Well, I am home now. A wee bit jet-lagged this past week (I was up at 3:30 tackling some ironing) but, nonetheless, glad to be home.
A few people have asked how things wrapped up. On the 18th (Monday), in our great building blitz, we constructed the two main shelves. Tuesday, they were full of inventory and organised. Wednesday we did a bit more sorting and planning. Thursday, I discussed the project with the Chief Pharmacist and the hospital's Public Relations Officer (PRO). The Chief Medical Director (CMD) was not available due to the opening of the TB sanatorium.
The report I had prepared (I was typically writing late at night and between power outages) outlined the project over the three weeks I was there. I outlined the baseline situation of the annual pharmacy budget, and physical and human-resource constraints. Then I presented the results of the assessments I had completed during my first week. I was able to gather that the pharmacy department was fairly keen on implementing a computerized inventory system. While in some ways it would be advantageous for them, my assessment indicated that the number of inventory items, frequency of distribution and IT deficits did not make computerisation the best option. However, due to their interest in computerisation, I tried to outline a number of areas that would need to be remedied (i.e. regular updating of inventory records) before such a conversion should occur. The state of the inventory system as a whole was also discussed: inaccuracy of records, cost of expired inventory items, challenges with donated supplies, and barriers/solutions to implementing an effective system. I hope that getting the report to the pharmacist, PRO and CMD will be enough to spur change and motivation in the pharmacy department ... maybe even the hospital as a whole!
When I left at the end of the third week, the plan was to construct two more sets of shelves to hold the remaining inventory. The storeroom is completely different than when we first arrived. They even have a few more of the overhead lights working which further adds to the visibility of inventory.
Of course, there are more things they need to do. The inventory records (tally cards) need to be updated with information from the requisitions and invoices. Ordering processes and distribution on both a hospital and government level need to be examined. Additional pharmacists should be hired. And the hospital needs to be firm in how it handles receiving drug donations. While there are policies at the hospital and national level, and guidelines from the World Health Organization, the hospital continues to accept pharmaceutical and other donations that are not appropriate: a very short time until the expiration date (or already expired), items that are not commonly utilised, and items that may not have been labelled or stored correctly. These and other opportunities were outlined in the report. Hopefully, it is circulated to enough individuals in the right positions that change will occur.
The other projects also went very well. A number of people went daily to a charity centre for malnourished children. They played with the children, changed diapers, fed the children and put them down for their naps. While I was unable to go due to my commitments at the hospital, it was amazing to hear the stories from those who went. The children are dropped off by family members -- although sometimes their mother stays. Often the mothers go home to care for their other children. Being malnourished, the children are extremely small for their age and many are also sick with other illnesses. Many friendships and bonds were formed, and I heard many reports of the children start to return to health.
Others with CVM were involved with teaching at the YWAM Discipleship Training School (DTS). The DTS is home to an all-African group of students who have come to "develop in personal character, to cultivate a living relationship with God, and to identify their unique individual gifts and callings in God." Over the course of the month, various members from our group had the opportunity to be involved with teaching and sharing with these students.
A number of nurses were also part of our group. While they were invaluable in delivering our neighbour's baby during our second week (mom and baby are doing well), they were also very busy assisting and teaching at the hospital. One nurse taught a class about neonatal resuscitation. Putting the basics of this knowledge into practise was often limited by equipment and supplies (e.g. stethoscopes, blood pressure cuffs, face masks) not being available. Another nurse with an infection control background, spent much time touring the hospital and also provided in-services and promoting things we might consider common-sense: covering your face while coughing and good hand-washing. A wound care nurse was quite involved with participating in the diabetes clinic (people with diabetes are prone to foot infections), student evaluations and education sessions.
In addition to CVM's involvement in the village of Sittanunku (in 2006-2007, CVM assisted with repairing the water pump), we also started making connections in the village of Gida. A part of this was hosting a football (aka soccer) tournament between the two villages. Using these newly formed relationships, CVM hopes to begin some agricultural development work in these villages.
So there I was in Africa building shelves. Or more appropriately, having other people build shelves. (I did move some plywood and hammer and drill holes too.) I tried to motivate and change the work ethic of one person (Sarjo, the one in charge the main pharmacy storeroom). Occasionally, I was frustrated and a bit exasperated that working diligently did not seem important. I think what was most important was that I began to develop a relationship with that person. We learned about each other's families, countries, interests and faiths. On my last day, he said to me, "I don't know, maybe I am just lazy. But don't worry, I will work on those tally cards."
I began to read a book before I left for Africa which discussed two areas of missions work that Christians participate in: telling people about God and social justice. It discussed how certain Christian groups would often focus on only one of these areas and neglect the other. The argument was that both aspects are not only crucial but intrinsically connected. Part of CVM's mission statement is to "both proclaim and enact the gospel by being fully committed to meeting people's physical, emotional and spiritual needs whenever possible." So, was the trip successful? Was I able to meet some needs of the people I met? While I do think that I was able to meet some needs, my deepest hope and prayer is that the changes we were able to make would be sustainable ones.
Now that I am back in Canada, one of the things I find most difficult to respond to is hearing the statement: "Wow. Volunteering in Africa. Good for you!" The reason I find a response so difficult is that helping someone else, whether in Africa or in Canada, is not something I do to get another gold star for my wall chart. (I don't, in fact, have such a chart - actual or figurative.) Helping other people --serving-- is my life calling, my purpose, my raison d'être. What I have recently come to realise is that fulfilling one's calling really is "good for you." (I'm glad you all noticed this before I did!) So now I just respond with a smile and a nod.
And with that, I will wrap up this very long final update. If you would like to hear more of the details, or if you would like to go to Africa yourself, please do drop me a line. I would love to hear from you! I am in the process of posting photos from my trip, although they likely won't all be up for a few days.
Thank you again for partnering with me in my second African adventure. I hope that I may also have sparked an interest for you to make a difference in your own small part of the world!