Digitally challenged: REflections from Sri Lanka
Today we are bombarded with mountains of input thrown at us at warp speed. Smart-phones allow us to listen to our music, text our friends, update Facebook, read the news, check our email and more--all in the palm of our hand… while alienating everyone in the room.
“Technology keeps distant friends close, and nearby friends distant”
As our technology becomes more integrated, our lives become more segregated. This is especially apparent when we look at our approach to health in the U.S. Often we are placed on a veritable health care conveyor belt, passed from registration, to nursing assistant, to physician assistant, to doctor, then sent to a specialists. We are compelled to answer the same questions over and over again while caregivers rarely take their eyes off of a computer screen. Our interaction is little more than checking allergies, blood pressure and "what’s your problem?"
The process often misses the big picture by focusing only on the immediate health problem. This industrial-style care negatively distorts our individual perspectives on wellness. Myopic views on health contribute to our national crisis of obesity and other related illnesses, causing untold problems.
Walk a Mile in Another Man’s Shoes
Sri Lanka is a tiny island south of India. Despite a recent nearly 30-year-long civil war and unpredictable weather patterns, the developing nation exceeds the United States in nearly all health indicators. How is that possible? The United States boasts some of the best medical facilities in the world. In contrast, Sri Lanka lacks most modern technology and in some places it struggles with the most basic of infrastructure. Clearly, there is something to be learned. To discover what makes Sri Lanka so good for your health, one must walk in their shoes.
There’s No App for That.
Six brave Global Health students boarded a plane and headed to Sri Lanka, a country that many of us could not place on a map before this trip. Throughout the trip, students examined health from a variety of lenses. We began by looking from the inside out through a village home stay during which we participated in shared labor project (shramadana) of building a pre-school/community center alongside locals. This experience was a "wear the other man’s shoes" approach to learning about Sri Lankan cultural practices, lifestyles, food systems and family structures. Students observed key differences between Sri Lankan and American cultures and analyzed how those differences affect health.
During the village stay, families showered us with attention and food. Lots and lots of food. The shramadana was an intimate event, and we mixed well with locals. Our Sinhala language lessons began by counting bricks as they passed from hand to hand. Villagers were entertained by our failed pronunciation attempts. In this village, the majority of the men worked in local sand minds or away from the village. The women and children impressively assumed leadership roles and enthusiastically participated in the community action.
After a few short days yet insightful days, we bid Uddadaha farewell and headed North to the district of Anuradhapura. Our visit corresponded with a major local holiday, Possom Poya. Possom Poya celebrates the Buddhist conversion of King Asoka, who subsequently introduced Buddhism to Sri Lanka. 600,000 pilgrims dressed in white flocked to Anuradhapura city. Many traveled long distances tightly packed in buses and piled on the back of pickup trucks with only umbrellas to protect them from the relentless sun. We took it all in, filing passed makeshift stands selling toys for children and lotus flowers for offerings. We saw huge open fields where pilgrims had slept the night before. Entire families had huddled together, completely vulnerable to the elements. We were in awe of such collective sacrifice.
Sri Lankan Approaches to Health
As much as culture plays role in health, so does policy. Sri Lanka has an extensive healthcare system. The government spends more on health per capita than any other South Asian country. Throughout the trip, we learned about governmental approaches to health through visiting the Family Health Bureau, a government sponsored ayurvedic hospital, and meeting with leading epidemiologists, health officials, and various doctors. Speakers took pride in the exemplary success of their health programs including vaccine initiatives (eliminating cholera and nearly eradicating malaria) and village-based midwifery programs, all without the use of Internet or a single smart phone. We noted that health care providers take a holistic approach to patient care, focusing on the psycho-social heath as well as the spiritual state of the individual.
Also, the Sri Lankan government coordinates closely with non-governmental organizations such as the Sarvodaya Shramadana movement. Sarvodaya has extensive, island-wide, pre-school programs. Health initiatives are easily integrated though these facilities. The pre-schools host a spectrum of classes for parents such as nutrition, parenting and child development, first aid and much more. The increased awareness from these programs directly and indirectly benefits health of the community.
The Last Word
The trip came to a close in Sarvodaya’s peaceful meditation center. We gave our final presentations using pre-trip research and information gathered from in-countries lectures, site visits, and personal observations and experiences. Our presentations culminated an incredible experience witnessing, dialoging about, and participating in a one of the planet's most interesting comprehensive health care systems.