Author: Jayant “Jay” Kairam
While core medical skills, triaging and differential diagnosis are very translatable to my
professional environment, where we must prioritize in service delivery and amongst finite resources. What needs to be addressed now? What can wait? What can subsist with basic service? Assess the problem and identify solutions. The right recommendations must weight costs and benefits, and balance the needs of all stakeholders. That is my form of differential diagnosis.
You have to trust. Trust yourself, your team and those that you’re serving.
Listen to the people, engage those you are serving. A lesson I learned a long time ago is development work is built on trust. It’s easy to get caught up in the stats, the best practices and innovation – how many kids did we see? How many cases of malaria did we diagnose? But you need to recognize the human face and story behind it.
For me the reality was endemic, structural poverty. And that’s a hard lesson when you’re there for a week doing direct service. It’s hard to rationalize the value of your work. How can one make a change? One consult? You must recognize that the greater value is the change in you. Recognize how this motivates you? How did it teach you? Did it teach you? 
Be critical and compassionate.
There was no crisis. In my limited exposure to the people, they lived in the shadow of the cruise ship. Awareness of something better, but resigned to 50 years of political and economic ineptitude. Perhaps I’m projecting a bit. However, what I found most hopeful was the receptivity of people. That’s a credit to the work HVH has done in building relationships and committing to sustained development work. I felt safe, I felt that the people, though enduring terrible hardship, were bound by kin and community. There didn’t feel to be an air of violence. These are critical aces on which lasting development work can be done. 
