Just trying to get by

  Rhitu Chatterjee
Sandamalgama, Sri Lanka

As a journalist living and working in a foreign country (I’m an Indian citizen, but live in the United States), I like to think of myself as being culturally sensitive and aware regardless of where I’m reporting from. But I hadn’t realized that the pressures of being a journalist can dampen some of that sensitivity. At least that’s what happened on my recent trip to Sri Lanka, where I faced a situation very different from what I expected.

I visited the country for the first time this summer to report on a mysterious kind of kidney disease that is affecting thousands of rice farmers and their families.

It was a hot afternoon in late July when I arrived at the village of Sandamalgama in Sri Lanka’s North Central Province. I’d learned that 10 out of the 27 families in this tiny village had at least one person with the disease. I was there to meet patients and their families to understand how the disease was affecting their daily lives.

Now, Sri Lanka isn’t the only country facing this mysterious form of kidney disease. A similar disease has cropped up in several Central American countries. And there, patients and their families were frustrated with their governments for not providing adequate health care facilities. They were also angry at the government and sugar companies, which employ the workers afflicted with the disease for not investing enough in uncovering the cause of the disease.

I was prepared for similar reactions in Sri Lanka.

The doctors and public health officials I had met so far were indeed frustrated with their government (see my story for more details on that).

But in the tiny, peaceful village of Sandamalgama, life seemed to be going on as usual. Families busied themselves with household chores and farm work. Kids, just back from school, played in the spacious yards. Women cooled off from the summer heat by bathing at wells in their or a neighbour’s yard.

K. Sumanavati was home alone when I showed up at her door with my translator. Her eight year-old son was outside, playing with his friends. Her husband, Wimal Rajaratna, a 46 year-old kidney patient, was in a hospital getting dialysis and treatment for some health complications from his disease.

Sumanavati hadn’t seen her husband for several days. Visiting the hospital required a long and expensive bus ride, one she couldn’t afford to take every day. She did receive updates about her husband’s health from her older son, who lived closer to the hospital.

And yet, when we spoke, she seemed calm and composed. She smiled a lot as we spoke and even laughed while answering some of my questions.

I was baffled by her composure and frustrated that I wasn’t getting what I needed to make my audience understand her situation and care. So I said something I’ll regret for the rest of my life.

It must be hard for you to be here while your husband is in the hospital, I said. Has this latest hospitalization made you more worried about your husband’s health?

I didn’t expect what happened next. She started to cry. She told me that she didn’t like being asked these questions about her husband’s health again and again. Did I think it was easy for her to talk about these things? We’re just trying to get by and do our best, she said.

I apologized and turned my recorder off. But her words and her expression will stay with me forever. Of course, she and others like her were just trying to get by. They were trying to stay strong and do their best in the face of great adversity. They were coping with dignity.

It wasn’t very different from my home country, India, where people feel uncomfortable talking about their most difficult experiences, especially with strangers. In fact, talking about one’s emotional life is sometimes looked down upon.

What I was experiencing in Sandamalgama—the warmth, the smiles, the composure—was also people doing what they’re expected to when there’s a guest in your house. That is, be warm, friendly and hospitable. And don’t unload your own troubles on your guest.

It also reminded me of something psychologist Kanako Taku, a Japanese psychologist at Oakland University, had told me about how different cultures dictate different reactions to trying times.

According to Taku, in the U.S., trauma survivors often show something psychologists call “post-traumatic growth,” this sense that people have overcome difficulties and have grown as a result of the experience. Survivors of Katrina, for example have described such growth. This stems from a belief that “bad things shouldn’t happen to me,” says Taku. As a result, people treat trauma and difficult experiences as an adversary to be defeated.

But in Japan, it’s hard to find much evidence of similar post-traumatic growth. Taku says that’s because Japanese culture teaches people to expect difficulties as part of life. So one accepts trauma or other difficulties as much a part of one’s life as the happy circumstances.

I don’t know if anyone has studied this elsewhere in Asia, but I’m willing to bet they’d find the same applies to other countries including India and Sri Lanka.

It isn’t that people here don’t feel pain or frustration. It is just that they don’t necessarily look for something to put the blame on.

As I said goodbye to Sumanavati, I didn’t have the heart to interview anyone about their experiences with the disease. In my journey back to Anuradhapura, the regional capital, I couldn’t stop thinking about my own transient presence in the place. The disease was there to stay in the village and in the lives of its residents. And they would have to deal with it every day of their lives.

Rhitu Chatterjee is a reporter for PRI’s The World. Read Rhitu’s story about the mysterious kidney disease that took her to Sri Lanka.

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David Lindsay
is the Managing Editor of Global Health Frontline News.

Carol Cassidy
is a producer for Global Health Frontline News.

Anna Tomasulo
is the editor-in-chief for The Disease Daily at HealthMap.

Lizzie Litt
is a medical student from the University of Liverpool in the UK.

Deogratias Niyizonkiza
is a native of Burundi and founder of the non-profit organization Village Health Works.

Kevin Cain
works for CDC-Kenya and is the Chief of the tuberculosis branch for KEMRI/CDC in Kisumu, Kenya.

Jamie Skinner
is principal researcher and water team leader at IIED.

Ingrid Arnesen
is an award winning television news and print journalist.

Mark Arnoldy
is the Executive Director of Nyaya Health.

Rhitu Chatterjee
is a reporter for PRI's The World and is based in Boston


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