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Each week throughout the first year of my work with the Agency for Toxic Substances and Disease Registry (ATSDR) I selected one word to reflect on. Much of my work focused on the relationship between chemical contaminants in the environment and the impact of these contaminants on the health and well being of the rural Alaska Native population. This essay addresses work at the interface of government and indigenous people. Each word of the week is incorporated into the essay in order and every sentence includes at least one word (in italics). The essay is being used as a discussion paper on work across cultures by ATSDR and others.
There is always a context in which our actions play out at the interface of government and indigenous people. That which has come before and that which will come after, determines if there is truly meaning for our work. It is easy, of course, to make the assumption that our work has significance for others. The true challenge is to address what is real for those we serve, to recognize that others experience importance for things in a way we are incapable of knowing and in a reality where we are expendable.
This is not to question our worth or our desire to do what it is good for others. Instead it identifies our need to have the willingness to accept a different, more appropriate place for our selves in serving others. We may fear the consequences of a less prescribed role but it is here where we have the greatest hope of tapping our creativity and serving more effectively.
We work with others in pursuit of truth to improve their health and well being. Pursuing truth with others does not guarantee we will immediately find a fruitful direction. There is more than levity down a path that bears no fruit. It is only after we complete a number of these paths that the goals we are destine to realize come into sharper focus.
We have a place in promoting the health and well being of others. This is the duty we have chosen. Our relationship with those we serve requires us to be authentic, both reliable and genuine. It forces us to probe the depth of our commitment to truth that empowers others to achieve wellness.
We cannot truly know what those of another culture believe. But we can begin to know how others understand and relate to their environment and, in our work, where others perceive harm. This is where we can shine the light of our knowledge and find our place in the lives of others.
This seems trite to say, but above all we must be able to listen. We must see the world in the words of others and choose an inclusive and unbiased path that values every fact, near fact, and feeling. We must deliver on a message that comes to us from Albert Einstein, “Not everything that can be counted counts, and not everything that counts can be counted.”
We do not give of ourselves in a vacuum. Those we serve may find it difficult to forgive and to disassociate us from “the deeper psychological and social forces that have led to drastic instability within their lives,” as architect Christopher Alexander observed. This is regardless of how pure our intent to do what is good. In this context, we are no one until, with each breath, we cultivate a relationship of depth by extending trust, demonstrating deference, exercising flexibility, and offering patience to those we serve.
In building relationships we must resist the notion that we and those we serve some how understand things in the same way. And, that what we do will necessarily resonate with others. In Alaska, for example, a remote, contaminated military site may have had an overarching societal utility, yet it has no utility for indigenous people whose customary and traditional use of the land at the site reaches back to time immemorial. If we are ever to decipher a role for ourselves in such a scenario we must understand why the only acceptable remedy for the indigenous people in this situation is to be made whole.
Each day we have to ask ourselves who will benefit most from our actions, ourselves, our institution or those we serve. We must know that every contact with those we serve is a new opportunity to either engender or diminish trust. Building trust in relationships does not necessarily require that we do more but that we do better. Above all we must move beyond indifference, beyond neutral in addressing the inequities inherent in providing service to indigenous people.
ASPA member Joe Sarcone is the Alaska Regional Representative for the Agency for Toxic Substances and Disease Registry (ATSDR), U.S. Department of Health and Human Services in Anchorage, AK. Email: [email protected]v