Thursday, January 21, 2016

GHSP Lemonade


They say, absence makes the heart grow fonder. I hope this sentiment applies to my blog absence for the past too many months. The power has gone out yet again on campus, and I am left without Internet. I figure now is an excellent time to write that blog post I have been intending to do since November. As many who have lived abroad know, the novelty of living in a new country wears off and eventually everything becomes routine. This is one of the things I was pondering on my 20-minute walk to campus this morning. I was reminiscing about how the sights, sounds, and smells of my commute are no longer new or strange. Each journey, I pass two construction sites and familiarly greet the workers. They always reply with a wave, a smile, and an appropriate greeting for the time of day. As this has become the reality of my new life, I find it harder to translate my experiences into blog format. The lack of Internet today has inspired my written verbosity (although power outages and lack of internet happen to be nothing new). Last time we met, I believe I was sharing my experiences during orientation at a health center in Blantyre. I do believe I promised a part 2 to that post, but that will have to be postponed in favor of playing catch-up.

At our In-service Training (IST) in December, we were asked to share our successes and challenges so far at our sites. We were given fair notice of this, and in all honesty, it caused a bit of anxiety on my part. Having done Peace Corps previously, I was aware that this experience would have its challenges. However, I never anticipated that my challenge would be not having any courses to teach first semester (November-March). We were already starting later than some of the other institutions, and this revelation pushed my “start” back to the end of March. What was I going to do for 5 months? You know that cliché saying, “When life gives you lemons, make lemonade”? Well, I truly feel that this applies in my situation. My successes at site so far have come from my biggest challenge.
How did I make the GHSP lemonade? In the spirit of collaboration, I reached out to my fellow GHSP volunteers seeking any and all advice on how to occupy my time. They responded with amazing opportunities to utilize my skills and passion. As I have been on my reproductive health soapbox before, you will not be surprised to find out that I have been spreading my love of long-acting reversible contraceptives (LARCs).

Target One: The Interns
The OBGYN Department at Queen Elizabeth Central Hospital (or “Queens” as we say) has been amazing. It just so happened that they were in need of someone with experience in family planning to train their interns. In Malawi, the nurses provide the majority of family planning services. With a large physician shortage, many services have been allocated to be provided by the nurses. At Queens, the vision of the OBGYN Department is to have the interns provide family planning to patients on the postpartum unit and after receiving care for a miscarriage. Enter the LARC enthusiast. I had the opportunity to share my love of LARCs with the OBGYN interns in two sessions. The first session was spent discussing LARC use, and the second session was an opportunity to practice Implanon insertion and removal with Implanon training kits. I just want to give a huge shout-out to my former co-workers that so kindly donated these kits, and to my friend Terra who lugged the kits around Africa. You have assisted in planting some seeds.  




Target Two: The Medical Students
Two of my fellow GHSP volunteers are teaching the Family Medicine rotation to 4th year medical students at a district hospital in Mangochi. The thing about Mangochi is that it is hot. Sweat dripping everywhere kind of hot. The it’s so hot all I can do is sit in front of a fan kind of hot. In Blantyre, we have a lovely breeze that swoops in just when you were about to complain about the heat. In Mangochi, there is no breeze, and the “feels like” temperature is always at least ten degrees hotter. Sounds like a great place to visit in the hottest months of the year, right? In the name of family planning and LARCs, I ventured to Mangochi to assist my fellow GHSP volunteers in teaching the 4th year medical students. The students rotate through a variety of units and clinics at the hospital. I was tasked with supervising/teaching the students in family planning, STI, and antenatal clinics. I had two great groups of students who impressed me with their knowledge and inspired me with their eagerness to learn. They even had the opportunity to insert a few implants! One of my tasks was to grade an observed consultation. Imagine a small exam room with one patient, two students (one being graded and one interpreting for me), and me, basically melting from the heat. Now, throw in a patient that is very tangential, and you get a recipe for a potential disaster. I was extremely proud of the student who was interviewing the patient, as he was able to redirect the patient multiple times and obtain a fairly complete history. I had been working with this student all week and had one of those “proud mama” moments. If I am ever suffering from doubts of “what am I doing here”, I remember these moments and know that the students make it all worthwhile.

Target Three: Midwifery Students
This past week, I had the opportunity to finally teach the nursing students! My counterpart was asked to guest lecture for the first year midwifery students. When she found out she was unavailable, I was given the opportunity to lecture on another one of my favorite topics, epidemiology. My inner public health nerd was smiling with glee when I found out the topic. Over two days last week, I attempted to make epidemiology exciting for 18 first year students. When I say first year students, I mean first year college students, as in 18-20 year olds. I absolutely loved teaching them, and told them that if the only thing they remembered from my lectures was prevention and promotion, I would be happy. When I walked through the gate at school the other day, I waved to a group of the first year midwifery students. They responded with “Hi Amanda” and then, they started chanting “prevention and promotion”. I had the biggest grin on my face when I walked into my office and knew that I had made an impact.

That is how I have “made lemonade” over the past several months. Throw in a trip home to Minnesota, several trips to Lake Malawi, Batik class, and multiple game drives, and you have a general picture of my activities over the past few months.
 
Lake Malawi
This is how I Batik
Our artwork drying
My instructor Ellis is an amazing Batik artist. This one is coming home with me.
Vervet Monkeys
Zebra Selfie
Elephants-an amazing sight and sound
Antelope and Warthogs


 I am lucky to be surrounded by a great group of GHSP volunteers that not only allow me to teach their students and interns, but also provide tons of support and hours of entertainment.

The Blangochi Crew


Although I make no promises, I am hoping my next update will not be so delayed. Until we meet again…

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