Who knows best?
(A SAMPLE CRITICAL INCIDENT)
"The only hard thing, rather one of the two hard things, is knowing your purpose in this world. The other which is harder, is not to corrupt it after knowing what your purpose is."
One day a Peace Corps Volunteer decided to take a different route home after working the afternoon at the local health center. She did this from time to time so that she could meet more people in the village and let them get to know her a little instead of just hearing about her or seeing her ride by on her bicycle. This day she was on foot and stopped to introduce herself to many people who were out in front of their homes. One family in particular left an impression on her that day.
As she was passing by this family's house she noticed a rather loud and heated discussion going on. Nevertheless, when she walked by, someone stopped to smile and say hello, so she went to greet everyone there. She noticed a young man, sitting on a mat, who had a guinea worm coming out of his foot. She looked carefully at the wound and the worm and remarked sympathetically that it must hurt him, but she was glad to see that he was keeping the sore clean. She re minded him that washing the sore each day with soap and water was helping him to avoid infection. She asked him if he had a clean cloth to cover the sore. The young man said that he didn't want to cover the worm because it would stop the worm from coming out. Her counterpart had explained that many people in the village held traditional beliefs about guinea worm disease that would be hard to change. In fact, she had heard others express this same fear about covering a guinea worm sore, but she knew it wasn't true. Covering the sore merely protected it from dirt and infection. She didn't argue with the young man be cause it was obvious to her that he was keeping the sore clean.
In the meantime, two of the older family members present continued to discuss excitedly what should be done with the young man's worm. One of them re called that the boy's grandfather spoke of a village where he saw people pull on the worm to help it come out. He felt strongly that they should do the same thing in this case. The other elder man seemed to agree and expressed his sup port for pulling the worm out. They were speaking in the local language and the Volunteer thought she was understanding most of what was said but she did not make comments. Normally she relied on her counterpart to help with translations of the local languages and felt more confident in trying to explain when he was there to help her find the right words.
A third family member, a young student at the local high school, insisted that the worm be left alone and wound carefully around a small stick until it came out all the way. He said his teacher had explained in a hygiene class that you could prevent guinea worm disease by drinking filtered water and by keeping infected people away from the pond so that their guinea worm could not recontaminate the water source. The teacher also explained that if you were unlucky enough to have guinea worm disease you had to just take care of yourself and wait for the worm to come out on its own.
The two older men absolutely disagreed with the student, saying that it could take months for the worm to come out and that the young man's fields were already going to ruin. But the schoolboy said pulling on the worm would make it break and then the young man would suffer even more. No, the elders said, if the worm broke it would not be a problem. It would just come out somewhere else.
Confused about what to do, the young man with guinea worm asked the Peace Corps Volunteer what she thought. He explained to her in French what every one had said so far. The Peace Corps Volunteer reacted adamantly, saying, NO! to pulling the worm out. She said that despite what Grandfather had said, the worm should be left alone to come out at its own pace. She said that no one should ever pull on a guinea worm, that it can cause infections and prolong the painful process of getting the worm out. She said experts had come from the United States to explain about guinea worm and she was sure she was right about this. Her response seemed to please the young student, but the guinea worm sufferer looked sullen and the two older men seemed almost angry. The conversation ended there. The Volunteer said good bye and continued on her walk home. After just a few moments, she could hear the loud discussion continue as the family gathered around the young man on the mat. She was thinking how the conversation might have gone better if she had been with her counterpart. She would talk to him about it tomorrow.
1. What consequences might this simple interaction have in the village for the PCV? What about for her future efforts in the community?
2. Where is the balance when necessary information conflicts with local beliefs or customs?
3. What other ways might the PCV have handled the interaction?
4. How might having the counterpart present improve the results of this scene?
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