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Thursday, October 28, 2010

No, really, what do you do in Mongolia?

I've been at my job for about two months now, and I finally feel like I can answer the million tugruk (which would be about $750) question from before we left home: What are you going to be doing in Mongolia?

Well, I've figured out what...I'm just not sure how.

So I have written before that I am working in the Bayanzurkh District of UB at the District Health Unit. I'm a member of the Public Health Department, and I am tasked with setting up a Community Health Volunteer (CHV) Program for the 24 sub-districts (that will split into 28 come January) and serve a population of 280,000 people. This population represents one tenth of the entire country. That's a lot of Mongolians.

The way that the project is set up, there will be four years of work that ultimately leads to a sustainable Community Health Volunteer Program. The volunteers will be trained in all manners of health promotion, from sanitation (basic hand washing even) to preventative health care. They will reach the farthest of the far in their district and offer services to people that would otherwise not reach the Family Group Practice (FGP). They will lessen the strain and workload for the already overloaded FGPs. They will educate the public, improve overall health, and serve as a link between the community and the health care professionals. In short, they will be little Health Promotion Heroes!

But where do we find them?

Excellent question...especially in a community that does not understand the concept of a volunteer. As of now, some FGPs boast hoards of volunteers, or people that they call once a month and ask for help making some phone calls. These are no Health Promotion Heroes, that's for sure. And that's okay...for now. But my job is to educate the staff at each FGP about volunteerism and what role a CHV can play at their FGP. This seems easy enough...offer some trainings, educate them about volunteers...but the health care system here is so darn hierarchical that often doctors won't listens to nurses, nurses won't listen to social workers, and no one will listen to a measley little volunteer. Needless to say, there is some basic educating to be done.

Following that basic educating, there will be recruiting, training, inducting, and managing of volunteers. And then there will be more training...more recruiting...more inducting...and on and on and on.

Now. This seems like a big task with lots to do in two years' time. What makes it even more interesting is that since I arrived in my office of three non-English speaking Mongolian women and me, I have not had an interpreter. For a brief moment this week, there seemed to be hope that one would soon arrive. Then that hope was dashed. Two of the best candidates declined an offer on account of the salary being too low, and the other two...well...the other two didn't speak English. I mean they kind of did, but not really. So they won't work.

Alas, here I sit. This week's breakthrough was telling my coworkers in Mongolian that I was heading to VSO for a meeting in the afternoon. It's funny though...whenever I speak in Mongolian, they always respond, in English, what? And then I say my little sentence again, and they're shocked to realize that the words coming from my mouth are not English but Mongolian. It's a fun game to play.

Anyways. Work is work for the time being. It is frustrating and overwhelming and some days I wonder when I will make any progress whatsoever. And then I have a silly little Mongolian/English exchange, and it makes my day, and suddenly that feels like important progress all its own. From where I sit now, two months into work, I can only picture what my role will be 2 years down the line...what progress we will have made...how comfortable this odd little place might feel to me. For now, it still feels frustrating with a healthy dose of optimism, and one of my main goals for the two years will be to retain at least some of that optimism. I try to maintain realistic goals, and I'm very good about realizing that this experience is as much for me as it is for the people I work with here, but I do like to remain hopeful that I can make something positive happen. For now I just wait and see...

As for this weekend, we're heading out and about to the countryside once again. Saturday Chris and I will hike south to Zuunmod (we hiked from Zuunmod to UB a while back - the one time we went camping in Mongolia). We'll meet a bunch of friends there for a night in a ger. It should be fun. Last time we stayed in a ger, it was just the two of us; this time it'll be fun to have a big group. Sunday we'll catch a ride back to UB with the rest of the group, and then next week we do it all again...

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