“May I know your story?”: A postcolonial analysis on the application of community-based medical education in post-disaster Aceh, Indonesia

Abstract The problems of inaccessibility and inequality in healthcare are related to significant challenges in doctor-patient interactions, which have increased in disaster-affected areas. Many medical education researchers have been trying to contribute to solving problems within poor doctor-patient interactions by applying various strategies, including the community-based medical education (CBME) approach. However, there is a dearth of research exploring the implementation of this approach in disaster-affected contexts. This paper examines the application of CBME in post-tsunami Aceh, Indonesia, and analyses it in light of postcolonial theory. The researcher used ethnographic tools to observe 8 medical students’ interactions with disaster-affected patients during the implementation of CBME. The 225 hours of participant observations reveal that The implementation of CBME in disaster-affected areas was beneficial by allowing common problem exposure, the application of preventive and promotive measures, and the identification of social determinants of health. The application of postcolonial theory may help to reveal several important issues in CBME: Medical orientalism, othering process, and counter-discourse, which suggest that there was a great power imbalance between student doctors and patients. These findings call for improving the CBME implementation by employing reflective practices and a change of paradigm toward a more balanced power relation between doctors and patients, especially those who are living in disaster-affected areas.