If it hasn’t already been mentioned within the first two minutes, I usually start the interview off with a joke about how tall and awkward I am. A joke that has been well received wherever I have traveled. Nothing like good physical humor to make up for my inadequate language abilities.
Most of my day-to-day work in the field involves doing a socioeconomic assessment of incoming TB patients. This involves about 45 minute interview in which I insert myself into their living situation, their education, their family members, alcohol abuse, monthly income, and health history. Their personal life is my interest, and I need them to want to share it with me.
The newly diagnosed TB patients are usually in a state of disbelief that this could happen to them–that is, if they don’t already know someone with TB. Most don’t know what to expect during their treatment or if what they are feeling is normal. That’s when I show up to explain that I’m from the health post and want to do an interview with them to see if we can support them in addition to the medication they already receive (with extra food or an extra room with good ventilation perhaps). This explanation and their fragile desire to learn more about their disease is enough to get me in the door. But that’s the easiest part. Getting the information is the challenge.
An example of house people now live in after the earthquake
I’ll understand that they don’t completely trust me right away. After all, when’s the last time I willing answered the questions of people who have appeared at my door and stated their good intentions? That’s where the joke comes in. Maybe it’s about my height. If there is a little girl in the room, I’ll ask her what her age is and then claim to be five-years-old as well–always good for a shy smile. And there’s no better way to get mother to open up than to show your care for her kid(s). All I really want to do is show the patients that I care about them; that I’m not just there to fill out some stupid form and leave as fast as possible; that I’m interested in what they have to say.
If I’m successful in getting a person to open up, instead of hearing that she’s bored all day at home (because TB patients can’t work because of treatment), I get her to tell me that she hates being alone for three days at a time, waiting for her husband to come home from a fishing expedition, only to have him mistreat her. I get her to give me the details of how she wishes her family, who lives ten hours away, could come see her but they can’t because she might give them tuberculosis. I get her to tell me that she cried the entire first week after she found out she had tuberculosis. Then I can recommend her to the women’s advocacy center in town. Then I can use her family as motivation for her to continue with treatment. Then I can recommend her to a psychologist and to group therapy. Then I can do what I came there to do: provide support for her outside of the medication which she receives in the health post.
This approach is one which I take on an individual level, but it also can be extrapolated to a community level. Do you care about the people of the community? Or just the disease which you are trying to treat? Why should the community welcome an organization whose goal is not centered around its people, but instead centered around appearing to good? PIH uses TB treatment as a method for entering into the lives of the community, but from there, once we’ve gotten through the door, we direct our efforts and care toward the entire community.







