I completed my weeks of observation at St. Mary’s Hospital and I definitely learned so much! As my aim was to gain a holistic understanding of the implementation of prevention of mother-to-child transmission (PMTCT) of HIV policy into practice, I spent time in many wards and departments of the hospital. I shadowed doctors, nurses, and counselors in the antenatal clinic, a visiting OB/GYN from one of St. Mary’s referral hospitals, doctors and nurse midwives in the maternity ward, nurse midwives in the Midwifery and Obstetric Unit (MOU), a doctor from the pediatrics and nursery wards, and an HIV counselor in the MOU. I really got a unique chance to learn about the health system in South Africa, health professionals’ views on their system and PMTCT, and a plethora of information about obstetrics.
There certainly were challenges throughout my time at the hospital; for one, most of the communication between healthcare professional and patient was in Zulu. I was glad for my 7-week intensive Zulu class from SIT, as even a preliminary understanding was helpful to build connections with professionals and patients alike. I was grateful for the people I shadowed who clued me in on patient issues and provided me with in-depth explanations of medical conditions for my learning purposes.
As far as PMTCT goes, it was very interesting to see the most recent South African PMTCT guidelines (from the beginning of 2013) actually implemented in practice. I won’t bore with a long explanation of the program, but it involves testing all mothers for HIV status, providing them with counseling and antiretroviral therapy (ART), supplying HIV-exposed newborns with ART prophylaxis, and following up on those newborns to ensure that the virus is not transmitted to them. Getting a chance to observe all of those policies firsthand was invaluable.
The last step in the ISP process is now to compose a paper about my Learnership at St. Mary’s that will be somewhere between 30-70 pages. By the end of my write-up I can definitely say that I have a good grasp on PMTCT policy in South Africa. Hopefully I can take the information I’ve learned here and take it back to the DC to do some sort of comparative research to our PMTCT programs in the States; that way I’ll be able to give back some of the knowledge that I’ve gained by shadowing at St. Mary’s.