Microenterprise in health care and health education

Over the last decade, development aid has increasingly used a more collaborative model, with donors and recipients both contributing ideas, methods and goals. Though many examples of collateral aid projects exist in agriculture, business administration and banking, few have found their way into health care and health education, a typically donor-dominated model. The following case report describes a collateral project in health care education. This case report analyzes data-inducing project proposals, personal interviews and project reports obtained through standard archival research methods. The setting for this joint project was the collaboration between international nongovernmental (NGO) aid foundations and the faculty of a major sub-Saharan African Medical School's Department of Anesthesia. The initial goal of this project was to improve record keeping for all anesthetic records, both in the operating theatres and outside. Analysis of the data was performed using ethnographic methods of constant comparative analysis. The purpose of the analysis was to critically evaluate both the goals and their results in the Department of Anesthesiology. The findings of this analysis suggested that results included not only quality assurance and improvement programs in the department but also advances in the use of critical incidents as teaching tools, hospital-wide drug and equipment utilization information and the initiation of an outreach program to district hospitals throughout the country for similar projects.     

Ethnography as storytelling

In every case the storyteller is a man who has counsel for his readers. But if today “having counsel” is beginning to have an old-fashioned ring, this is because the communicability of experience is decreasing. In consequence we have no counsel either for ourselves or for others. After all, counsel is less an answer to a question than a proposal concerning the continuation of a story which is just unfolding. To seek counsel one would first have to be able to tell the story. (Quite apart from the fact that a man is receptive to counsel only to the extent that he allows his situation to speak.) Counsel woven into the fabric of real life is wisdom. The art of storytelling is reaching its end because the epic side of truth, wisdom, is dying out. This, however, is a process that has been going on for a long time. And nothing would be more fatuous than to want to see in it merely a “symptom of decay,” let alone a “modern” symptom. It is, rather, only a concomitant symptom of the secular productive forces of history, a concomitant that has quite gradually removed narrative from the realm of living speech and at the same time is making it possible to see a new beauty in what is vanishing Walter Benjamin, “The Storyteller; Reflections on the Works of Nikolai Leskov,” (1936) in Illuminations (New York; Schocken 1969) p. 86; also see “Eduard Fuchs: Collector and Historian,” (1937) in One-Way Street (London: New Left Books), pp. 351–352. .     

Gypsies and health care.

Gypsies in the United States are not a healthy group. They have a high incidence of heart disease, diabetes mellitus, and hypertension. When they seek medical care, Gypsies often come into conflict with medical personnel who find their behavior confusing, demanding, and chaotic. For their part, Gypsies are often suspicious of non-Gypsy people and institutions, viewing them as a source of disease and uncleanliness. Gypsy ideas about health and illness are closely related to notions of good and bad fortune, purity and impurity, and inclusion and exclusion from the group. These basic concepts affect everyday life, including the way Gypsies deal with eating and washing, physicians and hospitals, the diagnosis of illness, shopping around for cures, and coping with birth and death.