About the protein thing, I think I have definitely been eating too much tuna, it's getting really gross. HOWEVER, I am going to try yak cheese this afternoon.. I can get plenty of that from this Government Dairy Development Center near where I live, but the I have not thus far because the place looks pretty sketch, with flies everywhere...
I hear it's totally clean though, but that yak cheese might make me "yack," so to be super careful with how much I eat. Sounds kind of gross anyways, but always an adventure.
I had several more meetings today, one of the least inspirational was my last this afternoon. The Nepal Environment Commissioner for the World Health Organization and I finally made connections. He was not as helpful as I had hoped for my project specifically, but I think he made some very very good assertions about the problem or issue of the environment impacting people.
One of his many points was that any environmental issue, by nature, is entirely too complex to separate from any other. So, in approaching the environment plus people, he said that the relationship is entirely dualistic and mutually enforcing. Thus, people affect the environment, and the changed environment affects them back.
He went on to point out, sort of on a different note, that the only way to protect people from climate change is to preemptively increase their self-reliance. This is where it gets interesting. In the case of Nepal, or other many other developing countries, the people used to be entirely self-reliant, obviously, they survived long before we got here. He says that the introduction of many types of humanitarian aid has made them less independent. For example, community members no longer think holistically about the ways in which they are ill, as in food allergies, or blood types. Instead, they view doctors as "car repairmen," light on the diagnosis and heavy on the shots, or pills that will hopefully, and usually make them better in the short-term. These people no longer look to the root of their medical problem, which could be allergies or whatever, they look to the quick-cure that lots of western aid provides.
(Jimmy please pipe in whenever, this is obviously not my expertise, and I'm sure you have come across this in much more detail and depth)
Thus, getting back to the point, to enable people at the local level to have a higher resilience to things like climate change, or environmental factors in general, you must increase their resistance, by increasing self-reliance (quite the ring-around-the-rosy to end up with such a mouthful).
So, have we (as good-intentioned westerners) unwittingly lowered the resistance of men and women in developing countries to those same negative externalities which we cause? We cause problems for them - like global pollution- then introduce non-sustainable fixes to those problems, which then increases their reliance on us to desperate extremes to continue these quick-fixes. (again, ring-around-the-rosy)
Well, at least that is what this Danish man from World Health Organization seems to think. I guess in any case, increased self-reliance is a great route. Please tell me your thoughts. (especially Jimmy)
And, now to yak cheese.....
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you may get better insight from a hearty helping of yak cheese, or the enlightened delirium it may evoke from your insides...
... but what you've written really resonates with me. I was on a track to investigating root problems of illness through my public health degree. That's unfortunately on the back burner now that I'm stuck in the trenches of medical education.
In my public health training we focused more on community-oriented assessment and responses to poor health - developing techniques to engage communities in defining not only the existence of illness, but also their origins - on multiple levels, ranging from biological and behavioral, to community, cultural, social, and economic. We focused on root causes and learned to work with communities in ways that elucidate their realities, in their own terms, and in doing so assisted them in developing programs to more appropriately address those problems. In the classroom it seemed very abstract, and to many of us, very idealistic.
In the little time I had, though, in projects through school and later in Nicaragua, the first steps actually worked. For a year I worked in a small North Carolina town where train tracks still marked divided blacks and whites (the growing Hispanic population had everyone really confused). Through processes of interviewing, mapping, joining in church picnics, and walking streets where many people were taught not to go, we learned about and publicized perspectives and histories that many other people would be more comfortable ignoring.
In Nicaragua, I was sent by an NGO with all the best intentions to investigate the health status of a rough, urban neighborhood in Managua. It was suggested that I look at diabetes and heart disease, mostly because "lots of people in that neighborhood look like they probably have heart disease or diabetes." After living there a little while, handing out cameras for people to document what affected health in their community, they came up with very different interests. Trash was #1, and they went to great detail to describe the individual, societal, and economic influences that lead to trash accumulation - and then described the rains, the clogged storm drains, the standing water, the mosquitos, and the incredible toll that dengue and malaria take on their fellow citizens - diseases that are 100% treatable, and should be 100% preventable. I was sent to investigate disease, but with a little insight into root causes from that community's perspective, trash was a much more appropriate place to start.
What you've written also brings to mind that initially in Nicaragua, before I had one bit of medical training, everyone assumed that I was a doctor and had come to dispense medicines. I had a week-long waiting list of people expecting to see me the next day in clinic. A little freaked out, whatever broken Spanish and sign language I threw out at that point quickly did away with the waiting list.
Reflecting on it all has given me several valuable lessons. One being that true change is only going to come when people have the opportunity to explore, express, and act upon root causes from their own perspective. Another, that is tough at times to swallow, is that sometimes medical care is the most appropriate first step - people need to be helped back to a certain point of health before they can dig deeper into root causes.
Perhaps the most frustrating lesson, and the one that still challenges me the most, is the commitment of time. I spent 9 months in that North Carolina town, and only two months in Nicaragua. Both experiences were barely enough to scratch the surface of an assessment. My projects did nothing to actually come up with lasting solutions. Hopefully the momentum we started carried through, but I left well before ever seeing it. In the ideal world in which I hope to practice, I'll stick around long enough to make a difference.
I read about a good person today, Larry Brilliant. Check him out: http://www.rollingstone.com/politics/story/19968512/the_guru_of_google
The article put a book at the top of my summer reading list, as well: http://www.amazon.com/White-Mans-Burden-Efforts-Little/dp/1594200378
You and my brother will have to get together to discuss cheese. After learning to love Nicaraguan cuajada, John came down and dubbed it "cow sweat cheese," forever ruining it for me.
Thanks again for sharing everything you're seeing and thinking.
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