S1E13: Peace Corps

Leen: Can I lower this? I think I shrunk. I feel like I shrunk. I think we all shrunk over the weekend.

Margaux: Too short?

Chloe: No, I think you're good actually.

Margaux: Okay. Hey, this is the "Bundle of Hers," and this is Margaux here. Thanks for tuning in this week. So as the nature of medical school goes, Harjit and Bushra are not able to join us today, but Leen and I have our classmate, Maggie Bale, joining us today to talk about her experience with the Peace Corps. Hey, Maggie. Welcome.

Maggie: Hi. Thank you.

Margaux: You may or may not know, but the Peace Corps does have several health missions, right? It may be a good option to explore if you're pre-med or thinking about looking into medicine as a career before you choose which school you want to go into. And so we would love to have your input on that, Maggie.

And then let's just hear your experience with healthcare in a different country and working in the Peace Corps in general, because I honestly don't really know anything about it, and I'd love to learn more.

Let's get to know you a little bit first. Can you just tell us where you're from, why you went into medicine, and then maybe about your decision to do Peace Corps?

Maggie: Yeah. So, again, my name is Maggie. I am a second-year medical student. I'm from Utah. I grew up in Holladay, went to Cottonwood High School, and then for college went out of state. I went to Middlebury College in Vermont. And then when I finished there, I got a master's degree in public health at Emory University, and then joined the Peace Corps.

So I thought about becoming a doctor for a long time. My dad's a doctor. He's a pediatric neurologist here at the university, and my mom also works in the health field at ARUP Laboratories. So medicine has been something that I've been thinking about for a very long time.

But my path wasn't so clear cut, and I made a lot of back-and-forth choices about medicine throughout, and doing the Peace Corps was really what led me back to wanting to be a doctor.

Leen: Just a little bit of backtracking for people who might not know what the Peace Corps is, could you please explain to us maybe a little bit about what it is and what you do there?

Maggie: Yeah. So the Peace Corps is a program that's run by the U.S. government. It was started in 1961 by John F. Kennedy as a way to help with the development of underserved countries.

It has three primary goals, not just the one of helping countries with skilled labor or skilled workforce, but also helping to bring Americans to other countries, to let people of those countries understand a little bit more about what it means to be an American, and then also to bring information about those countries back to the U.S. to tell our fellow citizens what people are like around the world. And I think the idea around those two goals, which I find are the most important, is that the more you know about someone, the more human they become.

Margaux: That's very true.

Leen: Wow. So tell us a little bit about your experience in the Peace Corps.

Maggie: So I served in the Peace Corps in southern Africa, a country called Botswana. A lot of people refer to as Botswana, but the locals say Botswana. That was one of the first things I learned going there.

And I actually wanted to join the Peace Corps because I have two older brothers who both did the Peace Corps. So a little bit of competition, a little bit of seeing what they had done and being excited about living in a new place and exploring a new culture and then doing what I could to help them. That last thing is probably the least part of Peace Corps. The exploring myself, exploring a new culture, those things are much bigger pieces.

Margaux: Did you get to choose the country that you went to, or what does that process look like?

Maggie: So it's recently changed, but when I applied, I didn't get to choose anything. They chose for me, which was a struggle for me. I didn't really get what I wanted and it ended up being a blessing. But it took me a long time to get over that.

But the Peace Corps has changed our application process so that you can choose both what field you want to work in . . . they have different sectors like education, health, agriculture, business, things like that . . . and you can also choose what country you want to go to. Not every country has every sector, so you may not get exactly what you want, but you have a lot more flexibility when you apply.

Margaux: Did you do a health sector, or was that lucky for you to get matched into that?

Maggie: Yeah. So as a someone coming from a master's in public health program, they specifically picked the health sector for me, which is why I didn't get to go to the location I wanted to go to, but it ended up being good.

The sector that I was in has since changed to a youth and development sector. In Botswana, Peace Corps is there doing HIV work specifically. Every volunteer is there to address the HIV epidemic. And so that was a lot of the work that I was doing, was promoting healthy lifestyles among the kids in my village.

A lot of the work I ended up doing was teaching core subjects, science, math, English, social studies. But my actual assignment was to teach health education.

One of the best things I did was I ran a life skills club, and I was technically a life skills volunteer, so trying to teach kids things like self-esteem, communication, decision-making, things like that, things that aren't a part of a particular curriculum but are really important skills that kids learn and have a big impact on whether or not they contract HIV down the road.

And so I would meet with the kids. These kids were mostly the older ones in the school who had better grasp of the English language, and we would do activities that related to those themes, so things that just set them up to be a more successful adult.

Margaux: This may be an ignorant question, but what is the main language spoken in Botswana?

Maggie: Yeah. So it's a little bit of a complicated story when it comes to language in Botswana. Botswana is a former British protectorate, a little bit different than a colony, because the Botswana people, which are called Batswana . . .

Margaux: Interesting.

Maggie: Yep. So the leadership, the chiefs went to the UK, and they went and asked for protection from the Boers of South Africa. Those are the descendants of the Dutch who were trying to invade their land. And so they became a protectorate.

In my westernized opinion, I think it functioned pretty similarly to a colony, and English became kind of the official language of Botswana. So things are supposed to happen in English. Schools, anything that's government run, which is most everything, is supposed to happen in English.

So the best tip I received from other volunteers was when going to a meeting, sit next to the note taker because they have to write notes in English.

Leen: Oh, noted.

Margaux: Interesting.

Maggie: However, it's like 80% of the people in Botswana come from one tribe. The Tswana tribe, which also covers parts of South Africa as well, and they speak Setswana. So most of the things actually happened in Setswana, which is why it was important to sit next to the person writing in English because otherwise, I didn't know what was going on.

I learned a little bit of Setswana when I was there, mostly commands because I was working with small children.

Margaux: That's important.

Maggie: Yeah. The youngest ones couldn't understand English very well, so in order for them to not be totally unruly, I had to speak to them in Setswana.

Leen: Traveling to any country that is very much different than our own personal environments, we always get culture shocks, right? Can you tell me maybe what was the biggest culture shock you had there?

Maggie: That's a hard question, mostly because I am on the other side now, and so looking back, it's like, "Oh, everything was so normal." I guess everything about the day-to-day, from food to . . . Their food is very similar to southern food, really meat heavy and then starches. I am generally a vegetarian, so going there, I had to adapt a little bit. And I do like to eat what local people eat when I travel, so I flexed a little bit with that. But it was a lot of beef and other animal meat. So that was tough.

And then the day-to-day, it's using public transportation. That may not appear to me as the safest. And then just walking around. I guess that's the biggest thing. Walking around, I stick out like a sore thumb. It's different than being a person of color in the U.S. where a lot of the feelings are negative. In Botswana, being White is seen as a good thing. But it was still a lot of attention, and it was not fun most of the time.

I remember one time I was walking . . . I worked with a theater group in my village, and they practiced at night. And I generally never left my house at night, except if I had people with me. But one night, I made an exception, and I started walking to the theater group. My village was very safe, so it wasn't a problem.

But I remember a couple minutes outside my house, and I was like, "Oh, this is totally fine. No one will even know it's me." And then I passed one person, and they said, "Oh, hey." They said my local name, and I was like, "What? I even glow in the moonlight." So even at night, when it was dark, I still stuck out like a sore thumb.

Margaux: What was your local name?

Maggie: My Setswana name is Olorato. It means God is love.

Leen: Oh, wow.

Margaux: That's cool.

Leen: That's awesome. What about in terms of healthcare? Did you see any similarities between maybe healthcare problems they have there versus here? And of course, we talked about major differences, but did you see anything that's like, "Wow, this is really maybe a more global problem than we thought it would be"?

Maggie: I think what's interesting with global health, in general, and as the world transitioned to being more developed is the transition from infectious disease to more chronic illness. And even HIV, the way that HIV is managed now is as a chronic illness. Especially in southern Africa, PEPFAR, the Presidential Emergency Fund for HIV and AIDS, has done wonders for getting people the drugs that they need to manage their HIV illness.

And so most people have the access to the medications they need, but they have to take it every day, just like chronic illnesses we see in the U.S. And then the rise of chronic illness in developing countries is huge and it's going to be the biggest burden now and into the future.

Margaux: What would you say if you noticed anything that they maybe did better there in their healthcare system than we do here?

Maggie: To be honest, I didn't have a lot of interaction with the healthcare system, but I think one thing . . . I think access is a problem, and it's a problem here, too. But I think one good thing is that they rely more on other type of healthcare providers to provide that frontline care. And the U.S. is transitioning to that using nurse practitioners and PAs.

But there, in my village, we had a health center, a health post, and it was staffed by nurses. We didn't have a doctor come to the village maybe ever. They were in a hospital in a town about 30 minutes away by car, and that was fine. The people in my village still had enough access to healthcare, even though it was a nurse, because nurses can do just as much as doctors. And for the people providing the day-to-day and the primary care, we probably don't need to send someone to school for seven, eight years to do that.

Margaux: I know that historically, the locals in Africa maybe have had a negative perception of the USAID and the policy surrounding HIV prevention in Africa. I'm curious what your experience was with the locals and how they perceive the work that you were doing with them.

Maggie: There are a lot of complicated stories with, I think, development in general, and the U.S. going in. I think I was really lucky to be in Botswana where the relationship with the United States is really good. A lot of that due to the Peace Corps and the impact that volunteers have had in their local communities, and also just really spectacular ambassadors and other representatives of the U.S.

And then Botswana is a very stable country, and so there hasn't been a lot that the U.S. needed to intervene on in a negative way.

I think there are still tons of myths around HIV, including that the western world created HIV to get rid of the African people . . .

Margaux: Interesting.

Maggie: . . . which was something that we had to come up against a lot. And we learned in our training that these myths exist and how to talk to people about them.

I was the first volunteer in my village, and people generally really liked having me there. At least they interacted with me in really positive ways, for the most part.

I think the biggest impact that I saw was I was working with really small kids, and it was surprising to me that they wanted me to teach HIV education, because when you teach about HIV, you have to talk about sex. And these were kids that were 14 years and younger. But that's just the reality that Botswana has faced since 2001 when the epidemic peaked, and they were losing just so many people because of this disease. And so they've integrated HIV education into every subject, and it's really spectacular.

But I think the stigma around talking about sex still exists. And in my village, we had a lot of grandparents raising their grandkids because the parents of my kids went away to the capital or bigger cities to work. And when you have that generational divide, people are even more hesitant to talk about sex.

So people were really glad that I was there talking about it because they understand the importance, but they didn't really want to do it themselves, which I feel like happens in the U.S., too.

Margaux: Oh, totally. Yeah, that totally parallels, I think, our health sex education in the U.S. as well.

So one thing you may or may not know is I did my senior thesis in economics on HIV epidemic. And I found that women who were empowered to take control of their own sexual health by either choosing their own contraceptives, whether or not their partner agreed with it or not, were much less likely to contract HIV. So I'm curious, did you do any sort of sex education on contraceptives and condoms and stuff like that as part of your program?

Maggie: Yeah. In training, we learned tons of games that you can do to teach people about contraception, and condoms in particular. And then I did some of those with the older kids in my school, and then I also worked with a community organization in my village. It was a theater group who created plays around health education, particularly HIV. And they would always talk about condoms in those, and then distribute them.

People have so many excuses, and this happens here in the U.S., too, for not using condoms. The silliest stuff, like they smell bad, whatever excuse you can come up with to not use them. But it was interesting because we would distribute condoms as part of these theater performances, and they would always be gone by the end.

I really tried to focus on the girls in my school and empowering them to make their own choices. Just like in the U.S., there's a huge difference in the amount of power that a man has than a woman, and it was devastating to see what would happen to my kids.

It made it really hard to leave knowing that I may be able to teach them to have self-confidence and self-esteem and to make their own decisions, but they're still living within the system that doesn't really support that. And once they don't have the support, hopefully, from the support that I gave them, but also from their peers, or their family, or whatever, if they're going away for school, or anything like that, then the things that can happen to them were just hard to see.

Margaux: Yeah. So, Maggie, do you have any criticisms of the Peace Corps?

Maggie: I don't think the Peace Corps is a perfect program. I think when I was with other volunteers, we did a lot of criticizing of the program. But with people outside the program, I think the Peace Corps is doing a good job, especially relative to other types of international relations that the U.S. has.

I think the Peace Corps is a really necessary program. Like we talked about at the beginning, I think the more that we know about other people around the world, the more we see them as real people and the harder time we have objectifying them.

I think objectifying people is really dangerous. And some of the stuff that the U.S. has done to other countries or that we do to each other is because we don't see each other as human. And so I think getting people who are good representatives of everyday Americans on the ground in these communities is really valuable.

I think it all depends on the type of volunteer you have and what their motives are for doing the Peace Corps. Our country director said it best when he said, "You have to have a good balance of altruism and selfishness when doing the Peace Corps." If you're going there just to help other people, you probably won't last, because it's really hard and you fail a lot. And if that's your only measure of success, you're going to feel like a failure. You have to have some sort of personal stake in it.

For me, I really wanted to grow as a person. I really wanted to travel. I wanted to see that part of the world. And honestly, every single day in my school felt selfish because I got so much out of it. The kids were just incredible, and I loved hanging out with them.

But I think, too, if you're just there for yourself and you're there to travel around or to . . . I don't know what other people's motives are, but if that's all you're there for, then you're also not a good volunteer because you're not representing the U.S. in the best way possible, in my opinion.

So I think it does take the right kind of volunteer, and I think the wrong kind of volunteer can have a really detrimental effect on the Peace Corps.

And again, there are parts of the Peace Corps that aren't good and that need to be improved. I think about five years ago, right before I went into the Peace Corps, there was a lot of news around the way that Peace Corps handles rapes in countries and other sort of sexual harassment and sexual assault that volunteers experience.

Thankfully, those people have come forward and have made Peace Corps improve the support system they have for volunteers. But I think there's still work to be done. The agency can still be better, but I think it's a good thing and I think that it should continue and that people should do it.

Leen: I love how you said it's an opportunity for you to actually be the person on the ground and bring the change from a firsthand perspective as well as bring your own personal gain. I think that's a big motivator for me in med school. Everyone's like, "You should go into politics." It's like, "I don't want to be the person on top. I need to be on the ground and actually see the change firsthand." I love how you said that.

Just for our listeners who are pre-meds, if you have any last little bits of motivation to go towards the Peace Corps, any advice, anything they can do to prepare themselves, and what you think would be very valuable for a pre-med to get out of it in order to further their career in medicine?

Maggie: I think the Peace Corps was an incredible experience for me. One thing is I think it gave me real world experience, and I think that's really important for me in medical school. It keeps me grounded. It focuses me to have a balanced life, because I know that med school isn't the end-all be-all.

It also gave me time to mature, and it's much easier for me to make decisions and to stay grounded because I took those two years before starting medical school to grow.

I think the Peace Corps is a great program. It's not for the faint of heart. It's a two-year commitment, and most people do make it through the full two years. Your heart has to be in it. If your heart's not in it, you're not going to do a good job for your community or yourself.

But I think I would say absolutely 100% that Peace Corps helped me get into medical school. And it was Peace Corps that made me want to apply. I had a public health degree before. I'm really interested in global health, public health, impacting the health of communities, and it was Peace Corps that made me realize that it's the one-on-one interactions that I have with people, the relationships that keep me going. And that's why I decided that I needed that in my practice. So I needed to see patients to be able to motivate me to do the public health work.

Margaux: Wow. That's really inspirational, Maggie. I think that if any of our listeners are considering doing the Peace Corps, it sounds like it's a great option to explore, for sure.

Leen: Well, thank you so much, Maggie, for sharing your story and sharing your experiences with the Peace Corps. I think it's a very unique perspective and it's a perspective lots of people have questions about.

For our listeners today, thank you for joining us. Please remember to subscribe to us on iTunes, leave a review. We very much appreciate your audience as well.

That was lame. All right. Well, thank you all for joining us. This is the "Bundle of Hers." See you next time.