by John Eybel
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INTRODUCTION |
ACTION AND REFLECTION METHOD OF LEARNING
Accessing their personal experience is difficult at first for participants in this clinical course. Many are used to a more cognitive or directive learning process. The conventional wisdom has been Ukupigao ndio ukufunzao. (What beats you is what teaches you.)
Now, a more autonomous, experience-based and problem-oriented method of learning (action and reflection) calls for increased activity on the part of the learner: Kila ndege huruka kwa bawa lake. (Each bird flies by its own wing.) Ndege mwigo hana mazowea. (A bird that imitates others does not get used to a place.) Asiyeuliza, hanalo ajifunzalo. (He who asks no questions has nothing to learn.) Atangaye sana na jua ajua. (The one who wanders around a lot by day, knows.)
THE LEARNING GROUP
Am I safe in this group? In this hospital? Will I be accepted? Students ask themselves these questions and tend to avoid risky self-disclosure until they come to value personal growth more than their safety. I have invited self-disclosure with the proverb: Mficha uchi, hazai. (The one who hides nakedness will never have a child.) Students come to the course looking for tips and handy advice on dealing with sick people. They come to realize that the course concerns itself with something much more personal and individually authentic and with what might be unique to one's self. They are thrown onto patient wards and into a human relations laboratory with little to go on by way of instruction. To make matters more difficult, they are then challenged to be personally responsible for what happens--all of which becomes grist for the mill of self-awareness.
Gonga gogo, usikilize mlio wake. (Knock a log in order to hear the sound it makes.)
Student caregivers have one class together in which they practice helping skills in a workshop format. They present real personal issues to one another for exploration and problem clarification. Sometimes, for the sake of the exercise and to avoid real personal involvement, a caregiver will present something out of the past, for example a long troublesome bus safari from Dar es Salaam to Mwanza. Soon the futility of discussing this as a present problem is apparent and the safari is dismissed humorously with Mavi ya kale hayanuki. (Old droppings do not stink.) or with Yaliyopita si ndwele, tugange yaliyomo na yajayo. (Let's not worry about what is in the past, let's concern ourselves with curing future ills).
The scrutiny brought to bear on personal functioning in the wards and in the training group can be disconcerting to some. It is scary to take a stand on how you see a patient or peer (he speaks in rambling sentences) or to hear their feedback offered to you (if I were the patient I would get tired of hearing your advice). A student who is sensitive to criticism might back down on or change the story about what he/she felt, saw, said or did. In figurative language: Ulimi hauna mfupa. (A tongue has no bone.)
Sometimes a student will choose to report on a satisfying interview in which things went smoothly in a helping relationship. I invite them to thank God for the successful ministry and then to turn their attention to difficult relationships (with patients or fellow caregivers) in which they stand to learn new and more challenging ways of relating to others. In action and reflection, problems are their friends encountered in the process of learning. Kupotea njia ndiko kujua njia. (To lose the way is indeed to learn the way.) Asiyekubali kushindwa si mshindani. (The one who admits no defeat is no competitor.) Kujikwaa si kuanguka, bali ni kwenda mbele. (To stumble is not to fall down, but is to go forward.)
In discussing patient interviews together, students discover differences among themselves: strengths and weaknesses to be identified and reflected upon. Strengths are to be celebrated and exploited; weaknesses may be an opportunity for personal growth, or limitations to be accepted. A proverb couches the pain of personal limitations and unfavorable comparisons in the context of a divine plan. Aliyekupa wewe kiti, ndiye aliyenipa mimi kumbi. (He who gave you a throne, is the one who gave me a coconut husk [to sit on].)
LEARNING EMPATHY
More often than not, the problems that a student faces in pastoral care are challenges to greater empathy. The principle is easy to accept: Kitanda usichokilalia, hujui kunguni wake. (You cannot know the bugs of a bed that you have not slept on.) Hucheka kovu asiyefikwa na jeraha. (The one who laughs at a scar hasn't been wounded yet.)
Students are encouraged to notice non-verbal cues to a patient's feeling or a peer's response (as when a patient covers her head with a blanket when approached by the caregiver, or when a young male caregiver spends a disproportionate amount of time with a young woman patient): Mapenzi ni kikohozi, hayawezi kufichika. (Love is like a cough, it cannot be hidden.)
Often enough, caregivers see their shadows in the behavior of patients and peer group members. (The shadow represents behavior which a person would unconsciously condemn--or deny in themselves.) They judge this behavior in others and so they show up short on empathy with patients and peers. For example, a caregiver meets a sick mother on the ward who is furious that her husband hasn't come to the hospital with food or some other item. The caregiver, confronted with her angry shadow and without adequate empathy, advises the mother against anger. The supervisor's job is to help the caregiver to accept that bit of anger, starting with self, to access his/her own experience of being angry, and then to take another look at the angry mother. Proverbs help a student own up to the shadow in oneself. Nyani haoni kundule, huliona la mwenziwe. (A baboon doesn't see his own backside, he sees his companion's.) Ajabu ya ngamia kucheka nundu ya ng'ombe. (It's amazing that a camel laughs at the hump on the cow.)
A trainee will be surprised that attention has been turned on him or her and away from the case, and will often deny any such shadow behavior in the self (anger toward a spouse or close associate, for example, a peer in the training group). A good supervisor presses patiently: Hamna! Hamna! Ndimo mliwamo. (It is not there! It is not there! That is where it definitely is.)
ENCOUNTERING RESISTANCE
Sometimes a caregiver lacks adequate empathy and fails to understand or accept the world of the patient. A caregiver might resist a patient's doubt about whether or not he is getting adequate medical care in the hospital; or resist a woman's long-standing bitterness toward a man who has neglected her. A caregiver's s agenda can keep him/her from really listening to the patient. "How can I get through to this person? She won't listen," a caregiver says, complaining that a patient refuses to listen to direction given by God, the church, or the pastor. A supervisor challenges the caregiver to take a more empathetic approach with a proverb: Kila kufuli ina ufunguo wake. (Every padlock has its key.) Kila mtu kwa mtuwe. (Every person is reached through another.) Kuambiana kupo, kusikilizana hapana. (There is plenty of advice-giving, but no listening.)
"I can't help her if she is so argumentative," the caregiver insists. A supervisor will refuse to take part in the blame and might add a proverb as a commentary: Mbaazi ukikosa maua, usingizia jua. (When a pigeon-pea shrub has no flowers, it blames the sun.) For success in this caregiver-patient standoff, the caregiver must see the uselessness in insisting that the patient change. The supervisor might want to discourage such a powerless strategy. The proverb says: Fimbo ya mbali haiui nyoka. (A stick which is not at hand does not kill a snake.)
To console a caregiver who is faced with a patient that she would not have chosen, a supervisor might add... Ulipendalo hupati, hupata ujaliwalo. ( What you want, you don't get, you get what you are granted.) Caregivers don't always meet persons who behave in the way that they would choose, but they can always choose to accept persons in the way that they behave and to look for possibilities there: Mshoni hachagui nguo. (A tailor does not choose the cloth.)
Caregivers often attempt to manage patients' feelings and solve their problems for them. Allowing others to learn from their own experience requires considerable faith. Such faith comes to light in the proverb: Mwana akililia wembe, mpe. (If a child cries for a razor blade, give it to him.) Sometimes a student will refuse to accept the situation the way it is, and imagines what might have happened so that it would be different. For example, if Maria had not complained so bitterly about John's coming home at 3 a.m., he would not have beaten her so severely. She should have waited until he was sober. While that is good reasoning when faced with a severely beaten Maria, it is not what she needs in contemplating her next step with John. This point is clear with the proverb: Maji yaliyomwagika hayazoleki. (Spilt water cannot be gathered up.)
COPING WITH CONFLICTS
Sooner or later, both with their patients on the wards and in the group with their training peers, students are faced with conflict, and with the option of accepting or condemning it. Proverbs help bring anger, hatred, and enmity out of the shadows. Vikombe vikikaa pamoja havina budi kugongana. (If cups are put together they are bound to hit one another.) Wagombanao ndio wapatanao. (The ones who quarrel are the ones who reconcile.)
Most of us who are caregivers-pastors, religious and other church workers, tend toward the highly socialized end of the spectrum. We've depended on rules and social conventions to regulate our lives and we expect that it is the same for others. Only later do we develop the skill needed to negotiate the conflict when, for example, someone in the house plays his radio at 5 a.m. and awakens others, and there is no rule against it.
The skill of self-assertion can be confused with blame. Trouble could well ensue. Or, some might think that self-assertion means forcing their way on others. They might choose to withdraw with shades of resentment. Proverbs help foster the skill of making requests. Mwombaji siyo kama mwizi. (Someone who asks is not like a thief.) Aulizaye hajamkasirisha ye yote. (One who asks has not yet angered anyone.) Eleza haja upate haja. (Say what you need, get what you need.)
ACCOMPANYING ONE ANOTHER IN THE PERSONAL WORLDS WE CREATE
Caregivers are trained to find out what it is like to be in the world or in the proverbial bed of their patients. In discussing patient interviews with their peers, they have the double task of understanding not only the world of a patient featured in a report, but also the world of their fellow caregiver who conducted the patient interview, and is presenting the case to the group. The give and take of group feedback and discussion brings to light what everyone sees in the world and what the limits, distortions and creations are in a single person's world.
A proverb serves in helping caregivers to become responsible for the limits and distortions of a personal world, especially their own. Msema pweke hakosi. (One who talks to himself cannot be wrong.)
A proverb also makes clear that what we see on our television screen coincides with the channel we choose: Lisilokuwapo moyoni halipo machoni. (That which is not in one's heart is not in one's eyesight.) Heart, which appears in the above proverb, serves us as a seminal word in the process of transformation. We all live out our personal histories in which our vision was acquired according to the choices we have made. Hence the proverb: Mtoto umleavyo ndivyo akuavyo. (As you raise a child, so will he grow.)
Caregivers are invited into the worlds of adult people who have grown to see themselves, some as blessed, some as deprived. From their heart they tend to accentuate one aspect or the other. Two proverbs illustrate this psychological phenomenon: 1. Apewaye ndiye aongezwaye. (The one who is given is indeed the one given more.) 2. Asiye na bahati habahatiki. (An unlucky person never becomes lucky.) A caregiver (supervisor or student) who exercises genuine authority, takes the opportunity to supply the heart or the faith intention (as in the proverb below) for an unseen blessing. The proverb says: Nia njema ni tabibu, nia mbaya huharibu. (Good intention is a doctor, bad intention damages.) The caregiver brings good news, not for vociferous preaching but for quiet knowing while present to another. The good intention or heart of a caregiver shows up creatively in the language he uses for another's world. A proverb playfully announces: Akipenda, chongo huita kengeza. (He who loves calls a one-eyed person just a squinter.)
A skillful caregiver, faced with another's world of trouble, can create with language a new frame or context in which an overwhelming problem can be seen in a manageable perspective. A proverb suggests a bigger picture perhaps in which to endure a marital dispute: Maji ya moto hayachomi nyumba. (Hot water does not burn down a house.)
In one of our programs, a young novice visiting men-patients who loved to debate with one another on the Bible, was asked for a spontaneous explanation of the first chapter of St. John's gospel. Never having taken a Scripture class, and knowing very little about John's gospel, she went to her supervisor to say that she didn't think she would be able to do this course on pastoral care. She was pleased to know that she would be just fine saying the rosary with dying patients and that the house of caregiving was bigger than she thought. She put the Bible discussion into the hands of the seminarians in the program.
A wise caregiver, supervisor or hospital chaplain will know when painful past events come to distort the people seen in the present world of a person. Mwenye kovu usidhani kapoa. (Don't think the owner of a scar has healed.) An abused child, for example, might someday have some vengeful feelings to reveal to or to transfer on to a caregiver. Resentments for parents, former teachers and authorities can also lay hidden in the shadow of a learner. Together with empathy, caregivers challenge growth in the way persons shape their worlds. They will always take a patient's stand for new possibilities that originate from within: Penye nia, pana njia. (Where there is a will, there is a way.) Subira yavuta heri. (Patience brings blessing.)
This growing mode of being means that persons are freer on the inside and are no longer caught up in reacting negatively to what they see on the surface: Heshima kitu cha bure. (Respect is a free gift.)
And with a world now filled with possibilities, they are much more responsible for their own feelings and actions: Kozi mwana mandanda, kulala na njaa kupenda. (A goshawk is skillful, if it sleeps hungry it is by choice.)
CHOOSING PROVERBS
Proverbs have been useful in building awareness of one's presence or mode of being in relationships and in having a chuckle about it. The most effective proverbs for supervisory interventions are the well known proverbs that students don't have to think about. Not-so-well-known proverbs that I use repeatedly achieve a well known status in the course and work as well. With trainees I avoid those proverbs which might be easily understood primarily for teaching moral value and which keep me in a one-up position, a less than desirable model for caregivers. For example, Kucha Mungu si kilemba cheupe. (The fear of God is not the wearing of a white turban.) This seems to have more agenda on hypocrisy to it than a more earthy and accepting proverb that allows a place for our human duplicity: Kuchamba kwingi kuondoka na mavi. (To wash thoroughly after toilet is still to leave with human waste.)
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