From nucleus - May 2015 - the world's your oyster [p16-17]
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Vicky Lavy explains why everyone should consider an elective in a low-income country.
What an opportunity - a chance to go anywhere and do anything (well, almost). Where should you go? Swaziland or Switzerland? New Zealand or Nepal? Different people are looking for different things; some are after a centre of excellence in a particular specialty, some are visiting family across the world. Some stay in the UK because finances are tight, while others are looking for good beaches! There are many considerations and options, but in my (humble) opinion, you should take the opportunity to go to a low-income country if you possibly can, and here's why:
In fact it's how the other 80% lives. The vast majority of the world live in low or middle income countries (LMIC). Here in the UK we enjoy a standard of living, level of education and quality of healthcare that most of the world will never experience. As global citizens, we should try to understand what life is like for the majority of the world's people, even if we never intend to work there in the future. An elective in an LMIC gives us at least a glimpse into some of the challenges people face.
Child mortality - the number of children per 1,000 that die under the age of five - is a very good indicator of the health status of a nation. This map of the world above has been adjusted according to child mortality rates in different countries and shows the enormous contrast between rich and poor nations.
The world's biggest health needs are in LMICs. Of course there are many needs in the UK but the global figures are very striking: LMICs see 99% of maternal deaths, 95% HIV infections, 90% of people with visual impairment…the list goes on. (1) An elective in an LMIC gives us some exposure to these big global health issues and some perspective on the world's problems.
God asks his people to care for the poor and to work for justice. He doesn't call all of us to live and work in a poor country, but he does call some. Your elective is a time to listen. What part could you play in the future?
If you do your elective in an LMIC, you are likely to see diseases you'll never meet here. Malaria is one of the world's biggest killers but you may never come across a case if you stay in UK. You may see some advanced pathology and clinical signs you have only read about in textbooks - or may never have heard of. On my elective I remember being shown a patient with 'uraemic frost.' A new one on me! (Look it up if it's new to you too).
Hopefully your clinical skills will increase. With fewer investigations available, it may be just you and your stethoscope to make a diagnosis. It actually matters whether or not there is stony dullness on one side of a patient's chest if the X-Ray machine is broken - do they need antibiotics or a pleural tap?
Stepping out of your comfort zone into a different world will stretch you in other ways as well. Living in another culture makes you look at your own through a different lens and reassess what's important. Seeing poverty and suffering may force you to think through some big questions. Meeting new situations, away from familiar routines and people, will mean you have to rely on God in a new way and you'll grow in your faith.
We're part of a family with two billion members and it's great to meet some of our distant cousins. If you go to a mission hospital, many of the staff will be Christians and you'll have the chance to learn from them and see how they live out their faith in their context. Wherever you go, you'll hopefully meet some Christians at church and see how they worship, and have the fun of joining in. More than 75 countries now have national Christian medical movements that are part of the International Christian Medical and Dental Association (ICMDA), the umbrella organisation that links us all up across the globe. You may be able to connect with a local CMF while you're away - they will be encouraged to have you and you will be blessed. (2)
So what are you waiting for?
Don't miss this chance to explore, learn and grow. Step out of your comfort zone and do your elective in a resource-poor setting. It will change the way you look at the world, and it may even shape your future.
1. WHO factsheets 2014 2. Read Laura Seymour's account of going to a local CMF conference on her elective