Week One

The first "real" week of study is now over... and I feel only slightly less lost than I did a week ago.  I have a desk at the university, a more-or-less complete proposal and a growing pile of books and articles to read.  But while I have a clear sense of long-term direction (write a thesis!) I don't have a very defined path for the immediate future (how am I actually going to achieve this).   So, I'm awaiting my supervisors comments on the proposal, doing some reading and have bought lots of shiney new stationary in an effort to look organised.  I have also booked a "research consultation" at the library for next week (both librarians for the college of Humanities were on leave at the beginning of the semester... not much help to me!).  Truth is, right now I'm really starting to appreciate the term "independent research"!  
 
One book I finally did get through this week was a study by Barbara Parfitt (1998)- Working Across Cultures- A Study of Expatriate Nurses in Developing Countries in Primary Health Care.  While Parfitt's study primarily focuses on nurses working long-term in developing countries it highlighted several issues that I'm interested in.  I was particularly intrigued by Parfitts ideas about power and knowledge- the inherent power of being a white, western health professional in a developing country, and how this can be used both positively and negatively. Parfitt concluded that wherever cross-cultural nursing takes place it is necessary to take account of values which influence practise.  Her argument is that how a western nurse behaves and practises is influenced by his/her beliefs about what constitutes good practise, but that "good care" is defined by the western medical establishment.  I have long been interested in how western-oriented belief and value systems (as a whole, not just in medicine) influence the care given by westerners in non-western environments. It has certainly been my observation to date that many health practitioners are quite unaware of the influence their values have on their practise.. but to what extent is that negative or damaging? Is it relevant at all in the context of short-term medical missions? (feel free to add comments to this post!!)