A Time to Remember

I feel very fortunate to have participated in the launch of the International Health Practicum course at the IHP. Our travel to South Africa was an adventure that I will always remember. The trip was not a vacation, Inge used each day of the 2 ½ weeks to expose us to the various aspects of the healthcare system. We visited urban and rural hospitals and quickly learned of the difference in care that is provided in the private and government funded hospitals. Much of the care that is provided to patients is influenced by financial constraints. Many of the clinicians are burdened by the overwhelming number of patients that are in need of care and their limited ability to care for them. I was shocked to learn that in one particular hospital mothers who give birth are released 4 hours after delivery, if there are no complications, in order to make room for other expecting mothers. The administration of antiretroviral (ARV) medication is also influenced by finances. Patients must qualify with a low CD4 count in order to be considered for treatment. Co-morbid illnesses that occur late in the disease can make their prognosis grim, even with the initiation of treatment. One researcher raised the question of whether or not there should be a cutoff to ensure that the medicine is given to the patients who will receive the most benefit.

Travel to South Africa enhanced my knowledge of caring for patients who are HIV/AIDS infected. It amazes me that in the three years of my nursing training in the United States I have not provided care for this patient population. S. African nursing students are expected to have a thorough knowledge of the disease process and treatment of HIV/AIDS upon graduation. This is necessary since 1/3 of the population is infected. I learned of the physiological and psychosocial needs of this population. Many patients who are infected experience isolation and shame as a result of the stigma that is attached to the diagnosis. Family members may avoid personal contact with the individual for fear that they will also contract the virus. I remember one young woman, age 30, who experienced the hardship that comes with stigma. She was near death when she started receiving ARV therapy. Her family did not permit her to live in their primary residence and instead built a home out of scraps of metal for her and her son. We visited her home and were appalled by the living conditions. There were visible holes in the ceiling and no place for comfortable rest. The visiting nurse who accompanied us explained that this young woman was treated very poorly by her family, especially her father. I went home that evening feeling sorrow in my heart, wishing that I could do more to support people like her.

Despite the stresses of poverty and illness, many South Africans maintain a sense of hope. There was an apparent reliance on God and spirituality. This was evident in the patients as well as in the staff caring for them. One clinic providing ARV therapy interrupted their morning registration process for worship. Staff lead the songs and patients joined in collectively. Following song, clinicians provided a few words of encouragement based on scripture. The importance of spirituality was also evident in a rural hospital in which the staff gathers together for worship and prayer each morning prior to providing patient care. Spirituality is often encouraging and it was nice to see how this culture of people used it in a field where encouragement is most needed.

These are just a few examples of the experiences that I had in South Africa. I learned a lot about the healthcare system and about the history of the country. I hope other groups of students from the IHP have an opportunity to take this wonderful course.

Nikki

Time for Reflection :)

Hello Blog Readers!
It has been just over a month since our return from Durban and I find myself still thinking about just how wonderful this International Health Experience has been. I find myself looking at nursing and the healthcare field through new eyes and I feel that I have only begun my journey in Nursing. I have felt drawn to nursing from the start because of the holistic approach to patient care and my respect and appreciation for the nursing profession has grown tremendously in the last two years since I have been at the Institute! Upon returning from South Africa, I find that I am also drawn to using my nursing to work with those who are most vulnerable.

We had the privilege of meeting many people suffering from AIDS in South Africa. It was quite humbling to talk with people about their struggles due to AIDS. Many situations we were told about were almost incomprehensible to me….that people can endure so much suffering….it renews my faith in the strength of the human spirit. We were fortunate to meet Nurses and Physicians who are working to relieve the afflictions caused by the AIDS virus in South Africa. For me it was inspirational to meet healthcare professionals who were so deeply motivated in their work.

One surprise from this trip…I have found that this experience has caused me to see research in an entirely new light. I have never found research particularly intriguing; however, learning about the field research being done in regards to AIDS vaccines, ARVs and their use with pregnant women and babies, adherence to ARVs, etc…there is so much that can be gained that will hopefully help to lead to a cure and at the very least a reduction in suffering.

The most memorable part of my experience…The Sinekethemba AIDS clinic at McCord Hospital in Durban. I know we have talked about this in our blog…One particular morning I was at the clinic during their morning prayer. The patients arrive at the clinic anytime after 6 am to register for their appointment (it could be an initial ARV consult, a follow-up to check their labs, a sick-visit, etc.). The people are patiently waiting, sitting in order of arrival, and at 7:45 am everything stops. In unison, everyone (patients, nurses, doctors, research coordinators) join in singing a beautiful gospel song, followed by a reading, and one more song to begin the day. The singing was quite moving. Seeing people suffering from AIDS and those working to help all joining together singing was an unbelievable experience. It again reinforces for me the power of the human spirit. I found out that this clinic also has a choir that performs and have a cd….I was listening to the cd the other day and there is one song that says it perfectly,
“Dear God, help us find a cure”

-Meghan

What an experience !

It is hard to believe that we've been back from S. Africa for over a month already. Believe me, it was not easy to readjust to the routine.

The warm memories and experiences of this trip will stay in my heart for ever. The trip was as exciting and wonderful as I thought it would be. We went to so many places and had the privilege to see a side of S. Africa not usually seen by a regular tourist. I consider that in itself a blessing because it is the only way to really learn about a country. I was very impressed by the warmth of everyone we met. We were greeted with smiles, kindness and generosity everwhere we went.

Like my colleagues I was moved by the disparity of wealth and poverty which we witnessed from the very first moment we set foot in Durban. Durban in a cosmopolitan city with an outstanding infrastructure, modern buildings and prosperity. At the same time poverty and need was mixed with riches everywhere. We quickly learnt about the difficulties for survival of the poor.

It was also very difficult to face the HIV-AIDS problem first hand. It not the same to read about it in a book or hear about it from a TV program. It definitely was a humbling experience to see the patients in the HIV clinics we visited fighting for their lives with minimal resources and keeping their faith and their spirtis up. We were witnesses to the social problems that HIV-AIDS bring to the population like the many orphans left behind with no support or the increasing number of households run by children or grandparents.

We were also witnesses to the dedication and generosity of the many healthcare workers we met throughout this trip. The care takers, the nurses, the social workers and the doctors were all performing their mission with pure love. The hand of God was there.

But I also found S. Africa to be a vibrant modern country. I felt that people were working together towards positive social changes post-apartheid. Understandably it is not an easy task, and all the injustices may never be erased but I saw hope and a positive attitute. I saw many opportunities to grow and prosper.

I will keep a fond memory of S. Africa and its fascinating cultures and traditions. I hope my return trip is not too far in the future !

Carmen

The Africa Center and going on Safari at the Hluhluwe Game Reserve

What wonderful memories!

As you can see from the posts and pictures, we have wonderful memories from our visit to South Africa.

My memories include: worrying as to whether everyone would get to Logan Airport in time for the 6:10 AM flight(we did!); doing my "night nurse" routine and checking on members of the group during the flights (they were fine and I got my exercise to prevent DVT's); seeing Costa at the airport to greet us; going to dinner our first evening at Jenny and Costa's home to bid old friends and colleagues Kathy and Dotty farewell; seeing friends and colleagues at Highway Hospice,the Nursing School at UKZN, McCord Hospital, Church of Scotland Hospital where we also visited an orphanage and went on home visits, St. Mary's Hospital, Lamontville Township feeding program, Africa Center, Crompton Hospital,Inkosi Albert Luthuli Hospital, and the Doris Duke Research Center at the Nelson Mandela Medical School(UKZN)and much more.

People always make the difference in every trip. There are so many people who made our trip memorable and we're grateful to all of them. Many have been special friends for a number of years. Although I won't mention names I will make one exception with Costa and Jenny who were incredible hosts. They did far more than rent us rooms. Their thoughtfulness made for a wonderful trip for the group.

Culturally, we visited a flea/craft market, saw Durban and environs, had a picnic breakfast at Tala Private Game Reserve, attended the African Footprints production, had a weekend at the beach, saw the uShaka aquarium, St.Lucia Wetlands,and Hluhluwe Game Park among other activities.

A special treat for us was the presence of the President of the MGH Institute of Health Professions for the first few days of our stay. She came to be with us and to express her support of the international activities of the Institute. We were all sorry to see her leave.

We squeezed a lot of activities into a very brief period of time. It was special for me not only because of our South African colleagues, but also because of the composition of our group. They came on this very first educational venture abroad for us as an educational institution when not all of the details had been worked out because they were committed to learning more about international health care. They came and we were all conquered with the commitment to return.

My gratitude to all who helped make this possible- who supported us in large and small ways both in South Africa and in the U.S. Thank you also to those who have decided to support the work of our South African colleagues. Inge

Sinikithemba Clinic, Church of Scotland Hospital, and a meeting with friends from Lamontville

Nation of contrasts

People love 80's music in South Africa; one can hear it all over: it's playing in the airport upon arrival to the country, in the public bathrooms, shopping areas, from homes. This begged the question: what does South Africa have about this music?

In retrospect, South Africa seems to be a nation of contrasts, the most striking being the division and distribution of wealth. Huge mansions with walls around their borders and caged doors sit next to (and sometimes even a block away from) miles and miles of "informal settlements," which is a very "nice" description for the millions of homes that have been build by the people (illegally) that grip to hillsides and areas just outside of major urban areas. The informal settlements do not have government-supplied sanitation or electricity, and people use plastic trash bags as roof-tops. It is rumored that the government has begun a housing project, where a sturdy home of wood or brick will be built for every family in a settlement; however, according to a South African I met, "it will take over 100 year at the rate they're going." I am not sure of the proportions of people living in informal settlements to those living in mansions, but I would suspect that it mirrors the ratio of those with health care to those with none: 5:1.

Another contrast: in the few settlements I observed and in other communities throughout the country, people were pulling together. South Africans are very proud of where they live, and they identify with and want to help others around them. Florence, a "retired" nurse and dear friend of Inge, works day and night for her community; she runs a soup kitchen that feeds hundrend of the sick and injured daily, and she is building a health center for AIDS and hospice patients. People love her, they trust her, people want her near them as a leader. Then, we have the counterpoint: crime rates are extremely high in South Africa. Theft and rape are major problems, and they are crimes diametrically opposed to the neighborhood trust I just described. It seems to me that the crime in South Africa is directly related to poverty and to the lingering sting of apartheid. Despite these problems, I never once felt threatened or scared, and if I did, I believe that a mere "yelp" would have garnered the help of many.

The next conrast has to do with racial tensions in the aftermath of aparthied, which ended only 11 years ago. I think that South Africa has come a long way, especially in terms of equality in politics and law (at least on the surface). In the cities especially, the populations seem to be more diverse and integrated than in smaller, more rural towns. That's not to say that the urban areas are completely intergrated: they aren't, but neither is Chicago, New York, LA, etc. However, there still exists extreme racsim along with major differences in income, academic and employment opportunities, and access to resources, like healthcare, between races and gender. Hopefully with time these discrepencies will diminish, as they are slowly doing in our country. Just talking to people elicited different responses about the situation in South Africa since Apartheid; several people I spoke with think that they have come a long way but still have a long way to come. On a good note, at the various healthcare settings we visited, from small clinics to large hospitals, the workers and patients - of many races - worked together and were treated side-by-side as equals.

Sub-sarahan Africa in general and South Africa in specific have been struck by the HIV and AIDS epidemic. Admist the pain, sorrow and difficulties that surround the impact of HIV, hope, altruism and love are clearly evident and seem to outweigh the hardships. And that gives me hope. I think that is why people love the 80s music in South Africa: to me it is a music (corny at times, yes) filled with compassion (remember "We are the world?") and messages of community, love, and hope for a better future.

Courtney

Reflections on South Africa

Dear friends and readers,

I returned from South Africa approximately three days ago and I am just beginning to recover from the jet lag (although I do enjoy waking up and feeling awake at 5am). In any case, I will try to summarize my overall impressions of my experience in South Africa.

One of my first impressions of the country and the one that has remained with me throughout my travels was the incredible vibe that I felt there. There was a political vibe, a cultural vibe, and a spiritual vibe. Politically, the country continues to recover from the apartheid years and the effects of apartheid are still very prevalent; particularly the existence of townships. Culturally, the country is so incredibly diverse that it pulses with diversity and multiculturalism. South Africa has the largest Indian population outside of India and eleven national languages! Spiritually, South Africa is vibrant. We saw this spirit displayed in several ways, from protests to prayer ceremonies. On two separate occasions we witnessed protesters doing the characteristic toyi-toyi dance to demonstrate their cause. One protest was among workers at the local "Pick and Pay" supermarket. The other protest was in a rural area called Tugela Ferry. Protesters there were holding signs that read, "Away with Sex"; most likely because the rural areas have such high rates of HIV infection. Song and dance is used often in South Africa during prayer and other ceremonial acts and is very very effective.

A major focus of our international health experience was the issue of HIV/AIDS. We began to understand why HIV and AIDS are so rampant in South Africa and what is being done (or not being done) to curb the devastating effects of the disease. South Africa is more developed than most other African nations, yet the problem of HIV in South Africa is the worst. I can only explain this by considering that as a developed nation, South Africa has easier and faster modes of transportation. Men, in particular, will leave their homes to work in mines or other faraway destinations. People are undereducated and traditional belief systems are prevalent. Women are marginalized to a considerable degree and many men have multiple sexual partners. Condoms are not widely used. The idea of testing for HIV is nonexistent for many people because of the incredible stigma of being infected. The rollout of antiretroviral medications is extremely slow and only began last year. Traditional remedies of olive oil, potato, leeks, and garlic are still endorsed by the minister of health. Only those who can afford to pay the monthly fee for medications are priveleged enough to have it in most places. Programs implementing ARVs have strict protocols for teaching adherence and only those who will be adherent will qualify for medications.

Tuberculosis is a common comorbidity of HIV/AIDS and more people will die from TB than HIV. People are typically treated for at least two weeks on TB medications before initiating antiretroviral medications. This is done to prevent an immune reconstitution syndrome whereby the latent TB bacteria surge do to a sudden resurgence of the immune system from the ARVs. This can actually kill people relatively fast so prevention with TB medication is necessary.

I am glad to have had the chance to visit such a phenomenal country and to have met so many outstanding people. People who work so hard despite the odds against them. It was an inspiring trip that truly changed my life. Thank you to Inge and everyone else at the IHP for making it happen. Thank you to Costas and Jenny for taking such good care of us while we were there. The group could not have been any better and it was a pleasure having Ann with us in the beginning.

Thank you again and Cheers, Lisa

The African Centre

Friday. July 29th: The last Friday of our trip we drove to the region of Hluhluwe (shoosh-louie) located North of Durban. Our first stop was to the African Centre near the town of Mtubatuba. The Centre is a joint project of the University of KwaZulu-Natal and the Medical Research Council of South Africa. The centre receives financial support from the Presidents Emergency Plan for AIDS relief (PEPFAR).

The African Centre is dedicated to HIV-AIDS research studies, and to the delivery of health to the KwaZulu Natal region. It is located in a brand-new, state of the art facility near the town of Mtubatuba and provides help to the community at different levels including: community-based HIV surveillance, support to the Hlabisa Hospital, and several on-going prevention trials. Some of the research programs include: Microbicidals development program, Population based counseling and testing, and Adherence to HIV treatment vs. depression. The centre has also developed a very comprehensive data system of the area.

The centre takes pride in its environmental friendly approach of management, and to being a source of employment to the town of Mtubatuba. The town of Mtubatuba has a population of 90,000 people. It also has one of the highest rate of HIV-AIDS in S. Africa.

There is a lot more of information about the centre but in the interest of time I should finish here. However, if you want more information abut the center, and about their research studies you can visit their website at www.africacentre.org.za

Enjoy,
Carmen

It was hard to say goodbye to Sr. Regina and St. Mary's Hospital.

St. Mary's Hospital, July 27, 2005

Hello Blog readers!
Well, it has been almost a week since our return and we still have so much to share from our International Health Experience :)
The last Wednesday we were in Durban, we spent the morning with Sr. Regina at St. Mary's Hospital just outside of Durban. St. Mary's is a 200 bed community hospital which services the Inner/Outer Ethekwini Community (750,000 people!).
One program at St. Mary's is the Ithemba ARV Program which is funded by PEPFAR. The clinic was founded in 2003 as a collaboration between St. Mary's, Harvard University Partners AIDS Research Center and Pangea San Francisco AIDS Foundation.
The Mission of this clinic:

"To give life and improve quality of living to the community we serve by delivering holistic care to patients and families with HIV/AIDS by returning hope and delivering ARV's"

Quite a powerful mission...and Sr. Regina is a phenomenal Nurse! She walked us around the different units of the hospital as well as the outpatient antenatal clinic (I think we all liked this one a lot because of the cute babies there with their mothers for check-ups etc.). Everyone we met was not only welcoming and willing to talk more about what they do, but also quite motivated to work hard because they are making such a difference in the lives of their patients.

It was exciting to talk to one of the research assistants who explained one research study being done to test out ARV's on AIDS-infected infants...the thought is that since the babys' immune systems are immature, perhaps the use of ARV's initially followed by periods of no ARV's may allow the infant's developing immune system to begin to fight off the virus. It is quite hopeful that some of this research may lead to less infants dying from AIDS.

Spending time at St. Mary's, with Sr. Regina, was truly inspiring...to see all the good work being done in the fight against AIDS was hopeful...

Lamontville on July 26th

Our new friends at the Lamontville Community Soup Kitchen.......they are doing such good work!

Florence (in the front) is truly amazing. She started a soup kitchen only two months ago and it is a huge success. The way she runs the organization seems like she's been at it for years. The volunteers love her! She is feeding about 250 people a day...but this is not enough in a community of roughly 80,000 people. If you want to support her work you can donate to an organization called Sibusiso. Sibusiso is a local organization....(in Boston that is!) that raises money for projects on the ground in South Africa. Florence's soup kitchen is one of them. Go to www.sibusisopartners.org or call 617-731-7751 for more information.

Tala Private Game Reserve on July 17th

Springbok antelope grazing by the lake......

We saw giraffes! Don't worry they were very very friendly....

Time for relaxation

It is hard to believe that we have less than a week left of our trip. This weekend we went to Ramsgate beach, a fantastic area located south of Durban in a small village on the Indian Ocean.
Our hostesses accompanied us on this trip. We are very grateful to our hostesses for their generosity and their friendship. They have made our stay in South Africa very special.

On Saturday after a refreshing swim at the beach we came back to watch on television part of the celebration of Nelson Mandela's (Madiba) 87th birthday. The celebration took place in Johannesburg during the opening of the rugby championship game between South Africa and Australia. Madiba received the torch which was presented by South Africa's soccer and rugby captains. Afterwards everyone sang the South African national anthem. The national anthem is usually sung in the four most common languages spoken here: Zulu, Sotho, Afrikans, and English. It was a real privilege to see Nelson Mandela enjoying his birthday next to his wife and among so many people who love him.

The weekend brake at the beach was invigorating and rewarding after a very intense week of work.
Wish you were here, Carmen

22 July 2005

Hi Everyone,
Thanks for following our blog so far! It means a lot to us to be able to share our wonderful experiences here in Durban with you :)
Today we met up with Professor Leana Uys who is the Deputy Vice-Chancellor and Head of College for the Health Sciences Department at the University of Kwazulu-Natal's Westfield Campus. Inge was quite excited to meet up with her colleague and we were fortunate to meet such an inspirational nurse who has applied her nursing role to not only the academic realm, but also nursing research. Professor Uys is the the African representative for Sigma Theta Tau, the International Nursing Honor Society, and has done research surrounding the issue of Stigma and HIV/AIDS.
There is much stigma associated with HIV/AIDS here in Africa. Often times it is the stigma that prevents people from seeking treatment and far too often people are discriminated against and even excommunicated from their friends and families. One of the current studies that Professor Uys is working on is comparing/contrasting stigma surrounding HIV/AIDS in South Africa, Botswana, Tanzania, Lesotho and Swaziland. It will also be interesting to see how, and if, stigma changes due to the governement roll-out of anti-retroviral medication....another study, I'm sure!
I was immediately drawn to Professor Uys because of her background in psychiatric nursing and her research surrounding stigma and HIV/AIDS. We were able to talk to Professor Uys about her role as a nurse in academic life at the University and what the Nursing role in the South African health system has been like for her.
Next, we head to the beach for the weekend! We are going to Drakensburg right now and I know that someone will update the blog after our weekend!
take care, Meghan

Doris Duke Research Center at the Nelson Mandela Medical School on July 19th, 2005

abangane

Sanibonani abanganes! (Hello friends!) [in Zulu],

South Africa has 11 official languages, which represent only a sprinkling of its myriad cultures and traditions. I was initially surprised at how diverse the urban areas are here, as the apartheid ended a mere 11 years ago. Several South Africans we have met so far seem to think that while much work still needs to be done to undo the damages of apartheid, the country has made mighty and impressive leaps towards building a stronger, better, and more equal society.

We have seen evidence of the social changes occurring all around us, in various forms. Two people mounting programs to elicit social change have really made an impression on me for their dedication, vision and determination. We met a "retired" nurse named Florence who has a contagious laugh and very powerful presence. She meant to relax after retiring recently, but instead she has found herself busier than ever creating soup kitchens and a health/wellness/hospice center in her own community. She is regarded as a leader, and her community trusts her and is embracing the sercices she seeks to bring. And then we cannot forget Darlene. Darlene's an amazing woman who has her hands in all sorts of programs: she set up an income-generation project in a very impoverished area that trains men and women in various trades so that they can get jobs, she has set up a database of unemployed persons so that her group and the government can help to train and then employ those in need, and she has created several systems that are currently being used in hospitals and clinics to tract and distribute medications for HIV. Today, Darlene helped us escape hub-bub of Durban and travelled 2 1/2 hours northwest to the rural hills of a small town named Tugela ferry, where we visited an HIV/AIDS clinic, a hospice and an orphanage. The HIV clinic was full of persons wearing surgical-type masks, as TB is a major problem here. In fact, around 90% of South Africans who have HIV get TB, and the prevalence of HIV in this country is staggering (the latest stats report around 33% of pregnant women as being HIV positive). We were fortunate to meet a caregiver who took us to peoples homes who have suffered from and are surviving the HIV virus with the help antiretroviral medications (ARVs). Everyone - from the city to the towns - has been so curtious, friendly, warm and welcoming to us; in fact, many like to wave at us (except for one chap who waved with one finger in an insultory way! I think he was joking.)

There is major stigma around HIV/AIDS here, which is very difficult to see, but it is also heartbreaking for those infected with the virus. Today we met a young woman whose parents threw her out of their home and refuses to eat anything she cooks b/c of her HIV status. Perhaps this discrimination stems from all of the myths circulating about HIV (i.e that HIV is spead by touch or that the ARVs spread the disease), or b/c people who have HIV have become so sick in the past. But, now that the SA government is finally rolling out ARVs to the population, people are recovering to the point where they are asked "you have HIV? I don't believe you!" Our new friend was very sick and unable to walk 2 years ago, and now she looks incredibly strong and beautiful, thanks to her healthy living, positive spirit and ARVs.

Being here has been an amazing experience, a life-changing one actually. Thanks for checking our blog, and for the visual people out there, Lisa and Carmen will be loading up some of their wonderful pictures soon. sabonga (thanks)!

All the best, Courtney

The Adventure Continues-Experiencing South Africa's Clinics

Hello everyone!

We are now on day 6 of our travels and we are fascinated by the experiences that we have had thus far. We have enjoyed learning about the history and health care system of Durban, South Africa.

This past weekend our adventures included shopping at a local craft fair, a driving tour of the city, and a visit to a game reserve. We also attended an African show entilted "African Footprints." The performance displayed a perspective of the journey of Black Africans from prior to apartheid to the present and concluding with a vision of the future.

IHP President (Chancelor) Ann Caldwell, described the activities of Monday when we visited the nursing department at the University of Kwa-Zulu Natal and the Albert Luthuli Hospital. On Tuesday, we continued our tour of the Durban health care system by visiting McCord Hospital and the Doris Duke Research Center at the Nelson Mandela Medical School. We learned of their research that aims to discover an HIV/AIDS vaccine. They have the advantage of collecting a larger number of data sets as a result of the high incidence of HIV/AIDS in South Africa.

Today we visited McCord Hospital where we witnessed a typical clinical day at the Sinikathemba outpatient HIV clinic. The registration process paused to allow a brief morning worship and prayer session, a daily routine. The singing was amazing and the message presented by one of the clinicians was moving. Through conversations with others we quickly became aware that the sessions are considered beneficial to both the patients and staff.

We were impressed by the manner in which the clinicians interacted with the patients. They were supportive and culturally sensitive. They provided pertinent health education in a manner that could be easily understood by the patients. They addressed their spiritual needs as well as their physiological needs. We would like to give a special thanks to all of the clinicians and staff who dedicate themselves to improving the quality of life for those suffering with HIV/AIDS.

A Glimpse of S. African Healthcare and Education

Monday, July 18: We began the day at the University of KwaZulu Natal School of Nursing, which is situated high on a hill overlooking the city and will celebrate its 50th anniversary next year! We were greeted warmly by the faculty and given an overview of nursing education here and how they are reorienting nursing education to serve the needs of the different communities in this changing country. Over tea, we shared the history and mission of the Institute and had a chance to learn from one another; the UKZN faculty were especially interested in the diverse backgrounds of Institute students and graduates.

We next went to the brand new Inkosi Albert Luthulu Central Hospital, an extraordinary "quaternary" hospital created by the SA government to represent the best practices and latest technology in healthcare. We met with the senior management team who described for us the mission, organization and services of the hospital. We then toured the hospital, visiting an ICU, a critical care unit and their staff development department. The hospital has a fully implemented electronic medical records system and relies heavily on IT systems, requiring extensive staff training and orientation.

It was a full and interesting day! There's a lot to be learned in South Africa. Ann

Ann Caldwell

Let me introduce myself. I'm Ann Caldwell, President of the Institute, and I joined the group on Saturday after spending two weeks touring in other parts of South Africa and will be with them until I return home to Boston and Providence on July 20. As it is for all of the Institute students and graduates on this trip, it is my first visit to South Africa and first to this vast continent.

From Logan Airport (Gate A7) to Durban, South Africa (outside)

Sawubona from South Africa!

Yesterday we had our first South African healthcare experience in Durban. It was eye-opening to say the least. We spent the day working with the nurses from a non-governmental organization called Highway Hospice; Janet, Zee, and Mandla. They were amazing people who took us out into the community to make house calls with them. We all saw different neighborhoods and had different experiences, but in the end each had very special experiences. Meghan and I went out with Zee into Chesterville and Mayorville where we met with three patients all of whom were very sick and dying of either AIDS or cancer. For me it was very emotional....especially when we went to the house of a 27-year-old woman with end-stage AIDS who was emaciated and so sick that she could hardly move. We sat with her and her two cousins while Zee examined her and we held her 10-month-old baby girl. It was devastating to acknowledge her imminent death while embracing the vibrant child who will inevitably become an orphan. It was unbelievable to see how little people have but how they adapt to such limited conditions. The extent of what they need is overwhelming! The Hospice gave us a list of things they could use to give to their patients. Some of those things I will list here and if you want to send something or make a donation to an organization that is doing great things....please do so!

Children's Clothing:
Baby to 16 years old, boys and girls
Children's shoes 0-16 years old boys and girls

Toys:
Jigsaw Puzzles
Crayons
Coloring books
Building blocks
Dolls
Soccer Balls
Cuddley Toys
Children's Books/simple with lots of pictures

Any toys....especially educational!

Please mail toys or clothing to the following address:

Highway Hospice
PO Box 28
Westville 3630
South Africa

Also check out their website and make a donation at www.hospice.co.za

We'll send you more updates on our journey and what we are seeing.......thanks for reading.

Lisa

We're here

We're here in Durban after 29 hours of travelling. We got settled and took a walk around our environs. Costa and Jenny had us to dinner along with some other colleagues from the States. It was a lovely evening. We go to a hospice tomorrow AM. Time to sign off and get some real sleep. All the Best from all of us. INGE

Lisa

Hi Everyone. I'm Lisa...another recent graduate from the IHP Nursing Program. I specialized in Acute Care and I currently work as an RN in the urgent care department at Upham's Corner Health Center in Dorchester. I have so many reasons for wanting to go on this trip...........one of which is to explore South Africa's rich culture and beauty. However, I also value the opportunity to have an insider's look at the health status of this diverse country. I have studied some of the social and political influences of diseases like HIV in sub-Saharan Africa, so witnessing it first hand will be really eye-opening. I hope to learn and grow a lot during this trip. We'll keep you posted on our adventures!

Less than one day and we're going

Can't believe that 24 hours from now we'll be over that Atlantic and enroute to Durban with stops in Sal, Cape Verde and Johannesburg.
All of this has more meaning since I completed reading Long Walk to Freedom, the autobiography of Nelson Mandela, a book required for this course.
Amazing story, amazing country, amazing people. We also watched a film about Steve Biko, an other impressive individual, in preparation for this educational experience.
Have my passport and my tickets. The group meets after clearing customs. It's a very early flight. Hope we all get there. Will let you know! Inge

Meghan

My name is Meghan and I am a third year Adult NP Student at the Institute. International Health has always been an interest of mine and I am honored to be going on this trip to South Africa! Currently I am working as a nurse on a thoracic surgery/ oncology floor at Mass General Hospital. I know that there will be a world of difference between Boston and Durban...I know I will truly value this international health experience and that it will forever change my perspective of health, wellness and illness. I look forward to sharing more of my experience as it unfolds! :)

Two days and counting

Only two more days and we'll be taking off for South Africa. We're all getting excited and have lots to do before taking off. The most important thing for us to do is to remember our passports or we won't be able to leave much less return. And while the bombings in London are distressing to say the least, we take our cue from all of our friends in England and are just getting on with it.
By understanding more about health care in South Africa, we learn more about international collaboration around issues of common concern. The only fireworks we're interested in are those of celebration because we're working jointly to improve the health care received by our patients and the citizens of the world. Inge

Carmen

Hi, My name is Carmen. I am a recent graduate from IHP. I am presently working as an RN as St. E's. I am very exited about the trip and looking forward to this wonderful experience. I hope that we are able to learn from our colleagues in S. Africa and perhaps be able to help them in their difficult endeavour. This is my first time on a "blog" I hope that this page is helpful to other IHP students that may be thingking about taking this course next year.

introduction

Hi, my name is Courtney, and I am a 3rd year student in the family nurse practitioner program at the IHP. I've been craving an African adventure for years and am very excited to share our jouney and experiences with you! However, I must admit, my love for travel and learning about other cultures has not helped to alleviate my fear of flying (hopefully there'll be some good movies for distraction).

Nikki

Hello everyone. I would like to introduce myself, I am Nikki. I am a recent graduate of the IHP, receiving a MSN. I am currently working as a pediatric RN at NEMC's Floating Hospital for Children. I am excited about this upcoming trip to S. Africa and sharing my experiences with all of you.

8 Days and counting

8 Days from now, we'll be on our way. It will be winter in South Africa, but the sort of temperature that some people will be in shorts by the afternoon, as it will have warmed up considerably. In the morning however, we'll need jackets as it will be chilly in the way it was in Boston in May. The excitement grows.

Opening Page

This blog will chronicle the experiences of students in an international health experience course in Durban, South Africa. The "students" (recent graduates and 3rd year students from the graduate program in Nursing) are from the MGH Institute of Health Professions located in Boston, Massachusetts.

Departure for Durban is scheduled for 6:10 EST 7/13/2005, with the group arriving in SA the 14th. Look back here for posts both prior to and after departure. The purpose of the course is to expose students to international health care in a country with varied health care challenges.

This blog is being shared betweeen all the students and the professor in this class. We'll introduce ourselves in a later post, but for now, I, Inge am making the initial posts. I'm the professor of this class, I've been a practicing Nurse for many years and a faculty member at the MGH Institue of Health Professions for 12 years. I've been very involved in various international healthcare projects. My books are a sample of the variety of subjects in Healthcare that I'm very interested in. Here is my Google Scholar link.