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Group Reflections on a GEMx Family Medicine Exchange from University of Zimbabwe to University of Kwazulu-Natal

Filed under: GEMx Regional Exchanges, GEMx Student Reflections

Post by Nyasha Manyeruke, Leslie Mashayahanya, and Talent Munjombi, medical students at University of Zimbabwe College of Health Sciences who completed a elective exchange at University of Kwazulu-Natal School of Nursing and Public Health (South Africa) through the GEMx-AFREHealth Regional Exchange Partnership.

 

Students selfie in Durban

INTRODUCTION

When we signed up for the GEMx Elective experience in South Africa, we hoped to experience and gain better understanding of the clinical setup in a neighbouring African country and improve our overall clinical skills in preparation for our final year of medical school. We happily report, that the experience exceeded our expectation and broadened our knowledge overally.
Under the supervised guidance of Proffessor Mergan Naidoo, we had an opportunity to rotate in different wards at the hospital, that is- High Care Unit, Out Patients Department, HIV clinic and Accident And Emergency Department. We had multiple opportunities throughout our elective to interact with Family Medicine constultants and Registrars for “one on one” tutorials as well as group tutorials. We also interacted with other members of the clinical team including interns, counsellors and nurses, who taught us and encouraged us to perform certain procedures, such as, drawing blood for investigations, inserting urinary catheters, suturing and so forth. Outside clinical activities at the hospital, we also explored Durban –visiting the beach, shopping malls, indulging in local delicacies, and interacting with fellow Zimbabweans living in South Africa, as well as the other locals we encountered in our day to day activities. We gained a greater appreciation of the multicultural and diverse society that makes up South Africa, Durban in particular, and how this correlates to patient management in the hospital setup.
In this report, we have summarized our elective experience into experiential sections and attached pictures accordingly.

Hospital Clinical Experience
1. Out-Patients Department
We each spent a week attached to the outpatients department, participating in local procedures and guidelines. In our logbooks we had clear learning objectives and subjective measures to assess our progress throughout our elective. We enjoyed ourselves thoroughly, and below in Figure 1.1, the picture illustrates Leslie clerking patients seated on the bench waiting to be served at the Out-patients Department.

MD student looking at papers

2. High Care Unit
We each spent a week attached to the high care unit. We mainly learnt ward management of patients and ward conduct as well as protocol. Besides knowledge learnt on commn ailments in our setting, such as, HIV, TB and Myorcadial infarctions, from the various ward rounds and tutorials,we also assisted the interns in performing their daily ward duties, such as, taking blood, performing lumbar punctures, inserting chest drains and so on, as well as interpreting lab results for investigations. Figure 1.2 below illustrates Talent taking blood from a newly admitted patient, with the assistance of one the nurses.

Students taking care of patient

3.HIV clinic
We each were attached to the HIV clinic for one week, and we mainly participated in patient adherence counselling, reviews, as well as initiation of patients on Antiretroviral medication. We learnt about the importance of the multi disciplinary team and we often assisted the nurses at nearby clinic( gateway clinic) in using the referral system tool effectively in ensuring patients receive the best care. Figure 1.3, is a picture showing Nyasha, standing at the entrance for Gateway clinic.
Student in front of hospital sign

4.Accident and Emergency
We each spent one week at this department. This was a very busy department, it was very interesting learning about the triage system at this hospital and the acute management of patients. We learnt about the importance of time and sharing tasks amongst members of the clinical team in order to manage patients adequately. In figure 1.4, the picture below illustrates Leslie, preparing bloods to be sent to the laboratory for investigation.

5. Other Hospital Related Activities

Talent and Leslie reviewing clinical magazines for updates on recent research findings, new additions to clinical guidelines and for Continuing Medical learning(CME) in the doctor’s tea lounge during some of our lunch breaks.

Students Reviewing Journals

Talent(female) and Leslie, standing in front of college of health sciences building for the University of Kwazulu-Natal. We visited the medical school a few times during our stay and we marveled at the architecture

Talent(female) and Leslie, standing infront of college of health sciences building for the University of Kwazulu-Natal. We visited the medical school a few times during our stay and we marvelled at the architecture

A selfie taken after our GEMx end of elective exercise and discussion with us and Professor Ross( one of the consultants at the hospital. We enjoyed our interactions with him during ward rounds and our various tutorial sessions.

A selfie taken after our GEMx end of elective exercise and discussion with us and Proffessor Ross( one of the consultants at the hospital. We enjoyed our interactions with him during ward rounds and our various tutorial sessions.

As we come to the conclusion of our elective experience, we would like to thank all the people who made this elective experience possible, we thank you for impacting our careers in our fruitful and adventure filled manner. We hope you continue your great work.

THANK YOU
Siyabonga

Report on GEMx Postgraduate Ophthalmology Elective in Mombasa, Kenya

Filed under: GEMx Post-Graduate Exchanges, GEMx Regional Exchanges

Post by W’mosi Brenda Achieng, an Ophthalmology resident at University of Nairobi Faculty of Medicine (Kenya) who completed a elective exchange at Lighthouse for Christ Eye Centre through the GEMx-COESCA Regional Exchange Partnership 

 Ophthalmology Elective Experience

Residents standing in front of hospital

Me with colleagues, I am the on the extreme left. Dr. Basha in the middle, was winding up his elective term and I had just begun.

In my second year as an ophthalmology resident I had the opportunity to do my first elective term. I chose to do it at Lighthouse for Christ Eye Centre and applied through GEMx.

Traveling:

I flew to Mombasa early in the morning. The airplane ride was short and comfortable. I had booked the ticket two weeks in advance so I bought the ticket at a good rate. I would advice anyone who wants to fly there to buy the tickets online way in advance as they are a lot cheaper as compared to purchasing them a few days to the journey. I took an uber from the airport to the hospital.

 Weather:

The weather there is generally hot and humid. It is advisable to carry lots of light clothes and some sunscreen. There were occasional rainy periods during my stay but the rainfall was quite light.

Arrival and stay:

I arrived and went to report at the hospital. I met the Medical Director who is also a Cornea specialist.

He gave me a quick orientation and introduced me to all the staff. He gave me an overview of the values and mission of the hospital and communicated what was expected of me during my elective period.

I was informed on work attire and would put on my white coat on top of my clothes or wear scrubs. I would advise on putting on scrubs to work as they were comfortable and easy to work in the hot weather.

Everyone was very welcoming and friendly. I had no doubt that I would feel at home away from home. He gave me the afternoon off to go and settle myself at my accommodation as I was to stay at a nearby flat outside the hospital for the first 3 weeks.

After 3 weeks I moved into the hospital accommodation. It was a quite a big room, with a bed, fan, fast Wi-Fi and a set of sofas. It was self-contained with a shower and toilet. The kitchen was however adjacent to it with its own key. The kitchen was clean and had a table top cooker and gas. Utensils were also provided in the kitchen.

Work experience:

Photo of the hospital

The hospital

My first day was in the general clinic which runs every day. The clinic is usually very busy. There was a visiting consultant from Japan who is an anterior segment specialist. Together with him and the medical director, we were able to see about 100 patients on day 1. Some of the other clinic staff were on an outreach in another county doing free cataract surgeries in the community.

I was able to attend the other clinics which run concurrently with the other clinics on specific days. I attended some of the cornea clinics which would run on Tuesdays. I also attended some of the Wednesday clinics which were paediatric ophthalmology clinics. Main theatre days are on Mondays, Wednesdays and Thursdays. I was able to review challenging and interesting cases with the medical director who was always available for consultation. I also managed to review interesting paediatric ophthalmology cases with the paediatric ophthalmologist. I also learnt a lot from the other cadres at the hospital. Apart from the ophthalmologists, there are also two ophthalmic clinical officers two ophthalmic nurses, and other cadres. Everyone was willing to teach and also learn something from the other.

At Lighthouse for Christ Eye Centre, there are visiting ophthalmologists from time to time. They are from various countries and different sub specialties. Apart from getting to work with the Anterior segment consultant from Japan for a week, I also got to meet and work with a visiting Cornea specialist from India. Together with the medical director and the visiting cornea specialist, I was able to review patients with them and learn a lot over the few days.

I also managed to learn a lot surgically. I did my first complete cataract surgery and managed to do 13 cataract surgeries. I was also able to learn and do other procedures like 3 excisions of pterygiums and conjunctival masses. I learnt how to excise chalazions and also how to do punctum repair when doing a lid laceration repair, and also learnt how to do YAG-capsulotomy. There are also Continuous Medical Education seminars every last Friday of the month. I was able to attend 3 seminars during my stay at the hospital which were very informative.

Day to day living:

I would cook most of my meals in the kitchen. However, at lunchtime, I sometimes would buy meals at an affordable price at the hospital canteen. The meals sold there are balanced and healthy with fresh ingredients. Price range was about ksh50-100 for a full meal. For fresh vegetables, there is a market not too far away in town where one can access fresh raw ingredients. The hospital and the central business district are very close to each other. About 5-10 minutes away from each other. I had access to the supermarkets, ATMs and banks as they were just a few minutes away. My main means of getting around were ‘Tuk-tuks’ and ‘matatus’ for nearby places as well as Uber taxis for the places that were far. Most means of transport were affordable and convenient.

For some of the cultural dishes, there are many hotels that serve the authentic coastal dishes that were affordable and a walking distance from the hospital

I did my own laundry and there is a good outdoor hanging line.

Security within the hospital was very good and it is round the clock. Both the room and kitchen had padlocks. In case of emergencies, there was an alarm within the room as well as an indoor phone which you could contact the other residences within the hospital or the main hospital block. The security officers were always courteous and willing to help in case of anything.

There are also many tourist sites that one may visit over weekends when free. For example, there are some tourist sites not too far from the hospital for example Fort Jesus. There are many beaches as well as the marine park just to mention a few.

Religion:

Lighthouse for Christ Eye Centre is very tolerant of all religions despite being a Christian institution.

It serves a community which has Christians, Muslims, Buddhists among others. All patients are treated equally and with respect regardless of religion, race and socio-economic status.

There was devotion twice a week, on Tuesday mornings and Friday mornings at 7.15 am -8 am which I attended. All staff were welcome and the sessions were always spiritually uplifting.

Overall:

My overall experience was great. The work experience was different and very interesting. I got to work with different people and cadres. The staff at Lighthouse were hardworking and professional as well as very warm. Learning was both ways and I learnt a lot from everyone. I was exposed to so many different conditions from which I learnt a lot in terms of management and surgeries. I was able to perform surgeries under supervision and my teachers were patient.

I am grateful to GEMx for granting me this great opportunity. It was invaluable in my training in ophthalmology. I would not trade that experience for anything.

My GEMx Elective Placement At Kiambu Leavel 5 Hospital Under Kenyatta University

Filed under: GEMx Regional Exchanges, Uncategorized

Post by WAMUBIRIGWE EMMANUEL MAKERERE, a medical student at Makerere University College of Health Sciences (Uganda) who completed a elective exchange at Kenyatta University School of Health Sciences (Kenya)

Acknowledgement

Meeting the GEMx students of Kenyatta University

Meeting with GEMx students of Kenyatta University

I am grateful to the Global Educational Exchange in Medicine and Health Professions (GEMx) for this opportunity to participate in the exchange program at Kenyatta University and facilitating my electives period and stay in Kenya.

I would also like to appreciate Ms. Faith Nawagi the African GEMx representative, Dr.Ssinabulya Isaac GEMx coordinator at Makerere University and Ms. Phiona the assistant coordinator for international programs at MakCHS. Dr.Kahiga Titus, GEMx coordinator at Kenyatta University and Madam Dorothy for the good reception at Kenyatta University.

Dr.Ngatia Justus the chairman obstetrics and gynecology department Kenyatta University. Dr. Were Francis, my supervisor at Kenyatta University and the fourth year students I was rotating with, thank you for making my rotation wonderful.

Travels

At KICC, Nairobi town view.

At KICC, Nairobi town view.

It was on 25th May when we boarded the modern coast bus heading to Nairobi. We set off at around 10:45pm. All my colleagues Muhumuza Mark, Agaba Kenneth,Turyamureba William and Isingoma Simon were all on board on the same bus.

However, it being night, we all slept off and woke up at the Busia boarder for the check up and we cleared everything. Our first stop over was in Nakuru town where I bought some breakfast. The price of the coffee was 100ksh and I felt it was so cheap but when I tried converting to Uganda shillings, it’s when I felt it was quite expensive.

We arrived in Nairobi safe and luckily enough, Madam Dorothy didn’t take long to come pick us up and she took us to Destiny park hostel in Kahawa Wendani, which would become our new home for the next four weeks.

First day

I did my clinical rotation at Kiambu level 5 Hospital

I did my clinical rotation at Kiambu level 5 Hospital

At the hostel we found some people there and these would be our first friends in Kenya, the likes of Derrick. Madam Dorothy got us lunch served in the dining room; we had rice and meat on our first day in Kenya. Later on, Derrick showed us around that day, there was a pool table and we started by spending part of the evening playing pool.

We moved around the place Kahawa while we were going for our supper with Derrick.

Food

Food seemed to be a shock at first because what seemed to be snacks back in Uganda was main food in Kenya. There was a variety of food in Kenya, chapatti, beans, meat, dengu, matumbo, ugali etc.

Their matooke wasn’t made like in Uganda. It was a little different and people eat one type of food at ago, they don’t mix all varieties at ago. Most people were eating chapo(chapatti) with beans which looked weird because back home, such food was eaten when someone ran out of options that day and was completely broke.

They have very good fish; my best meal I ate was ugali with fish plus some greens. I ate that meal every Sunday supper. It was my best. However normal days at hospital I used to eat rice, beans, dengu, ugali, matumbo, chapo depending what I wanted that particular day.

I also had a chance to eat the local food ‘mukimo’ it’s a mixture of smashed irish potatoes, maize, pumpkin leaves. It appeared greenish and it had a very good taste. I liked it most with meat. Also had a chance to eat githeri, amixture of beans and maize fried together. I didn’t enjoy it that much though.

People and the language

One particular thing I liked was the fact that these people have one common language they all speak, Swahili. It makes communication so easy. Of course I found it a challenge because I didn’t know the language. However, by the end of my stay, I had learnt some few words and phrases. How to greet, asking for price of something, asking for food. I had friends who always told me which word to use.

The people are so friendly and welcoming and always willing to help in case your lost or don’t know where to go. They were always willing to teach me a few Swahili words for survival around.

I made some good friends in Kenya, Ivy Reni, Onsare, Gibs, Felix, Bonniface and we have always kept in touch with them. They all promise to come to Uganda very soon.

In terms of transport, I was used to boda boda in Kampala but in Nairobi they are very rare. However the matatu are similar to ours in Uganda. But the matatus are not allowed within the city center so I used the bus mostly when going to the city center then matatu when going to campus, going to other places outside the city center.

There were the taku taku, I got a chance to board one while going from the by-pass to go and have chama choma. I had never sat in any of them, they are comfortable but so scaring, I always had a feeling they were going to knock it because it’s very small and sharing the road with big vehicles. But it was very safe.

Weather and climate

We were in Nairobi around the rainy season, it was really cold both day and night. I wasn’t used to wearing sweater whole day but Nairobi made me get used.

Hospital work

Fellow students rotating in obstetrics and Gynecology at Kiambu Hospital

Fellow students rotating in
obstetrics and Gynecology at
Kiambu Hospital

I was doing my rotation from Kiambu hospital level 5. It’s a county referral hospital of Kiambu county. I used to go to hospital in the University bus together with other medical students in the morning. We had different buses going at different times so you had a chance to board a bus that is convenient for the timing.

I was rotating in the obstetrics and gynecology department. I was oriented by the class representative, Onsare together with Ivy Reni. There were different wards, the gynecology ward, antenatal ward, postnatal ward, outpatient clinics and the theatre.

I decided to rotate in all these departments at least to have a feel of everything. I used to clerk patients with the help of my friends from Kenyatta University because of the language barrier. Presented to the doctors and discussed different conditions and their management. I had a chance to attend all the lectures organized in that period.

I also attended the labor suite where I mainly assisted the nurses in delivering mothers, went to theatre during obstetrics days and gynecological days. I had a chance to witness procedures that I had not seen in Mulago hospital especially the gynecological procedures. I also witnessed ward procedures like the manual vacuum aspiration.

The doctors were willing to teach and they demonstrated to us different skills we needed to learn. They were good and explained every question you asked during the teaching. I enjoyed mostly the bed side teachings where we had to clerk the patient, present to the doctor then we discuss the patient and management with the doctor. I had a very good experience with my rotation.

Social life

At the Biennial Infectious Disease Conference Nairobi Hospital

At the Biennial Infectious Disease Conference Nairobi Hospital

Socially Kenyans were nice people. The people we were staying with were very good, we became friends and used to watch television together, we used to play pool together especially in the evenings back from hospital. We used to prepare our own food on some days but we mostly used to buy from the nearby restaurants.

On weekends, we used to go out to some good places around. We got one of our friends from Kenyatta university and we used to tour with him around Nairobi town. We went to the parliament, the railway station, KICC, Uhuru Park, where we had some ice cream, horse riding.

One of the things valued a lot in Kenya is nyama choma. So we had a chance to go and have a taste of this nyama choma, we boarded and went in the evening with our friends and it was really nice. We also had a chance to visit Thika and Ruiru towns. We went to Thika road mall and had some good time there.

All in all, my experience in Kenya was a wonderful one. Had never thought I would get a chance to experience a life outside my home country, but Kenya gave me that experience. Will live to remember my days I spent in Kenya.

Internal Medicine Elective at Queen Elizabeth Central Hospital (Malawi)

Filed under: GEMx Regional Exchanges

Post by Tebogo Bolani, a medical student at University of Witswatersrand (South Africa), who recently completed a GEMx elective at the University Of Malawi College Of Medicine (Malawi).

Umuntu ngumuntu ngabantu. This a Zulu proverb that I have never fully appreciated until I arrived in Malawi. My first experience of Malawi was the airport – it was certainly not what I expected. We were welcomed by a small group of local children standing behind a fence waving at us stepping off the plane. It was humbling and exciting at the same time. I completed my elective at the Queen Elizabeth Central Hospital (QECH) in Malawi. We arrived on the 26 of November and stayed until 23 December 2017.

When we arrived at our temporary home at Kabula lodge, we were greeted with no electricity and no food and no means to get food. The food situation certainly improved throughout our stay, the electricity not so much. Power outages and load shedding occur regularly in Malawi. The country is reliant on hydro energy, but there has been a drought of late resulting in electricity shortages. All in all, the next month looked like it was going to be a challenge. We made it work though, we started cooking outside on a coal stove, locally called a Mbalula. Funnily enough the president came to town and for the entire duration of his stay we had continuous power.

villagers sitting around a tent
Monday morning, we woke up bright and early to go to the hospital. What struck me first was the bright colours from the chitenje that the locals wear. Malawians take pride in their culture. The chitenjes are used as clothing, bedding, to carry babies and many other uses that I have never encountered. I spent a significant amount of my time collecting different patterns and colours as gifts and to wear myself.

We were allocated to the internal medicine department, at our request. When I first walked into the ward I was shocked. It was nothing like I imagined. I expected a similar setting to South Africa, instead I found poverty and overcrowding but also the spirit of Ubuntu – which translates as “a person is a person through other people”. Malawians have a true sense of community. We joined the ward round and soon found out that resources are severely limited and that receiving something as basic as an ECG can be near impossible for the low-income patient. They do not have a Blood Gas machine or CT scanner. An MRI machine is available, provided the proper procedures are followed.

There are no barriers between patients resulting in no privacy, there are inadequate beds resulting in patients sleeping on mattresses on the floor and some even in the corridors.
One of the things that impressed me most about QECH is their ability to improvise. No chest drain is available, so they use a catheter, no hand sanitizer is available so they poke a hole in a bottle of spirit and use it as disinfectant. Also, they have what they call guardians. I am used to a system whereby nurses bear the brunt of the responsibility. In Malawi patients are always accompanied by their guardians. Guardians are family members that stay with the patient at all times, they do a lot of work that would ordinarily be considered the nurses’ job. Guardians empty catheters, give patients bed pans, feed patients and provide some of the medical history. They have no medical training and sometimes, they are a hazard (force feeding a patient with a reduced GCS), but I still consider them invaluable. Guardians sleep on the floor next to their relative without a blanket or pillow or mattress. I honestly believe they keep the hospital running. They exemplify the spirit of Ubuntu.

selfie of four african medical students
I have this memory in my head. It is the image of an elderly gentleman who was very ill. He was visibly wasted, weak and confused. His son was his guardian. Every day I would watch his son position himself behind his father on the bed and allow the father’s upper body to rest on his chest as he fed him. It was heart-breaking to watch. Partly because the father was very sick and had a poor prognosis, but also because his last moments where spent in a hot hospital, with flies everywhere that he did not even have the energy to swat off himself. It just seemed like a very unpleasant way to die, my only consolation is knowing that he was never alone, and his son was by his side.

Patients in Malawi seem to have a very high tolerance for pain. I was shocked when I assisted in performing a lumber puncture and no local anaesthetic was given. This is the norm here. Of all the patients that received a lumber puncture, not one screamed in pain. At home in South Africa local anaesthetic is used, and the majority of patients scream at the top of their lungs, so much so that the nurses come and check what is wrong. One of the senior doctors was asked why patients here never complain. He claimed that in the patient’s eyes, doctors can do no wrong and they are too polite to complain. The only response patients seem to have is to reach towards the hand causing the pain. But they never make a sound.

On a more positive note, the academic teaching in the internal medicine department is excellent. They have daily case presentations prepared by the students and everything from history, management and microbiology is thoroughly discussed. I learnt most during these early morning sessions. My Chest X-ray interpretation skills have improved. I loved that it is a platform for active learning. The consultants would sit in a line in the front row and the students and registrars behind them. After the presentation the consultants would ask questions about the case. It did not come across as an interrogation at all. It was academic discussion amongst academics.

The ward rounds where similar. Students are part of the work force. They clerk all the patients with the assistance of the intern and registrar and on Mondays and Thursdays present their patients on the consultant ward round. They ordered their own investigations and drugs as well. They are very independent when managing patients. Sometimes they would even come in on Sunday to prepare for Monday’s consultant ward round.

Four African Medical Students
The ward round was another platform for teaching. I am accustomed to passive ward rounds where students do not really participate. But QECH certainly does not conform. The ward round is run by the students with help from the junior doctor. The students, which soon included us, would present most patients and then have a discussion with the consultant. It is probably what I enjoyed doing most. It was the perfect combination of theory, clinical skills and fun. Granted it was exceedingly stressful, because of the pressure and fear of doing something wrong, but it always worked out in the end.Once we got the hang of how things worked we started seeing our own patients. I found it very satisfying to be managing my own patients from admission to discharge. I was certainly grateful for the help that the students and registrar provided. It was probably the first time I have ever felt like I am really becoming a doctor. It was stressful at the best of times and writing a discharge summary in the health passport is time consuming, but the joy of doing something right outweighs it all.

Looking back now, my experience at the hospital is not what I expected at all. We were necessary labour and I appreciated that. We became part of the team. We made friends with the students so much so that even though they have left, we still chat with them on WhatsApp group. My independence has definitely been put to the test. Being away from the comforts of home was difficult but bearable. I got used to the new normal. I think I gained more completing my elective internationally than I could have at home. I developed my ability to communicate with people that don’t speak the same language and my ability to adapt to a new community and culture. I also succeeded at performing procedures that I have repeatedly failed at, at home (lumber punctures). Additionally, I have proved to myself that I can live in another country and still be happy.

Daily Reflections from a Nursing Student’s Community Health Elective Exchange in Uganda

Filed under: GEMx Regional Exchanges

Post by Akingbohungbe Oluwatosin Sonia, a nursing student at University Of Ibadan. Department Of Nursing, College Of Medicine, in Nigeria, who completed a elective exchange in Community Health through Makerere University, College Of Health Sciences, Department Of Nursing, in Kampala, Uganda.

 July 2019

All thanks to God for this opportunity, I was privileged to be one of the students selected to participate in the exchange program in Makerere University, Kampala Uganda by the Global Education in Medicine Exchange (GEMx). The exchange school was the Department of Nursing, College of Health Sciences, Makerere University, Uganda.  The program started on the 17th of June 2019 and I joined them on the 22nd of June 2019 due to logistics. We took off from Lagos Murtala Muhammed International airport on the 21st of June 2019 by 12:40 P.M, We had a stopover in Nairobijomo Kenyatta International Airport By 11P.M and board another airplane to ENTEBBE by 12:55 A.M on the 22nd of June 2019. The plane landed in ENTEBBE by 02:10 A.M and we were picked up by Mr. Martin the driver to the department from where we were taking to the prepared accommodation where we slept over for the night. The following day we were taking to Ms. Lydia Kabiri at the department of nursing around 11a.m for proper welcoming, recognition and further directives on how the program will run. Afterward we left for Mpigi to join the rest of the students in the Mpigi Health Center IV where we were also welcomed warmly by Katumba Lawrence and kwikiriza Grace followed by the rest of the students Gerald, Olivier, Innocent, Sonita, Janet, Francine, Shilla and Clement the leader of the group. The students were on a recess posting which includes Domiciliary midwifery and community health as subset of Public health nursing. The Health Centre had different units, the General ward, Out-Patient Department (OPD), Antiretroviral Therapy Department, Maternal child health Department and the Labour ward. Alongside the posting into the ward, we also took part in Continuous Medical Education (C.M.E) undertaken by health practitioners in the Mpigi Health Center IV, the forum is a productive and an interactive one which affords everyone both students and the health workers to brainstorm and learn new things through researches and new discovery for rendering health services to the people.

Day 1

24/06/2019

The day started with meeting with the senior nursing officer, in charge of the health centre and she welcomed us and then there was a brief orientation to the setting of the health facility, visiting the various units of the health centre. The various units include the Out-patient Deapartment, the General ward, the Maternal and child health unit, the Maternity unit and the Anti-retroviral (ART) clinic. Day 1 started with posting to the General ward of the health facility. The ward included the male, female and paediatric wards and conditions found there includes malaria, pneumonia, injuries and other minor health conditions. On the ward, orientation was given and the nursing duties peculiar to the ward was explained to us. Observation of the assessment of patients, administration of medications and admission was carried out.

Also, one of the students from the university, Akwanya Innocent, gave a health talk to nursing mothers and we were all in attendance. The topic was on Danger signs during postpartum and it was delivered to the nursing mothers and women who came for antenatal clinic at the maternity unit of the health facility. The student nurse spoke in English language while another student helped to translate in the local language Buganda. The education was for about 20 minutes. Mothers asked questions about the topic discussed and they were duly answered.

In the evening, it was a period for discussion among the students and the topic on Community and Prevention-oriented population-focused practice: the foundation of specialization in Public health nursing. Discussion was on what public health nursing is, the core functions of public health which includes assessment, policy development and assurance. Categories of public health workforce competencies was discussed and also health services pyramid with the largest base being population-based health care services, Clinical preventive services, primary health care, secondary health care, tertiary health care and finally the benefits of public health nursing was discussed.

Day 2

25/06/2019

Work continued at the General ward today. Admission and discharge of patients was carried out. Administration of medications was also carried out and patients were given adequate care.
Health talk on Family planning by Egwela Clement was given to mothers and women who came for antenatal and postnatal clinic respectively, they were shown pictorial guides and models were also used to explain further the various method of family planning.
Due to the unavailability of adequate data on the population and logistics of the different settlement of the community we were yet to visit the community.
In the evening, there was group discussion and it was a continuation of the topic discussed yesterday on changes and continuation that has occurred in public health nursing and also Perspectives in Global healthcare. We discussed the topic with sub-topics on primary health care, nursing and global health, major global health organizations. We all discussed the topic, questions were asked and they were duly responded to.

(more…)

Faith Nawagi – GEMx Global Partnership Development Representative, Africa – wins Nursing Now Scholarship, May 2019

Filed under: From GEMx Staff, GEMx News


We are pleased to inform you that Faith Nawagi was 1 of 30 nurses who received a scholarship award from Nursing Now; out of 800 applications. Faith attended the WHO 2019 World Health Assembly in Geneva, Switzerland, and received training in global health policymaking and advocacy.  This award was in recognition of the work Faith performs for GEMx; developing inter-continental, institutional partnerships to facilitate student exchanges across Africa.

Faith met with leadership of Nursing Now, Sigma Nursing, and the International Council of Nurses.  Leaders of these organizations expressed a strong interest to form a global nursing exchange network using the GEMx web-based platform.  GEMx plans to meet with leadership in November of 2019.

Faith also met with Dr. Jim Campbell, Executive Director of Global Health Workforce Alliance and Director of the Health Workforce Department at the WHO.  Dr. Campbell acknowledged the good work of ECFMG FAIMER, and is pleased that GEMx is a service of such a wonderful organization.

ECFMG FAIMER continues to receive recognition for the good work we do around the world.  ECFMG FAIMER continues to strengthen opportunities for our services and programs like GEMx, and garner opportunities to collaborate with WHO, Nursing Now and other highly-reputable organizations that are committed to global health, education and quality health care.

Faith standing by WHO sign

We congratulate Faith Nawagi on her good work, contributions and commitment to GEMx, and to ECFMG FAIMER.

About Nursing Now

Nursing Now is a “three-year global campaign (2018-2020), aims to improve health by raising the profile and status of nursing worldwide.”  Nursing Now works in collaboration with International Council of Nurses and WHO.  Barbara Stilwell is the Executive Director of Nursing Now Global Campaign; a former FAIMER Board member.

That was epic: my one month rotation at Universidad Iberoamericana!

Filed under: GEMx Global Network, GEMx Student Reflections

Basel Magdy Abdelmohsen Abdelazeem, Ain Shams University student in front of UNIBE

Basel Magdy Abdelmohsen Abdelazeem

For those who dare to dream, the world spreads out its arms, and for those who aspire to realize their dreams, they conquer the world. This belief has made my family and I walk diverse paths to learn, compete and shine. Due to the continuous strive to chase our passions, we became a family of dreamers.

My name is Basel, Student at Ain Shams University – Faculty of Medicine, Cairo, Egypt. My nickname is Dr. Nobel because My dream is to get the Nobel Award in Medicine in the future Insha’Allah.

Abdel in front of Hospital General de la Plaza de la Salud emergency center

I’ve gone on a lot of electives worldwide, but this was a totally new different experience in the Dominican Republic. My rotation was divided in two hospitals. The first one in Hospital General de la Plaza de la Salud (HGPS) which is a teaching hospital facility and has helped more than 140,000 low-income patients with discounts and waivers of its health treatment plans. I did one week at internal medicine Department both inpatient and outpatient in addition to one week in ICU and Emergency Department.

At the second hospital,Hospital Escuela Dr. Jorge Abraham Hazoury Bahles (INDEN), one of the greatest hospitals in diabetes’ management in Latin America, I went through every aspect in diabetes management starting from the outpatient clinic by ordering basic lab & imaging and adjusting the doses of medication and Insulin up to management of diabetic retinopathy and surgical aspect of the Diabetic foot. It was really an amazing experience.

Abdel with several colleagues in a classroom

Can you imagine that you go through all medical specialties in a month while getting the opportunity to improve your Spanish at the same time?! We had morning case report, grand round, interacted with physicians and residents and finally the awesome UNIBE students  who are all so nice, humble and willing to help you as much as they can. And fortunately, they speak both English and Spanish so you Ain Sham Universcan overcome the language barrier while interacting with the patient.

 

There are seven broad benefits of my rotation there and you should consider them in your next medical rotation.

  • First, I expanded my clinical knowledge and skill set as the style of medicine you’re studying is not universal, nor are the cases you’re familiar with.
  • Second,  I must admit, I was nervous on my first day on the wards. I had no idea what to expect but the doctors made me feel like a part of the team. I found out what I’m made of and strengthened it.
  • Third I made myself more employable as an elective abroad stands out as a badge of durability, resourcefulness, and aptitude.

  • Fourth, traveling is an opportunity to see a part of the world you’ve never seen and might never otherwise consider.
  • Fifth, an elective helped me in building my personal and professional network and if you’re clever about it, you can also build an international network of professional contacts
  • Sixth, I sharpened my language and communication skills, right now I’m confident enough to take history and doing the complete physical examination in Spanish.
  • And finally, it renew my perspective on the worldwide health and I mentioned before my life goal is Nobel award and you should know a little bit about everything in each field in this world and you must know everything about your specialty.

 

Away of medicine, let’s talk about the country and culture.  The Dominican Republic is the most popular tourist destination in the Caribbean region. I traveled a lot, so I learned how to enjoy each country to the most.

Abdel with friends from UNIBE having fun at a bar
This country is awesome if you have the correct company, I mean that you should interact with the real Dominican people and hang out with them. There is an amazing beach here, the old city, jungles– I mean literally– great nature. If you like dancing and drinking we’d definitely have a lot of fun as everyone literally is dancing to Latino music everywhere.,  Don’t forget to visit the Colonial Zone and Punta Cana. And make sure that you eat Dominican food made by locals and ask them to teach you how to dance to Latino music. You will have a lot of fun if you have good communication skills and know a little bit of Spanish.

Abdel with a professor and a colleague

My last word is thank you for everyone who helped me to get this rotation, for every doctor who taught me during the last month, for every student I met there and helped me.

Thank you, Dr. Mejia, Program Manager of HGPS

Thank you, Dr. Ammar Ibrahim, Director General of INDEN

Thank you, Danny, UNIBE Coordinator

Thank you, Eunice Kamami, GEMx Student Engagement Assistant

And Big Thank you to GEMx to giving us these opportunities.

Reflecting on the 2019 IQMU Competition in Manipal India (Sponsored by GEMx)

Filed under: GEMx Sponsored Events

Post by Harsh Kahlon and Mahisha Virdiana, Medical Students at Kasturba Medical College Manipal

Team of medical students

The International Quiz for Medical Undergraduates, IQMU, is a student-run initiative hosted by Kasturba Medical College, Manipal, a name synonymous with quality medical education, as proven by its consistent ranking amongst the top 10 medical colleges in the country over the years. KMC Manipal is a constituent of Manipal Academy of Higher Education, a world-class institution sprawled over 600 acres in Karnataka, India.

Students working together

IQMU was conceived from the experience and inspiration gathered by a team of students who attended a similar international competition – CICoM, in Mexico, in the year 2016. Upon their return to Manipal, their stories ignited a spark in their fellow peers to create an event which strives to facilitate international academic and cultural exchange, and thus IQMU made its debut in 2017 under the expert stewardship of Ms. Nandini Majumdar and Ms. Anushree Puttur, and the continuous support of its sponsor, GEMx.

IQMU's 3rd edition was hosted in Kasturba Medical College, Manipal from 6th to 9th March 2019, and saw the release of an online portal for international teams to participate from their home countries. IQMU 2019 saw participation from across India and countries such as Mexico, Nigeria and Nepal. The quiz consisted of five rounds, which tested the participants' knowledge and understanding in the fields of basic medical sciences such anatomy, physiology, pathology and pharmacology, and core medical subjects such as medicine, surgery and obstetrics.

 

Students working together to answer questions
The rounds varied far and wide in their formats, ranging from spotters and clinical vignettes, written question papers comprising of multiple-choice questions, matrices and comprehensive passages, to IQMU’s acclaimed Mental Relay, which provides participants with a clinical case scenario that must be solved by ordering from a set panel of investigations that would lead to diagnosis, in a relay fashion, as would be in a hospital setting. This year’s edition saw the addition of a crowd-favourite – an escape room-based wild card round that challenged the participants’ clinical and diagnostic skills in the presence of a ticking clock.

Participants were also engaged in enlightening, fun workshops conducted by the college’s academic clubs and mesmerized by cultural events which served to both provide a reprieve from the fierce, competitive quizzing and to also enrich their experiences.

IQMU is thus an amazing opportunity for medical students worldwide to experience the best possible 3-day quest comprising of an extensive, nail-biting quiz, informative workshops, programs showcasing the rich culture of India, clinical and medical learning and most importantly, interaction and exchange with other medical students of different backgrounds from around the world!

lighting a ceremonial lamp

The next edition of IQMU will take place at KMC, Manipal on 6th to 8th March, 2020. Email iqmu.manipal@gmail.com to get started on signing up for the adventure and learning of a lifetime at Kasturba Medical College, set against the scenic backdrop of the coastal university town of Manipal.

Follow IQMU!
Facebook:
https://www.facebook.com/IQMU2019/
Instagram: @iqmu2019

Dermatology in the US

Filed under: GEMx Global Network, GEMx Student Ambassador Network, GEMx Student Reflections

Post by Divya Gautam, Student Ambassador at Royal College of Surgeons in Ireland (RCSI) and University College Dublin (UCD) Malaysia Campus has completed an elective exchange at PAGNY in New York City.

Divya Gautam

The aims of this elective were to gain a better understanding of some of the rotations that I am interested in and to narrow down the field in which I hope to specialize as well as to learn how the American healthcare system functions. In medical school, we were unable to achieve a specialized exposure to Dermatology and therefore, this elective was very attractive to me as it offered the opportunity to shadow one of the most established dermatologists in the United States. As an international student in Malaysia, I have gone through most of my clinical years barely scraping the minimum requirement for patient interaction. It is an entirely different experience to be able to converse with a patient about their problems in your first language and be able to counsel a patient directly, instead of through a translator. Another major objective was to be able to work on research with PAGNY, an established organization that is responsible for publishing hundreds of quality papers. Forming contacts within the United States system is extremely vital for me to give myself a chance for furthering my career.

Divya with Dr. Bijan Safai, Dermatologist

Throughout this elective, there were some ups and downs due to the mere timing of the placement as it was around the winter holiday period. There were fluctuations in the number of patients being seen; however, I was, without a doubt able to identify some key differences in the practice of medicine in Malaysia and the USA. I was very happy with the way I was treated as a medical student. When I was rotating from clinic to clinic, I was always introduced as part of the consulting team and was asked for my medical opinion when it came to clinical decision making. Working with the physicians at PAGNY, encouraged me to continue my journey in medicine. I was on the elective with three other students, and during the research segment, we were given the option of being put on existing research or creating our own topic and literature review. We, of course, being extremely ambitious, as medical students are, chose the latter. Our research paper is a cross-cultural literature review on the substance use patterns in the countries that we are from. In my opinion, given the massive burden of substance abuse and dependence on the healthcare systems, globally, this paper can be an asset to warrant further research on intervention and public policy.

Now for some fun stuff—since I grew up in the States and a lot of my friends from boarding school ended up there, I spent a lot of time catching up with old friends and just drinking A LOT of apple cider and eating A LOT of Christmas market food. I could list about a hundred things I fell in love with while I was in Manhattan. The dollar pizzas, the museums, the brunch spots, the convenience of the subway, the musicians and street artists, the hustle and bustle of Wall Street, the fantasy lifestyle on the Upper East Side, the strolls through central park, hearing over 20 different languages on your way home from the clinic, the list goes on and on and on and on!

Divya with Anna, Justin, Maureen, (PAGNY exchange facilitator), and other students at PAGNY

I want to thank GEMx for providing me with this fantastic opportunity. It is rare to carry out an elective in the United States without having given the USMLE, and together with PAGNY, this was made possible. All of the physicians that I worked with were extremely kind and did not hold back on teaching us and guiding us through the rotation. Our research coordinator was always available in case we were having difficulties and provided us with ample resources to aide our monumental task of doing a literature review over a span of 6 weeks.

Overall, it was also a great experience, being able to live in Manhattan and experience the diverse culture of the state of New York—that too during the most wonderful time of the year!. I’m more confident in my decision to practice in the United States as I feel that I understand the structure and inner workings of their healthcare system. I’ve been able to successfully establish a good relationship with practicing physicians that have been kind enough to offer recommendations and continued contact for mentorship.

Take Hold of the Learning Opportunity

Filed under: GEMx Regional Exchanges, GEMx Student Reflections

Onthatile Thusi

 

Post by Onthatile Thusi, a medical student from University of the Witwatersrand Faculty of Health Sciences [South-South] who recently completed an elective exchange at the University of Malawi.

The plane cut through the clouds to reveal the first views of Malawi from the sky. The land was patterned with areas of green and brown and scattered housing. The scene was a great contrast to the landscape of Johannesburg which is populated with housing. As the plane began to fall towards the earth the exhilaration rose in my body while the thought of stepping my feet onto to a foreign land soon became a reality.

Queen Elizabeth Central Academic Hospital found in the city of Blantyre, Malawi is the largest referral health facility in the country of Malawi and was the setting of my 4-week elective along with 4 other students from South Africa. I was in the Department of Medicine under the supervision of Dr. Mallewa.  I was placed in the male medical Ward 3b and was welcomed by the team responsible for Bay 2 which consisted of Dr. Lester, an experienced consultant, Dr. Basami a proficient intern, Dr. Pink an enthusiast registrar, and Allan Masapi a friendly and helpful final year medical student. The only directive we were given for the elective was to follow the final year students timetable and we were given the freedom to attend any of the lectures or teachings carried out by the Department of Medicine.

Onthatile Thusi with her colleagues

“You are responsible for your own learning”.

This was a statement repeated to us throughout our second year of study and it is now in this elective experience, that I have come to grasp the significance of this statement. There are numerous opportunities to learn from patients whilst in the wards. The team working in Ward-3b, Bay 2, and the members of the Department of Medicine was willing to impart their knowledge onto the students. However, it was my responsibility to take hold of the learning opportunity and initiate engagement and discussion with every source of knowledge at my disposal. Other than the scheduled final year student lectures, and the bedside teachings carried out during the ward rounds twice a week, learning was often self-directed.

My day at Queens began with student case presentations which I found very valuable. In these case presentations, I saw the theoretical knowledge acquired in medical school come to life through practice.  It is in the discussions of these cases where I learned the value of the art of medicine in a resource-limited setting. Each investigation was challenged for its relevance and utility. The principles imparted in these discussions are some that I hope to apply in my personal practice of medicine in my home country of South Africa that face a number of resource limitations with a similar HIV burden. Following case presentations, were morning ward rounds often done with the intern and joined by the student and consultant twice a week. It is in these ward rounds that I was inspired by the extremely knowledgeable intern Dr. Basami and had the privilege of seeing the art of medicine practiced with efficiency and great proficiency despite the many limitations.  Under the patient guidance of interns and final year students, I was able to carry out a number of my clinical skills and acquire new skills with the encouraging consent of the patient.  It was often that the ward round and ward work was completed before 13:00, and I would find myself with nothing to do the rest of the day. I attempted to shadow an intern in the medical admissions in the Emergency Department or searched the wards for a doctor to have discussions surrounding patient’s cases.

One of the very exciting experiences was at the Grand Ward round which took place once a week. It is in this ward round where ongoing studies at the hospital were presented. Exhilarating discussions were had on the clinical relevance of the study and conclusions were made from the study. Active conversations between departments would take place on how the challenges and recommendations brought forward by the study could be mitigated and implemented. It was exciting to hear the dynamic interactions between professionals that bring tangible change in public health and ultimately improve patient care.

Malawi home

Malawi the warm heart of Africa. The pulse of this heart is felt through the people of Malawi.  The patients I encountered were willing to engage with me and consented to my intention to learn new skills with welcoming eyes. The language was a great obstacle, as most of the patients speak Chichewa, there were very few patients that spoke English. I felt that my opportunity to gain crucial experience in clerking and presenting patients was hindered. This language barrier limited my ability to perform procedures and examinations using a patient-centered approach, as all communication was done through a third party.

The pulse of this warm heart of Africa extended outside the hospital confines. The owners and staff at Home Up guesthouses, our accommodation for the duration of the elective, welcomed our arrival with expectant and cheerful spirits. Throughout our stay, they created a friendly and cozy environment. The staff was eager to help in any regard and provided valuable information to make the most of our experience in Malawi.

The vibrant and energetic spirit of Malawi is reflected in its landscape. We had the privilege of exploring some of the great sites in Malawi. We trekked through the majestic Mount Mulanje, trudged the lush green forestry of Zomba plateau and strolled through the tranquil fields at Satemwa tea plantations.

Views from Zomba Plateau

The friendly people, the warm culture and the exposure to a number of new medical experiences made these 4 weeks greatly fruitful. Despite the delays during the application process and the challenges in securing the funding before my departure, thanks to the diligent work of Mr. Motlhabani and all involved this elective experience was made possible. Each moment has been a true privilege. I have obtained valuable exposure to a wide range of medical conditions, although ideally, I would have enjoyed the chance to rotate through the different medical wards and engage with different doctors. Similarly to South Africa, Malawi has a large HIV burden and through this elective, I learned crucial principles concerning the monitoring of HIV in a resource-limited setting. The greatest personal revelation that I have taken from my 4 weeks in the Department of Medicine, is that true learning comes with an eager and earnest attempt to acquire it. I have retained a great amount of information due to a personal growth desire to gain a greater understanding of the patients I encounter and I hope to continue to grow into an experienced and proficient doctor.

 

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