Substance

I realize that after all these entries of the fun activities I am doing (or not doing, in some cases), you might be wondering about the research work which I came here to do. The truth of the matter is that after a month and a half, I am wondering the same thing. Not because I lack initiative or anything like that, but rather because the process of getting business done around here seems to take forever. Every time I seem to ask about a specific topic in which I would be interested in researching, five people jump in and offer five different perspectives of how I and where I should go about working. Although this is extremely helpful and I am learning a lot, it has also left me very confused.

I spent the first few weeks learning about the health system, wandering around the hallways of the public health school meeting tons of different professors and grad students hearing about the work they are doing, and trying to get a feel for a place. In anthropological work you can't just jump in right away without getting your bearings...it takes time to learn about possible research options and then decide on one that will probably turn into something else anyway. So eventually I decided on a group of contracted public health professionals who are in the conception stage of a project that sounds really interesting.

Just today we turned in a draft of the theoretical background to get full approval and funding from the university after diligently reading, writing, and revising for two weeks. The title of it is "Bienes Preferentes y Bienes Meritorios en salud y mecanismos de mercado en el contexto del Sistema General de Seguridad Social en Salud: Caso atencion materno-infantil, Medellin 2008." A mouth-full, eh? It basically deals with looking at the faults in the health system due to the fact that the government contracts out services to hospitals and clinics who then administer the services, which results in those sites operating in their best economic interests rather than for the good of the people. The specific part of the population that we are looking at is pregnant woman, and the ethical issues that come into play when an unborn baby doesn't get the chance to live because their mothers receive inadequate attention. The legal and economic foundations for the work have turned out to be much more in-depth than I originally anticiapted; which has proved difficult yet beneficial in that I have had to teach myself a crash-course in health economics.

We still have to work out the methodology and break-down of research responsibilities, but I am looking forward to leading discussions with health officials from the city, doctors and nurses, as well as the women themselves. I am not sure how, as a medical anthropologist, I am supposed to fit in with the other public health administration majors etc., but it seems like the faculty here have a very holistic approach to their research which fits in well with my own training. More to follow....

As for my independent research, I have a meeting next week with the dean, head of the investigation department, and research advisor to whom I will present my grand plan. Deep down I know what I want to investigate: the mental/emotional effects of being displaced by drug-related violence, but the problem is that I don't know how to go about conducting this research in a safe manner. Since being here I have felt somewhat disconnected from the reality of poverty that the majority of the population experiences. Rotarians, friends, and university contacts alike are all very or relatively well-off compared to national standards; something that doens't provide me with a very comprehensive understanding of the people. I think that in order to really fulful my duties as an embassador (so that I return to the US with as much information and experience I can possibly accumulate in one year), as well as live up to the service-oriented ideals of Rotary, I must find a way to access the impoverished communities and work on their behalf.

Colombia has the second-largest population of internally displaced people after Sudan, and Antioquia--and Medellin--is one of the districts that hosts a large influx of them. These people move into the city and settle in the most precarious places, and suffer from many environmental factors. (Every day on the news there are reports of 5-10 people--read displaced persons--who die during the torrential rains because their corrugated-tin homes are washed into the bloated rivers running down the sides of the mountains all around the city). These people also bring with them involvement with informal economies and their own set of violence, which makes their new settlements dangerous--especially for outsiders like myself.

I also have this somewhat fantastical impression that the (medical) anthropologists who have written the most interesting and widely-read ethnographies are those who took the most personal and professional risks. At this point I don't really have professional training or an established career, (nor is my scholarship about accomplishing personal career goals), but my idea is that if I could find a community of people with an untold story from an important helath perspective, maybe this could be a big break that in a year could get me into my preferred PhD program. But at the same time maybe I am young and overly optimistic and shouldn't jeopardize my chances by making stupid decisions now. Or maybe I am just blowing things out of perspective.

Either way, I have a lot of thinking or planning to do, and any advice or insight would be much appreciated.