This fortnight’s blog post is again from Dr. Christine Thorne, who shares her thoughts on the Haitian concept of dégagé. Indeed, it shows the power of such short term trips and perhaps speaks to why young professionals pursue them – a chance to understand another culture, and experience something completely different from their day to day life while making a difference, even if it’s just building bridges between disparate realities. Essentially, a chance for people to dégagé from their own realities, and remind themselves what’s important on this earth.
Anticipating the coming trip to the Dominican Republic, I thought it was appropriate to write a short blog post about a French/creole word we used a lot when I worked in Haiti on short-term trips.
The work is dégagé. It’s literal meaning is to “be free of constraint: according to the Merriam-Webster Dictionary. In Haiti, the people I worked with translated the use of dégagé as “to make do”. It meant that you needed to let go of all of your preconceived notions and constraints of expectations, time, plans etc. and make do with reality. This kind of making do is an important part of any overseas work. Americans often come in thinking that we know how things should be run, that we will bring things up to snuff, that there is a right way. However, the key to working overseas is generally the opposite, it is flexibility, being free of constraint, a cultivation of the ability to dégagé, to make do with what is at hand and to do one’s best in hard situations.
Here are a few examples from my work in Haiti:
Dégagé in travel:
– Waiting a day to set out on your journey because the rivers are too high to cross and your car doesn’t have a snorkel (there are no bridges, you drive through the rivers).
– Driving around the burning tires, the potholes, the sinkholes large enough to swallow a car and in one notable instance, a dead body in the middle of the road. (Depending on your expectations, you could also include run of the mill traffic: donkeys, people, chickens, goats, mopeds and tap-taps – overloaded, brightly painted buses).
Dégagé in living:
– When the power turns off at 9pm you go to bed or sometimes use a flashlight to hunt down a spider the size of the palm of your hand, and then go to bed.
– When the power turns on at 3am, delight in the running fan and note how locals are up in the middle of the night to do electricity-requiring work, such as welding.
– Cooking during hours where there is electricity and putting up with charcoal smoke when there is not.
– Eating goat even when it’s not on your preferred list of foods.
Dégagé in medicine:
– Chasing chickens out of your exam rooms.
– Using a broken BP cuff as a tourniquets and have someone stand there to keep it inflated while you repair an artery.
– Using local anesthesia in an emergency where you would normally use general (because the OR is under construction).
– Treating what you can, when you can and hoping for the best, because the next level of care is a 10-hour expensive car ride away and your patients cannot afford the time or money to get there. You are it.
This is not to discourage anyone from the upcoming trip. Only to help to orient people to what they might be expecting. Haiti is more impoverished than the Dominican Republic and the DR will have more resources available. Regardless, the ability to let go of one’s expectations, to be free of constraints of time, plans and procedures and to relax and make do will remain essential. This trip will require all travelers to cultivate the ability to dégagé.
Dr. Christine Thorne is a resident physician in California.