So, had a lovely three day weekend for Heritage Day on Friday, which involved dressing up, of course. Pictures to come. Promise. But I must say, I looked damn good... and that alone should be enough incentive to keep you reading this blog. :) Anyway, this weekend was nice and gave Tim and I some opportunities to explore the area, make a new friend with a local Peace Corps volunteer, and enjoy some quality pool time, many of these experiences leading to some pretty classic "You know you live in Africa when..." experiences, which will for sure be posted in the next couple days. Another promise of things to come to keep you reading... :) But, today I wanted to take the opportunity to talk a little about the specifics about what I am actually doing here, because I realized I haven't really done a whole lot of that; rather more explaining about the organization, the living situation, the culture, telling entertaining stories and anecdotes, etc, etc. I realized I had actually explained more about what mysterious Tim the Roommate does than what I do (and yet again, another ploy to keep your attention, there is still so much to learn about mysterious Tim!) Ok, so here goes...
The first week was mainly spent getting a better sense of the organization, how it's grown in the last two years, the directions we are moving in now and, of course, where I fit into all of this. This involved everything from going out into the field to experience all branches of our efforts, from IT training to soccer camps (which inspired a few stories seen here in the blog), to sitting in on management meetings and reading grants (less riveting, less to blog about, but learning a whole hell of a lot). This side of things included major preparation for a grant review and fights with PEPFAR yet again on contract technicalities (like exchange rates) that are the difference between being able to pay the staff or not. And in all honestly, this is the side of things that brought me back to this organization. Two years ago, I got a small taste of what Mike (more or less my boss who is the head of Mpilonhle and an American trained pediatrician with a fellowship in ID) does day to day, and it's not medicine. It mainly consisted/consists of him sitting in his office on his computer, on his phone, writing and rewriting grant proposals and reviews, fighting on the phone for purchase approvals and promised money from grant contractors. And my first instict was "I don't wanna do that. I am not becoming a doctor to do that." But, then I realized, "Well, I better at least learn about it. Cause if I'm not going to be doing it, I am going to be working for someone who is going to be doing it and I should at least understand it. And who knows? Maybe some day I will have the balls to start my own organization". So I decided to learn from the best. Mike has been doing this type of work since he finished his fellowship, so about thirty years, starting in Bangladesh. And he does what few NGO's are ever able to accomplish, run an efficient and effective organization that is sustainable. That is a global health dream. And the even cooler part is that I had the opportunity to get in on the ground floor (the organization was less than a year old when I first worked here two years ago) and see how you build such a beast. So, basically, I sit in on these meetings/read this documentation and be like, "I don't think I could ever do this... but, God am I gonna try and soak up as much as possible". It is truly over my head. But, I also know it is an essential component to this world that I want to make my life.
Okay, so a lot of background, but the second week, aka last week, I got started on some of the projects that they felt best fit my medical student expertise. :) Most of this involved taking some of the workload off of Thuli, the head nurse here, aka the lady who runs all the healthcare aspects of the organization. First and foremost, I love Thuli. We became fast friends the last time I worked here. She is crazy smart, on top of her game, and super fun to be around. She also really respects me and my role here. We talk medicine, which is always fun, and since day one she has been helping me set up opportunities to broaden my medical experience here. She always says that while she loves dumping her work on me, she wants me to get the whole healthcare experience here. "That's why you came, yeah?" This includes her setting up potential shadowing/volunteering in clinics and/or hospitals and taking me along to things that she thinks would interest me, even if they have nothing to do with an assignment of mine. Basically, she's the best.
And that was more background, yeesh! So, things I did last week included:
- writing a standard operating procedure for TB screening of employees, which entailed reading South African DOH, CDC, and WHO guidelines, and putting together a puzzle that meets everybody's criteria and standards to some degree
- starting to develop policies for quality control of our nurses, including a combination of chart review, observed interview and procedural skills (and you best believe I'm gonna be using some POM templates for the interview skills business... thank you Mintzy!)
- reviewing the existing material for our digital healthcare database and building the team that can hopefully mobilize this thing
- editing the Memorandum of Understanding with the local DOH that agrees upon our role in the community, services we provide, and how they will help support us
Those are some of the smaller projects that were more thrown in my lap because they needed to get done stat for grant review, etc. I feel like I have a decent grasp on these things now and it felt good to do something quick and productive that was helpful for the organization, some instant gratification to earn my keep. And then there are two bigger projects I have been brought in on which I am super excited about:
1. OneSight- this is an NGO that provides eye health and glasses to populations in need. We are setting up all the groundwork on our end and then they come in with their 40 person team and run clinics with us for 2 weeks. On our end, we get to offer health education, counselling and testing to huge populations that come motivated by the possibility of cool new glasses! No, we are not above a bribe to convince people to become educated and get tested for HIV. This involves working closely with not only this other NGO, but also the DOH here. It is a cool project for me because I've had the opportunity to be on the other end of things, part of the team who gets to waltz in, benefit from all the setup, and do some amazing work. Now, I am getting to see all the work that goes on behind the scenes and gain a major appreciation for the logistics of an operation like this and the people that make it happen. So thank you to all my support staff in the past, from Guatemala to Haiti, you were all amazing!
2. Grant for sexual reproductive health and rights- SAVING THE BEST FOR LAST! THIS is my baby, THIS is the thing I am MOST excited about. It's in its very first stages, which is scary and exciting. It means I get to be involved from stage one, but also means a lot to do. At this point, we have the grant, which is awesome, now we just gotta do something with it. Our basic goal is to create adolescent pregnancy awareness through school based interventions. This includes:
- health education with a focus on pregnancy, contraceptives, and pregnancy options
- offering and providing contraceptives
- developing a support system for pregnant students and mothers for both physical and mental health, which will involve training and assigning mentors and advocates, including nurses, social workers, school employees, and peers
Through these means we hope to reduce the rate of pregnancy, create a supportive environment to make choices for those who do become pregnant, and provide the resources they need to make a safe choice, including being able to finish high school. Aka, this project is my dream! I can't tell you how stoked I am on this! We are working with a pediatrician from UMass who seems awesome and I'm really excited to work with her. I'm a little nervous about getting too hyped up and attached to this project (and as you can see from above, that effort has been pretty futile) because you never know how things will go in the global health world, but I'm keeping my fingers crossed believing this could be incredibly awesome.
Anyway, I'm sure I will keep you posted on all of these projects. If any of them struck a chord or inspired you, I would love to hear some ideas/feedback. I'm all ears!
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