Friday, 2 December 2011

Part 5

Sat 3rd Dec
Yesterday was a cruisy day at work, but productive. We tied up quite a few loose ends including getting our diarrhoea treatment poster properly printed by a company in town, distribution by mail of the Pharmacy Division newsletters to the provinces of the Solomons, and printing of the two surveys that Larry and James (a Pharmacy Officer and Pharmacist respectively) will conduct at 5 clinics in the Western Province next week.
I was meant to take part in this trip but health concerns over the past week and a half have forced me to pull out of it. I’m comforted by the fact that I was only ever going to be an extra pair of hands on this trip, recording the answers of nurses and patients we surveyed with translation help from James and Larry. They can still carry out the work without me. The pair will fly into Segae (I think that’s how you spell it!) on Monday and then travel to five clinics in four days. While this sounds like an easy and relaxed tour, travelling time will take up a lot of the four days so things will be tight. Everyone I talk to raves about the beauty of the Western Province with its huge lagoons and stunning environment. I’m told these remote areas capture the essence of Solomon culture so I’m disappointed I won’t get to explore these areas on my trip. 
My recent health concerns have actually forced me to make urgent arrangements for an early return to Melbourne. Please don’t be alarmed, I just need to see a specialist to rule out any serious concerns. I’ve been struggling with ongoing issues since the viral gastro I had a few days after I arrived. All will be fine I’m sure, I just need to get back for specialist advice. I’ve been offered assistance and the names of doctors here who could talk with me about what’s been going on, but for tests and investigations, it’s best that I’m in Melbourne.
So I was running around during lunchtime yesterday making arrangements for my return which is all pretty much settled. I’m due back in Melbourne late tomorrow night.
After lunch, Michelle and I explained how the surveys have been together and other details about them with James, and then I took off with Michael to the timber yards! Yep, this is part of the sometimes unpredictable job description of a pharmacist working here! There’s a second level medical store being built in North Malaita (a region in the Solomon Islands) at the moment and quotes from timber companies are being collected at the moment to establish where building materials will be sourced from. A second level medical store is a storage facility that’s one step down from the National Medicine Store (NMS) in Honiara (the one I mentioned is about half the size of my local Bunnings!). The second level medical store receives stock from the NMS for subsequent distribution to dispensaries in the region and it’s very important that this secondary facility is adequate for storage of medicines and the right temperature, humidity, etc. 
Unfortunately these jobs got us back to the hospital after 4.30pm when everyone from the Pharmacy goes home for the day so I could only say a proper goodbye to a handful of people who were still around when I went in to pick up my stuff. I’ll send the department a proper thank you and goodbye note from Melbourne and I can stay in touch with those who have Facebook!
We had drinks at IBS last night where there was a spectacular view over the water and to the nearby islands. It was good to be able to say goodbyes to friends I’d only really started to get to know :(
Emma and I headed down to the Make and Bake Market this morning for its debut in the community calendar. It was a great setup where locals and expats rented tables (I don’t think locals had to pay for rental, in order to encourage their participation) and sold paintings, jewellery, baked goods and many other things they’d made themselves. It was a great morning and it was good to see more people there before I leave. Emma and I met Eddie at the markets and we went onto the markets which were teaming with more fresh fruit and veges than I’d ever seen! We also bought some beautiful flowers that were too good to not grab to jazz up the house!
Just a quiet afternoon now and I might lay low tonight. Erin and Michael are taking me to the airport tomorrow (I’ll refrain from any jokes about them forgetting me..! :P) and I’ll see another couple of mates for lunch before takeoff. 
I feel guilty having promised to help here and work for five weeks then having to bail out after two, but I believe I’ve achieved some good things in this short time and I have other work lined up that I can do from Melbourne to help, such as doing the write up of the surveys after they’ve been done in the Western Province and other bits and pieces like organising uniforms to be made for the staff of the Pharmacy Division across the country! We want the uniforms to be done in Melbourne because those made by local companies in Honiara are apparently not great quality...
So while this is me signing off on my stint (albeit a short one) in Honiara, there’ll be more news and I’ll be doing more work in the next few weeks to hopefully help those involved in pharmacy here. Pharmacists, Pharmacy Officers, Inventory Managers, amongst many others, work so hard and so thoroughly at what they do and the Pharmacy Division in the Solomon Islands is undoubtedly the most organised and efficient division within the Ministry of Health. Our Diarrhoea Treatment Poster was presented to a contact of Michael at the WHO yesterday to prove what work we’re doing on the diarrhoea ‘outbreak’ I’ve been going on about. We had done this when Health Promotion and other relevant Divisions had no progress to show. Anyway enough of that, I may be biased, but I’m proud of what pharmacy and its associated professionals can add to healthcare.
There is a lot of room for improvement here in Honiara and the Solomons as a whole regarding some areas of Pharmacy Operations but overall, and considering the amount of time that this place has had to rebuild itself since tensions and unrest in years past, the further potential is exciting. ‘Baby steps’ is a common reminder if discussions of health-related development issues here become overwhelming. After speaking with many expats here, I’ve discovered many options and pathways to do more great work here. All the expats I’ve met are incredibly intelligent, driven and open-minded about their work here and while obstacles might affect progress a times, their patience and determination with the process is admirable. 
I’ll stop now before I go on all day. I guess what I’m trying to say is this, just two weeks of this experience has opened my eyes to the culture of this developing country and its current stage in progress and improvement, and also opened my mind to the possibilities for this nation, for me and my work. I’m excited :)
Much love to all xo

Thursday, 1 December 2011

Part 4

Apologies in advance for a not-so-exciting post this time..haha we're getting stuff done, eventually :P
Wed 30th Nov
Still working on the surveys for the Western Province; one assesses patients’ and nurses’ comprehension and acceptance of the poster I mentioned earlier that Michelle and I are making on how to give ORS and zinc tablets, as well as their comprehension of new diarrhoea treatment cards we’ll be distributing which includes information on both ORS and zinc. The other survey tries to establish what resources are available in the clinics we visit, and the nurse’s knowledge of what information they contain. The surverys hopefully just need a couple of changes before printing by the end of the week.
Today started with a Continuing Education session at 8AM about the current possible diarrhoea ‘outbreak’, lead by a lady from Infection Control, a nurse I think. She ran the session in Pijin but I tried to follow what she was saying through her powerpoint and the random English words along the way. From what I gathered, she was praising the work of those who conduct ‘Syndromic Surveillance’ (which I think is a fancy label for the collection of data about the incidence of disease etc) and so have helped identify the spike in diarrhoea cases recently. Noone’s been able to confirm whether it’s actually an outbreak, essentially the lab is holding things back because only when they confirm what the diarrhoea going around is being caused by can real and direct action can be taken, if necessary. A couple of people from the pharmacy staff here raised similar points to the meeting on Monday, questioning whether the number of reported cases really indicate an outbreak and the lack of definite answers from lab even after alarm bells went off a couple of weeks ago. Criticism is actually rare here in the Solomons. This first came up on Monday at the first meeting when I couldn’t understand why the lab representative wasn’t being told in a stronger way to get a move on with things, to test stool samples more promptly and establish the cause of the diarrhoea going around. The rep was indirectly criticised only when another doctor arrived late to the meeting. The doctor leading the meeting, while bringing him up to speed on what had been discussed mentioned that the lab ‘need to get a move on’. Apparently even this indirect criticism would’ve been considered rude though Michael explained that the lab rep and the doctor leading the meeting have probably known each other for a long time and that’s the only reason he would’ve done it.
Anyway there’s another meeting at 1.30PM today where all who attended on Monday are to report back on their progress. Will be time for lunch!
Thurs 1st December
So that follow-up meeting went for another 2 hours, like the first one on Monday...! It’s still hard to say if this is truly an outbreak but I’m sure you’re sick of hearing how things are going around in circles. The lab had tested 3 samples between the Monday meeting and yesterday, from two children and one adult. The samples from the two children contained E.coli but this is apparently quite common for the region, only significant growth is concerning. When this point was raised, the lab rep added shakily that yes, it was significant growth...hmm. I think the doctor leading the meeting caught me nodding off at one point, oops. Luckily Michelle and I had an excuse to bail out of the meeting at the 2 hour mark, the pharmacy department was having a going away afternoon tea for Viera, the lovely Pharmacy Officer I’ve mentioned earlier. She and her husband are moving to Gizo, in the Western Province. This is a huge loss for NRH but Viera’s going to do similar work to what she’s doing currently in a new hospital in Gizo which is exciting and they’ll be lucky to have her. So afternoon tea involved a big spread of food that had been ordered in - everyone had pitched in money during the week - and brief speeches from those who felt inclined. I’ve only known Viera a week and a half but I missed her at work today!
Doreen and I had a folding marathon this morning! We’ve now got 600 copies of the Pharmacy Division newsletter done! This is the newsletter that we were working on last week. Luckily the girls in the Medicine Information Centre where we working like my music so the folding sesh was a breeze! These will be distributed by the Medicine Store staff when they deliver meds to clinics across the country, I’m chuffed that I was a part of that! Finally got the surveys and posters properly finished today. The editing process was longer and more tedious than I expected, with the documents going between Michael, Michelle and myself, but they’ve turned out really well. The trip to the Western Province is arranged for Monday to Thursday of next week. So not much else to report right now, I’m definitely ready for the weekend, much like everyone at home I’m sure :)
Much love, missing you all