Alison left Zim this week shortly followed by Gurdeep and Anita, but not before we had our partnership meeting hosted by ZimCan PVO, organized and sponsored by Gurdeep and Anita. Report to follow but highlights included supporting the academic road we are on with the universities, as well as POCUS and community health/social determinants. In addition, Dr. Chitaka donated a solar pump system for one of the wells we installed last year making 2 with pumps now, one with a bush pump and this solar one. Gurdeep and Anita are putting together the report with Mike.
The POCUS team went out to Karanda and taught there. The students for the course were nurses with a Canadian Surgeon joining the team and remaining longer to reinforce the learnings. There was one Karanda doctor registered but clinical commitments drew him away. He is still keen but suggested that offsite training might be better as it helps to focus on the learning. The POCUS team left at the end of the week. We had a debrief and the following are key points:
- They see huge value in the work and are committed to helping us find other instructors.
- They don’t think we will have a problem, though suggest one course for a 2 week block is better, as cramming in two courses is draining and has not resulted in as many POCUS students reaching the “train the trainer” stage as we would have liked.
- Ray Wiss has donated the curriculum.
- They have suggested that the type of things POCUS is used for here will be different to a Canadian setting, so work needs to be done on customizing curriculum.
- The MOH did not give permission for philanthropic licenses as they are still conflating POCUS with diagnostic Ultrasound. We have been working on clarifying the differences. It did result in the instructors teaching under the umbrella of the university with no patient contact.
- We will need to guard against this training being seen or used as diagnostics (ie charging for an Ultasound).
- The next trip the model will be based in a centre and we will try to get more docs in.
In subsequent conversations I have spoken with the new PMD of Mashonaland West (Dr,Dhege) who will support us to hold one in Chinhoyi next year and the second course we plan to hold at NUST (? University Hospital in Bulawayo ) and regroup the Registrars there, pending confirmation at the end of the trip.
Rasper
Things are moving nicely. While we are here, the first aid station was adopted by the Ministry of Health as an outreach clinic from Norton. There was a grand opening which I unfortunately could not make. This only happened because of all the work that Susan put into this area and the help of our partnership and visits to this area. This is huge as it now is self sustaining,as was our initial plan. Our role moves into supportive.
I have spoken to the DMO and we are consolidating what that might look like but I suspect it will be supporting the nurses to reach community health workers/educators and then supporting the workers around data gathering.
Students
The medical students arrived this week and went out to Karanda to help with POCUS and then spend the next 2-3 weeks up there. Their clinical work is curtailed as I did not manage to get permission to practice as the rules had changed and we need the Permanent Secretary’s permission. It looks like the MOU with the PVO and Ministry of Health, will be a key piece for us doing clinical work here in the future. I have organized the students to spend their last week in community working with the nurses and on social determinants as well as at Rujeko Clinic. We managed to find a donor to support paying the Karanda doctors an honorarium to preceptor the students ($100 per student for 2 weeks)
So the total donor cost per Student this trip has been $400 per student ($300 extra that the university charged and then preceptor stipend)
