Learning to listen

Seven years ago Alexa Valavanis was living in Guatemala, where she co-founded and directed a nonprofit called Seeds of Life whose purpose was to funnel donations and provide assistance to indigenous groups working to improve living conditions in that war-torn country.

Today she’s doing similar work in Chico, as executive director of the North Valley Community Foundation, but she remembers her life in Guatemala and the people she met there vividly. Last weekend, her two closest friends from that time, Christian Nix and Godwin Orkeh, were in town for a reunion. It was the first time they’d seen each other in seven years, and it was a joyful occasion.

But it was also a time for reflection and outreach. All three have long histories of doing health-care and development work in third-world countries, and their experiences in Guatemala and subsequently have given them a shared understanding of what works and has lasting impacts for the better—and what doesn’t.

In addition to interviews on KCHO and KZFR, Orkeh was scheduled to meet that afternoon with a group of doctors and nurses affiliated with Enloe Medical Center who have been doing clinical work in developing countries.

Nix, an American who still lives in Guatemala but travels extensively, is a licensed acupuncturist who operates a training program for “barefoot doctors”—practitioners who use both traditional Chinese medicine and Western techniques in their work—as well as other, similar services.

Orkeh, who is from Nigeria and trained as a physician, was working for the United Nations in Guatemala studying the best ways to deliver health-care services. He now works for the UN’s World Health Organization as a technical officer for disease prevention and control.

Of the three, he has had the most varied career, because of his position with the UN and his specialization, which is systems development in countries’ “early recovery phase” following a crisis such as civil war or natural disaster.

For example, he was sent to Pakistan soon after the 2005 earthquake that killed some 75,000 people. There he worked as a coordinator with such groups as the Medical Aid Committee and the International Rescue Committee. He’s also spent time in Afghanistan and Somalia, but mostly he’s been stationed in Sudan, sometimes in Darfur and currently in the Nuba Mountains of south Sudan, site of a 20-year civil war that killed, directly or indirectly, nearly 2 million people.

As the only black African physician doing his kind of work, he’s gotten the nickname “Dr. Africa,” a handle he wears with pride.

The UN gave him an internship fresh out of medical school and asked him to work on HIV/AIDS prevention, he said, but he quickly became more interested in studying the intersection of social systems and health.

For example, at one point during his tenure in Guatemala he was doing research on the possible causes of diabetes, but he couldn’t get any villagers to come in for studies. When he realized they all went to the local church, however, he went to the priest for help—and with his blessing the villagers became cooperative.

In another village, the priest was ineffective, but there was a strong municipal government, and it was able to support him and bring in the villagers.

In these and other cases, Orkeh learned to get inside the society before trying to help people. As Nix put it, “a doctor or administrator who stands outside the culture and tries to ‘fix it’ won’t succeed, but someone who lives in the community can be very effective.”

“We all do difficult work,” Valavanis added, “but we agree that it’s best to go in as students, not teachers. We learned in Guatemala that we have to listen first.”

Western paradigms often don’t apply in third-world countries. Orkeh told of working with Afghan refugees in a camp in Pakistan. Western officials were collecting health data, including mortality figures, in two primary categories: for those under age 5 and those older than 5. But that was an “oversimplification” that “missed the story,” he said, which was that too many babies were dying.

Western science, Nix said, “is so good it exists on a level by itself,” but in many situations it can’t compete with the kind of functional medicine that combines technique with art, knowledge with intuition and insight. “Doctors are scientists, but we also need the healing art.”