Motivations

As I get properly into the swing of things, I’m trying to work out what I’m meant to be doing here and why I’m doing it. If by late June, when I plan to leave, I have just gained experience of tropical medicine in a limited resource setting, will I feel satisfied? Or will I think that there was much more that I should have done? Currently I’m just doing “service provision” without any attempt at “service improvement”, which could be much more productive in the long term. I’m experimenting with ideas for teaching and for audit, but it’s difficult to know what is actually useful in the long term. I could gather data and do an audit on anything, but how do I know it will actually be any use? I think a bit of patience, and waiting for a problem to become apparent – either from experience, or from talking to the staff here. As for the teaching, I don’t want to be the western doctor who comes over, tells everyone they’re doing it wrong and then disappears again. I want to set up a system of mutual development, which will continue when I leave – this might be a little romantic, but at least I’m setting out with good intentions.

Intentions and motivation are an interesting point, which I’ve been thinking about a bit over the last few days. My reasons for being here are many, and vary quite widely. Some are at the more self-centred end of the spectrum; I want new experiences, to maybe make me a broader, more interesting individual and to help me understand myself more. I would also be lying if I said that this trip, and doing audits and teaching wouldn’t be helpful for ticking boxes and career progression in the future. As long as I’m honest about these, I don’t think they’re particularly bad reasons to be here, but they’re not my only reasons. I’ve known for quite a while that I should come back here and be more helpful/productive than I was when I was a student (not really that hard), and I do really care about South Sudan and its people; I think I’m meant to use the skills I’ve been given to do something productive here, even if I’m not quite sure what the big plan is. As for future big plans, they’re quite hazy still – several friends that I’ve met that are working with NGOs out here have asked about future plans, and right now, I really don’t know the answer.

On a broader level, it’s been interesting to find out about the motivations of the other doctors that I work with – it has definitely been challenging. One of the doctors that I work with also works at the government hospital, and at another private clinic. He’s easily doing the equivalent of 2 full-time jobs. When I spoke to him about why he works so much, he explained that he supports his mother and brothers, who are in Sudan and Uganda, to ensure they have enough to live on and study. I didn’t ask for a copy of his accounts, but from what I know, at least two-thirds of his ‘disposable’ income goes to his family. That made me realise just how fortunate I am. My motivation for doing medicine is not money; that said I’m incredibly fortunate that I get paid well for doing a job that I love. I’ve realised how lucky I am that this can be the case, my family haven’t been displaced by decades of conflict, and they live in a country that has a pretty good state welfare and education system (sorry daily mail readers, but it’s true in comparison to a lot of the world); when someone gets sick there isn’t the need to spend all my money on private healthcare for them, because we have a health system that provides excellent care. I’ve got a bit of a new perspective on life; I wonder how (if at all) it will change me?