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
Monday, September 12, 2005
Tuesday, September 06, 2005
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
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
Thursday, September 01, 2005
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 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
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