Sunday 3/23/2024

Good morning! 🌞

It's early Sunday morning, 80 degrees (which feels like heaven!), and a bit overcast. It is supposed to get into the high 90's this week, with thunderstorms and rain, but not break 100. We shall see! The locals are not looking forward to rain, because of the mud, and I have left my rain boots back in Kampala. I am looking forward to some rain and I have always loved thunderstorms. Rain will bring mosquitos...but they are already here, so I don't know if I will notice a difference. 

I've had a busy week of training and spent 10 hours yesterday working on additional lectures, final exam, and a schedule for the next three weeks. This morning, I was finally able to download some exams that Samalie (the lead educator, in charge of curriculum, etc...) had sent me. The Wi-Fi was so slow yesterday that downloading even the shortest document failed.  I made sure to tell my trainees that I was available all weekend, so I also had a midwife come to me for some additional tutoring. She is a mother of two very young twins, who she brought along with a couple of young girls to care for them while she is in class, but the twins have taken some time to settle in and none of them are sleeping very well. I often see some of my students nodding off in lecture, which is not surprising considering the excessive heat, outside responsibilities and the fact that many of them are also still taking classes for their master's degree. I try to be as supportive as possible, letting them know that they can come to me for additional help anytime I am awake. We have created a WhatsApp group, so I can let them know if I have left the compound or if I am in the classroom.

Some of you may have experience teaching, whether in a classroom setting or otherwise, and although I have been a "teacher" in a number of settings I am not trained in any professional capacity. I have attended a conference specifically focusing on training in an ultrasound setting and I have done a lot of research on training methods over the years, (dating back from my own late diagnosis of ADHD) in an attempt to learn better teaching methods for myself.  I am a Socratic method teacher, asking a lot of questions to lead a student through the thought process, and I believe in focusing on clinical relevance especially regarding ultrasound. 

Samalie has a (Ugandan) master's in education and is an exceptional teacher, but I find that the established curriculum is a challenge for me and my thought process. The order of the lectures and the some of the exam questions do not seem logical, even though I know they do to her. I do not see the point in asking questions that do not have clinical relevance, especially in this training setting, with our limited training time. Even though I am training for 4 weeks, the allotted time for this phase of training, that is not a lot of time to understand and visualize some very complex aspects of ultrasound and ultrasound physics. This is my first time (with ITW) that I have been doing all of Phase 1 training on my own and I did not have any time with Samalie or the Ugandan training team to discuss every detail of the training, exams, curriculum, etc... The hands-on training is especially challenging as I am bouncing between three beds, with two trainees. Once again, I am walking a fine line between organizing the curriculum to best suit me and my students and maintaining respect and deference for the people in charge. I spent some time yesterday, talking to Samalie and arguing my case about additional lectures that I am adding to the curriculum, which also gave me the opportunity to understand some of the limitations within the established curriculum. When I am back in Kampala, I am hoping to sit down with the education team and discuss the importance of a specific curriculum for the training of midwives. Midwives have a specialized scope of practice that clinical officers and sonographers do not, so I believe we can make these changes and additions without compromising the ethical boundaries of the course. 

Rachel and I have been talking in great detail about future training opportunities and one of MHI's top donors will be here at the birth center for a short visit. Rachel and I are hoping to convince her of the importance of training midwives in ultrasound and we have plenty of examples from this week alone. It is our hope and plan, that with funding, this training partnership can continue indefinitely. Rachel also has plans to expand into Kisumu, Kenya, where we have established training, so the possibilities are endless! It's very exciting! My personal goal has always been to do this volunteer work as long as I possibly can, so this could be amazing for all of us. 

So, there is my monkey brain dump. WHEW! 😁 Now for some photos...

This handsome guy is Frankie. He lives next door with the nuns at their compound
and Sister Georgina (one of my trainees) was talking about what a nice dog he was.
He came over for some breakfast scraps and was thrilled that I knew his name!

This is the main cooking area and "stove" for the birth center. Zilla is

the main cook, with many of the ladies and even the children helping

with prep. She was raised by aunties from a very young age, which is 

where she learned to cook, and everyone at the compound talks about how

delicious her cooking is. It is astounding the amount and caliber of food

she is able to make on this wood burning stove! 

Zilla makes the BEST chapati I have ever tasted! She adds 
a little ginger, sliced onion and salt, and either milk, water or oil
(depending on what is available) to flour. In order to control the 
heat better, she cooks these on the stovetop in Simsim oil (sesame seed).
They fry up fluffy and flavorful and are so popular that she makes
extra and the neighbors come by to buy them.

Every couple of months or so, the mud huts will get a new coating of mud.
They will wait until I leave to add another layer to the inside of my hut.

A midwife is taking vitals on a mother in labor, 
using one of the donated LuminAID solar lamps!

I have showed photos of the outdoor shower before,
but I thought I would explain the system in a bit more detail.
When the birth center was being built, $40,000 was spent on 
a very deep well. A solar pump system was installed, so water 
is automatically pumped into a number of areas, one being the
showers. The pump does not work at night, so when the tank
is empty, you must wait until the next day when the sun comes out.

This little buddy was taking a break in one of the huts, and needed to 

be rescued from the screaming of the person in the inhabitant!

Here I am, falling back on my wildlife rehabilitation training, removing the little fellow. Before I receive a barrage of frantic messages from everyone, I received bat training and my rabies vaccines when I worked at the University of TN Vet School. So, YES I know plenty about bats, how to handle them safely and the risks involved. (Thanks for your concern. 😘) This was a few days ago, when it was well over 100 degrees, and this little guy was probably dehydrated and exhausted. I set him/her loose and did not see him/her the following day, so I'm hoping for a survival story. 

Considering the internet connection, I think I will plan on blogging only on the weekends. I am up very early on training days, but often preparing for lessons, and too wiped out at the end of the day. Know that I am very well fed and well taken care of here, in spite of the weather, mosquitos and wildlife adventures!

Much love to you all, thanks for joining me on my journey!

Jo/MB