Choosing the Right Battles

During my Peace Corps job interview I was asked to describe a time in which I had been part of a group that was doing something I did not agree with, but I could do nothing to change the situation. The question surprised me. When I disagree with something, I’m generally not shy about voicing my opinion or trying to change the situation—that’s why I wanted to join the Peace Corps, to make change happen! Was this a trick question?

My (boy) neighbor, Queen of the Universe

After some thought, I told the recruiter about my Catholic upbringing which directly conflicts with my strong beliefs about women’s reproductive rights. “In high school I often attended mass with my mother, and there was a particular Sunday the priest was delivering his sermon, talking about the evils of contraception. I got so upset I had to walk out of the Church to collect myself in the bathroom before going back in”. The recruiter smiled, “You’re going to have a lot of situations like that in Peace Corps; it’s all about picking your battles”.

There are plenty of battles to choose from at my health center. The number of battles I choose not to fight is actually rather depressing. But, if I told everyone at work when I disagreed with their actions, I would have no friends and probably no job. Gaining trust and acceptance is a long, daily process that I’m working hard on. If I attain the trust and respect of my coworkers, I can hopefully fight, and win, one or two battles. What often keeps me up at night is that seven months into my work, I have friends, and I’m starting to notice that coworkers do trust and respect me, but I still haven’t picked a battle.

Rwandan national policy requires every malnourished child who comes to a health center for treatment to receive an initial health check up. In theory, a nurse will complete a malnutrition patient chart and file that includes prior medical history, vital signs, and tests for tuberculosis, HIV/AIDS, and parasites. At my health center, this does not happen. When a mother comes with her malnourished child, my counterpart, the health center nutritionist, takes down the family names and address, the child’s age, weight, and MUAC, gives the mother Plumpynut, some advice, and then sends them on their way.

A few months ago I organized the patient files for all the malnourished children. When I say organized, I mean I started charts for all children who were enrolled in the program. I included all the information available (which was not much) and talked with the nutritionist about completing the rest. She seemed genuinely interested, but then reminded me that she is not a nurse and has no training or knowledge on how to complete the files. So I sighed, and we agreed to keep better records and complete as much as the two of us were capable. 

Several weeks later, the district hospital nutritionist along with the nutritionist from the International NGO working on childhood nutrition in the district, came to “supervise”. They asked for the files of all children being treated for malnutrition. We took out the incomplete files I had worked on. When they remarked about the incompleteness, my counterpart stared blankly and then asked me “Alma, why aren’t these done?”. 

I was furious. Was this not her job? Had I not tried to get her to complete the files? Was she seriously putting the blame on me? What I was most furious about, however, was my sudden realization that this was a battle I had decided not to fight, and in retrospect, I probably should have. There are a million excuses to let things go here. Was I becoming lazy and apathetic? Am I ever going to choose a battle?

Since the “supervision” I have made more contact with the nutritionists at the hospital and NGO. With my counterpart and the health center director, I have discussed the challenges we need to overcome to ensure all children receive checkups and proper service, not just Plumpynut. Everyone verbally agreed to collaborate, but action remains slow. Still, I think I have found a battle to fight.