Expectations vs. Reality

Cindy is a fourth year medical student at Marian University. She is currently applying to Family Medicine residency programs with her professional interests including Primary Care, Women's Health, and Global Health. Cindy is a FIMRC alumna- she participated in the Summer International Health Fellowship at Project Bududa, Uganda during the summer of 2019. Her experience was so amazing she decided to learn about a different FIMRC site in a long-term volunteer experience. Cindy spent the month of April as a volunteer at Project Alajuelita, Costa Rica; below is her initial reaction to the community and FIMRC’s work after being on site for one week. We will hear from her again soon to learn about her reflection on her entire time on site.

I packed my bags three weeks early.  I purchased copious amounts of sunscreen.  Unable to contain my excitement, I carefully selected and wrapped gifts for my host family.  For months, the first and last thirty minutes of each day were dedicated to studying Spanish. Each time my month-long stay in Costa Rica with FIMRC’s Project Alajuelita came to mind, a thrill of excitement coursed through me. After spending an incredible two months at FIMRC’s Project Bududa in Uganda a few summers prior as a second-year medical student, I was filled with anticipation about what the coming month would bring. During my time in Uganda, I made lifelong friends, Ugandan and American alike. I found myself busy (on many days over one hundred patients passed through the clinic doors), working hard, but completely fulfilled by the work I was doing. As we traversed slippery paths newly muddied by the daily rain, I cherished these opportunities to educate community members about common medical conditions and their prevention.  Now a fourth-year medical student less than a month from graduation and becoming a physician, I was fairly bursting with excitement for one final adventure before starting residency. 

Prior to my departure, I reflected that this would be my first truly immersive experience abroad. Though my past global health experiences included an overseas study program in Botswana, a medical mission trip to El Salvador, and my aforementioned time in Uganda, I had always been surrounded by fellow American students. Together we processed, learned, and grew through our experiences. Once my plane landed in San Jose, I suddenly found myself surrounded by Spanish-speaking Costa Rican nationals, without an English-speaking American to be found.  From the moment my FIMRC driver picked me up from the airport, I was employing every ounce of Spanish my brain possessed. Because of my previous months spent abroad, I naively assumed I would be immune to culture shock. Yet those first several days of my experience in Costa Rica served as a reality check, despite my every attempt to keep an open mind and positive attitude.  My expectations were out of line with the reality I was experiencing, creating a cognitive dissonance that I had historically remedied by the company of those experiencing it alongside me.

At the clinic, I likewise needed to abandon all expectations at the front gate. While I knew that my experience in Alajuelita would be markedly different from that in Bududa, my visualization and expectations persisted – a Bududa remix, in Spanish trappings. I expected to work in a busy medical clinic, serving a great need in the community, but the COVID-19 pandemic had forced the clinic operations into largely virtual visits. Instead of meeting patients face-to-face, I was typing messages in Spanish to them over WhatsApp. Where in Uganda I was examining malaria specimens under the microscope, teaching about health education topics, and hiking mountains to visit mothers and their newborns, I am now spending mornings behind a laptop creating clinic reports or in the pharmacy filling medications for patients to pick up following their virtual visits. Moreover, I have been repeatedly discouraged by my attempts to understand and be understood in Spanish. Blinded as I was by my enthusiasm and love for Project Bududa, I did not give myself the mental space to appreciate how different one experience would be from the other, despite both existing to fulfill FIMRC’s mission. When we travel to a different country and culture, we are told how essential it is to maintain an open mind, a flexible attitude, and a posture of humility. Yet this is more difficult to translate into practice, but only achieved through intentional practice. With two weeks of my Costa Rican journey completed and two weeks remaining, I will continue to learn and grow and seek out ways to serve in this unique season of Project Alajuelita.