Tag Archives: Fintan

Of Monsters and Men

By Dr. Fintan Sheerin

24th June 2014

Blog 3 redAs I think of yesterday, I am reminded of the title of one of Morrissey’s songs, November Spawned a Monster. For me it might be better titled Monday Spawned a Monster! I am not sure, though, who the monster is and whether it is one of the actors in the events of last night, or the underpinning structures which form the background for our actions as health professionals.

The day started well, with three of us visiting a school in Kasungu and meeting with special needs teachers who maintain a resource room for children with disabilities. The meeting was positive and we were made very welcome. It was notable that, although the resources are limited, the teachers work with an enthusiasm, knowledge base and dedication that are admirable. Indeed, the lack of resources is a problem everywhere and, in anticipation of this, Dale and I had brought four large suitcases of medical supplies, many of which, whilst officially past the ‘best before date’, remain viable and usable for many more months. As health care professionals, we are very aware of this fact but note that, despite this, these are routinely discarded to waste in our own countries. The decision whether or not to bring them was essentially a dilemma as I had wondered whether expecting Malawian people to use items which were not deemed usable amongst our Western populations was in some way devaluing the former group. In the end, knowing that the supplies were still safely usable, I decided that the need of the local Chilanga people took priority and met with the ethical principles of non-maleficience (do no harm) and beneficience (actively do good). And so, following the meeting at the school, Dale, Eloise, Suzanna and Shayla visited a designated clinic in Kasungu and delivered the medical supplies in the presence of a large number of local people and health care professionals. It was clear, from their invited tour around the clinic, that resources were indeed scarce and that these materials were a considerable addition to the empty shelves in the treatment room. Following the handover, the girls left feeling very positive. As we returned to Makupo village, the positivity of the morning was tinged with a sense of uncertainty as all afternoon meetings had to be cancelled on account of a local funeral.

Out of the depth I cry to you… (Psalm 130)

The uncertainty reached a nadir of negativity in the late afternoon following a telephone call which left me feeling utterly devastated. A medical official in the clinic contacted us to say that they could not use the ‘expired items’ and asked us to come and collect them. It had been clearly indicated that the medical supplies were beyond their ‘best before date’ but this man indicated that he was worried about the risk to his job if such items were found in the clinic. So, in the face of having no resources, it was deemed appropriate to refuse recently expired but viable resources! In real terms, this could be the difference between a person bleeding out from a wound or being in a position to stem the bleeding! I don’t know, but this did not make sense to me and the central issue influencing this decision appeared to relate to the need to protect one’s back and not to the saving of lives. It led me to question where Hippocrates’ medical imperative of non-maleficience and that of beneficience were in reaching the outcome of this decision. Have we reached the point whereby the protection of the professional and institution is considered to outweigh that of protecting the person? In the light of this event, I found myself at the lowest and most emotional point on this Malawian trip, such that I became very angry and tearful as disbelief and disillusionment grew.

In reflection today, this is not a uniquely Malawian problem but may be emerging here due to globalising commercial and professional forces which are recreating here what is already extant in our Western countries. Thus, in Ireland, the fear of litigation and allegations of professional misconduct have increasingly become the context within which health care is being provided with the need to assign blame when something goes wrong. This is reminiscent of the infamous medical model in which the person, as human being, is reconstructed and objectified as a patient, bereft of his/her identification as a human being. Illich has written extensively about this in his books, Disabling Professions and Medical Nemesis, and has suggested that this objectification of the person creates dependence, disempowerment and loss of individual identity: dehumanisation. This is the result of the development of a bureaucratic approach to health care which, he has further posited, is essentially a major iatrogenic (physician-originating) threat to health. It may be considered that this is evidenced in the creation and maintenance of a small elite of powerful professionals and a much larger mass of disempowered people: oppressors and oppressed.

Redemption

Despite the negativity that characterised the earlier part of the evening, there was to be yet another twist in the emotional rollercoaster. One hour later, we were approached by another medical doctor who shared our view on the medical supplies and who expressed a desire to obtain them so that he could use them to treat local people in his own clinic. Whilst his actions, in many ways, countered the gloom of the previous hour, there remained in me a disquiet which is leading me to explore and challenge the roles that each of us play in sustaining policies and practices which lead to waste in our countries: both material and human.

The Search for Voice

By Dr. Fintan Sheerin

Sunday 22nd June 2014

Community conversations

Community circle

Some years ago, I found myself at a congress in Greece, during the height of the protests against austerity. This was a critical pedagogy event and was supposedly grounded in the principles of participation, collaboration, social justice and dialogue set out in Freire’s (1996) writings. One of our local hosts asked us to support them in the protest march in central Athens. A number of attendees joined their colleague in solidarity but I did not. When faced with the request, I found myself rooted to the spot, afraid of what might happen. I went to a quiet corner and broke down in tears, unable to explain why I felt so disempowered by fear. Upon reflection, I could only surmise that, in some way, I had inherited the internalised fear of the colonised that is described by Memmi (1990) and Fanon (1967). Despite having grown up in an independent Irish Republic, I had experienced the control of the predominant Roman Catholic religion which had controlled much of Irish life well into the 1990s. Such experiences, whether due to national or religious colonisation, often produce a largely passive or passive-aggressive subject who prefers silence and withdrawal to protest and confrontation.

Throughout the past two weeks in Chilanga, we have noticed such responses among local people. This is particularly evident when they are faced with the request for independent thought and action. More often than not, the response is one of silence and acquiescence to anything that is suggested by us. This has been a difficult situation for us, particularly where our work with the villagers is, by definition, grounded in participation. Whilst we see ourselves as researchers, engaged in an educative process of dialogic action, it seems clear to me that our local partners see us rather as teachers, as defined in the banking model of education; bearers of expert ideas and, perhaps, resources. This is not meant to be in any way disrespectful to the local people and is just my attempt to understand the relationships that I am seeing. It is as if the local people have yet to rediscover their own voice; that which was taken during centuries of colonisation, slavery and national oppression at the hands of western powers. They must, as Freire (1996:69) notes, reclaim ‘their primordial right to speak their word’. This is a central piece of the work that we have set out to undertake with the people of the Chilanga region, but it will take time and courage from all involved.

Enjoy the Silence

By Dr. Fintan Sheerin

A moment to behold

A moment to behold

Saturday 21st June, 2014

The other morning I woke early and went for a walk around the area adjacent to the house that I am staying in. It was about dawn and, even though the villagers themselves had been awake for some time, there was a natural silence around, bereft of man-made sounds, but broken now and again by the crowing of the cockerel and the dying hum of grasshoppers. As I walked I was reminded of my own experiences, many years ago, when, as a religious student, I had engaged in two eight-day silent retreats.

The 7th century Chinese philosopher, Lao-Tze, proposed silence to be a time of revelation. During my two lengthy periods of silence I became acutely aware of myself, of the world around me and of my place in it. I noticed the cacophony of noise which forms the backdrop to the lives of many in a world of increasingly urban living. But I also became attuned to the sounds that were coming from within me; both physical and mental. I have since learned that many of these sounds or thoughts allow us to come face to face with our strengths, weaknesses; our humanity and the reality of our situation. These can be painful revelations and sometimes it is easier to prevent their emergence through the denial of any period of real silence. Silence can be a means of revelation but Lao-Tze also suggests that it can be a source of great strength.

In the silence of my Malawian morning walk, I noticed a man sitting alone, in silence, at a distance from me. Freire (1996) writes of the developing awareness that accompanies dialogic engagement. Facing oneself and one’s reality in a moment of silence is an internal dialogue which, perhaps brings about such awareness. But, then again, maybe it can also lead to the confirmation of one’s current situation of disempowerment. I wonder what the silence heralded for this man…

 

Introducing the 2014 Group: Trinity College

Fintan Sheerin

Fintan Sheerin

My name is Fintan Sheerin and I am a lecturer in intellectual disability nursing at Trinity College School of Nursing and Midwifery in Dublin, Ireland. A drop-out from several institutes of higher education, I originally embarked on a life in religion, and entered the seminary of a Roman Catholic missionary congregation. THAT didn’t last long and I am now happily married with four daughters.

As noted, my professional background is in nursing. I am a registered intellectual disability nurse, a registered general nurse and a registered nurse tutor. After 20 years in practice, I took a teaching job in Trinity College where I have been exploring the praxis of social justice among people with an intellectual disability for some years. This has revived my passion for human rights. It is from this background that I have come to Praxis Malawi. I have been asked to coordinate work with the local community around the development of a health initiative or ‘clinic’. This initial and developing dialogue will be the main focus of my work in Malawi and I look forward to working with Canadian, Malawian and Irish colleagues in this regard.

 

Eloise Sheerin

Eloise Sheerin

My name is Eloise Sheerin. I am one of the Irish crew heading on this exciting trip to Malawi. I will be going with my friend from my college Suzanna and my dad Fintan (also my lecturer!).

I am 20 years old and live in County Cavan, Ireland (in the countryside). I love travelling and have done some of this in Europe mainly. I was an au pair in Switzerland for a year before college where I learned French and a lot of life lessons. I love doing outdoor activities but also snuggling up on the couch for a film or reading a book.

I am a student Intellectual Disability Nurse studying in Trinity College Dublin. I feel that my experience in working with people with intellectual disabilities who are marginalised in our society will help me work with and understand those in a similar position. I also work as a carer for people with intellectual disabilities and behaviour that challenges on weekends and through the holidays for 2 years now. I am glad that I can work and study in the same field.

The part that I probably like the most about this project is that we, as volunteers and the community members, are all working as equals as everyone has an expertise in something and we all have something to learn from each other. We are not simply going over with the idea that we have all the answers to their questions but quite the opposite! I have had to rid myself of any preconceived notions I had and push myself to never assume I know.

I am aware that the community has asked for a health clinic initiative to be discussed and work done to pursue this. I will be helping in this as much as I can with some of the others in the Health team. Hopefully, this will be followed by putting realistic stepping stones in place for something to come.

As my background is in working with people with intellectual disabilities, I would like to tie this into the work we are doing. Suzanna and I have similar ideas in this and will be working together. We want to understand more about the life of people with intellectual disabilities and research people’s knowledge and ideas about them in their community. We would like to encourage inclusiveness into society (if this is not already there) working alongside the other members of the group from Praxis Malawi involved in work such as education and health. An idea formed was to set up a kind of support group (again, if not already done so) for people in the community to talk about and learn from each other about intellectual disabilities from the people themselves, their families, friends and anyone else.

Following from this we would like to introduce an idea of multisensory stimulation for people with intellectual disabilities. This could be a way for inclusion and socialisation. This idea could be developed by the community and they can come up with ways to interact with and support people with intellectual disabilities in their community.

I hope to be able to listen and work towards the desires of the community and leave with a new bountiful knowledge base and an unforgettable experience!