How should we serve?
Supporting change from the inside out
by Kelly Anderson

It was June of 2007 and I was one of eight students and health professionals on a long flight from Toronto to Kilimanjaro, Tanzania. Beneath us lay 400 kg of medical supplies in cargo, and on our minds lay the prospect of treating more than 200 HIV-positive individuals and disadvantaged youth within six weeks.

This was not the first time I had made the decision to jump into a foreign community with the intention of “helping.” Yoga is the underpinning of my often misguided dreams of serving the causes of health and equality in underserved places. It is deeply ingrained within me that what affects the poorest individuals is merely an indication of where humanity must work the hardest to serve us all. Serving is often articulated and explained as karma yoga: selfless service to others, consciously creating a future freer from selfishness and egoism.

In the months leading up to this trip, I found myself asking: What does it mean to serve? What if coming in from outside to serve these communities is not the best (or only) way to facilitate the ascent out of poverty and to fuel positive change?

Once we were prepared to see patients, the message that there was free medical care available trickled out to the HIV-positive community through word-of-mouth. People flowed in, sometimes traveling long distances and waiting for hours on the sun-drenched lawn outside the tiny hospital. Our team was limited in its work by lack of translation services, space, equipment, and the correct medicines, but most of all by our inability to diagnose problems. Often, even with the presence of a Canadian infectious disease specialist, our team would not be able to provide care beyond a package of Tylenol. Inevitably, much of our work involved referring patients to a local, experienced physician who could often instantly recognize illnesses that were puzzling to us.

It begged the question, was our help truly helping? I spent my weeks continually debating whether this was the best way for me to serve this community. International projects like ours are often glamorized and made to sound exotic, partly to boost fundraising efforts and partly to assure ourselves that we, as resource-rich nations and individuals, are making a difference for those materially less fortunate. But despite the benefits international aid does bring, the extent of global poverty and disease cannot be remedied solely by well-intentioned international projects and aid organizations.

In my international endeavors, I have found it troubling that the experience is often self-congratulatory and blown out of proportion as compared to the benefits actually imparted within the served communities. From our first days in the clinic, it was indisputably clear who provides the real care for these individuals in need. Although we were bringing in much-needed medication, what struck me most was the depth of care provided by the communities themselves. These intricate systems of support are often overlooked by international NGOs and service projects. It will be those systems, not international aid projects, that do the real work of building communities and governments into establishments that will meet the needs of their constituents.

As an international development worker and future physician, I believe in many long-term, well-planned projects that serve those in need around the globe. Aid must exist and we must support it. International collaboration in fighting poverty is paramount. However, in terms of volunteerism overseas, let us be more careful in our service. Karma is not short-sighted. For every medical clinic built by an international team, who will ensure there are health workers to staff it and resources to supply medicines and equipment? How will we ensure that there are adequate physicians trained for the community? For every direct medical treatment given by a relief physician, where will that person access care in the future? Ideally, all communities must be supported in ways that allow them to increasingly support themselves. This is sustainable health care, and local sustainability is the core of community development.

In all the communities where we serve, we must look for the existing leaders, the change-makers and the silent servers among friends and family. How can they be helped to do their work? Indeed, it is communities, families, and individuals that are the experts on their own suffering. Communities are taking care of themselves. For those of us incidentally blessed with resources and power, how can we make it easier for those who wish to make a difference in their own community?

My international endeavors have made me thoughtful about how to serve with longevity and sustainability. This is something we can all bring to our practices of karma yoga, whether they take place in our own town or on the other side of the world. The communities in which we work may require us to serve as an integrated part of the community itself, as opposed to outside of it. They may require us to work long-term, with greater attention to the details of our service. Through practicing a thoughtful, local mindset in our communities of work, we will not only truly help others, but also move humanity collectively toward a future of unity, longevity, and freedom from suffering.

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~ by kcanderson on January 11, 2008.

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