8:00am Sunday 11/11
I am now at Opit Health Center, the 3rd Clinical Site in the Gulu District. The past view days have been quite a challenge, primarily due to an almost consistent lack of power throughout the district. Ultrasound is pretty dependent on power, so we always leave all of our electronics plugged in at all times, for just such an occasion, but eventually the batteries drain along with our external battery sources. So forgive me for the sporadic posts! Training has been both a challenge and wonderful. The current program has Shallon travelling to multiple clinics, training for a couple of days, and moving on. The trainees are not able to keep a machine until they have been "signed off" with a >75% knowledge of multiple categories, ranging from patient care and interaction to physics and OB ultrasound skills. The challenge is that Ultrasound is a hands-on skill that can only improve with practice. Many of the concepts related to Ultrasound, such as the physics involved, tomographic study and the ability to imagine in 3-D while you capture images in 2-D, are difficult to grasp if you are not actually scanning. No one has been able to train the Midwives at Pabbo Clinic for a few many weeks, then I arrive and try to teach them Physics and expand their scanning skills in 2.5 days, and we leave with all of the equipment. As a team, we have all been discussing this dilemma on a nightly basis, in an attempt to come up with solutions. Kristen will be in Uganda next week, which I am sure will be a week on non-stop meetings and collaborations.
In the mean time, I am learning the importance of flexibility and thinking "outside of the box"! Pamela and Proviscovia, the midwives at Pabbo Clinic, where having some difficulty understanding the concept of identifying the location of the placenta within the uterus. I told them I would create a lecture that evening, specifically about the placenta, and we would have lecture in the morning before scanning patients. I have tried to keep a library of images on my computer, but I don't always have what I need, and am dependent on the internet. Some of the power loss we have been experiencing has not affected our internet connection, so I was hopeful I would be able come up with some slides that would help explain the concept of imaging the uterus and placenta as 3 dimensional structures. Renny and I both had work stations set up in the common room, working on our perspective projects. For no more than 5 or 10 minutes at a time we would have power and Wi-Fi, then it would go out and we would let out exasperated sighs, continue on what battery power we had, and wait. Once the power returned, we would reboot our mobile Wi-Fi units, wait for connection, and scramble to get what we needed before the power left us again, our frustration mounting. Renny is working on a Grant deadline, and I have only 1 more complete day of training available. I believe it was somewhere between 10 and 11pm, that we both gave up and went to bed. I eventually drifted off to sleep, while my head was spinning with ideas of how to teach without access to the images I was looking for. I woke at 4am with an idea, because heaven forbid I should come up with a helpful idea during normal waking hours. I decided to hollow out a couple of oranges, for sagittal and transverse views of the uterus, and use an orange segment to represent the placenta (Shallon took photos, which I shared below). Through a lot of laughter, we all had to admit that the idea worked!
In spite of the continued intermittent power loss, nd a loss of water as well, we continued training through Saturday afternoon, packed up the van, and got back on the road.
It was a gorgeous day for a road trip, and we had a few errands to run on our way to Opit, but we could not out run the late afternoon rains. We arrived in Opit late last night, settled in, and today is another beautiful morning in Uganda! We are still without power, as is most of the town, but it's difficult to be in a bad mood when you are surrounded by such beauty and such wonderful people. Today is a "rest" day, so I will spend most of the day with a tour of the clinic, working on lectures, and being grateful for the opportunity to be here.
oxox MB
I am now at Opit Health Center, the 3rd Clinical Site in the Gulu District. The past view days have been quite a challenge, primarily due to an almost consistent lack of power throughout the district. Ultrasound is pretty dependent on power, so we always leave all of our electronics plugged in at all times, for just such an occasion, but eventually the batteries drain along with our external battery sources. So forgive me for the sporadic posts! Training has been both a challenge and wonderful. The current program has Shallon travelling to multiple clinics, training for a couple of days, and moving on. The trainees are not able to keep a machine until they have been "signed off" with a >75% knowledge of multiple categories, ranging from patient care and interaction to physics and OB ultrasound skills. The challenge is that Ultrasound is a hands-on skill that can only improve with practice. Many of the concepts related to Ultrasound, such as the physics involved, tomographic study and the ability to imagine in 3-D while you capture images in 2-D, are difficult to grasp if you are not actually scanning. No one has been able to train the Midwives at Pabbo Clinic for a few many weeks, then I arrive and try to teach them Physics and expand their scanning skills in 2.5 days, and we leave with all of the equipment. As a team, we have all been discussing this dilemma on a nightly basis, in an attempt to come up with solutions. Kristen will be in Uganda next week, which I am sure will be a week on non-stop meetings and collaborations.
In the mean time, I am learning the importance of flexibility and thinking "outside of the box"! Pamela and Proviscovia, the midwives at Pabbo Clinic, where having some difficulty understanding the concept of identifying the location of the placenta within the uterus. I told them I would create a lecture that evening, specifically about the placenta, and we would have lecture in the morning before scanning patients. I have tried to keep a library of images on my computer, but I don't always have what I need, and am dependent on the internet. Some of the power loss we have been experiencing has not affected our internet connection, so I was hopeful I would be able come up with some slides that would help explain the concept of imaging the uterus and placenta as 3 dimensional structures. Renny and I both had work stations set up in the common room, working on our perspective projects. For no more than 5 or 10 minutes at a time we would have power and Wi-Fi, then it would go out and we would let out exasperated sighs, continue on what battery power we had, and wait. Once the power returned, we would reboot our mobile Wi-Fi units, wait for connection, and scramble to get what we needed before the power left us again, our frustration mounting. Renny is working on a Grant deadline, and I have only 1 more complete day of training available. I believe it was somewhere between 10 and 11pm, that we both gave up and went to bed. I eventually drifted off to sleep, while my head was spinning with ideas of how to teach without access to the images I was looking for. I woke at 4am with an idea, because heaven forbid I should come up with a helpful idea during normal waking hours. I decided to hollow out a couple of oranges, for sagittal and transverse views of the uterus, and use an orange segment to represent the placenta (Shallon took photos, which I shared below). Through a lot of laughter, we all had to admit that the idea worked!
In spite of the continued intermittent power loss, nd a loss of water as well, we continued training through Saturday afternoon, packed up the van, and got back on the road.
It was a gorgeous day for a road trip, and we had a few errands to run on our way to Opit, but we could not out run the late afternoon rains. We arrived in Opit late last night, settled in, and today is another beautiful morning in Uganda! We are still without power, as is most of the town, but it's difficult to be in a bad mood when you are surrounded by such beauty and such wonderful people. Today is a "rest" day, so I will spend most of the day with a tour of the clinic, working on lectures, and being grateful for the opportunity to be here.
oxox MB
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