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ɖʀʊӄքǟ ӄʊռʟɛʏ 🇧🇹🇹🇩 Profile picture
@kunley_drukpa
Sep 9, 2024 • 13 tweets • 7 min read • Read on X
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AMERICAN MEDICAL STUDENT IN HAITI DESCRIBES WORKING WITH HAITIANS - A Thread 🧵

Haitians have been making the news yet again - A Short Thread once more re-sharing the Infamous Blog Post of a Medical Student’s Experience in Haiti about ‘How Haitians Think’ 🇭🇹 Image
It has proven hard for me to appreciate exactly how confused the Haitians are about some things. Gail, our program director, explained that she has a lot of trouble with her Haitian office staff because they don't understand the concept of sorting numerically. Not just "they don't want to do it" or "it never occurred to them", but after months and months of attempted explanation they don't understand that sorting alphabetically or numerically is even a thing. Not only has this messed up her office work, but it makes dealing with the Haitian bureaucracy - harrowing at the best of times - positively unbearable.Image
Gail told the story of the time she asked a city office for some paperwork regarding Doctors Without Borders. The local official took out a drawer full of paperwork and looked through every single paper individually to see if it was the one she wanted. Then he started looking for the next drawer. After five hours, the official finally said that the paper wasn't in his office.Image
Part of it is Haitian education. Even if you're one of the lucky ones who can afford to go to school, your first problem is that the schools can't afford paper: one of our hosts told stories of Haitian high schoolers who were at the level of Western 5th graders because they kept forgetting everything: they couldn't afford the paper to take notes on!
The other problem is more systemic: schools teach everything by uninspired lecture even when it's completely inappropriate: a worker at our camp took a "computer skills" course where no one ever touched a computer: it was just a teacher standing in front of the class saying "And then you would click the word FILE on top of the screen, and then you'd scroll down to where it said SAVE, and then you'd type in a name for the file..." and so obviously people come out of the class with no clue how to use an actual computer. There's the money issue - they couldn't afford a computer for every student - and a cultural issue where actually going to school is considered nothing more than an annoying and ritualistic intermediate step between having enough money to go to school and getting a cushy job that requires education.Image
There are some doctors and nurses, who are just as bad - though none at our compound, which is run by this great charity that seems to be really on top of things. We heard horror stories of people graduating from nursing school without even knowing how to take a blood pressure - a nurse who used to work at the clinic would just make her blood pressure readings up, and give completely nonsensical numbers like "2/19". That's another thing. Haitians have a culture of tending not to admit they're wrong, so when cornered this nurse absolutely insisted that the blood pressure had been 2/19 and made a big fuss out of it. There are supposed to be doctors who are not much better, although as I mentioned our doctors are great.Image
But I was going to talk about the patients. I don't really blame the patients. I think they're reacting as best they can to the perceived inadequacies around nurses and doctors. But they seem to have this insane mindset, exactly the opposite of that prevailing in parts of the States, where medicine is good. In particular, getting more medicine of any type is always a good thing and will make them healthier, and doctors are these strange heartless people who will prevent them from taking a stomach medication just because maybe they don't have a stomach problem at this exact moment. As a result, they lie like heck. I didn't realize exactly how much they were lying until I heard the story, now a legend at our clinic, of the man who came in complaining of vaginal discharge. He had heard some woman come in complaining of vaginal discharge and get lots of medication for it, so he figured he should try his luck with the same. And this wasn't an isolated incident, either. Complaints will go in "fads", so that if a guy comes in complaining of ear pain and gets lots of medicine, on his way out he'll mention it to the other patients in line and they'll all mention ear pain too - or so the translators and veteran staff have told me.
I haven't gotten any men with vaginal discharges yet, but many (most) of the patients I've seen have just complained of pains in every part of their body and seen if any of them stick. A typical consultation will be a guy who comes in complaining of fever, coughing, sneezing, belly pain, body pain, stomach pain, and headache. The temperature comes back normal (not that our thermometers are any good), abdominal, ear, and throat exams reveal nothing, and we send them away with vitamins and tylenol or maybe ibuprofen.Image
My cousin Samantha and my friend Charlotte, both of whom have come with us, have studied medical anthropology and think this is fascinating. I am maybe a little fascinated by it, but after the intellectual clarity of medical school, where every case has textbook symptoms that lead inevitably towards some clever but retrospectively obvious diagnosis, I'm mostly just annoyed.
Also, if I ask a question of the form "do you have X", people almost always answer yes. "Are you coughing?" "Yes." "Are you coughing up sputum?" "Yes." "Is the sputum green?" Yes." "Is the sputum coalescing into little sputum people who dance the polka on your handkerchief?" "Yes".
A depressing number of our patients have split into two categories: patients with such minor self-limiting illnesses that there's not much we can do for them, and patients with such massive inevitably fatal illnesses that there's not much we can do with them. There are a few who slip in between: some asthma patients, hypertensives, diabetics, people with UTIs and other bacterial infections, a man with serous fluid in his knee that my father drained for him - but they're depressingly few. And even when we can help them by, say, giving an asthmatic a month's worth of asthma medication, it's worrying to think about what happens when the month is up. Coming back to our clinic requires traveling on awful Haitian roads and waiting in line in the awful Haitian weather with two hundred other people and then hoping there's even a doctor who will see you, so I don't know how many people return for refills or what the effect of having to do so on quality of life must be.Image
To be honest I think a lot of what we're giving are placebos. And placebos have their uses, but here I think we have lost the comparative advantage to our competitors, the witch doctors, who can placebo the heck out of us. One of our translators' grandfathers is a voodoo priest, and he was describing some of the stuff he did. It sounded pretty impressive, although at least no chickens get harmed during any of our treatments.

But we have certainly helped a few diabetics, people with bacterial infections, and the like; and we're connecting a lot of kids with vitamins (not to mention stickers), so I do think we're doing a bit of good. My father loves working in Haiti and has made best friends with all the translators and is always going out into Port-au-Prince to see the sights and taste the social life. I think it's great for my education, great for my resume, and great to be helping people, but I will breath such a sigh of relief when I get back on that plane to the States.Image
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If you liked this Thread you may also like the Africa Resource Megathread - a compilation of similar stories and anecdotes from Africa web.archive.org/web/2018020111…

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More from @kunley_drukpa

ɖʀʊӄքǟ ӄʊռʟɛʏ 🇧🇹🇹🇩 Profile picture
Dec 19
USING VOICENOTES INSTEAD OF WRITTEN TEXTS TO DM LATINAS

One thing you notice if you DM with Latinoids is that almost all of them communicate in voicenotes on messaging apps. Why? Just something inside them, some kind of impulse they have, that’s just how they are. Think if you’re a WASPy-Hajnaler this is sometimes quite an alien way of communicating, you get your messages filled with these little podcasts all the time which you have to whip out your headphones for and spend three minutes listening to whenever you receive them. A lot of the time too 80% of this content is just boring filler, they really are incredibly low content density - you could just say what you need to say in 15 seconds you don’t need to waste my time with a full live reading of One Hundred Years of Solitude every other message

My preference is to communicate in text and if someone is really into it ideally walls of text. I struggle to match the Latinoid ‘vitalidad’, the Iberianoid ‘duende’, that constant heightened state of emotion, expression and authenticity apparently imbued in every voicenote these people send. No thanks, I prefer my vanilla ice cream, my plain bread and butter toast, my analytic philosophy and my text-only DMs

This kind of natural disdain granted, was somewhat to my chagrin when I gradually discovered that Latina women respond much more enthusiastically to voicenote messaging than written texts. You know, this is the art of being able to put yourself in someone else’s headspace, of being able to build a theory of mind for the ‘other’. When I DM these women if I could I would just write them little funny texts but no it doesn’t quite work like that, you’re speaking to a woman and then again to a Latina woman. You need some spoken ‘impulso vital’

So I started sending more voicenotes, not with any content in particular just sort of riffing for two minutes that doesn’t go anywhere and wastes your time. Really really disrespectful time wasting. Responses on average far more enthusiastic - they genuinely love this stuff. Selling your WASP soul to the devil here, fighting against every natural instinct you have and properly going native by forcing yourself to burble out voicenotes is, pro-tip, a major boost - it really seems to work so… everybody has their priceImage
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The Written Text - Voicenote distinction is a major, well-documented cultural divide between the West and the Global Sourh
Your comments on this… Image
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ɖʀʊӄքǟ ӄʊռʟɛʏ 🇧🇹🇹🇩 Profile picture
Dec 18
WHAT IS ‘ETHNIC LITTERING’?

An occasional feature of history - mass population transfers of groups from their home territories to other, different and often alien territories for labour or other ideological purposes. This type of motivated transfer of non-sequitur groups is ‘Ethnic Littering’; the process of moving groups into territories where they make no (historical or cultural) sense, ‘Littering’ in the sense that the transfer is frequently careless, short-termist and unconsidered and creates and entrenches cultural, political and demographic problems in the territories these new populations are imported into

These top down transfers (as distinct from colonisation) are rarely reversed and the transferred populations often establish themselves in the new territory over time, sometimes creating novel creole fusion cultures. Where these creole fusions are unsuccessful or only partially successful entire territories are frequently condemned to intractable kinds of low level conflict because of the irreconcilable nature of the groups that have been forced to live up against other post-‘Ethnic Littering’

‘Ethnic Littering’ is characteristic of the motivated mass immigration seen into the west in the 21st century, in Britain for instance it has resulted in the beginning of the process of ‘Yookayification’. There are many other earlier historical examples of ‘Ethnic Littering’ to different degrees though too, eg in Assyria, Persia, Greece, Rome, Imperial China, later the Incan Empire (where under the ‘Mitma’ system groups were forcibly resettled to territories they were not native to transfer their loyalties to the state as well as to spread Inca culture) and also under the Ottoman ‘Sürgün’ system, in Imperial and Soviet Russia etc

One of the most egregious examples of ‘Ethnic Littering’ post-Atlantic slavery was the indentured labour C19th population transfers of particularly South Asians to territories of the European Colonial powers, primarily under the British Empire. In many ways the rationale for importing South Asians to Fiji, Mauritius, Guyana, Trinidad and Tobago, South and East Africa etc in the 19th century is the same rationale for eg importing South Asians to former industrial towns in Northern England in the post war years. A slight difference perhaps in that more recently mass population transfers have also taken on the dimension of a moral dogma, though both historical population transfers represent a kind of ‘Ethnic Littering’. Few of those countries receiving indentured labour transfers then are today properly ‘First World’ and many of those countries are still plagued by eg low level ethnic conflict. Many of those countries are artificial too, like the British and French Guyanas, formerly Dutch Suriname etc in the sense that they are countries with populations almost entirely composed of the now ‘locked-in’ descendants of ‘Ethnic Littering’ historical labour

This is the flipside of ‘You Can Just Do Things’ - you can transport entire non-sequitur groups halfway across the planet for whatever trivial reason and then in two hundred years you will have created a strange new synthetic fusion culture from the resulting mixing. You Can Just Do Things. Why not? Import a load of Kazakhs to Honduras if you want, create an ‘exciting’ new synthetic Kazakh-Honduran creole culture with no attention paid to the types of problems this kind of transfer later creates. It is true to a certain extent that this is how mass population movements have always worked throughout history, ‘human history is a story of migration’ is a truism for a reason - the distinction here seems to be though the motivated arbitrariness of the population transfer, how inorganic and careless it was, the often quite asinine ends it is undertaken for and then the jarring bizarro ‘nations’ with intractable structural problems the process produces centuries laterImage
A term often used to describe this ‘post-act of Ethnic Littering’ creolisation-recombination process is ‘Brazilification’, which has the broader sense of ‘Thirdworldification’ but also the more more specific sense of ‘the mixing of different groups’ in a territory that was once more homogenous. ‘Ethnic Littering’ is then also the act of transferring non-sequitur populations to a territory such that the process of creolisation or ‘Brazilification’ begins, perhaps ‘Thirdworldification’ too if the new mixed culture is too divided or non-cohesive and so not particularly functional. ‘Yookayification’ is a version of this. Brazil of the eponymous ‘Brazilification’ is in this respect the perennial ‘Country of the Future’, ‘something’ like what you get everywhere ‘Ethnic Littering’ runs uncheckedImage
About Belize as an example of ‘Ethnic Littering’
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ɖʀʊӄքǟ ӄʊռʟɛʏ 🇧🇹🇹🇩 Profile picture
Dec 10
YOOKAY PARALLAX

Quoted article below by a British Muslim writer makes the suggestion that ‘The Left’ should co-opt the term ‘Yookay’ as a positive descriptive term but then goes onto to repeatedly misunderstand what is actually meant by the term. Don’t think this is because the concept is obscure or especially difficult to understand - commentators like Lord Frost have been able to give accurate accounts of what is meant by it. These writers are then either disingenuous and pretending not to ‘get it’ for rhetorical purposes (possible) or, more likely, just do not exist in a conceptual headspace where it is really even possible to ‘get it’. WRT ‘Yookay’ here they are seemingly unable to conceptualise the world historical demographic and cultural change that recent migration into Britain represents

This inability to enter into a different conceptual space was capture by Jean-François Lyotard with his notion of ‘The Differend’ - which refers to a situation where a conflict between two parties cannot be fairly resolved because there is no common language or framework of judgment that both sides recognise. In a differend, one party’s suffering or claim cannot be properly expressed or validated within the dominant discourse, meaning that misunderstanding occurs not because of falsehood, but because of the inability to be heard within the available linguistic or conceptual system. This is a perennial feature of contemporary British political discourse

I have not yet seen a mainstream ‘Left Wing’ person argue “Yes and that radical population and cultural change is a good thing” when they try to critique the concept of the ‘Yookay’. This is strange, because the ‘Yookay’ represents the actual material outcome of their ideological project. This is what you wanted! Instead they often try to pretend ‘Yookay’ doesn’t represent any meaningful change at all and, if they address the account itself, that all the images there are fake or don’t pick out any meaningfully representative aspect of Britain. This is a generous version of the position:

“Britain hasn’t meaningfully changed at all but also all these obviously new cultural interpolations are good things and we are happy that they have been introduced”

The author of the article herself does not even reach this level. She says “we should reclaim Yookay” but then describes ‘Yookay’ as class antagonism erroneously misdirected towards “black and Muslim people”. It is therefore a ‘populist cope’. ‘Yookay’ so-reclaimed to her then apparently means a united multiracial working class front against ‘The Rich’ ergo the ‘Yookay Aesthetic’ will be reclaimed as a ‘good thing’ because it represents anti-capitalist solidarity(?)

I mean why bother at this point? She doesn’t even mention demographic and cultural change as an important component of the concept because to her, again, there hasn’t been any meaningful demographic and cultural change. Any counterbalancing of a ‘Historical Britain’ to the ‘Yookay’ represents, she says, “a fictitious past”

My sense of the concept, and sorry if indulge myself a little here, is that it does ‘pick out’ meaningful changes in national character - and because many of those meaningful changes are (by many subjective evaluations) undesirable the act of documenting them and pointing out that these changes have taken place is read as some kind of attack by ideological advocates of that transformation. Some of these commentators will also leap to “ergo it must be a racist project” to bridge the gap between their idealised visions and the actual reality of that sweeping national change. Here it becomes difficult to describe these changes in strictly neutral terms, let alone negative terms. If commentary on real world imagery and videos (that because they are real necessarily represent some aspect of the real world as it actually is) is not strictly positive you are in danger of having your posting construed as crass and racist attacksImage
Again, would like one person to actually defend the change at a properly intellectual level instead of just denying the demonstrable change represents any kind of change at all. You cannot ‘co-opt’ a term if you are unprepared to honestly address the actual original sense of it
‘Tribune’ was first founded in 1937 as a democratic socialist magazine and its previous editors have included Aneurin Bevin, Michael Foot and… George Orwell. It is now owned by a Tunisian Islamist
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ɖʀʊӄքǟ ӄʊռʟɛʏ 🇧🇹🇹🇩 Profile picture
Dec 7
MINNESOTA - “SOMALIA’S PROMISED LAND” 🇸🇴

In recent weeks a new meme has emerged on Somali social media in which Somalis claim Minnesota is the promised land for Somalis and invent histories about how Somalis came to settle there. Collection thread of some of these memes 🧵
‘Somali Manifest Destiny’ Image
“A native American Somali man who's ancestors and tribes dwelled the land of Minnesota for centuries .🪶 Fun fact traditional dishes like banana and rice were served in thanksgiving back in those days also”
Read 13 tweets
ɖʀʊӄքǟ ӄʊռʟɛʏ 🇧🇹🇹🇩 Profile picture
Nov 18
ON THE THIRD WORLD CITYSCAPE - ABOUT GUATEMALA CITY 🇬🇹

Spent some time in Guatemala City. It isn’t a very interesting city but it is a good example of what an average Central American / Third World city looks like. A thread about the common features of these kinds of cities 🧵 Image
When you fly in above, I don’t want to say the place looks like slum but it does look sort of the next step-up from a slum. Just a sea of corrugated iron roofs. These kinds of cities are not hugely appealing from above. It looks visibly ramshackle Image
There are whole areas of the city that you “just don’t go”. “Aye aye aye… es muy peligroso” you will be warned. “We don’t go there”. This threat is a little exaggerated, you can walk more places than people say you can, but it is also true that there are places you shouldn’t Image
Read 13 tweets
ɖʀʊӄքǟ ӄʊռʟɛʏ 🇧🇹🇹🇩 Profile picture
Nov 17
“Bro if immigrants scare you don’t ever visit Dubai, 90% of the country are immigrants”

“Those people are guest workers”

“And somehow… they aren’t collapsing.
They’re booming”

“They aren’t eligible for citizenship”

“I might get a UAE passport myself”

“Literally impossible” Image
Image
Another day in upside down world where someone uses an example that demonstrates the exact opposite opposite of what they are trying to argue to argue because they don’t know anything about anything
Have to make some version of this tweet maybe every three months
Read 5 tweets

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