Wind Blows Deeply

Unpacking

There are two quotes that I often think of when I return from Africa or any far away adventure.

The first: Coming home from very lonely places, all of us go a little mad: whether from great personal success, or just an all-night drive, we are the sole survivors of a world no one else has ever seen.
~John le Carre

I always find it difficult to sum up my experiences. This trip seemed to be fairly normal. I returned to familiar friends and colleagues, to familiar housing and transportation, to an ever increasingly familiar culture. Things happened more or less as expected.
Teaching the country’s first-ever class of pharmacy technicians was both an honour and a memorable experience. Being quite ill for half of my first week was frustrating but a good (forced) reminder that I need to slow down occasionally. ‘Remembering’ how to drive a) a standard, b) a LandRover, and c) in Africa was undoubtedly memorable for my passengers.

The second: Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.
~Margaret Mead

There was a mix of returning and new volunteers on this trip. Old friends who just ‘know how it is’. New friends who remind me to be excited and amazed at things that have become familiar.  The two University of Manitoba pharmacy students who began my trip with me remain in The Gambia for another two weeks.  They will be wrapping up their stay with some more continuing education sessions for pharmacy staff.


Class of 2013

One of my main projects in The Gambia was to teach the first set of lectures to the very first class of pharmacy technicians.  I shared on a variety of topics from ‘history of pharmacy practice’ to ‘pharmaceutical and medical terminology’ to ‘introduction to palliative care’.

Planning for this technician program has taken many years and I am very excited to see this first class graduate in a few years.



Recognition

I was honoured to receive a Commitment to Care and Service award in the category of ‘Charitable Work’ on November 29, 2011.
The award is “presented in recognition of exceptional volunteer work, contributions to charitable organizations, creation of a charity program, performance of a humanitarian deed or overall commitment to charity work by an individual or team.”
Visit the Commitment to Care and Service awards page to read more about my entry and the other award recipients.



Lend a Hand

It’s good to be back

I arrived in The Gambia one week ago.  Getting off the plane was the all-to-familiar smell of ocean, dust, diesel and burning garbage.  Perhaps not the most inviting of smells, but the familiar can be comforting.  Of course there was also the heat and humidity.  Fortunately, it has cooled done from a Humidex in the high 40′s to high 30′s.

It has also been good to see so many familiar faces.  Several past volunteers are also here, making it a bit of a family reunion.  My Gambian friends and family are also here — so wonderful to be seeing each other again.  There is my African grandma, the housekeeper and her energetic 4 year old, those living at or associated with a community development project, and many staff at the hospital (pharmacy and other departments).

Time for work

At the hospital, I spent a few days with the two pharmacy students (from the University of Manitoba) observing local hospital pharmacy practice.  One student began providing continuing education classes for existing staff on Wednesday.

Due to illness, the other pharmacy student and I have been at home the latter of this week.  Although we are much improved with the help of prayer and some antibiotics, neither of us our quite back to normal.  Walking a few blocks this morning was a bit too much for both of us.  Hopefully we will be in full health on Monday when the second student can begin her classes and I can begin teaching the inaugural class of Gambian pharmacy technicians.  It is so exciting to be a part of this program which has been in the planning stages for several years.

The importance of relationships

The more I volunteer in The Gambia, and hear the stories of other volunteers, the more I am reminded of the importance of relationships.  I have been returning to the hospital and The Gambia since 2006, and it is incredible to be welcomed back so warmly each time.  The Gambia, and much of Africa, is highly relationship focused rather than task focused.  At a basic level, there is great importance on proper, and sometimes lengthy, greetings — inquiring about all number of things before getting to the item at hand.  Likewise, time invested in a person or community is an essential component to bringing change.  Of course, other things like money, supplies, technology, and human resources are valuable.  Lasting change requires relationships.

I have seen real change in the pharmacy department.  Several suggestions/discussions that I was a part of in previous trips are now being routinely implemented.  One is the labelling of repacked medications — this helps to tell one white round pill from another.  The other is set stock days for the hospital — rather than departments picking up stock from the pharmacy on any day or time they wished, they are now limited to two set days per week.  This allows the storekeepers to update their inventory records and replenish their stock from the national stores.

Culture clash

We have been able to highlight the huge differences in culture that exist in The Gambia to the new volunteers.  On our second day, we ventured down to the pool at a local resort hotel along with a Canadian surgical resident.  (CVM has collaborated with Medicos en Action – a charitable organization associated with the Canadian Society of General Surgeons (CAGS).  Most of the team had left, except for this resident who was departing quite late the next day.)  While living at the CVM residence is more than comfortable, the sight of green grass (think of the water requirements), the variety of food and drink options, and the sight of tourists supposedly experiencing The Gambia was a significant contrast.  We did enjoy our time at the pool (free with purchase of a drink) and the opportunity to cool off.  Unfortunately, the ocean has been off limits this past week due to dangerous currents.

Our second culture clash was more of the same.  After remembering how to drive standard again, I drove our group to an upscale hotel/resort to hear members of the band Baatin play.  (I heard them play at the same location in 2009.  Watch the video)  One of the Canadian volunteers is good friends with the group and was able to play with them.  A bit more opulent than the first hotel/resort, our group was certainly aware of the difference from typical Gambian life.

Support a pharmacy student

You can still join the team supporting a Gambian student studying to become a pharmacist in another African country.  Emily is currently in her third year of studies.  I spoke with her mother earlier this week.  After this semester, the family no longer has funds to pay for tuition.  The total amount required for the remaining one and a half semesters is just under $17,000.  I know that it sounds like a lot of money — and it is.  But I am also so very thankful for those that have already contributed to the tuition support fund.  It’s not too late.  I will accept donations for as long as they come in, but would prefer them by early December to allow the student to continue into the second semester.

I hope to have more details from Emily about her studies and experiences as a student soon and will forward them to you.  I know that she does plan to return to The Gambia as a pharmacist on completion of her studies.  She has already volunteered (without pay) at the hospital pharmacy during her summer’s off.

May Day came at the end of a very interesting week and another busy month. “Doudu” and “Samba”, two volunteers I mentioned in the last update, returned home to Canada. My parents arrived and had a very full few weeks. I celebrated Easter with my family at a gathering upcountry.

Personally, I was able to have some time to rest and prepare for the volunteers coming this month. This past week was dedicated to time at the pharmacy department: storeroom audits, student exams and handling the influx of an unanticipated donation of
unsorted medications.

April Update
During Easter break, a three-day workshop-conference was held for local teachers. Topics discussed included classroom management, encouraging participation, review of teaching methods and how to
evaluate students.

Work continues at the community garden: produce is being sold, the compost is producing wonderful earth, the solar dryer is preserving fruit (mangoes!), and space prepared for the planting of
new crops. Such abundance!

Meant for this
Remember the story of Jesus appearing to some of his disciples by the Sea of Galilee? (John 21) Being closer to the ocean here than in Canada, I have enjoyed watching the bustle of fishing boats return with their catch, gulls circling, women with children bundled on their backs gutting fish.

With Jesus seemingly absent, Simon Peter goes back to what he knows: fishing. One particular night, they have caught nothing. At dawn someone from shore calls out some advice – try the other side of the boat. They catch a net-full, realize this is Jesus and come to shore to find breakfast prepared. It is after breakfast that Simon Peter’s calling is renewed.

What lessons have I gleaned from the life of Simon Peter? Well, I know that God gives each of us a purpose and asks us follow His leading. Sometimes I try to do things my own way and sometimes I fail completely. Yet God is faithful and will renew the purpose we are given.

The label placed under my experiences this past week would have to be “I was meant for this.” I audited two storerooms, dedicated time with one of the staff, marked an exam I gave to the pharmacy assistant students and sorted through an unanticipated medication donation (about seven duffel bags of unsorted items emptied onto the storeroom floor). Despite being busy and putting in long days (and long nights), my spirit felt renewed. Each day it was as though I was exactly where I needed to be and where others also needed me to be.

I am called to be a pharmacist. A desire to serve, plan, teach and mentor has been placed deep in my soul. I was pulled to
volunteer in a small African country. I was meant for this.

I will saturate my day in prayer. My success will not so
much depend on the things I have done, the people I have impressed, the money I have made, or the honours I have obtained but on my ability to imitate Christ.

I will seek to love and serve beyond the call of duty. I will endeavour to become humble, patient, selfless, joyful, grateful, kind, honest, and merciful. I will practice with self-control, empathy, commitment and persistence.

The patient’s well-being and personal goals for health will be my utmost priority. Whenever possible, I will seek to assist and empower them in self-care. Together, we will be proactive in obtaining their optimal health.

I will seek to fulfill the most urgent needs of society for the distribution, education, consultation, selection, monitoring, and evaluation of pharmacotherapy. I will try to balance the individual’s health with the interests of society.

I will become a team player by building collaborative relationships with the patient and other health care providers. I will respect other health care professionals and honour their expertise; whenever necessary, I will seek their guidance or refer my patient to them.

I will be open to change; I will be an instrument for change. I will become an autonomous thinker, using critical and creative thinking skills. I will endeavour to stay current with advances in the practice of pharmacy.

I will take care of myself so that I can take care of others.

Each time I return to Africa I learn something new. On my first trip, I learned about the U.N.’s Millennium Development Goals and experienced the burden that often comes with donated medications.

My second trip taught me about finding ways to enable and equip others; to teach people to “fish” so to speak.

This trip, my third visit to The Gambia, I have been reminded about the things I take for granted. Where in Canada it would be shocking for a woman or child to die in childbirth, here it happens all too frequently. I
have witnessed the difference water and determination makes in a town. I am understanding more fully the need we all have to live in community.

Just over one week ago, the last of the short-term volunteers from the February/March project left. With the house empty, I have reflected on our own little community. Each person brought his or her own unique understanding, perspective and gifts. In addition to building into the team, they taught me many things and were an enormous encouragement.

Village Update
::Kids’ Camp
We were able to hold a two-day children’s camp in the village. Slightly over one hundred children attended each day! We told a series of Bible stories starting with the creation story in Genesis, Abraham’s two sons (Isaac and Ishmael) and lastly of Jesus. Through each story we emphasized that “God has a plan” despite what looked like failure.
We played games, made crafts and provided lunch with a special treat.
I constantly had children hanging on each of my fingers, crawling on my lap or tugging at my shirt. The children were absolutely incredible and it was so special to be able to show them love and attention.

::Water Project
We have also been a link between a local engineering firm and the village to set up a system to supply their water needs. People currently spend a large portion of their day filling containers of water from a single hand pump to take back to their compound.
The dry season still has its hold on the land—most everything is in various shades of brown. A stark contrast was seen in the village: A man living close to a well had taken the initiative to plant a small garden with fruit trees. Truly an oasis! We were given a fresh-cut bunch of bananas from one of his trees to take home with us.

Individual projects: Nursing, Maintenance, Pharmacy
The neonatal nurse was quite busy during her stay. Just after arriving, we learned of a nursing conference relating to the partogram – an assessment tool used in fetal assessment. So, in addition to teaching midwives about neonatal resuscitation, she was able to teach general nurses and nursing students. We hope to identify some key midwives who could be involved in a “train-the-trainer” workshop in the future – training local nurses to teach their peers.

A millwright from B.C. assessed two major projects at the hospital: repair of the generator at the main outpatient clinic area and repair of the second autoclave for sterilizing medical equipment. Both are estimated to be have been out-of repair for several years. He has also worked with another Canadian volunteer to set up an irrigation system in a community garden and build a solar dryer.

Personally, I have also had a satisfying few months. I had a series of extremely useful meetings with the principal pharmacist through which I was able to gain a sense of how the national pharmacy system works. The only pharmacy related training in the country is that for pharmacy dispensing assistants and occurs at the hospital. (These assistants then go on to work in retail pharmacies, health centres or remain at the hospital.) I have now taught a number of courses for the trainees, including review session the students requested! However, they have urged that the exam questions not be too difficult – hopefully they do well!

Coming up next…
With an empty house and some larger projects completed, I have been focusing on continued pharmacy work and eagerly anticipating the arrival of my parents next week!

There is further work to be done at RVTH. My initial assessment seems to show that inventory record keeping has improved from last year. Storeroom staff is changing once again bringing additional opportunities with the turnover to strengthen the system.

I have begun to prepare opportunities for participants of the May/June project. It appears that there will again be a diverse group working in many exciting areas. Amongst others, Andy, a CVM staff member I worked with in 2006, is returning and will be continuing the water project. Also, a pharmacy student from Toronto will be joining me in some pharmacy-related endeavors. I am looking forward to seeing God use each of the volunteers!