Table 4

Quotes on understanding local context

Position

Some of the things take time here, for example, the laboratory investigations. So they would really like to have everything very quick, … they demand for results, and we don’t have them for quite some time, so that becomes a little conflict.


Resident

We are overwhelmed by lack of resources….if you have six children who are in respiratory distress and you have only one port of oxygen what are you going to do?….I think for me what I learnt from them is that one patient is very important… It gives an example to give each patient the maximum amount of concern. In the end you try to…you save those you can.


Resident

I remember one of them asking how we didn't have a neonatal intensive care unit and does it bother you that ethically you should be doing this but you're not doing it? So I said okay, of course it bothers me but I don't have the resources to do what I know could be done.


Senior faculty

And one of them came back and they found that the thing which they recommended at the last visit nothing changed and [one could] really see his disappointment.


Junior faculty

Maybe in the African culture….People tend to be cautious. They tend to not be so confrontational….They might speak in parables or make suggestions that this might not be the best way to do things, whereas someone from another culture would say, “That’s the wrong way to do things”. So those kinds of cultural differences in the way people communicate might sometimes create issues.


Senior faculty

In training we all speak the same language. So the cultural part, I don’t think [cause problems],… the issues that occur are personal issues.


Resident