Fifty years in three months: a journey of cultural and educational discovery and growth in Bangladesh
Ci Ci Stuart, University of Sheffield, UK
Paper presented at SCUTREA, 31st Annual Conference, 3-5 July 2001, University of East London
This paper focuses on my experiences when working in Bangladesh - a country I was visiting for the first time.
Via an aid project to strengthen nursing education and services in the country, I took on the challenges of designing and facilitating four standalone two week 'teacher training workshops' for a number of unqualified Bangladeshi nurse educators. The teaching was translated from English to Bangla. The remit of the workshops was to introduce the educators to interactive classroom teaching methods as teaching practices were predominantly pedagogic and didactic in nature.
Reflections on the workshops are drawn primarily from experiences of the first one as the content and processes of each workshop had many similarities. Material will be quoted from my journal kept of my stay in Bangladesh. Any material quoted which is in brackets has been altered for the sake of clarity.
Preparation
In preparation for my trip I thought it useful to develop a degree of cultural awareness to become 'appreciative and sensitive to the values, beliefs, lifeways, practices, and problem solving strategies of [the others'] cultures' (Campinha-Bacote 1999, 204) so as not to appear foolish or alienate the people (Andrews 1999). As I made a study of Bangladesh, its people and their culture, I realised that I would be amongst people who would be strangers to me. I would be entering their world as an 'outsider'- the 'outsider' does not belong and is not trusted (Kauffman 1994).
According to Kauffman, the 'outsider' has neither been born or socialised into the group and therefore does not possess the direct, intuitive sensitivity that makes empathetic understanding possible. It is highly likely that the group will exclude the 'outsider' in principle from gaining access to it.
I saw it as my responsibility to break down any barriers, to gain and build trust - to 'get in' - so that the educators will start working with me. So much was at stake -several people working in the Aid Project in Bangladesh were expending huge amounts of time and energy in making these workshops possible; these workshops were costing no mean sum of public money; I was spending a lot of time and energy readying myself; the educators had to travel from various parts of the country to the training centres and stay for the duration of the workshop; I had to travel halfway round the world to facilitate these workshops. There are health risks such as contracting gastro enteritis and malaria. The cost in human terms for all involved, either directly or indirectly, including significant others, cannot be measured.
The workshops simply must be successful in terms of the amount of learning engendered.
Arriving and requiring 'care'
In a strange land when one does not speak the language the importance of being met by a friend cannot be stressed.
I thought I was 'tough' but my anxieties were recorded in my journal: We have landed - I feel so nervous ... I am so pleased and relieved that I am being met. This experience has made me realise how important it is for someone arriving alone, in a new place, (to be met). It helps to relieve the anxiety level - not having to worry about finding one's way around initially, especially if one can't speak the language (6 March 1998).
The reality of being amongst people of a different culture in a strange land hit me when I landed at Dhaka. At Dhaka International Airport there are simply dozens and dozens of pairs of arms of various lengths reaching out to attempt to 'divest' you of, and 'help' you, with your luggage! As their bodies heave amongst each other from across the barrier, their voices are imploring you to let them carry your bags so that they can earn a few taka. With the voices coming almost in unison and in a language that Id o not understand, they sounded loud and aggressive and was frightening. I also felt vulnerable as a female travelling alone in Bangladesh. I know I would have been terrified if my friends were not meeting me. Knowing that they would be there was extremely comforting.
Having grown up in Malaysia when it was a very poor and developing country I thought I would be prepared for the sights and sounds and smells I would encounter but I felt an alien - I was totally unprepared for the powerful emotions that threatened to engulf me and I wondered desperately how I would be able to cope with just being in Bangladesh - never mind running the workshops. The sheer scale of demeaning sights such as barefooted children picking through rubbish for some item that may be worth selling was heart-rending, oppressive and overwhelming.
In my early days I carried such unfairness of life as a baggage - 'I have and they have not'. This baggage was a troublesome burden at times but with the passage of time and increasing exposure to the sights the 'burden' diminished but did not go away. How can it when with every corner one turns, every direction one faces and almost every step one takes one is faced with some sight of poverty? On my third visit my journal recorded my relief as I 'stopped seeing': I am feeling much more relaxed this time - the sights (of suffering and misery on peoples' faces) do not hurt the way it used to do. It is amazing what one can get used to (as one casts) this cloak of defence around oneself. Somehow, things are less troublesome (8 August 1998).
Support from like-minded colleagues is necessary for survival. I was fortunate to be able to debrief with colleagues from the UK who were also working on this Aid Project.
One also needs to be 'cared for' and 'looked after'. When one is secure many aspects of interpersonal relationships are taken for granted. The human need to debrief, to 'pour out' and to share during times of strain was brought home to me during my stay in Bangladesh, particularly when the workshops were in progress. There are many records of experiencing loneliness in my journal. One entry is rather poignant for me: In a 'foreign' land with others around you speaking a different language, and you cannot be understood, and you cannot relate on the same 'wavelength', you very quickly realise how lonely it becomes ... I have not reckoned on how threatened I have felt, and also the loneliness. Being in a strange and totally unfamiliar environment has really sapped my reserves. How important it is to have a bit of caring and friendliness from others. It means so much, and helps one to cope, at a time when all around threatens to take over (10 March 1998).
However, thoughts of 'things are not like back home' and feelings of alienation and homesickness - the so called 'culture shock' (Andrews 1999), had to be overcome so that I could start to function during the workshops. The task of learning social cues and some essential Bangla words in order to communicate and interact was done speedily.
Although Kauffman (1994) suggests dressing as an 'insider' I did not go so far as donning a sari for fear that the yards of material draped round my form would cascade around my feet! Meals were taken with the educators using the fingers of my right hand in place of cutlery, as is the etiquette.
The workshops: finding out the 'real remit'
The first workshop was approached with much ambivalence.
I was looking forward to working with the 16 educators but was filled with the uncertainty of whether 'things would work'. Fortunately, it was not until I was shown around the training centre prior to the first workshop that I became fully cognizant of my real task. Feelings of panic rode high! In my journal I noted: Classrooms dismal and very grim; old wooden chairs with writing tablets set out in rows; a traditional black chalkboard; (teacher's desk and chair facing the class); bare walls; teaching models not used and locked away; one overhead projector in plastic wrapper in pristine condition (stored in the principal's office for the use of 8 educators); one boxed video recorder; (locked) library - dusty, with broken furniture, books under lock and key; student nurses been kept waiting in classrooms for 45 minutes but no teacher (there was a tendency to take 'extended' lunch breaks) - some complaining vociferously ... read students' notes (in English) -all read (exactly the) same as (notes) had been dictated by teacher (10 March 1998).
Students were afraid to question, nor were they questioned, in class. The above description is not intended to judge but to provide some background of the established and accepted work conditions and traditions of the educators. They have not had opportunities of experiencing any other. The educators indicated that they felt undervalued - not only are educational resources and support nonexistent or in very scarce supply, they do not have any opportunity for professional self-development. There was an attitude of 'we have no material resources and this is all we can do'. Feeling rather bemused by now, I realised that I now had a remit other than the introduction of a range of interactive teaching methods. They had to be empowered in two ways: firstly to know how, and what to do to create a learning milieu (Boud and Walker 1990) as I see this as one of the wider responsibility of teachers, and secondly, to believe that they are valued members of their profession as they play a crucial role in shaping the nursing profession in Bangladesh. They therefore also need to believe that they hold key responsibilities as nurse educators. I felt that I had to help them develop an increased sense of self-worth and worth to others so that they believe they can be change agents.
The sessions
I discussed my anxieties as an outsider earlier. I was lucky - as a group the educators accepted me readily although I could sense that some were holding back and there was scepticism on the faces of a few. There are many in the group who had been educators for many years. Why should they listen to me through a translator? I still needed to 'get in' so that the remaining barriers to mutual acceptance can be broken and new bonds created and strengthened (Kauffman 1994).
Firm in my belief that learning is best achieved in a trusting, non-threatening environment and the teacher is the facilitator (Rogers 1982) I was concerned that this type of learning climate is established and so that it can be experienced by the educators. With mutual consent the seating arrangement was changed from rows to a semi circular formation. To start to break down barriers, time was spent on the first morning of the workshop for 'social exchanges' (Kauffman 1994) using a planned exercise.
Everyone placed personal objects- rings, bracelets, watches - on the concrete floor in the middle of the room. Each person then took it in turn to tell her story about her belonging. We also defined expectations of each other and created mutual obligations which were recorded on a sheet of flipchart paper and pinned to the wall for the duration of the workshop. These processes essentially require the sharing of the self with another (Mead 1962) thus creating a deeper awareness of each other which enhances the development of trust and solidarity.
Teaching and learning strategies throughout the workshop concentrated on active participation to enable the educators to learn experientially to achieve more meaningful and lasting learning (Kolb 1984; Marton and Saljo 1976). Sessions and activities were planned so that the educators shared the outcomes of small group work.
These were organized around joint accomplishment of tasks that elements of the skill take on meaning in the context of the whole. In order that they do not become overloaded by a large amount of information at any one time or be overwhelmed by what they had to achieve, skills were built up bit by bit to permit participation without feeling threatened. For example, when exploring learning in the clinical setting, we brainstormed how this could take place and why they should play an active role in teaching in the clinical areas. Sub-groups then convened to discuss and present how they would use one method of clinical teaching, with each group exploring a different method. After the whole picture of how clinical teaching can be done was completed the educators then had to put theory into practice.
Each sub-group then planned how they would teach a group of students during clinical practice using 'their' method, carry out the task on the wards and then present their work back in class. The following learning diary exercise to promote learning through self-reflection and the development of critical thinking skills (Holly 1989 and Kolb 1984) was then carried out: and values they hold. Any changes in awareness of how practices can be improved may then lead to positive changes being made to educational practices.
It was important for the educators to believe that they are the key to learning and much can still be achieved without material resources. Their confidence increased as their creativity with the usage of existing resources surfaced.
As the workshop progressed the educators developed increased confidence in all aspects of classroom activities, including challenging each other and myself. By day three I felt sufficiently comfortable as the 'outsider' to be more challenging in my teaching. There were times when I unashamedly exploited the advantaged position held by the 'outsider' as the 'professional stranger' who is able to raise questions unlikely to be accepted from an 'insider' (Kauffman 1994). I particularly challenged their responsibility and ability in creating a learning milieu despite the lack of resources. Care was exercised as to the extent they were challenged as it probably would have been easy to end up with a group who felt even more helpless. I drew on Rogers' (1967) strategy of using 'unconditional positive regard' to balance the challenging and the accepting.
After our intensive time together the educators felt ready, confident and motivated to start to make changes to their practices and the training centre. They 'contracted' to carry out projects to put into practice what they had learnt.
Some challenges and joys of the workshops
A big challenge was working with a group who did not understand fully what I was saying, and learning to do it 'right'. It was important to agree with the translator how we wanted each other to proceed. When I was ready for
In relationship to your clinical teaching method, describe what happened. Include the preparation. How will you evaluate - How well did it work? the effectiveness of this - How did you feel? method? - How did the students feel? - How could you have made it better? - Will it work in Bangladesh? Why? - How will you put this method into practice in the future? - When will you use this method of clinical teaching?
Figure 1: Learning diary exercise on clinical teaching (after Kolb 1984)
Where feasible and appropriate, discussions and events taking place in class forming their 'here and now experiences' (Boud and Walker 1990) were explored and related to their practices as educators, the educational practices at the training centre, nursing and nursing education in Bangladesh. Frequently, fairly lengthy discussions took place as the educators contributed actively. These discussions were intended to raise awareness of their practices and attitudes material to be translated I would indicate my intent either verbally o rnon-verbally. There is probably an optimum amount spoken before translation is required. Listeners will clearly get bored if they are not able to understand for too long. Translators cannot be expected to have extraordinary memories. The complexity of the material should also be considered - the more complex, the shorter the speech before stopping for translation. When material is particularly important it should be made known to the translator before one speaks. Slower speech and the purposeful enunciation of words were helpful for the translator and the educators.
I also wanted the educators' 'talk' to be translated back to me but felt that I missed out on the nuances. These processes of translating meant that class sessions took longer and felt drawn out.
One significant physical strain was feeling overwhelming tired frequently - in the middle of class and at other times. There were numerous references to this state in my journal. One entry read: 'I am tired - day off tomorrow - I have never needed a day off as much'. The following were noted as reasons: 'not enough sleep; heat; intense concentration in class - participants need more help with group work; work environment not the most conducive - noisy, hot; language barriers make teaching much more intensiveand stressful; a lot of material in one day'. The responsibility of facilitating the workshop single-handedly was great for me and I felt the strain.
There are many joys I treasure. I feel a great affection for the educators whose sense of humour allowed much 'leg pulling' - I did not get away with it either. They knew I was on my own and tacitly looked after me. They included me in trips taken in the centre's spring less bus, bumping overstones and pot-holes to get to the seaside some four hours ride away! One day I contracted a severe bout of the dreaded gastro-enteritis. I was touched to the core when Mazeda turned up in a rickshaw full of coconuts and exhorted me to drink its delicious water which contains a high level of electrolytes, particularly potassium. During the workshop they threw themselves wholeheartedly into whatever tasks we were engaged in. Their motivation, indefatigable enthusiasm and 'hunger' for more and more acted as sustaining factors for me to carry on and brought out my best teaching efforts. I have never given as much to a group - it was a wonderful experience. Teaching and learning are truly two way processes.