Living the dream: an interview with De Neptune
Dewayne Neptune with the crew in Haiti
Dewayne Neptune is a 3rd year medical student on the 4 year (graduate entry) programme at St George’s, University of London. Like many on such courses his path to medical school has not been direct but his experiences en route from Trinidad to Tooting have shown him the direction he plans to take in his future career and confirmed his devotion to the cause of providing healthcare where it’s needed most.
“De, you call yourself ‘a fortunate man’ to have become involved in this line of work. Tell us more.”
‘A fortunate man?’ Who me? Yep, me. And why do I consider myself to be so fortunate? One simple reason. I have lived, and am living my dream. How many people can say that? And far from being over, the realization of my dream just opened up the door to many more dreams. So here I am, feeling like a sweet tooth kid with his arm elbow deep in the biggest candy jar he could reach in the candy store of life.
“How did that dream begin? What was it that first got you interested in medicine?”
I used to read a lot of books as a child and it opened so many magical worlds to me, so that to this day I must confess I still believe in magic and happy ever afters. The greatest gift I ever got from books was an awakened and opened mind. I can’t remember exactly how, but I must have been 8 or 9 years old when I figured out my raison d’être.
I truly believed, and still do, that the path to, if not eternal then at least lifelong happiness, is to learn all I can learn, gain as much knowledge as I can and, most importantly attain wisdom. Why wisdom? To me, my definition of wisdom means using the knowledge one has gained to help others. After all is that not the ultimate goal of wisdom, to help others? I truly believe it is.
Anyway, my dreams and my raison d’être inevitably collided in the tiny space where my brain resided, held onto each other and never let go. This is where medicine came into the picture. Medicine just seemed to be the most natural way for me to express any wisdom I might be able to scrape together along my life journey. For to my very young mind the art of medicine represented man’s greatest contribution so far to the wisdom of the ages. There seemed no better vehicle that would allow me to use a little knowledge to help others.
“And what gave an international perspective to your desire to practice medicine?”
Again I blame the books. For as long as I have wanted to wisely practice the art of medicine, and that is very long indeed, I have pictured myself working with people spread far and wide across the globe and who are just as far and widely removed from the basic health care that many of us take for granted.
From my own humble beginnings in the one small room my family and I shared in the little village of Never Dirty, Trinidad (one of those places we like to call ‘behind God’s back’ because even God doesn’t know where it is), I dared to dream of travelling the world. I dreamt of exploring and immersing myself in cultures foreign to my own. I dreamt of adventure and the sharing of knowledge. I dreamt of helping children who were ill get better so they could chase down their dreams like I was chasing down mine. I wanted to remove all barriers that stopped them from dreaming and pursuing their dreams. I wanted to even out the playing field, so that they started life on an equal footing by ensuring they had good health. I guess when you look at it, it seems almost more than anything else the factors that deny children good health, stunt their development and their ability to take advantage of the few opportunities that life might throw their way. So that is what I set about doing and that is why at my tender age I am currently struggling through my third year of a medical degree.
“How did you get into voluntary work?”
I had done some volunteering during my high school years, helping teenagers with learning disabilities. I then volunteered for a year with Community Services Volunteering in Manchester aiding a young student who had spina bifida, after which I did my degree in Liverpool John Moores University in biomedical sciences.
My past experience as a volunteer helped me get a job with a care agency working with many vulnerable groups. I knew I wanted to do medicine and that experience was very important, not just my academic work. I wanted to finish my degree with enough experience under my belt to be able to go for the jobs I wanted and have the upper hand. My back-up plan if I didn’t get into medicine was to try to get involved with a WHO international development programme.
“And was that how you become involved with international volunteering?”
I jumped at my first chance to volunteer overseas. My first chance came when a friend invited me to visit Ethiopia. While over there I met up with some missionaries and helped out in their primary care clinic and feeding program. The next year I chose India and worked in a remote village in the Godda district of Bihar collecting information for my project and providing basic health care at the village clinic. I graduated in 2000 and worked for a year with children with learning disabilities whilst saving money for my next project. I wanted to do two years volunteering in Central and South America to get some experience in medical practice in developing countries before re-applying to medical school so I applied to an NGO based in Mexico but, alas, was politely refused because they wanted a year minimum and I had asked to do six months.
“So what happened next?”
Well that’s how I ended up in‘the land of the blessed the country of the damned’ a.k.a. Haiti (more on which follows). When one door closes another door opens, right? I had found myself rejected by the Mexican branch of the charity organization, Our Little Brothers and Sisters, that I had applied to but before I even had time to lick my wounds, I was on the phone the next day being offered a one year service period in Haiti, where the organization ran a hundred bed paediatric hospital in the capital as well as an orphanage in the hills just twenty kilometres outside Petion-ville.
“At this point, of course, you still weren’t a doctor. How was that plan progressing?”
By the end of my time in Haiti, I was in charge of a health promotion project which saw me travelling to the NGO’s other homes in Mexico, Guatemala, Nicaragua, El Salvador, Honduras and Belize. I returned to the UK after my two years and applied to do medicine in the hope that I would be successful. I took the GAMSAT (the Graduate Australian Medical School Admissions Tests used by several UK medical schools) but missed out by a percent! Rather than worry about it I resigned myself to trying again, so out came the books again and off I went again back to Haiti.
“And, aside from the bookwork, what exactly were you doing there?”
I found myself having to help people cope after an environmental disaster that took many lives in just one night. That night’s torrential rains caused a breach in the banks of a mountain reservoir and the deluge of water swept down the mountain as people lay asleep, many never to wake again. Uncorroborated reports suggest that as many as two thousand people lost their lives that night and, for many who survived, their losses were devastating. I was put in charge of finding families that had survived in the remote mountains along the Dominican Republic border and offering assistance such as fertilizer, seeds, livestock and the rebuilding of homes for those families who had lost all during the disaster. To this date the organisation have built over thirty homes for many families in the region.
”You have referred to Haiti as ‘the land of the blessed, the country of the damned’. Why so?”
The day I landed in Haiti, I knew my life was going to change forever. On the ride from the airport to the hospital I couldn’t say a word. I was dumbstruck by the sights and sounds of a world very foreign from what I had expected and yet very familiar to the devil’s backyard of my early youth. Words cannot describe Haiti. It is an experience that needs to be felt, touched and seen with one’s very own being before you can understand the magic and desolation that trip and stumble across your consciousness like two desperately embracing drunk lovers across a rubbish-littered dance floor.
There was rubbish and lots of it. My eyes were drawn to the rubbish that filled the streets, the giant pigs that roamed the streets, the people that walked the streets and the children that begged the streets. My first energetic and amazing encounter was with the nearly five hundred children that lived in the orphanage followed swiftly by my acquaintance with young four year old ‘Robert’, sick with HIV and soon to die before two days had passed. The hijacking of our bus on which was yours truly, as well as forty children, by unhappy residents of a dissident village on our way to the beach two weeks later confirmed that my time in Haiti would never be dull.
“How did you develop your clinical skills in this time?”
Three months passing out medications and helping in the orphanage clinic was soon replaced by infrequent trips down the mountain to the inner city slums where I was started as a triage woundsman before being pushed up to an IV tech. With my biomedical and healthcare background, I was given more and more responsibilities and taught to do things that were necessary to save lives and ease the burden on the two doctors who had taken on the behemoth task of trying to save ‘the world according to Haiti’. From IVs, I was taught to do radiographs and TB stains, sutures, minor medical procedures and whatever else the beleaguered doctors had the faith to teach me and the time to supervise me.
Intermixed with the dramas that unfold when one works within the unstable environment that one finds in a tropical slum riddled with as many guns as people and gangsters as chickens, we cared for all the ills that predominate when a country’s health infrastructure is so corrupt as to be non-existent and is so useless as to be…..non-existent. From cancers to HIV to TB to leprosy and other extreme ailments, we struggled from day to day with nearly no resources and even less personnel.
“How did the organization you worked with cope with such challenges?”
The American doctor and priest, Father Rick who was the brainchild of the mobile clinic scheme relied totally on the grace of God and donations to be able to treat the innumerable ill and wounded we saw to on a daily basis. Minor surgeries were given an annual budget so a local doctor could help us with those injuries or maladies beyond our scope. Our yearly budget lasted only a month because we found it very hard to tell a person in pain that their injuries were not serious enough for us to pay for treatment, so as managers we failed miserably but as humanitarians I think we were a reasonable success.
For some reason it’s easier to tell someone in pain that there’s nothing you can do to help them because you have no money. Maybe because you know that if you did have the money you would do all that you could but having none eases the burden on a conscience having to make a decision based mainly on economics. Plus, no money is something I think everyone in Haiti can understand and even empathize with no matter how much pain they themselves are in.
“Haiti’s security situation at the best of times is dangerous enough that most aid agencies are unable to operate. How did you find yourselves working in that environment?”
I often get flashbacks of times when, despite the foreknowledge of impending or escalating turmoil (the only constant in the fluctuating and continual state of emergency that is Haiti), we always got up in the morning, packed our truck with medical supplies and headed to where our patients waited for us. We could not let them down.
I remember the times we headed into the slums and gunshots were ringing out as the gangs laid siege to each other. Onward we went, ignoring the astonished locals who frantically tried to wave us back. But no, we had people waiting on us, sick people. Even the times we had to cross burning barricades of tyres set up by the local gangs waiting with their guns to shoot any foolish enough to step outside their vehicle and attempt to move them or dare to drive through. Up we would drive, and I remember watching with fear in my throat as stethoscope in a fist held high, the Haitian doctor, Dr. Desert, boldly walked to one of the barricades and tried to displace the burning tyres, only to be surrounded in seconds by angry gun-toting youths demanding, ‘what gave him the right?’, ‘was he mad?’, ‘shoot him!’. The amazing thing was, within a few minutes they often let us through or even rode with us as far as the mission we working that day, to make sure no one else attempted to harm us. Do you know why?
After working in these places for so long, no matter where they went in the slums, there had not been one person or member of someone’s family who had not been treated by one of these doctors at one time or the other. From the biggest gang leader to the smallest child, we did not discriminate and they knew that. In return for years of free service the doctors’ reputations had grown and people realised that nobody else was coming in here to give them the help they needed. The untouchables had been touched, and we all benefited.
“You have mentioned Father Rick and the doctors – who else was in that healthcare team?”
By the end of that year I had a medical team made up of a motley crew of older orphanage children and the weirdest characters from the local community, including the local witch doctor. It was my responsibility to ensure all tasks were being completed, that everything ran smoothly and that my team was happy and therefore productive. I was dedicated and hard working and expected high standards of myself and those whom I worked alongside because that is what was expected of me by those who had put their faith in me. Our motto was simple – the people come first.
De - the big kid
“It must have been hard to leave your team and such experiences behind.”
I was asked to stay on another year but declined. Why? Because deep down, I knew, that if I stayed another year I would never leave. I did agree to stay on six more months, embracing every challenge that came my way – upsets and fights within our team, being caught in the middle of the gangs and the police, both suspicious of us but neither willing to lose the services we provided and the heartbreak that comes from watching lives slip away that could have been saved if only…
“So what did you take away from your time in Haiti?”
In this blast furnace of trials and tribulations I was shaped by the heat and grew into a person still far away from the ideal good but maybe a little closer to being halfway decent. To be honest, I can’t really tell, myself. All I know is that in Haiti, ‘the land of the blessed and the country of the damned’, I went from boy to man and back again. Hardened and humbled, strengthened and gentled and more in touch with that side that marks us all as being human. I learned the lessons that life wanted me to learn. By being a willing student I helped save more lives than I could ever remember but just as importantly, I watched and marveled as those who had nothing material to give, gave me more than they would ever know so that my own life was well and truly saved.
“With the exam difficulties and the potential to continue such rewarding work, did you ever have doubts about the plans for medical school?”
I had harboured a few doubts since my initial advance into the medical domain had been rebuffed during my early university interviews. My doubts were not about what I wanted to do but if I would ever get in to a university to pursue my beloved dream. I did my first degree in biomedical sciences with an eye to getting into a medical programme somewhere but fell short of the 2.1 required and had to settle for a 2.2 instead. At university I had sat down and developed my plan of action; if 2.1 achieved: apply to medical colleges, if 2.2 achieved: use degree, develop experience in developing countries, use experience gained to apply to work with WHO or UN, prove my worth and apply either through the WHO Medical programme or on my own to medical school.
By the time I arrived in Haiti I had already settled myself to working in the field of developing country healthcare. Getting into university again just seemed to be slipping further away. I was willing to accept a minor role, after all I told myself, I would still get to help and I would still be travelling. So UN/WHO here I came. But the Universe had other plans for me. While I was being emotionally stretched and physically challenged in Haiti, my mind came to a firm resolution.
The person who interviewed for medicine in my teenage years was not the same person who returned from Haiti. I had won the respect and friendship of my peers and friends in Haiti. When the doctors I worked with appreciated my efforts and even berated me at times for not going to medical school, I began to believe again. These were doctors who had retained the premise of medicine that to this day I hold dear. Medicine is an art, and it bestows upon one a great responsibility, because for someone to put their life in your hands means that they must place their trust in you. And the doctors never took this responsibility lightly. They taught me that medicine is akin to being in the service of mankind. Yes, we were servants to a higher calling, and our job is to heal the sick of spirit, the sick of mind, the sick of body and the desperation that often came with it. I was humbled again and again to be in the shadow of such artists who put the welfare of the sick before all else and did it selflessly.
Before I left the doctors offered to get me an interview at the local university and secure me a place there if I could pass the entrance exam but I, being the independent and stubborn fool that I was, felt that they had done more than enough for me and this part of the journey I would have to travel under my own steam. I did my research on the internet and by the time I left Haiti to do an education project in the other orphanage homes in Mexico and Central America, I was loaded down with revision books and during those long bus journeys from one place to the next I was studying for the GAMSAT and the American equivalent, the MCATs. I knew what I had to do. Now it was truly do or die. I had flirted briefly with the die part and it was now time to see what I could do.
“So from there it was to London and medical school or was there more between?”
In 2005 I travelled to Thailand where I worked with a Burmese doctor providing basic health care among the hill tribes that are scattered along the border of Burma and Thailand. I moved on to Uganda where I worked in a government clinic for a community development project and ended up in Haiti again on the last leg of my journey back. And then, believe it or not, I began studying medicine. Since then in 2007, I did a stint on the Peruvian Amazon River in the Amazon Hope Project medical ship and have just completed a month long Tropical Medicine course in Sudan at the University of Khartoum. (De has returned to Haiti several times whilst studying medicine and has taken the course in the medical care of catastrophes at the Society of Apothecaries).
“What has the volunteering experience meant to you?”
Inevitably volunteering challenges one’s perceptions. Forget about going out there to help the needy. It won’t take long to realize that the ‘needy’ just need opportunities to help themselves. Volunteering is not about changing people’s lives. Its about helping people improve their quality of life so that they, themselves can decide to what purpose they should devote their own life. It’s about providing opportunities and helping people to make the most of them, scarce as they may be.
It’s about sharing other people’s struggles and letting them know that at times they may be alone but they are never forgotten and that deep within themselves they have the strength to persevere no matter what hardships that come their way. Easy enough for me or any of us to say, I guess, but I have seen the proof that the human spirit in certain times can be indomitable and relentless in its will to survive and its pursuit of happiness.
It is about opening your and someone else’s world to a different way of thinking. Every experience I shared often left me feeling a bit of a fraud. For every single time I touched or played a part in a person’s life, my own life was so enriched by the encounter that I began to wonder who was helping who. I gained more than I gave. And it was not for want of trying. It was just that time and time again, for those who let me into their lives and allowed me to participate in their struggles the little and often fleeting assistance I gave never compared to the experience and life lessons that I, myself, was taught.
“What advice would you give to any medical students considering following the path of voluntary work overseas?”
‘Follow your heart, lead with your mind.’
The experience gained from volunteering is priceless.
Whether good or bad, there will always be a lesson to be learnt. The time you spend with someone is beyond value. I believe that if I make one child smile, then I have done my job. In the midst of poverty and fear is when we need to laugh and smile the most. In the moments of joy, we can find a moment when the pain of this life we cling to is often forgotten no matter how briefly. To misphrase a reading I was forwarded a while back,
‘…people may not remember your name or the colour of your hair, but they’ll never forget how you made them feel when you were there.’
Don’t go volunteering to find yourself, because who you are lies within. If you do go, go to shape yourself into who you want to be, to grow and share in the growth of others, to touch and be touched, to teach and be taught, go to make a difference to yourself and others. Forget what all the cynics say. One person can change the world. Do your research, go forth and help create the world you’ve always dreamed of, one soul at a time, starting with your own. Peace and blessings be upon you. I’m off to see the dentist…