks, again teaching the Program Planning and Evaluation course to post-graduate and master's level nursing students. The course goes ultra quick, and thankfully they are really smart students who seem able to keep up with the pace.
The start was rocky. I was exhausted and still in hyperdrive from the June crazies. That said, they were not exactly organized either. They were still drumming up students (so that it would be more than 4; we ended up with 6), wanting they syllabus reformatted to the UC requirements, the course webpage not accessible to half the students, and no plans for me to meet with other faculty. All of this took a week to mostly get sorted out.
I teach all day on Friday (9am-6pm, 1 hour for lunch) and 4 hours on Saturday. In Santiago, almost all of the small stores close by 2pm on Saturday for the weekend. It changes one's patten of living. The campus is about 30-45 minutes away on the Metro. Yes, I am a seasoned subway commuter here, including being squeezed into a train car during the evening rush. Not fun.
Lisette and I have been asked by the Minstry of Health to consult with them to develop a plan for how to improve the national disaster and emergency plan. Lisette had been asked to do this because a former classmate of hers is now in the position in the MINSAL (as it is abbreviated here). So, we have been coordinating that consulting work as well. Lisette is moving to US at the end of June to start the PhD program at the SPH. So, she too is ultra busy getting ready for that major life change.
Our first meeting include a representative from WHO/OMS. The international scene is fascinating to me. How the WHO provides support, but not really. How the national health system is both centralized and decentralized. These differences come up in my working with the students in the course. The reliance on MINSAL, but not really.
The start was rocky. I was exhausted and still in hyperdrive from the June crazies. That said, they were not exactly organized either. They were still drumming up students (so that it would be more than 4; we ended up with 6), wanting they syllabus reformatted to the UC requirements, the course webpage not accessible to half the students, and no plans for me to meet with other faculty. All of this took a week to mostly get sorted out.
I teach all day on Friday (9am-6pm, 1 hour for lunch) and 4 hours on Saturday. In Santiago, almost all of the small stores close by 2pm on Saturday for the weekend. It changes one's patten of living. The campus is about 30-45 minutes away on the Metro. Yes, I am a seasoned subway commuter here, including being squeezed into a train car during the evening rush. Not fun.
Lisette and I have been asked by the Minstry of Health to consult with them to develop a plan for how to improve the national disaster and emergency plan. Lisette had been asked to do this because a former classmate of hers is now in the position in the MINSAL (as it is abbreviated here). So, we have been coordinating that consulting work as well. Lisette is moving to US at the end of June to start the PhD program at the SPH. So, she too is ultra busy getting ready for that major life change.
Our first meeting include a representative from WHO/OMS. The international scene is fascinating to me. How the WHO provides support, but not really. How the national health system is both centralized and decentralized. These differences come up in my working with the students in the course. The reliance on MINSAL, but not really.
02 July 2010
June revealed
Yes, it has been way too long since my last post. The absence reflects the amount on my perveribal plate. But, I've not forgotten my blog followers and promise to post at least weekly for the forseeable future. So, what HAVE I been doing for the past month ~ besides packing, unpacking, mega-packing and moving too fast to even make a To Do list?
Early June: I spent three days in Washington DC. I gave two presentations at the ACHNE/ASTDN meeting in Crystal City. For those who don't know the DC area, this is a rather boring place, with mostly office buildings and half deserted underground quasi-shopping malls. And, aside from the academic-scholarly activities, I was mostly concerned with where to watch the US Soccer team play. World Cup trumped old women nurses trying to seem important. Sorry, ladies. I actually had stronger bonding with the doormen who were looking over my shoulder at the games. The amount of gray hair in attendance was spooky and foreboding for the future of public health nursing. I felt "embedded", like a reported with the armed forces. Watching, not wanting to get hurt, but still in the line of fire. Naturally, I was typically a-PC, and took a few shots. Not smart, I know, but it's frustrating to be around such myopia with such a big heart. It's a truly sad combination. Also frustrating was the lack of walking the talk, with regards to multi-disciplinary collaboration. On the up side, I had great times having dinner with my KRISP project co-investigators. I wish I could have more of those times.
Mid-June: The panic that had started at the beginning of June grew. Panic over the long list of tiny things that needed doing before the end of June when I would leave for Chile ~ At home I needed to pack, ready the house for guests, find a place for Lisette to live, put a hold on the newspaper delivery, assure that my neighbor would collect the mail, get my credit card cleared for international travel, keep up with my emails and secretary work for the Chicago MSIA Ministers, and empty the refrig through careful menu planning. At work ~ coordinate payment of summer salary from two grants and across two finance mangers, sign all needed forms for students planning to graduate in summer, keep up with grant activities like filing IRB amendments, respond to an astounding amount of email on what ought to be simple topics, and keep working on manuscripts and promotion papers. YIKES. Looking back on the list is enough to re-freak me out.
End of June: Get on the plane and arrive in Santiago, Chile. The Chilean saga will be in subsequent posts.
Early June: I spent three days in Washington DC. I gave two presentations at the ACHNE/ASTDN meeting in Crystal City. For those who don't know the DC area, this is a rather boring place, with mostly office buildings and half deserted underground quasi-shopping malls. And, aside from the academic-scholarly activities, I was mostly concerned with where to watch the US Soccer team play. World Cup trumped old women nurses trying to seem important. Sorry, ladies. I actually had stronger bonding with the doormen who were looking over my shoulder at the games. The amount of gray hair in attendance was spooky and foreboding for the future of public health nursing. I felt "embedded", like a reported with the armed forces. Watching, not wanting to get hurt, but still in the line of fire. Naturally, I was typically a-PC, and took a few shots. Not smart, I know, but it's frustrating to be around such myopia with such a big heart. It's a truly sad combination. Also frustrating was the lack of walking the talk, with regards to multi-disciplinary collaboration. On the up side, I had great times having dinner with my KRISP project co-investigators. I wish I could have more of those times.
Mid-June: The panic that had started at the beginning of June grew. Panic over the long list of tiny things that needed doing before the end of June when I would leave for Chile ~ At home I needed to pack, ready the house for guests, find a place for Lisette to live, put a hold on the newspaper delivery, assure that my neighbor would collect the mail, get my credit card cleared for international travel, keep up with my emails and secretary work for the Chicago MSIA Ministers, and empty the refrig through careful menu planning. At work ~ coordinate payment of summer salary from two grants and across two finance mangers, sign all needed forms for students planning to graduate in summer, keep up with grant activities like filing IRB amendments, respond to an astounding amount of email on what ought to be simple topics, and keep working on manuscripts and promotion papers. YIKES. Looking back on the list is enough to re-freak me out.
End of June: Get on the plane and arrive in Santiago, Chile. The Chilean saga will be in subsequent posts.
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