Micromanagement of Care

“Shweta, do you know what has always been one of the most important services of SPIRASI?” my supervisor asked me one day at the end of our faculty meeting.

I paused, rapidly going through the research I had done about SPIRASI’s many integrative undertakings.

Provide English Training Board certification to students to aid their transition in to the Irish job market? Create medical-legal reports to help asylum seekers receive refugee status in Ireland? Allow survivors of torture and trauma to receive therapeutic treatment?

Taking my silence as a white flag, my supervisor continued, “Since our inception, we have always provided tea and biscuits in the student canteen.”

My eyebrows instantly furrowed in confusion. SPIRASI is widely known for providing incredibly effective rehabilitative services, medical-legal consulting, and educational classes to refugee and asylum seeker survivors of trauma and torture. Nowhere on the SPIRASI informational pamphlet does it boast SPIRASI’s abilities to provide snacks and tea to clients, many of whom frequent the canteen for a maximum of 10 minutes per visit.

Given all of this, how could my incredibly brilliant and thoughtful supervisor put SPIRASI’s ability to put out a few inexpensive snacks and tea as one of its most respectable qualities?

Voicing my queries, I started, “Andreas, with all due respect, I am a bit confused. SPIRASI offers so many more important services, many of which I have personally seen you working extremely hard to execute. I feel our educational and medical services are far more important than our snack provision ones.”

Andreas smiled and started, “Shweta, you are not wrong! Our educational and medical branches are vital to SPIRASI; by now you have probably picked up that most of our time, money, and manpower is devoted to these areas. However, the fundamental mission of SPIRASI is to provide holistic care. This means that we work to target all of the needs of our clients, not just those that are most visible. Many of our clients trek long distances to come to SPIRASI, and feel comfort for the first time all day when they sit down in the canteen to have a hot cup of tea and a couple of biscuits. When we focus on caring for the entire individual, we can not afford to overlook even the tiniest of factors that could impact how cared for he feels. Our clients will always have the security of knowing that regardless of their past hardship and suffering, there will always be a warm cup of tea to drink, cookies to eat, and a place to call home at SPIRASI.”

As I went through the next few days, I began to take notice of the many tiny ways that embody SPIRASI’s model of holistic care provision. When I walked in to the building the next day, I tried to view SPIRASI from the eyes of a client. Picture this:

You walk in to SPIRASI. The first thing you see before even reaching the reception desk is a small waiting area, covered with boxes that read in bold letters, “Please take whatever you need. As you walk forward, you are instantly greeted by a smiling receptionist who likely knows you by name. You are asked, more than once, if you would like any tea or food while you wait for your appointment. 5 minutes before your appointment time, you start to walk towards the room, and notice that right across the therapy offices intentionally exist “The Nelson Mandela Level 3 English and the “Mahatma Ghandi Level 4 English” classrooms. After your appointment, you visit the restroom and see, right underneath the mirror, health related informational pamphlets available in more than ten different languages. You look up to view your reflection, and see the words “you are amazing” written on the surface of the mirror in marker, reflecting right back at you.

While SPIRASI fundamentally manifests its social responsibility through small scale, incremental change, some may argue that focusing so heavily on the individual can detract from understanding the scope of the actual problem.

Though a more comprehensive method of social change may be beneficial in other service organizations, I feel the heart of SPIRASI’s work would not be suited for this type of approach. Much of what SPIRASI does requires patience, time and personalized oversight, and I believe all of these factors are at risk of being lost when we at try to streamline services at SPIRASI. At the end of the day, we are always left with questions like “how do we create a one-size-fits-all formula of care for individuals who have all struggled in such intimate and complicated ways?” and “given our limited resources as an NGO, what do we lose when we focus on increasing the number of clients we offer our services to instead of the individual client himself?”

I may not have the answers to these questions quite yet, but one thing is for sure: at SPIRASI, I have become quite friendly with the idea that big journeys often begin with small steps.