After a sleepless night, two summers of preparation, and an unexpected scholarship award that feels like eons ago, the first day of our two-week volunteer trip had finally arrived. The day before, all 20 volunteers had gathered at the new teaching building of Sun-Yat Sen University for a final briefing before setting off on the 3-hour ride to Yu’nan County, half going by hospital van and the other half by bus.
Prior to setting out I had been gripped by a reminiscent anxiety. I thought back to the first personnel trainings we had carried out last year. Back then our target population was about 2 doctors and a nurse, and our goal was to simply prepare an effective screening flow. Prior to setting out, I had imagined arriving and sitting down with all the participants, explaining each step, doing a few walkthroughs with me as a mock patient, before heading off to a dinner and early rest for the next day’s work. Instead, we were immediately whisked off to a fancy dinner upon arrival where we proceeded to toast each member individually until we would have all made great uncooperative mock patients. When I later complained to the ZOC doctor that lack of preparation was a significant factor in our debacle of a screening, she metaphorically patted my head, warned me against clashing too much with the Chinese style of doing things, and explained to me that these things were iterative processes that would sort themselves out in the end.
This time, our target population was 22 VHWs, assisted by 20 volunteers, and our goal was to establish not only a one-time screening protocol but a long-term screening, referral, and feedback model. Determined to not let this be a repeat of last year, I assigned specific tasks to each volunteer beforehand and ran scenarios through my mind until each one ended in spectacular success.
Sadly, reality isn’t always as cooperative.
We started with the necessary work-together-to-conquer-blindness speech, followed by small group instruction on vision screening.
Our first stumbling block came in the form of the hospital director Dr. Huang telling me that our original 4-hour schedule would have to be cut down to about 3, which cut into some of our much-needed practice time.
Our second stumbling block was the fact that our brilliant JavaRosa referral form program was successfully installed on 1 of 21 phones (one VHW didn’t have a phone). It wasn’t a death sentence for our system, as patients could just as easily be referred by regular SMS using a specific template. But it was certainly underwhelming after all the hype we had generated during the pre-training session.
Our final stumbling block arrived in the form of one of the volunteer team leaders notifying me that they were leaving with their VHW that afternoon and the last bus out left at 3:30PM. The session ended with me issuing last-minute directions to the backs of volunteers and VHWs hurrying out the door. (Strangely familiar to our experience at YPH two weeks ago…)
In the end, I came to the humbling conclusion that even the most pre-planned, micromanaged events can tip into disorganization once the number of participants exceeds a threshold of about 5. That conclusion implies that no matter which attitude you take—relaxed fatalism or fervent control—a one-time mass training is not sufficient.
What you need is one-on-one follow-up training.