Entering as a Foreigner,
Leaving as an Ally
Tina Sang & Lisa Smith
2 October 2009
SW 701
Surmang Rural Health Clinic
• Community Health Worker Program
▫ Trained local Tibetan women to be birth attendants
(prenatal counseling, pregnancy warning signs, and
safe delivery).
▫ Interviewed CHWs.
• Home Visits to Grandmother's Village
▫ Visited elderly, observed living conditions, screened
elderly for high blood pressure, provided medications.
• Medical Emergencies
• Pictures!
Lisa's Internship Experience
• Abbreviated Internship Objectives:
• To examine disparities of access to adequate health
care between urban and rural populations, stratified
by gender and socioeconomic status
• To understand the role of a comprehensive social
business like the Grameen Bank in improving access
to health care
• To evaluate the health infrastructure in Bangladesh
with consideration for the active NGO environment
Lisa’s Internship Experience
• Asia Pacific Center for Security Studies:
▫ Discussions of microfinance as a mechanism for developing secure social
settings
• Grameen Bank Internship:
▫ In-depth study of finance and banking related mechanisms of the bank
as well as the health related changes mediated by the presence of
Grameen and their associated health programs in rural villages
▫ Projects Included:
 Comprehensive evaluation of one Grameen Kaylan health branch
office
 Participant observations at community loan meetings, district loan
offices and during loan disbursement procedures
 Meetings with a variety of Grameen sister organizations
 Analysis of collaborative work throughout Grameen organizational
structure
 Annual report writing for Grameen Trust on their China Grameen
model replication project
Lisa’s Internship Experience
• ICDDR,B: International Center for Diarrheal
Disease Research, Bangladesh
▫ Studied research programs targeted at the
intersection of poverty and health
▫ Worked within the social and behavioral research
department
▫ Enabled me to see how microfinance participates
in the health system at an infrastructural level
▫ Met with key policy makers to discuss health
status in Bangladesh
PREPARING FOR AN
EXPERIENCE ABROAD
Lisa:
▫ Spent a year writing papers and doing projects on
my topic
 Studied microfinance in-depth
▫ Went on short-term study abroad experience in
Bangladesh 3 months before leaving for my
internship
▫ Talked to a lot of people, asked a lot of questions
▫ Read local newspapers (The Daily Star)
▫ Read international news on the country (BBC
News)
▫ Applied for over 10 different funding sources
Tina:
▫ Undergrad research project in Tianjin, China
▫ Took international and multicultural-related courses.
▫ Found faculty members with connections in
China. Searched for an internship. Applied for
internship funding.
▫ Plans changed to go to Qinghai Province
 Read a history book on Tibet and China relations.
 Read a travel memoir of a Canadian who taught English
in Bhutan.
 Bought necessary equipment, packed light.
 Prepared mentally for a rural village experience.
DEFINING FEATURES OF A
FOREIGNER
▫ Tina: American, Han
Chinese, didn't speak
Tibetan, Altitude.
▫ Lisa: Skin color = wealth,
education & happiness
Gender Norms
▫ Different standards/expectations for us versus for
the local women
▫ Varying degrees of oppression
▫ Entering into both male and female spheres
 Child birth, family planning, home visits, kitchen,
religion, interpreters
 Dictated by male understanding and interest
Political Context
▫ General directorate of health meeting
▫ China:
 Dalai Lama has called for autonomy in Tibetan
regions of China and not outright independence.
 March 2008 Lhasa riots: Han Chinese settlement,
peaceful protests by monks, government backlash.
 Lack of civil society: Few non-profits, statecontrolled media, and state policy on religion.
Social Change
▫ People within the country need to recognize and
own a particular problem.
▫ Purpose is to create something sustainable that is
not driven solely by a foreign entity.
 Foreign aid, both through volunteers and money,
comes and goes according to political will and
economics.
▫ Community-level change that draws on local
people's knowledge and values.
EXERCISES IN CRITICAL
REFLECTIVE PRACTICE
Critical Reflection to Promote
Contextual Social Work Practice and
Education
• The global community is a concept used to indicate how
we live in a small world, primarily due to easy access to
communication and travel
▫ There is an urgent demand for relevant and adequate,
rather than universal, knowledge
▫ Embrace ambiguity!
• What is critical reflection?
▫ An educational and supervision method that combines
practice, research and education in a circular process




Learning about and improving practice
Learning to develop practice-based theory
Learning to connect theory and practice
Improving and changing practice
Critical Reflection
• Similar to reflective learning
▫ Circular experiential learning cycle of…




Action
Reflection
Conceptualization
Experimentation
• Critical elements emphasize how gaining personal insight
and learning to know oneself is a never-ending task,
important for professional development
• Reflexivity (a term often used in anthropology) refers to
critical reflection which is concerned with the positioning
of the self
▫ How power is experienced and exercised
Backdrop to Global Social Work
▫ History of colonialism
▫ Globalization
▫ Lack of critical self reflection and change among
international health and social service institutions
▫ Usually focused on specific disease or
humanitarian crisis rather than sustained change,
short funding cycles
▫ Tension between biomedical understanding and
local understandings of health and wellness.
Western models assumed to be universal.
▫ Development, modernization, and the economic
bottom line
Critical Incidents
• “If it made a ‘significant’ contribution, either positively or
negatively, to the general aim of the activity observed” (pg.
39 of text)
• Procedure is as follows:
▫ Describe the critical incident: analyzing and
understanding
▫ Reveal deep-seated assumptions
▫ Explore individuals’ experiences in light of historical,
social political, economic, cultural and religious contexts
▫ Ask if the discussion would be different if it were
happening elsewhere in the world and why.
▫ Create emancipatory knowledge resulting in professional
growth and development
▫ Create a collective professional knowledge base to be
followed by transformative change
Critical Reflective Practice
Case Studies
▫ Community health worker training program
(Tina)
▫ Cyclone relief effort and aid (Lisa)
• Exercise: In your groups, please develop a case
example where you/your group/your
organization, as an international social worker,
face a difficult ethical decision.
BECOMING AN ALLY
▫ Know your role. Don't come in saying, "I am
going to fix things."
▫ No Asshole Rule
▫ The awareness and sensitivity that you bring to a
situation may not be met with same response by
people of that country
 Power of the third party perspective
 Foreigners are hyperaware of the lack of awareness
between populations within country
▫
▫
▫
▫
Dissociation with lower classes in society
Tibetans and Chinese
Urban (Dhaka) Bangladesh and village Bangladesh
Same would be true of foreigner visiting the U.S.
China’s Urban
and Rural
Divide
Home in Qinghai
vs
Home in Beijing
Expat Suburb
▫ Active listening
 Sponge: soaking up information and asking questions
 Allowed for things to become more of an exchange than
strictly a benefit to me
▫ Language barriers
 Using non-verbal body language and smiles ☺
 Developing rapport with translators
 Try to learn the language, even if it is only 5 phrases
▫ Suspend Judgment then Reflect
▫ Making yourself available for experiences not
traditionally associated with your internship
 Looking at all experiences as opportunities to grow,
share and learn
 Be flexible. Combine your skills with their needs: grant
writing, networking with Westerners
 Yak tent, cyclone relief, following traditional religious
practices in a respectful way
▫ What country are you from? How long are you
visiting my country? Where have you been?
 Time = respect
▫ Developing personal connections




Use your social identities
Make friends
Like having an extended family abroad
Use your privilege to help local people
Impact Assessment of YOU!
▫ Despite these challenges, recognize the importance of
reflexivity and your development as an engaged and
interacting being
▫ Your job should be to fill in the footprint of your
influence through your actions during and after an
experience abroad
 You want to leave a situation at equilibrium
 Not stagnant equilibrium
 You continue to give back what you have received even
after your experience is over
 Ongoing iterative process that involves further critical
reflective practice
 Always carry those memories in the back of your mind
Ongoing Reflexive Practice
▫
▫
▫
▫
▫
▫
▫
▫
▫
▫
▫
▫
▫
▫
▫
Well-rounded person: self-care, relate-ability
Worrying
Time
Food
Water
Poverty
Expertise
Invest in people
Inform professional practice
Interconnectedness
Educate, share, advocate
Breaking stereotypes
Intricate situations – learn to love ambiguity
Remain curious!
Don’t accept mediocre!!!
Internship Funding Sources
• International Center Website
http://www.internationalcenter.umich.edu/swt/wo
rk/internfunding.html#gradtips
• Area Studies
• School of Social Work, Office of Global Activities
• Other Funders
William Davidson Institute, JW Saxe Memorial
Fund, Ginsberg Center, Wallenberg Fellowship,
International Institute, and more...