End of SEER…?

August 13: Yun’fu City

It seemed to simultaneously last forever and pass in a blink, but at the end of week two we once again found ourselves regrouped in Yun’fu city. Over two weeks, we had trained 29 VHWS, provided screening for 594 villagers and referred 245 for treatment.

Yet many aspects of a project like this are difficult to measure in numbers, and can only be gauged by discussion and reflection. On our last day in Yun’fu City, we gathered over a meal to reflect on the two weeks’ experience.

All of the volunteers who spoke up remarked that the experienced had “exceeded their expectations”. None of us—myself included—had expected so many villagers to show up for screening, a testament to the depth of the problem that still exists. After some initial reservations, almost all of the VHWs warmed up to our intentions, and many volunteers resolved to remain in contact with their group’s VHW in the weeks to come. For some of the volunteers, this was their first time living and working in rural China, and as they go on to become doctors in a health system heavily biased toward urban populations, there experiences here will likely continue to remind them of the healthcare need in this country.

The volunteers weren’t the only ones to gain from these interactions. During my meeting with Dr. Li of YPH at the end of our week’s activities, she told me that a VHW had called her one day. “These volunteers…are they for real, or are they liars?” he had asked. When she asked him to elaborate on his suspicions, he remarked, “They come all the way down here from Guangzhou, pay for all of their own expenses, live in incredibly difficult living conditions, and work all day without pay.”

She told me she had laughed and responded, “I guess volunteers just have a different mindset.”

Our experiences during these two weeks have pointed to one critical conclusion: a VHW-training program cannot be effective and sustainable without subsequent one-on-one training in the villages themselves. As a testament to this, there were 7 VHWs whose villages we unfortunately could not visit because of time and personnel constraints. As of now, not one of them has referred a patient via our electronic referral system. For a training like this to be sustainable, you need additional guidance in the field, you need active awareness-raising and patient education, and you need people with the time and enthusiasm to show the VHWs that you are as serious about this as you want them to be.

In our case, that was the role that the volunteers played. Of course, you do not necessarily need medical student volunteers to achieve this function. But the ZOC is already short on personnel, and as Dr. Li had remarked, “Volunteers just have a different mindset.”

Dr. Wang of the ZOC must have recognized this when he asked us, “So do you volunteers intend to make this into an annual thing?”

From the content of our discussions, the answer to that question is an overwhelming, “YES.”

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