Comments About Culture Shock

To varying degrees, FTC team members who travel abroad experience culture shock. This condition is comprised of more pronounced reactions to the psychological disorientation most people experience when they move into a culture strikingly different from their own. Signs of culture shock are:

Culture shock is a cyclical phenomenon, with the volunteer experiencing at least two "low" periods during the course of his/her time abroad. This condition is also staged as follows:

We ask that prospective FTC team members consider their own culture first in order to combat the subsequent culture shock. Foreigners has described Westerners/Americans as outgoing and friendly, and sometimes these traits are perceived as rude and informal. Americans are also viewed as hardworking, lavish, wasteful, know-it-alls, hurried, and disrespectful. FTC volunteers must be aware of cultural differences where they travel, in order to work well in close contact with others where expectations and values are not the same.

Another approach to confronting culture shock is to learn as much about the destination country as possible. Some of the countries where FTC teams go have citizens who are isolated and oppressed. Most FTC team members react significantly to such settings. It is especially important to be well-informed about, for example, being under the authority of communist officials. Volunteers must be cautious about how they conduct and express themselves where such governments rule over their citizens much differently.

The bottom line is to remain realistic, with perhaps lower expectations. Be flexible and allow for tolerance. Laugh and keep an adventuresome spirit.

As is always true, FTC team members will encounter glitches and challenges, regardless of how well they are prepared. These members do make a difference in the lives of those in need, but perhaps on a measurably smaller scale in painfully slower ways.

Reference: Robert L. Kohls, Survival Kit for Overseas Living, pp. 65-66. Some Tips for Volunteering Overseas

The concept of volunteering is one familiar to Americans. But in some countries, there is no word for "volunteer" in their native tongues. Be mindful, therefore, that some people may receive you with suspicion; perhaps there is an ulterior motive to what you are doing in their homeland.

At the same time, you may not understand the local host health professionals' ordering of events and priorities. Remember it is their prerogative if they opt to arrive late to the clinic or leave early to do other activities. Many of these health care providers must maintain private practices or hold other jobs, in addition to the roles they have at the clinics you visit. They may be every bit as concerned as you are in assisting those in need, but they may also have to do extra tasks to provide for themselves and their dependents.

Be prepared for health care settings that perhaps are not as clean as what you normally encounter. They will most likely be overcrowded as patients and loved ones spread out in whatever space is available. Other common conditions include a lack of reliable plumbing, water sources, and cleaning supplies. As circumstances allow, your example of good techniques for hygiene and minimizing contamination may become valued. You will have to choose methods, however, that preserve the hosts' and patients' sense of self-respect and avoid situations that cause undue embarrassment.

When you are faced with patients who are especially in dire need and have complex surgical and/or medical needs, please remember the "big picture". Consider such questions as:

Will recovery or care demands be too great for the local health care providers? Are the proper medications, equipment, supplies, technologies, etc. present and in the necessary amounts for whatever the cases demand? What about the special requests for treatment not part of FTC's mission or beyond the scope of the FTC team members? Do FTC teams do cosmetic surgery for the hosts' family members or communist party officials?

Each of these questions must be addressed as FTC volunteers try to strike a balance between functioning within the parameters of the mission and patient safety/promoting goodwill overall.

It is everyone's desire to improve the lives of the people with whom FTC teams come in contact. But FTC volunteers must be very careful not to raise hopes unfairly or state or imply promises that FTC cannot keep. Reassure the hosts of an ongoing commitment to helping through future FTC teams if that, in fact, is what FTC as an organization intends to do. The best rule of thumb, if in doubt, is to have the FTC team leader be the spokesperson and the team translator reliably convey such information.

It also is a precarious position to tell hosts the values of the items teams bring for use among or donation to the host providers. In some cultures, the native physicians expect that humanitarian organizations bring even more supplies than on previous trips. The hosts expend much personally to host FTC teams. Thus, some do not hesitate to ask for supplies and are offended if we do not meet their expectations. Some FTC teams have even had supplies not intended for donation impounded. Then some very delicate diplomacy ensues to get them back. This misunderstanding may not be well-received at all and dynamics may change.

Finally, approach your trip with a high level of curiosity and sensitivity. Use all your senses to appreciate this unique experience. Try to see yourself through the eyes of your hosts and the patients. Mutual respect will be the best path to learning, helping, and teaching.

Face the Challenge (FTC) was founded by Randolph (Randy) C. Robinson, MD, DDS, cranio-maxillo-facial surgeon, and his wife, Ginger Holmes Robinson, BSN, RN (cardiac and critical care). Since the late 1970's, they shared a dream to offer their medical services to the world's needy.
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