Course 101: How to Act on an International Trip

Every Action is Based on a Bit of Theory

The goals of the trip are to help spread the accumulation of knowledge that we have, to those without access. We achieve this through direct patient care, teaching our international counterparts, as well as the American students, and forming lifelong professional relationships. At the heart of this is the personal exchange of cultural values and ideas that lay the foundations for the relationship with the persons involved. The validity of these statements lies in the fact that the people with whom I interacted with 30 years ago are the speakers for the International Humanitarian Opportunities course, Surgery 150.
Remember that the purpose of the trip is to form long lasting professional relationships – it’s all about the people.
Here is the “How-To”:

Ask how they are doing.

Learn how you can help them rather than talk about yourself or your organization, or what you intend to do in the country.

(Perhaps they can help you.)

Smile at each person, especially those in the hallway, or on the sidewalk. In other words, use the smile on anyone who has eye contact.

When talking, show appreciation for all things, although not incessantly.

Stay with the positive things in conversation, and be sure to be interested in them.

Your common ground can be anything: family, the weather, compliment the weather even if it’s bad, food, their job, and ultimately, lastly, our mission.

Be a little outgoing, take a little initiative.

Talk to the person in the seat next to you on the airplane.

Meet everybody, from janitor to king.

Learn to put the other person before your questions.

Instead of asking “What time is it?” ask “How are you?” and “How is your uncle in Los Mochis?”

Be prepared for more physical contact: a hand-shake, a hug, or a tap on the shoulder.

Give eye contact and always smile.

The business card is a necessity. Give one to every single person, even those you think don’t want one. The business card is not for business; it is you. It’s the piece of you that stays after you leave, and it keeps alive the interpersonal relationship you have built while you were together. Keep it handy. Give it with sincerity, and pause to give them time to read it, then ask if they have one and show that they see you looking at it. This is also the easiest way to get their email and physical address.

Formatting the business card is important. In order of importance to the business card, it should show: 1. You and your qualification, 2. Stanford, 3. Global Health Volunteers or equivalent, 4. Something catchy

Finally, find your counterpart. In a natural way invite one of them to your home, or to your area. And mean it.

Latin American Protocol

In Latin America the culture is different, the person is more important than the thing. This has certain implications in our behavior. In conversation you stand closer to the other person than in America. In America, the distance is commonly 26-29 inches and in Latin America it is 18. When you meet a friend, the greeting is not necessarily an American hand shake, it is just as likely to be the Latin hug. The left arm is up, the forearm is bent at the elbow at 90 degrees, the hand and forearm straight up. The right arm is shoulder height and outstretched. You hug with the left, and put the right arm around and tap the scapula two times. You do not kiss the man usually, but certainly the woman if she is known to you. Some Anglos say “No way!”

When entering the room, especially the living room on Sunday afternoon at a family get together, proceed right to the alpha and shake the hand or kiss and hug. At that point, do the same with every single person in the room. This is “making the rounds.” Be verbal, and a little more outgoing than your usual. Be sure to ask how they are, and how is their family and things like “When did you arrive.” Be sure to express your happiness. “Muy contento,” with being there with them and in their beautiful city. In 50% of the cases you might even invite them to visit you. “When might they be in the United States?” I have had over 60 friends, old and newly formed, stay at my house. In one year, i had 110 such experiences, overnight stays, recorded on my tax return. This was to my benefit.

How to Act in the Hospital

On rounds or in clinic, the job is assessment of the patient and to record it in the chart so that the next person seeing the patient, is completely up to date.

The “How-To”:

1. Smile at the patient and say “How are you?”

2. Say something light, a little joke or something silly. “Do you feel lighter today with that heavy gallbladder our?”

Physician, Executive Director, and Patient after 22 operations
Physician, Executive Director, and Patient after 22 operations

3. Observe:

psychologically if they are UP, DOWN or NEUTRAL.

have an adjective to describe in writing

a male or female aspect

happiness? evaluate the smile.

4. The Verbal:

Do you have pain? The question “does it hurt” may not work in rural Latin America, because the man will say no.

Then ask, where does it hurt? They will point directly and groan.

Read into the position they have in bed and whether they’ve been out of bed.

5. Cultivate your power of observation and put meaning into everything.

6. Metrics: BP, P, Weight, HTC, I&O

7. Next is a formal exam. Wound bleeding? Drainage red or clear? Observe skin, eyes, heart and lungs, abdomen, extremities, genitalia. And use the info.

8. Charting: use the SOAP method

S, subjective

for example: “AOA”, Ah-Owww-Ah (moaning sound)

O, objective

for example: “great improvement”

A, assessment

for example: “no complications, a success”

P, plan

for example: “discharge to husband”

rev. 03/19/15

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