Sunday, July 27, 2014

The Work Begins (and a trip to Bujagali!)

The true work is already beginning and my wheels are turning. I can feel it.

My first week at JCRC consisted mainly of spending a bit of time with people from all areas of JCRC including pediatrics and adult clinics, doctors and their study patients, nurses in various departments, the ward (16-bed hospital), lab with PCR, data, and pharmacy so I can get a good idea of what all the roles are and what challenges everyone faces.

A frequent question of mine was "What is the hardest/most challenging part of your job?"
I learned that many challenges are related to the system and having to manually write things or type things in, but I hear there is a new electronic system in the works that will be implemented within the next few months to help facilitate many of these processes.

My most challenging day this far was in the ward with the nurses this past Wednesday. Nurse to patient ratios are much different from the States, and there is not a separate area for those more acutely ill. Helping to create more of an intensive care unit for the patients is something my supervisor, the head of nursing, mentioned having me do. There is simply no type of electronic MAR (Medication Administration Record) yet, which makes the nurses' work long and tedious and filled with paperwork. My hope is to help streamline these patient care processes for the nurses so they can spend more time with patients. It's a systemic challenge that is passed down to people.

I found myself in an ethical dilemma at times, wanting to provide the best care, but not wanting to be "that person" taking charge and trying to change everything in my first few days with my new place of employment. It's just not feasible or acceptable. I am here to listen, reflect, and learn right now, but that can be hard sometimes. Then I think that perhaps more constant monitoring is not the answer, but maybe one should shift to a model of comfort focused care instead for those patients that are terminally ill, and I am pushing to partner more with Uganda Hospice, and organization that provides pain relief medications and comfort care for those nearing the end of their experiences now on this Earth. And then I think, at minimum, at least these patients have some clinic to go to and some care to receive.

This upcoming week, I will be working with CQI, or the Clinical Quality Initiative, to see what they do and to learn as much as I can in terms of quality control. The beginning of this upcoming week is a bit uncertain. Due to not knowing exactly when the end of Ramadan will fall, I don't know if I have tomorrow or Tuesday off. Depends on the moon, and I will find out soon :)

So, this weekend, I felt I had to leave my bubble of Lubowa and venture off into Kampala and beyond. Friday later on, I went with my co-fellow, Kakeeto, to some of the markets in Kampala and purchased so many things. We met up with his friend Moses, who so kindly drove me home to Lubowa from Kampala after helping me bargain in the market through 1.5 hours of traffic at rush hour. Crazy.

Saturday I took a boda (motorcycle) to the old taxi park in Kampala, got on a bus that I hoped was going to Jinja (and I was right!), and took a car to a very rural area East of Kampala about 2 hours from the border of Kenya called Bujagali to meet up with GHC fellow Orrin, his friend Laurel, GHC fellow Devin, and his co-fellow Violet.

I took the great opportunity to see the "Source of the Nile" and sit on a docked boat on the Nile itself at night chatting with some great people. I loved seeing Devin's cute house (pictures below) and walking through his neighborhood with him as he enthusiastically greeted many people. "Muli mutya!" (not quite sure if that's how it's spelled, but for now it will have to do). I thoroughly enjoyed a "vegan rolex"-yes! It actually said vegan on the menu. Couldn't believe it. It was fantastically relaxing and refreshing to be out there.

In the morning, we saw monkeys in trees and some nice birds. The bird calls are fantastic here.

Also, success: I joined the gym here, B Active, and went to a cardio circuit class which was a blast. Next week, I should be moving to my new home as well a little away from here, but still close enough to walk/boda to work. More to come!

Pediatric outpatient clinic

Little multicolored lizard friend

My refrigerator has an "egg cum ice tray"?! What does this mean?!

Sunrise across from my temporary UN compound housing looking over Lubowa

Sunrise over the JCRC adult outpatient clinic on Wednesday morning

Double Cappuccino at Cafe Marie, my new internet hangout (gotta find one wherever I am!)


NRE (Nile River Explorers) campsite, where we camped Saturday night

Setting up our tents!

Devin is proud of his  tent

The Nile!






Orrin and Devin walking through Devin's neighborhood

SOUL Foundation where Devin is stationed this year. The founder is a nurse and her name is Brooke. Hilarious. 

SOUL

Orrin with many kids behind him

Ugandan sunset


Baby goat

Devin's outhouse


Devin's living room

Passion fruit!

Laurel overlooking the Nile



Can you spot the monkeys?


Red-tailed monkey

Matatu (basically a Ugandan shared car)

On the way to Kampala
Boda selfie

Picture of Kakeeto, my co-fellow, behind me on a boda





Tuesday, July 22, 2014

End of GHC training

As promised, here is a post on the bittersweet end of the 2-week GHC training! I will probably add more photos soon from the very last night, but decided to post this now.

The end of training was much more emotional for me than I anticipated, and I found myself throughout the training to be in a very in-between, strange space. I had just left a fairly stressful, chaotic space in Illinois and I had not quite left the states yet. Meanwhile, I was meeting a ton of new, intelligible, and fun people. I was so pleasantly exhausted by the end and I couldn't believe we were almost done. Overall, great success. I loved getting to know many of the other 127 fellows well and grow and explore concepts of global health with them.

Near the end of the training, we started to get into more practical advice that would be pertinent to all of our jobs. We heard a speaker who discussed a book called The First 90 Days, giving advice on how to make the best impact in a new workplace when you first begin and suggestions on how to streamline the learning process to be able to assimilate more efficiently, how to make a good impression, etc... We also made felt flags that expressed our vision statement in words and/or images and all hung them on a clothesline for all to see. It was quite spectacular.

On one of the last nights, we had a talent show/fellow showcase which was filled with traditional dances from every country that was represented by GHC (see below), even America, which was a  hilarious smash up of songs ranging from Electric Slide to Stanky Leg. I even got up the nerves (after a beer) to sing a rendition of Ella Fitzgerald's Misty for everyone to enjoy at the end of the night. After that, the dance party unfurled and

On our last night, we enjoyed an open bar, dinner, and dessert at the Omni Hotel in New Haven and had a blast. We shared a candle lighting ceremony, which has been a GHC tradition since the beginning. Everyone stood in a circle with an unlit candle and then the staff lit their candles. The staff with lit candles then went to someone they wanted to thank/say how this person had affected their lives, and then light their candle. The night progressed like this until everyone had a lit candle, and many candles were relit many times. It was as really creative way to say goodbye to all on that last night.

Stepping off the plane in Entebbe was wild to say the least.
Vision flags


Can you guess which one mine is?






All of the visions for this year


Sam and Heather, Ugandan co-fellows


Fancy night at the Omni hotel


Cool New Haven alleyway

Future Dr. Ashley and me

Staff and fellows

What I will be dreaming about in Uganda


Ashley with her wine

The guy who I thought was my co-fellow when I arrived and ran up to greet him (we joked around the whole time and called each other co-fellow throughout the training)




Ugandan fellows!

Crazy on one of the Yale quads!

Sunset

Ugandan pride meets New Haven sunset


My roommate Jen, regional director "Mama B", and others with the Ugandan flag and the national crane I mentioned in a previous blog post! 

Reading a poem during the talent show


Strutting her stuff


African style


Uncle Shema, Rwandan coordinator

American crew


American dancing


Harlem shake GHC style.

Melissa explaining about her new idea

Melissa's project

More traditional dancing










Dance party as the fellows offer their hands to other fellows in the audience to join them on the dance floor

Fife?

Belly dancing


Burundi fellows



Barbara dancing with the Burundi fellows



Chad demonstrating luau-Hawaiian dance


Ugandan fellows (I am there with the flag in the back)




Salsa dancing with Colombian fellows







Shisha after the talent show


Robyn

Robyn and Bryan, 2 of my favorite fellows

Sharing about readings with Barbara

Group conversations on our last day