A Haitian Schema

I was talking with Shelly, the nurse who is serving here with me, the other day and while she was at the clinic she saw one of the Haitian nurses was putting on gloves improperly. When putting on sanitary gloves, there is a specific way to put them on so that the surfaces of the gloves that will be only touch the patient without ever touching anything unsanitary, specifically the doctor or nurse’s hands. The nurse with whom Shelly was working put the gloves on in a way that contaminated the surfaces, thus posing a risk to the patient. The nurse did this not because she was careless, but because she didn’t know to keep the surfaces sanitary. The nurse thought that the gloves were there only to protect her hands, not to protect the health of the patient. The nurse did not fully understand what the gloves were for or how to use them. This is problematic, especially given the high number of infections present in Haiti.

The notion of sanitation in Haiti is nothing like in the US. A “clean” house is one that doesn’t have goats wandering in and out of it. To clean a house with Clorox and bleach every Friday would seem quite unnecessary to the average Haitian. In Haiti most children are born in mud huts as opposed to sterile hospital room. Though the biological nature of sanitation doesn’t change in the US or Haiti, the Haitian’s perception of sanitation is drastically different than ours, so the considerations Haitians make concerning are very different than ours. The considerations Haitians come to naturally when they are in a medical setting are different than ours. 

This difference in outlook is simple on the surface, but it is one of the most complicated issues facing any foreigner trying to help Haiti, or a place like Haiti, develop. Americans have a set of considerations we come by naturally in various settings. This set of considerations is called a schema.  American teachers, for instance, have certain schema that helps them develop their lesson plans and teach effectively. If you give an American teacher a projector, they will generally know what to do with it. They will be able to take the projector and fit it into their pre-existing logical structure of how a class is to be taught. They know how power point works, they have used power point in the past, they have seen it used well and used poorly, and they know how it can fit into their class so that is effectively compliments the rest of their lesson. A Haitian teacher on the other hand, has a totally different schema than an American teacher. In the Haitian teacher’s schema, there is not pre-existing logical structure that considers how any type of modern technology would fit into the classroom. They would have no idea how to use a projector. Most of the classes don’t even have electricity let alone a functioning computer that could support a projector. I helped install twenty black boards when I was here in January and that was one of the first times when all of the classrooms had a working blackboard. If I were to give a Haitian teacher a projector and tell them to integrate it into their classroom, they would probably use it as a paperweight.

Some of the biggest development projects involve importing some advanced twenty first century technology to the developing world and distributing it to the masses, expecting it to be a magical remedy to the poverty in that country. This is a natural inclination of any American NGO entrepreneur who goes abroad to alleviate poverty. One of the starkest differences between every developing country I’ve been to and my home in the US is the difference in technological capabilities. When we see this sharp divergence, we think that technology might be a formidable solution. When we see children struggling to read because the books they have are tattered and dusty, we think “these kids could learn so much more if they had a computer”.

What would happen if we gave those kids a computer? There was an attempt by the group “One Laptop Per Child” to give every poor child a laptop. This was a very flashy initiative with a bunch of technical support from MIT who developed a simple laptop that could be produced for less than $100 and distributed to children in Africa and throughout the developing world. The idea was great, but most of the people in the developing world don’t have a schema that can easily incorporate a computer. Most of the people in Africa, Haiti, and throughout the developing world, don’t have access to electricity. They would probably have trouble integrating light bulbs into their daily routines let alone computers. One Laptop Per Child was a flop because it failed to recognize that African families see the world with a different logical structure, a different schema, than Americans do. (One Laptop Per Child was a failure for many reasons, this was just one of them) This is one of the reasons simply importing technology doesn’t really help people in the developing world. In order for technology to be useful, people have to find a specific place where it will be useful. If we give Haitians new technology, we have to make sure they know how to use it and can find places in their lives where it will add value.

Shelly is a great nurse and she has been an asset to the community in many ways. Her technical knowledge of nursing and her ability to administer care has been of great value in some situations, but one of the greatest things she has given to the clinic is a new perspective on care. She has helped the nurses there understand issues like sanitation from an entirely different perspective. She has helped the nurses develop a more holistic schema when approaching medicine. One of the greatest values American doctors and nurses provide is not direct care to the average Haitian, but helping the Haitian care providers expand their knowledge. Though the clinic has a few issues, it is one of the best medical facilities in the area, in part because there is a consistant stream of medical professionals who come down from the US and work side by side with the care providers.   This type of help is difficult to quantify, but it is invaluable. The work Shelly is doing in the clinics with the doctors is making a difference that will stay in Haiti for years to come.